Monounsaturated Fat–Rich Diet Prevents Central Body Fat Distribution and Decreases Postprandial Adiponectin Expression Induced by a Carbohydrate-Rich Diet in Insulin-Resistant Subjects

Response to Paniagua et al.

  1. Karen Z. Walker, PHD and
  2. Kerin O’Dea, PHD
  1. Preventative Cardiology Unit, Baker Heart Research Institute, Melbourne, Australia
  1. Address correspondence to Dr. Karen Z. Walker, Preventative Cardiology Unit, Baker Heart Research Institute, P.O. Box 6492, St. Kilda Road Central, Victoria 8008, Australia. E-mail: karen.walker{at}baker.edu.au

We were interested in the demonstration by Paniagua et al. (1) that in obese insulin-resistant individuals, high-carbohydrate diets but not high-fat diets (either high monounsaturated [MUFA] or high saturated [SFA]) are associated with some redistribution of fat mass to abdominal rather than peripheral deposits. Their study confirms our earlier findings with high-carbohydrate and high-MUFA diets in people with type 2 diabetes (2,3). However, a similar change in fat distribution was not observed in nondiabetic women given hypocaloric diets (4), suggesting that the phenomenon may be pronounced only in insulin-resistant individuals and/or that, if it derives from increased de novo lipogenesis in the liver (1), it will only occur with a carbohydrate excess not present when calories are strictly limited.

In the study by Paniagua et al. (1), we would also have expected differences in fat deposition between the high-SFA and high-MUFA diets. Stable isotope studies in humans indicate greater oxidation of oleic acid (C18:1) than stearic acid (C18:0), and we have reported higher postprandial fat oxidation after a MUFA-rich rather than an SFA-rich meal. Moreover, in a randomized crossover study in overweight men (28 days in each arm), a high-MUFA, high-polyunsaturated fat (PUFA) diet led to significant fat loss from both trunk and limbs, whereas an iso-energenic high-SFA diet led to fat gain, mainly on the trunk (5). Total fat intake on each diet was equivalent (40% of total energy E). We have hypothesized that unsaturated fats (MUFA and/or PUFA), rather than SFA, are more effective in stimulating peroxisome proliferator–activated receptor-α leading to fat oxidation, with SFA being much more readily diverted to fat storage (5). Our studies and those of Paniagua et al. (1) indicate that further studies with well-controlled diets are needed to better elucidate the effects of both carbohydrates and different types of dietary fat on patterns of fat loss and storage.

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