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Comparison of a high-carbohydrate diet with a high-monounsaturated-fat diet in patients with non-insulin-dependent diabetes mellitus.

Abstract

We compared a high-carbohydrate diet with a high-fat diet (specifically, a diet high in monounsaturated fatty acids) for effects on glycemic control and plasma lipoproteins in 10 patients with non-insulin-dependent diabetes mellitus (NIDDM) receiving insulin therapy. The patients were randomly assigned to receive first one diet and then the other, each for 28 days, in a metabolic ward. In the high-carbohydrate diet, 25 percent of the energy was in the form of fat and 60 percent in the form of carbohydrates (47 percent of the total energy was in the form of complex carbohydrates); the high-monounsaturated-fat diet was 50 percent fat (33 percent of the total energy in the form of monounsaturated fatty acids) and 35 percent carbohydrates. The two diets had the same amounts of simple carbohydrates and fiber. As compared with the high-carbohydrate diet, the high-monounsaturated-fat diet resulted in lower mean plasma glucose levels and reduced insulin requirements, lower levels of plasma triglycerides and very-low-density lipoprotein cholesterol (lower by 25 and 35 percent, respectively; P less than 0.01), and higher levels of high-density lipoprotein (HDL) cholesterol (higher by 13 percent; P less than 0.005). Levels of total cholesterol and low-density lipoprotein (LDL) cholesterol did not differ significantly in patients on the two diets. These preliminary results suggest that partial replacement of complex carbohydrates with monounsaturated fatty acids in the diets of patients with NIDDM does not increase the level of LDL cholesterol and may improve glycemic control and the levels of plasma triglycerides and HDL cholesterol.

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  • Authors+Show Affiliations

    ,

    Center for Human Nutrition, University of Texas Southwestern Medical Center, Dallas 75235-9052.

    , , ,

    Source

    The New England journal of medicine 319:13 1988 Sep 29 pg 829-34

    MeSH

    Adult
    Aged
    Blood Glucose
    Cholesterol
    Cholesterol, LDL
    Cholesterol, VLDL
    Diabetes Mellitus, Type 2
    Dietary Carbohydrates
    Dietary Fats
    Energy Intake
    Fatty Acids, Monounsaturated
    Humans
    Insulin
    Lipoproteins, VLDL
    Middle Aged
    Random Allocation
    Triglycerides

    Pub Type(s)

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

    Language

    eng

    PubMed ID

    3045553

    Citation

    Garg, A, et al. "Comparison of a High-carbohydrate Diet With a High-monounsaturated-fat Diet in Patients With Non-insulin-dependent Diabetes Mellitus." The New England Journal of Medicine, vol. 319, no. 13, 1988, pp. 829-34.
    Garg A, Bonanome A, Grundy SM, et al. Comparison of a high-carbohydrate diet with a high-monounsaturated-fat diet in patients with non-insulin-dependent diabetes mellitus. N Engl J Med. 1988;319(13):829-34.
    Garg, A., Bonanome, A., Grundy, S. M., Zhang, Z. J., & Unger, R. H. (1988). Comparison of a high-carbohydrate diet with a high-monounsaturated-fat diet in patients with non-insulin-dependent diabetes mellitus. The New England Journal of Medicine, 319(13), pp. 829-34.
    Garg A, et al. Comparison of a High-carbohydrate Diet With a High-monounsaturated-fat Diet in Patients With Non-insulin-dependent Diabetes Mellitus. N Engl J Med. 1988 Sep 29;319(13):829-34. PubMed PMID: 3045553.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Comparison of a high-carbohydrate diet with a high-monounsaturated-fat diet in patients with non-insulin-dependent diabetes mellitus. AU - Garg,A, AU - Bonanome,A, AU - Grundy,S M, AU - Zhang,Z J, AU - Unger,R H, PY - 1988/9/29/pubmed PY - 1988/9/29/medline PY - 1988/9/29/entrez SP - 829 EP - 34 JF - The New England journal of medicine JO - N. Engl. J. Med. VL - 319 IS - 13 N2 - We compared a high-carbohydrate diet with a high-fat diet (specifically, a diet high in monounsaturated fatty acids) for effects on glycemic control and plasma lipoproteins in 10 patients with non-insulin-dependent diabetes mellitus (NIDDM) receiving insulin therapy. The patients were randomly assigned to receive first one diet and then the other, each for 28 days, in a metabolic ward. In the high-carbohydrate diet, 25 percent of the energy was in the form of fat and 60 percent in the form of carbohydrates (47 percent of the total energy was in the form of complex carbohydrates); the high-monounsaturated-fat diet was 50 percent fat (33 percent of the total energy in the form of monounsaturated fatty acids) and 35 percent carbohydrates. The two diets had the same amounts of simple carbohydrates and fiber. As compared with the high-carbohydrate diet, the high-monounsaturated-fat diet resulted in lower mean plasma glucose levels and reduced insulin requirements, lower levels of plasma triglycerides and very-low-density lipoprotein cholesterol (lower by 25 and 35 percent, respectively; P less than 0.01), and higher levels of high-density lipoprotein (HDL) cholesterol (higher by 13 percent; P less than 0.005). Levels of total cholesterol and low-density lipoprotein (LDL) cholesterol did not differ significantly in patients on the two diets. These preliminary results suggest that partial replacement of complex carbohydrates with monounsaturated fatty acids in the diets of patients with NIDDM does not increase the level of LDL cholesterol and may improve glycemic control and the levels of plasma triglycerides and HDL cholesterol. SN - 0028-4793 UR - https://www.unboundmedicine.com/medline/citation/3045553/Comparison_of_a_high_carbohydrate_diet_with_a_high_monounsaturated_fat_diet_in_patients_with_non_insulin_dependent_diabetes_mellitus_ L2 - http://www.nejm.org/doi/full/10.1056/NEJM198809293191304?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -