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Original Research

Effects of a Plant-Based High-Carbohydrate/High-Fiber Diet Versus High–Monounsaturated Fat/Low-Carbohydrate Diet on Postprandial Lipids in Type 2 Diabetic Patients

  1. Claudia De Natale, MD, PHD,
  2. Giovanni Annuzzi, MD,
  3. Lutgarda Bozzetto, MD,
  4. Raffaella Mazzarella, MD,
  5. Giuseppina Costabile, PHD,
  6. Ornella Ciano, RD,
  7. Gabriele Riccardi, MD and
  8. Angela A. Rivellese, MD
  1. From the Department of Clinical and Experimental Medicine, Federico II University, Naples, Italy.
  1. Corresponding author: Angela A. Rivellese, rivelles{at}unina.it.
Diabetes Care 2009 Dec; 32(12): 2168-2173. https://doi.org/10.2337/dc09-0266
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Abstract

OBJECTIVE To search for a better dietary approach to treat postprandial lipid abnormalities and improve glucose control in type 2 diabetic patients.

RESEARCH DESIGN AND METHODS According to a randomized crossover design, 18 type 2 diabetic patients (aged 59 ± 5 years; BMI 27 ± 3 kg/m2) (means ± SD) in satisfactory blood glucose control on diet or diet plus metformin followed a diet relatively rich in carbohydrates (52% total energy), rich in fiber (28g/1,000 kcal), and with a low glycemic index (58%) (high-carbohydrate/high-fiber diet) or a diet relatively low in carbohydrate (45%) and rich in monounsaturated fat (23%) (low-carbohydrate/high–monounsaturated fat diet) for 4 weeks. Thereafter, they shifted to the other diet for 4 more weeks. At the end of each period, plasma glucose, insulin, lipids, and lipoprotein fractions (separated by discontinuous density gradient ultracentrifugation) were determined on blood samples taken at fasting and over 6 h after a test meal having a similar composition as the corresponding diet.

RESULTS In addition to a significant decrease in postprandial plasma glucose, insulin responses, and glycemic variability, the high-carbohydrate/high-fiber diet also significantly improved the primary end point, since it reduced the postprandial incremental areas under the curve (IAUCs) of triglyceride-rich lipoproteins, in particular, chylomicrons (cholesterol IAUC: 0.05 ± 0.01 vs. 0.08 ± 0.02 mmol/l per 6 h; triglycerides IAUC: 0.71 ± 0.35 vs. 1.03 ± 0.58 mmol/l per 6 h, P < 0.05).

CONCLUSIONS A diet rich in carbohydrate and fiber, essentially based on legumes, vegetables, fruits, and whole cereals, may be particularly useful for treating diabetic patients because of its multiple effects on different cardiovascular risk factors, including postprandial lipids abnormalities.

Footnotes

  • Clinical trial reg. no. NCT00789295, clinicaltrials.gov.

  • The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.

    • Received February 11, 2009.
    • Accepted September 1, 2009.
  • © 2009 by the American Diabetes Association.
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Diabetes Care: 32 (12)

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December 2009, 32(12)
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Effects of a Plant-Based High-Carbohydrate/High-Fiber Diet Versus High–Monounsaturated Fat/Low-Carbohydrate Diet on Postprandial Lipids in Type 2 Diabetic Patients
Claudia De Natale, Giovanni Annuzzi, Lutgarda Bozzetto, Raffaella Mazzarella, Giuseppina Costabile, Ornella Ciano, Gabriele Riccardi, Angela A. Rivellese
Diabetes Care Dec 2009, 32 (12) 2168-2173; DOI: 10.2337/dc09-0266

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Effects of a Plant-Based High-Carbohydrate/High-Fiber Diet Versus High–Monounsaturated Fat/Low-Carbohydrate Diet on Postprandial Lipids in Type 2 Diabetic Patients
Claudia De Natale, Giovanni Annuzzi, Lutgarda Bozzetto, Raffaella Mazzarella, Giuseppina Costabile, Ornella Ciano, Gabriele Riccardi, Angela A. Rivellese
Diabetes Care Dec 2009, 32 (12) 2168-2173; DOI: 10.2337/dc09-0266
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