Effects of a monounsaturated fatty acid-enriched hypocaloric diet on cardiovascular risk factors in obese patients with type 2 diabetes

Barry Gumbiner, Cecilia C. Low, Peter D. Reaven

Research output: Contribution to journalArticle

55 Citations (Scopus)

Abstract

OBJECTIVE - To determine whether the lipoprotein response in weight loss in obese patients with type 2 diabetes can be improved by modifying the macronutrient composition of the commonly prescribed low-fat, high- carbohydrate (CHO) hypocaloric diet. RESEARCH DESIGN AND METHODS - Nine obese patients with type 2 diabetes were treated with a monaunsaturated fatty acid (MUFA)-enriched weight-reducing formula diet and compared with eight obese patients with type 2 diabetes treated with a low-fat, high-CHO weight- reducing formula diet. Weight loss ensued for 6 weeks, followed by 4 weeks of refeeding using isocaloric formulas enriched with MUFA or CHO, respectively. Fasting blood samples were obtained to measure plasma lipoproteins and LDL susceptibility to oxidation (measured as lag time: time required to induce in vitro formation of conjugated dienes). RESULTS - At baseline, there were no differences between the groups in plasma lipids, lipoproteins, or LDL susceptibility to oxidation. Weight loss was similar between the groups. Dieting resulted in decreases in total plasma cholesterol, LDL, HDL, triglycerides, and apolipoproteins A and B (P < 0.05), but the MUFA group manifested a greater decrease in total cholesterol, triglycerides, and apolipoprotein B and a smaller decrease in HDL and apolipoprotein A than the CHO group (P < 0.05). Improvements in these parameters were sustained during refeeding. After dieting, lag time was prolonged in the MUFA group (208 ± 10 min) compared with the CHO group (146 ± 11 min; P < 0.05). Lag time was prolonged further during refeeding in the MUFA group (221 ± 13 min, P = 0.10), while the CHO group remained unchanged (152 ± 9 min, P < 0.05). Lag time correlated strongly with the oleic acid content of LDL after dieting and refeeding (r = 0.74 and r = 0.93, respectively; both P < 0.001). CONCLUSIONS - Macronutrient content is an important determinant of the lipoprotein response to weight loss in obese patients with type 2 diabetes. MUFA- enriched hypocaloric diets potentiate the beneficial effects of weight loss to ameliorate cardiovascular risk factors in obese patients with type 2 diabetes.

Original languageEnglish (US)
Pages (from-to)9-15
Number of pages7
JournalDiabetes Care
Volume21
Issue number1
DOIs
StatePublished - Jan 1998
Externally publishedYes

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Monounsaturated Fatty Acids
Type 2 Diabetes Mellitus
Fatty Acids
Weight Loss
Diet
Apolipoproteins A
Reducing Diet
Formulated Food
Apolipoproteins B
LDL Lipoproteins
Lipoproteins
Fats
Weights and Measures
Oleic Acid
HDL Cholesterol
Fasting
Triglycerides
Research Design
Cholesterol
Carbohydrates

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Advanced and Specialized Nursing

Cite this

Effects of a monounsaturated fatty acid-enriched hypocaloric diet on cardiovascular risk factors in obese patients with type 2 diabetes. / Gumbiner, Barry; Low, Cecilia C.; Reaven, Peter D.

In: Diabetes Care, Vol. 21, No. 1, 01.1998, p. 9-15.

Research output: Contribution to journalArticle

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N2 - OBJECTIVE - To determine whether the lipoprotein response in weight loss in obese patients with type 2 diabetes can be improved by modifying the macronutrient composition of the commonly prescribed low-fat, high- carbohydrate (CHO) hypocaloric diet. RESEARCH DESIGN AND METHODS - Nine obese patients with type 2 diabetes were treated with a monaunsaturated fatty acid (MUFA)-enriched weight-reducing formula diet and compared with eight obese patients with type 2 diabetes treated with a low-fat, high-CHO weight- reducing formula diet. Weight loss ensued for 6 weeks, followed by 4 weeks of refeeding using isocaloric formulas enriched with MUFA or CHO, respectively. Fasting blood samples were obtained to measure plasma lipoproteins and LDL susceptibility to oxidation (measured as lag time: time required to induce in vitro formation of conjugated dienes). RESULTS - At baseline, there were no differences between the groups in plasma lipids, lipoproteins, or LDL susceptibility to oxidation. Weight loss was similar between the groups. Dieting resulted in decreases in total plasma cholesterol, LDL, HDL, triglycerides, and apolipoproteins A and B (P < 0.05), but the MUFA group manifested a greater decrease in total cholesterol, triglycerides, and apolipoprotein B and a smaller decrease in HDL and apolipoprotein A than the CHO group (P < 0.05). Improvements in these parameters were sustained during refeeding. After dieting, lag time was prolonged in the MUFA group (208 ± 10 min) compared with the CHO group (146 ± 11 min; P < 0.05). Lag time was prolonged further during refeeding in the MUFA group (221 ± 13 min, P = 0.10), while the CHO group remained unchanged (152 ± 9 min, P < 0.05). Lag time correlated strongly with the oleic acid content of LDL after dieting and refeeding (r = 0.74 and r = 0.93, respectively; both P < 0.001). CONCLUSIONS - Macronutrient content is an important determinant of the lipoprotein response to weight loss in obese patients with type 2 diabetes. MUFA- enriched hypocaloric diets potentiate the beneficial effects of weight loss to ameliorate cardiovascular risk factors in obese patients with type 2 diabetes.

AB - OBJECTIVE - To determine whether the lipoprotein response in weight loss in obese patients with type 2 diabetes can be improved by modifying the macronutrient composition of the commonly prescribed low-fat, high- carbohydrate (CHO) hypocaloric diet. RESEARCH DESIGN AND METHODS - Nine obese patients with type 2 diabetes were treated with a monaunsaturated fatty acid (MUFA)-enriched weight-reducing formula diet and compared with eight obese patients with type 2 diabetes treated with a low-fat, high-CHO weight- reducing formula diet. Weight loss ensued for 6 weeks, followed by 4 weeks of refeeding using isocaloric formulas enriched with MUFA or CHO, respectively. Fasting blood samples were obtained to measure plasma lipoproteins and LDL susceptibility to oxidation (measured as lag time: time required to induce in vitro formation of conjugated dienes). RESULTS - At baseline, there were no differences between the groups in plasma lipids, lipoproteins, or LDL susceptibility to oxidation. Weight loss was similar between the groups. Dieting resulted in decreases in total plasma cholesterol, LDL, HDL, triglycerides, and apolipoproteins A and B (P < 0.05), but the MUFA group manifested a greater decrease in total cholesterol, triglycerides, and apolipoprotein B and a smaller decrease in HDL and apolipoprotein A than the CHO group (P < 0.05). Improvements in these parameters were sustained during refeeding. After dieting, lag time was prolonged in the MUFA group (208 ± 10 min) compared with the CHO group (146 ± 11 min; P < 0.05). Lag time was prolonged further during refeeding in the MUFA group (221 ± 13 min, P = 0.10), while the CHO group remained unchanged (152 ± 9 min, P < 0.05). Lag time correlated strongly with the oleic acid content of LDL after dieting and refeeding (r = 0.74 and r = 0.93, respectively; both P < 0.001). CONCLUSIONS - Macronutrient content is an important determinant of the lipoprotein response to weight loss in obese patients with type 2 diabetes. MUFA- enriched hypocaloric diets potentiate the beneficial effects of weight loss to ameliorate cardiovascular risk factors in obese patients with type 2 diabetes.

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