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Persistence of hypertriglyceridemic effect of low-fat high-carbohydrate diets in NIDDM patients.

Abstract

Although low-fat high-carbohydrate diets are recommended for patients with non-insulin-dependent diabetes mellitus (NIDDM) in an effort to reduce the risk of coronary artery disease (CAD), the results of short-term studies have shown that these diets can lead to changes in carbohydrate and lipid metabolism associated with an increased risk of CAD. This study has extended these earlier observations by determining the metabolic effects of such diets over a longer period in these patients. The comparison diets contained either 40 or 60% of the total calories as carbohydrates, with reciprocal changes in fat content from 40 to 20% consumed in random order for 6 wk in a crossover experimental design. The ratio of polyunsaturated to saturated fat and the total cholesterol intake were held constant in the two diets. Plasma glucose and insulin concentrations were significantly (P less than .001) elevated throughout the day when patients consumed the 60% carbohydrate diet, and 24-h urinary glucose excretion more than doubled (0.8 vs. 1.8 mol/24 h). Fasting plasma total and very-low-density lipoprotein (VLDL) triglyceride (TG) concentrations increased by 30% (P less than .001) after 1 wk on the 60% carbohydrate diet, and the magnitude of carbohydrate-induced hypertriglyceridemia persisted unchanged throughout the 6-wk study period. Total plasma cholesterol concentrations were similar after both diets. However, VLDL cholesterol (VLDL-chol) was significantly increased, whereas both low-density lipoprotein (LDL-) and high-density lipoprotein (HDL-) chol concentrations were significantly decreased after consumption of the 60% carbohydrate diet. Consequently, neither total-chol-to-HDL-chol nor LDL-chol-to-HDL-chol ratios changed.(

ABSTRACT

TRUNCATED AT 250 WORDS)

Authors+Show Affiliations

,

Department of Medicine, Stanford University School of Medicine, California.

, ,

Source

Diabetes care 12:2 1989 Feb pg 94-101

MeSH

Aged
Blood Glucose
Cholesterol
Diabetes Mellitus, Type 2
Diet, Diabetic
Dietary Carbohydrates
Dietary Fats
Dietary Fiber
Female
Humans
Hypoglycemic Agents
Lipoproteins
Male
Middle Aged
Triglycerides

Pub Type(s)

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

Language

eng

PubMed ID

2539286

Citation

Coulston, A M., et al. "Persistence of Hypertriglyceridemic Effect of Low-fat High-carbohydrate Diets in NIDDM Patients." Diabetes Care, vol. 12, no. 2, 1989, pp. 94-101.
Coulston AM, Hollenbeck CB, Swislocki AL, et al. Persistence of hypertriglyceridemic effect of low-fat high-carbohydrate diets in NIDDM patients. Diabetes Care. 1989;12(2):94-101.
Coulston, A. M., Hollenbeck, C. B., Swislocki, A. L., & Reaven, G. M. (1989). Persistence of hypertriglyceridemic effect of low-fat high-carbohydrate diets in NIDDM patients. Diabetes Care, 12(2), pp. 94-101.
Coulston AM, et al. Persistence of Hypertriglyceridemic Effect of Low-fat High-carbohydrate Diets in NIDDM Patients. Diabetes Care. 1989;12(2):94-101. PubMed PMID: 2539286.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Persistence of hypertriglyceridemic effect of low-fat high-carbohydrate diets in NIDDM patients. AU - Coulston,A M, AU - Hollenbeck,C B, AU - Swislocki,A L, AU - Reaven,G M, PY - 1989/2/1/pubmed PY - 1989/2/1/medline PY - 1989/2/1/entrez SP - 94 EP - 101 JF - Diabetes care JO - Diabetes Care VL - 12 IS - 2 N2 - Although low-fat high-carbohydrate diets are recommended for patients with non-insulin-dependent diabetes mellitus (NIDDM) in an effort to reduce the risk of coronary artery disease (CAD), the results of short-term studies have shown that these diets can lead to changes in carbohydrate and lipid metabolism associated with an increased risk of CAD. This study has extended these earlier observations by determining the metabolic effects of such diets over a longer period in these patients. The comparison diets contained either 40 or 60% of the total calories as carbohydrates, with reciprocal changes in fat content from 40 to 20% consumed in random order for 6 wk in a crossover experimental design. The ratio of polyunsaturated to saturated fat and the total cholesterol intake were held constant in the two diets. Plasma glucose and insulin concentrations were significantly (P less than .001) elevated throughout the day when patients consumed the 60% carbohydrate diet, and 24-h urinary glucose excretion more than doubled (0.8 vs. 1.8 mol/24 h). Fasting plasma total and very-low-density lipoprotein (VLDL) triglyceride (TG) concentrations increased by 30% (P less than .001) after 1 wk on the 60% carbohydrate diet, and the magnitude of carbohydrate-induced hypertriglyceridemia persisted unchanged throughout the 6-wk study period. Total plasma cholesterol concentrations were similar after both diets. However, VLDL cholesterol (VLDL-chol) was significantly increased, whereas both low-density lipoprotein (LDL-) and high-density lipoprotein (HDL-) chol concentrations were significantly decreased after consumption of the 60% carbohydrate diet. Consequently, neither total-chol-to-HDL-chol nor LDL-chol-to-HDL-chol ratios changed.(ABSTRACT TRUNCATED AT 250 WORDS) SN - 0149-5992 UR - https://www.unboundmedicine.com/medline/citation/2539286/Persistence_of_hypertriglyceridemic_effect_of_low_fat_high_carbohydrate_diets_in_NIDDM_patients_ L2 - https://medlineplus.gov/diabeticdiet.html DB - PRIME DP - Unbound Medicine ER -