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Effect of changing the amount and type of fat and carbohydrate on insulin sensitivity and cardiovascular risk: the RISCK (Reading, Imperial, Surrey, Cambridge, and Kings) trial.
Am J Clin Nutr 2010; 92(4):748-58AJ

Abstract

BACKGROUND

Insulin sensitivity (Si) is improved by weight loss and exercise, but the effects of the replacement of saturated fatty acids (SFAs) with monounsaturated fatty acids (MUFAs) or carbohydrates of high glycemic index (HGI) or low glycemic index (LGI) are uncertain.

OBJECTIVE

We conducted a dietary intervention trial to study these effects in participants at risk of developing metabolic syndrome.

DESIGN

We conducted a 5-center, parallel design, randomized controlled trial [RISCK (Reading, Imperial, Surrey, Cambridge, and Kings)]. The primary and secondary outcomes were changes in Si (measured by using an intravenous glucose tolerance test) and cardiovascular risk factors. Measurements were made after 4 wk of a high-SFA and HGI (HS/HGI) diet and after a 24-wk intervention with HS/HGI (reference), high-MUFA and HGI (HM/HGI), HM and LGI (HM/LGI), low-fat and HGI (LF/HGI), and LF and LGI (LF/LGI) diets.

RESULTS

We analyzed data for 548 of 720 participants who were randomly assigned to treatment. The median Si was 2.7 × 10(-4) mL · μU(-1) · min(-1) (interquartile range: 2.0, 4.2 × 10(-4) mL · μU(-1) · min(-1)), and unadjusted mean percentage changes (95% CIs) after 24 wk treatment (P = 0.13) were as follows: for the HS/HGI group, -4% (-12.7%, 5.3%); for the HM/HGI group, 2.1% (-5.8%, 10.7%); for the HM/LGI group, -3.5% (-10.6%, 4.3%); for the LF/HGI group, -8.6% (-15.4%, -1.1%); and for the LF/LGI group, 9.9% (2.4%, 18.0%). Total cholesterol (TC), LDL cholesterol, and apolipoprotein B concentrations decreased with SFA reduction. Decreases in TC and LDL-cholesterol concentrations were greater with LGI. Fat reduction lowered HDL cholesterol and apolipoprotein A1 and B concentrations.

CONCLUSIONS

This study did not support the hypothesis that isoenergetic replacement of SFAs with MUFAs or carbohydrates has a favorable effect on Si. Lowering GI enhanced reductions in TC and LDL-cholesterol concentrations in subjects, with tentative evidence of improvements in Si in the LF-treatment group. This trial was registered at clinicaltrials.gov as ISRCTN29111298.

Authors+Show Affiliations

Medical Research Council Human Nutrition Research, Elsie Widdowson Laboratory, Cambridge, United Kingdom. susan.jebb@mrc-hnr.cam.ac.uk

