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Deleterious metabolic effects of high-carbohydrate, sucrose-containing diets in patients with non-insulin-dependent diabetes mellitus.

Abstract

The effects of variations in dietary carbohydrate and fat intake on various aspects of carbohydrate and lipid metabolism were studied in patients with non-insulin-dependent diabetes mellitus (NIDDM). Two test diets were utilized, and they were consumed in random order over two 15-day periods. One diet was low in fat and high in carbohydrate, and corresponded closely to recent recommendations made by the American Diabetes Association (ADA), containing (as percent of total calories) 20 percent protein, 20 percent fat, and 60 percent carbohydrate, with 10 percent of total calories as sucrose. The other diet contained 20 percent protein, 40 percent fat, and 40 percent carbohydrate, with sucrose accounting for 3 percent of total calories. Although plasma fasting glucose and insulin concentrations were similar with both diets, incremental glucose and insulin responses from 8 a.m. to 4 p.m. were higher (p less than 0.01), and mean (+/- SEM) 24-hour urine glucose excretion was significantly greater (55 +/- 16 versus 26 +/- 4 g/24 hours p less than 0.02) in response to the low-fat, high-carbohydrate diet. In addition, fasting and postprandial triglyceride levels were increased (p less than 0.001 and p less than 0.05, respectively) and high-density lipoprotein (HDL) cholesterol concentrations were reduced (p less than 0.02) when patients with NIDDM ate the low-fat, high-carbohydrate diet. Finally, since low-density lipoprotein (LDL) concentrations did not change with diet, the HDL/LDL cholesterol ratio fell in response to the low-fat, high-carbohydrate diet. These results document that low-fat, high-carbohydrate diets, containing moderate amounts of sucrose, similar in composition to the recommendations of the ADA, have deleterious metabolic effects when consumed by patients with NIDDM for 15 days. Until it can be shown that these untoward effects are evanescent, and that long-term ingestion of similar diets will result in beneficial metabolic changes, it seems prudent to avoid the use of low-fat, high-carbohydrate diets containing moderate amounts of sucrose in patients with NIDDM.

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  • Publisher Full Text
  • Authors

    , , , ,

    Source

    The American journal of medicine 82:2 1987 Feb pg 213-20

    MeSH

    Aged
    Blood Glucose
    Cholesterol
    Diabetes Mellitus, Type 2
    Dietary Carbohydrates
    Female
    Glycosuria
    Humans
    Insulin
    Lipoproteins
    Male
    Middle Aged
    Random Allocation
    Sucrose
    Time Factors
    Triglycerides

    Pub Type(s)

    Clinical Trial
    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

    3544839

    Citation

    Coulston, A M., et al. "Deleterious Metabolic Effects of High-carbohydrate, Sucrose-containing Diets in Patients With Non-insulin-dependent Diabetes Mellitus." The American Journal of Medicine, vol. 82, no. 2, 1987, pp. 213-20.
    Coulston AM, Hollenbeck CB, Swislocki AL, et al. Deleterious metabolic effects of high-carbohydrate, sucrose-containing diets in patients with non-insulin-dependent diabetes mellitus. Am J Med. 1987;82(2):213-20.
    Coulston, A. M., Hollenbeck, C. B., Swislocki, A. L., Chen, Y. D., & Reaven, G. M. (1987). Deleterious metabolic effects of high-carbohydrate, sucrose-containing diets in patients with non-insulin-dependent diabetes mellitus. The American Journal of Medicine, 82(2), pp. 213-20.
    Coulston AM, et al. Deleterious Metabolic Effects of High-carbohydrate, Sucrose-containing Diets in Patients With Non-insulin-dependent Diabetes Mellitus. Am J Med. 1987;82(2):213-20. PubMed PMID: 3544839.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Deleterious metabolic effects of high-carbohydrate, sucrose-containing diets in patients with non-insulin-dependent diabetes mellitus. AU - Coulston,A M, AU - Hollenbeck,C B, AU - Swislocki,A L, AU - Chen,Y D, AU - Reaven,G M, PY - 1987/2/1/pubmed PY - 1987/2/1/medline PY - 1987/2/1/entrez SP - 213 EP - 20 JF - The American journal of medicine JO - Am. J. Med. VL - 82 IS - 2 N2 - The effects of variations in dietary carbohydrate and fat intake on various aspects of carbohydrate and lipid metabolism were studied in patients with non-insulin-dependent diabetes mellitus (NIDDM). Two test diets were utilized, and they were consumed in random order over two 15-day periods. One diet was low in fat and high in carbohydrate, and corresponded closely to recent recommendations made by the American Diabetes Association (ADA), containing (as percent of total calories) 20 percent protein, 20 percent fat, and 60 percent carbohydrate, with 10 percent of total calories as sucrose. The other diet contained 20 percent protein, 40 percent fat, and 40 percent carbohydrate, with sucrose accounting for 3 percent of total calories. Although plasma fasting glucose and insulin concentrations were similar with both diets, incremental glucose and insulin responses from 8 a.m. to 4 p.m. were higher (p less than 0.01), and mean (+/- SEM) 24-hour urine glucose excretion was significantly greater (55 +/- 16 versus 26 +/- 4 g/24 hours p less than 0.02) in response to the low-fat, high-carbohydrate diet. In addition, fasting and postprandial triglyceride levels were increased (p less than 0.001 and p less than 0.05, respectively) and high-density lipoprotein (HDL) cholesterol concentrations were reduced (p less than 0.02) when patients with NIDDM ate the low-fat, high-carbohydrate diet. Finally, since low-density lipoprotein (LDL) concentrations did not change with diet, the HDL/LDL cholesterol ratio fell in response to the low-fat, high-carbohydrate diet. These results document that low-fat, high-carbohydrate diets, containing moderate amounts of sucrose, similar in composition to the recommendations of the ADA, have deleterious metabolic effects when consumed by patients with NIDDM for 15 days. Until it can be shown that these untoward effects are evanescent, and that long-term ingestion of similar diets will result in beneficial metabolic changes, it seems prudent to avoid the use of low-fat, high-carbohydrate diets containing moderate amounts of sucrose in patients with NIDDM. SN - 0002-9343 UR - https://www.unboundmedicine.com/medline/citation/3544839/Deleterious_metabolic_effects_of_high_carbohydrate_sucrose_containing_diets_in_patients_with_non_insulin_dependent_diabetes_mellitus_ L2 - https://linkinghub.elsevier.com/retrieve/pii/0002-9343(87)90058-1 DB - PRIME DP - Unbound Medicine ER -