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Altering source or amount of dietary carbohydrate has acute and chronic effects on postprandial glucose and triglycerides in type 2 diabetes: Canadian trial of Carbohydrates in Diabetes (CCD).
Nutr Metab Cardiovasc Dis 2013; 23(3):227-34NM

Abstract

BACKGROUND AND AIMS

Nutrition recommendations for type 2 diabetes (T2DM) are partly guided by the postprandial responses elicited by diets varying in carbohydrate (CHO). We aimed to explore whether long-term changes in postprandial responses on low-glycemic-index (GI) or low-CHO diets were due to acute or chronic effects in T2DM.

METHODS AND RESULTS

Subjects with diet-alone-treated T2DM were randomly assigned to high-CHO/high-GI (H), high-CHO/low-GI (L), or low-CHO/high-monounsaturated-fat (M) diets for 12-months. At week-0 (Baseline) postprandial responses after H-meals (55% CHO, GI = 61) were measured from 0800 h to 1600 h. After 12 mo subjects were randomly assigned to H-meals or study diet meals (L, 57% CHO, GI = 50; M, 44% CHO, GI = 61). This yielded 5 groups: H diet with H-meals (HH, n = 34); L diet with H- (LH, n = 17) or L-meals (LL, n = 16); and M diet with H- (MH, n = 18) or M meals (MM, n = 19). Postprandial glucose fluctuations were lower in LL than all other groups (p < 0.001). Changes in postprandial-triglycerides differed among groups (p < 0.001). After 12 mo in HH and MM both fasting- and postprandial-triglycerides were similar to Baseline while in MH postprandial-triglycerides were significantly higher than at Baseline (p = 0.028). In LH, triglycerides were consistently (0.18-0.34 mmol/L) higher than Baseline throughout the day, while in LL the difference from Baseline varied across the day from 0.04 to 0.36 mmol/L (p < 0.001).

CONCLUSION

Low-GI and low-CHO diets have both acute and chronic effects on postprandial glucose and triglycerides in T2DM subjects. Thus, the composition of the acute test-meal and the habitual diet should be considered when interpreting the nutritional implications of different postprandial responses.

Authors+Show Affiliations

Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada. thomas.wolever@utoronto.caNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

22397878

Citation

Wolever, T M S., et al. "Altering Source or Amount of Dietary Carbohydrate Has Acute and Chronic Effects On Postprandial Glucose and Triglycerides in Type 2 Diabetes: Canadian Trial of Carbohydrates in Diabetes (CCD)." Nutrition, Metabolism, and Cardiovascular Diseases : NMCD, vol. 23, no. 3, 2013, pp. 227-34.
Wolever TM, Gibbs AL, Chiasson JL, et al. Altering source or amount of dietary carbohydrate has acute and chronic effects on postprandial glucose and triglycerides in type 2 diabetes: Canadian trial of Carbohydrates in Diabetes (CCD). Nutr Metab Cardiovasc Dis. 2013;23(3):227-34.
Wolever, T. M., Gibbs, A. L., Chiasson, J. L., Connelly, P. W., Josse, R. G., Leiter, L. A., ... Ryan, E. A. (2013). Altering source or amount of dietary carbohydrate has acute and chronic effects on postprandial glucose and triglycerides in type 2 diabetes: Canadian trial of Carbohydrates in Diabetes (CCD). Nutrition, Metabolism, and Cardiovascular Diseases : NMCD, 23(3), pp. 227-34. doi:10.1016/j.numecd.2011.12.011.
Wolever TM, et al. Altering Source or Amount of Dietary Carbohydrate Has Acute and Chronic Effects On Postprandial Glucose and Triglycerides in Type 2 Diabetes: Canadian Trial of Carbohydrates in Diabetes (CCD). Nutr Metab Cardiovasc Dis. 2013;23(3):227-34. PubMed PMID: 22397878.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Altering source or amount of dietary carbohydrate has acute and chronic effects on postprandial glucose and triglycerides in type 2 diabetes: Canadian trial of Carbohydrates in Diabetes (CCD). AU - Wolever,T M S, AU - Gibbs,A L, AU - Chiasson,J-L, AU - Connelly,P W, AU - Josse,R G, AU - Leiter,L A, AU - Maheux,P, AU - Rabasa-Lhoret,R, AU - Rodger,N W, AU - Ryan,E A, Y1 - 2012/03/06/ PY - 2011/04/18/received PY - 2011/11/18/revised PY - 2011/12/22/accepted PY - 2012/3/9/entrez PY - 2012/3/9/pubmed PY - 2013/10/29/medline SP - 227 EP - 34 JF - Nutrition, metabolism, and cardiovascular diseases : NMCD JO - Nutr Metab Cardiovasc Dis VL - 23 IS - 3 N2 - BACKGROUND AND AIMS: Nutrition recommendations for type 2 diabetes (T2DM) are partly guided by the postprandial responses elicited by diets varying in carbohydrate (CHO). We aimed to explore whether long-term changes in postprandial responses on low-glycemic-index (GI) or low-CHO diets were due to acute or chronic effects in T2DM. METHODS AND RESULTS: Subjects with diet-alone-treated T2DM were randomly assigned to high-CHO/high-GI (H), high-CHO/low-GI (L), or low-CHO/high-monounsaturated-fat (M) diets for 12-months. At week-0 (Baseline) postprandial responses after H-meals (55% CHO, GI = 61) were measured from 0800 h to 1600 h. After 12 mo subjects were randomly assigned to H-meals or study diet meals (L, 57% CHO, GI = 50; M, 44% CHO, GI = 61). This yielded 5 groups: H diet with H-meals (HH, n = 34); L diet with H- (LH, n = 17) or L-meals (LL, n = 16); and M diet with H- (MH, n = 18) or M meals (MM, n = 19). Postprandial glucose fluctuations were lower in LL than all other groups (p < 0.001). Changes in postprandial-triglycerides differed among groups (p < 0.001). After 12 mo in HH and MM both fasting- and postprandial-triglycerides were similar to Baseline while in MH postprandial-triglycerides were significantly higher than at Baseline (p = 0.028). In LH, triglycerides were consistently (0.18-0.34 mmol/L) higher than Baseline throughout the day, while in LL the difference from Baseline varied across the day from 0.04 to 0.36 mmol/L (p < 0.001). CONCLUSION: Low-GI and low-CHO diets have both acute and chronic effects on postprandial glucose and triglycerides in T2DM subjects. Thus, the composition of the acute test-meal and the habitual diet should be considered when interpreting the nutritional implications of different postprandial responses. SN - 1590-3729 UR - https://www.unboundmedicine.com/medline/citation/22397878/Altering_source_or_amount_of_dietary_carbohydrate_has_acute_and_chronic_effects_on_postprandial_glucose_and_triglycerides_in_type_2_diabetes:_Canadian_trial_of_Carbohydrates_in_Diabetes__CCD__ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0939-4753(11)00287-0 DB - PRIME DP - Unbound Medicine ER -