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Effect of a High-Carbohydrate Versus a High—cis-Monounsaturated Fat Diet on Blood Pressure in Patients With Type 2 Diabetes

¹ Division of Nutrition and Metabolic Diseases, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas
² Center for Human Nutrition, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas
³ Department of Kinesiology, Texas Christian University, Fort Worth, Texas
⁴ Department of Internal Medicine, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas
⁵ Department of Internal Medicine, University of Minnesota, Minneapolis, Minnesota
⁶ Department of Medicine, University of California, San Diego, California
⁷ Veterans Affairs Medical Center, San Diego, California
⁸ Department of Internal Medicine, Stanford University, Stanford, California

Address correspondence and reprint requests to Abhimanyu Garg, MD, Professor and Chief, Division of Nutrition and Metabolic Diseases, Center for Human Nutrition, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX 75235-9052. E-mail: abhimanyu.garg{at}utsouthwestern.edu

OBJECTIVE—To investigate whether blood pressure is different in type 2 diabetic patients on a diet rich in carbohydrates versus a diet rich in cis-monounsaturated fatty acids. Data on the dietary effects on these diets’ glucose and lipid metabolism have been previously published.

RESEARCH DESIGN AND METHODS—The study compared the effect of feeding 42 type 2 diabetic patients a carefully controlled isoenergic high-carbohydrate (high-carb; 55% energy as carbohydrate, 30% as fat, and 10% as monounsaturated fat) and high–monounsaturated fat (high-mono; 45% energy as fat, 25% as monounsaturated fat, and 40% as carbohydrate) diet for 6 weeks each in a four-center, randomized, cross-over study on blood pressure. Twenty-one patients continued the diet they received during the second phase for an additional 8 weeks.

RESULTS—According to repeated-measures ANOVA, blood pressure during the last 3 days of each phase was similar after 6 weeks of the high-carb and high-mono diets (systolic blood pressure: 128 ± 16 vs. 127 ± 15 mmHg, P = 0.9; diastolic blood pressure: 75 ± 7 vs. 75 ± 8 mmHg, P = 0.7). However, after 14 weeks of the high-carb diet (n = 13), there was a significant increase in blood pressure compared with 6 weeks of the high-mono diet (systolic blood pressure: 132 ± 13 vs. 126 ± 11 mmHg, P = 0.04; diastolic blood pressure: 83 ± 6 vs. 76 ± 7 mmHg, P = 0.002). After 14 weeks of the high-mono diet (n = 8), the reduction in blood pressure was not significant compared with 6 weeks of the high-carb diet (systolic blood pressure: 118 ± 14 vs. 121 ± 16 mmHg, P = 0.4; diastolic blood pressure: 71 ± 8 vs. 75 ± 10 mmHg, P = 0.3).

CONCLUSION—Although the exchange of carbohydrates with monounsaturated fats may not affect blood pressure in the short term, long-term consumption of a high-carbohydrate diet may modestly raise blood pressure in type 2 diabetic patients.

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