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20739418

Citation

Jebb, Susan A., et al. "Effect of Changing the Amount and Type of Fat and Carbohydrate On Insulin Sensitivity and Cardiovascular Risk: the RISCK (Reading, Imperial, Surrey, Cambridge, and Kings) Trial." The American Journal of Clinical Nutrition, vol. 92, no. 4, 2010, pp. 748-58.
Jebb SA, Lovegrove JA, Griffin BA, et al. Effect of changing the amount and type of fat and carbohydrate on insulin sensitivity and cardiovascular risk: the RISCK (Reading, Imperial, Surrey, Cambridge, and Kings) trial. Am J Clin Nutr. 2010;92(4):748-58.
Jebb, S. A., Lovegrove, J. A., Griffin, B. A., Frost, G. S., Moore, C. S., Chatfield, M. D., ... Sanders, T. A. (2010). Effect of changing the amount and type of fat and carbohydrate on insulin sensitivity and cardiovascular risk: the RISCK (Reading, Imperial, Surrey, Cambridge, and Kings) trial. The American Journal of Clinical Nutrition, 92(4), pp. 748-58. doi:10.3945/ajcn.2009.29096.
Jebb SA, et al. Effect of Changing the Amount and Type of Fat and Carbohydrate On Insulin Sensitivity and Cardiovascular Risk: the RISCK (Reading, Imperial, Surrey, Cambridge, and Kings) Trial. Am J Clin Nutr. 2010;92(4):748-58. PubMed PMID: 20739418.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of changing the amount and type of fat and carbohydrate on insulin sensitivity and cardiovascular risk: the RISCK (Reading, Imperial, Surrey, Cambridge, and Kings) trial. AU - Jebb,Susan A, AU - Lovegrove,Julie A, AU - Griffin,Bruce A, AU - Frost,Gary S, AU - Moore,Carmel S, AU - Chatfield,Mark D, AU - Bluck,Les J, AU - Williams,Christine M, AU - Sanders,Thomas Ab, AU - ,, Y1 - 2010/08/25/ PY - 2010/8/27/entrez PY - 2010/8/27/pubmed PY - 2010/10/28/medline SP - 748 EP - 58 JF - The American journal of clinical nutrition JO - Am. J. Clin. Nutr. VL - 92 IS - 4 N2 - BACKGROUND: Insulin sensitivity (Si) is improved by weight loss and exercise, but the effects of the replacement of saturated fatty acids (SFAs) with monounsaturated fatty acids (MUFAs) or carbohydrates of high glycemic index (HGI) or low glycemic index (LGI) are uncertain. OBJECTIVE: We conducted a dietary intervention trial to study these effects in participants at risk of developing metabolic syndrome. DESIGN: We conducted a 5-center, parallel design, randomized controlled trial [RISCK (Reading, Imperial, Surrey, Cambridge, and Kings)]. The primary and secondary outcomes were changes in Si (measured by using an intravenous glucose tolerance test) and cardiovascular risk factors. Measurements were made after 4 wk of a high-SFA and HGI (HS/HGI) diet and after a 24-wk intervention with HS/HGI (reference), high-MUFA and HGI (HM/HGI), HM and LGI (HM/LGI), low-fat and HGI (LF/HGI), and LF and LGI (LF/LGI) diets. RESULTS: We analyzed data for 548 of 720 participants who were randomly assigned to treatment. The median Si was 2.7 × 10(-4) mL · μU(-1) · min(-1) (interquartile range: 2.0, 4.2 × 10(-4) mL · μU(-1) · min(-1)), and unadjusted mean percentage changes (95% CIs) after 24 wk treatment (P = 0.13) were as follows: for the HS/HGI group, -4% (-12.7%, 5.3%); for the HM/HGI group, 2.1% (-5.8%, 10.7%); for the HM/LGI group, -3.5% (-10.6%, 4.3%); for the LF/HGI group, -8.6% (-15.4%, -1.1%); and for the LF/LGI group, 9.9% (2.4%, 18.0%). Total cholesterol (TC), LDL cholesterol, and apolipoprotein B concentrations decreased with SFA reduction. Decreases in TC and LDL-cholesterol concentrations were greater with LGI. Fat reduction lowered HDL cholesterol and apolipoprotein A1 and B concentrations. CONCLUSIONS: This study did not support the hypothesis that isoenergetic replacement of SFAs with MUFAs or carbohydrates has a favorable effect on Si. Lowering GI enhanced reductions in TC and LDL-cholesterol concentrations in subjects, with tentative evidence of improvements in Si in the LF-treatment group. This trial was registered at clinicaltrials.gov as ISRCTN29111298. SN - 1938-3207 UR - https://www.unboundmedicine.com/medline/citation/20739418/Effect_of_changing_the_amount_and_type_of_fat_and_carbohydrate_on_insulin_sensitivity_and_cardiovascular_risk:_the_RISCK__Reading_Imperial_Surrey_Cambridge_and_Kings__trial_ L2 - https://academic.oup.com/ajcn/article-lookup/doi/10.3945/ajcn.2009.29096 DB - PRIME DP - Unbound Medicine ER -