Comparison of the effects on insulin resistance and glucose tolerance of 6-mo high-monounsaturated-fat, low-fat, and control diets. Comparison of high- and low-glycemic-index breakfast cereals with monounsaturated fat in the long-term dietary management of type 2 diabetes. Comparison of 3 ad libitum diets for weight-loss maintenance, risk of cardiovascular disease, and diabetes: a 6-mo randomized, controlled trial. Effects of High-monounsaturated Fatty Acid Enteral Formula versus High-carbohydrate Enteral Formula on Plasma Glucose Concentration and Insulin Secretion in Healthy Individuals and Diabetic Patients Long-term effect of varying the source or amount of dietary carbohydrate on postprandial plasma glucose, insulin, triacylglycerol, and free fatty acid concentrations in subjects with impaired glucose tolerance. The effect of a high-egg diet on cardiovascular risk factors in people with type 2 diabetes: the Diabetes and Egg (DIABEGG) study-a 3-mo randomized controlled trial. One-Year Comparison of a High–Monounsaturated Fat Diet With a High-Carbohydrate Diet in Type 2 Diabetes Effects of a Monounsaturated Fatty Acid–Enriched Hypocaloric Diet on Cardiovascular Risk Factors in Obese Patients With Type 2 Diabetes High-carbohydrate-low-glycaemic index dietary advice improves glucose disposition index in subjects with impaired glucose tolerance. Dietary Monounsaturated Fatty Acids but not Saturated Fatty Acids Preserve the Insulin Signaling Pathway via IRS-1/PI3K in Rat Skeletal Muscle Adverse effects on insulin secretion of replacing saturated fat with refined carbohydrate but not with monounsaturated fat: A randomized controlled trial in centrally obese subjects. A MUFA-Rich Diet Improves Posprandial Glucose, Lipid and GLP-1 Responses in Insulin-Resistant Subjects Comparison of a high-carbohydrate and a high-monounsaturated fat, olive oil-rich diet on the susceptibility of LDL to oxidative modification in subjects with Type 2 diabetes mellitus. Effect of a high monounsaturated fatty acids diet and a Mediterranean diet on serum lipids and insulin sensitivity in adults with mild abdominal obesity. Diet-induced change in fatty acid composition of plasma triacylglycerols is not associated with change in glucagon-like peptide 1 or insulin sensitivity in people with type 2 diabetes. Substituting dietary saturated for monounsaturated fat impairs insulin sensitivity in healthy men and women: The KANWU study Comparison of the effect of saturated and monounsaturated fat on postprandial plasma glucose and insulin concentration in women with gestational diabetes mellitus. A diet rich in high-oleic-acid sunflower oil favorably alters low-density lipoprotein cholesterol, triglycerides, and factor VII coagulant activity. The insulin sensitivity response is determined by the interaction between the G972R polymorphism of the insulin receptor substrate 1 gene and dietary fat. Effect of energy restriction, weight loss, and diet composition on plasma lipids and glucose in patients with type 2 diabetes. High-monounsaturated fatty acid diets lower both plasma cholesterol and triacylglycerol concentrations. Randomized Controlled Trial of a MUFA or Fiber-Rich Diet on Hepatic Fat in Prediabetes Potentiation of Effects of Weight Loss by Monounsaturated Fatty Acids in Obese NIDDM Patients
BACKGROUND The effect of dietary fat and carbohydrate on glucose metabolism has been debated for decades . OBJECTIVE The objective was to compare the effect of 3 ad libitum diets , different in type and amount of fat and carbohydrate , on insulin resistance and glucose tolerance subsequent to weight loss . DESIGN Forty-six nondiabetic , obese [ mean ( + /-SEM ) body mass index ( in kg/m(2 ) ) : 31.2 + /- 0.3 ] men ( n = 20 ) and premenopausal women ( n = 26 ) aged 28.0 + /- 0.7 y were r and omly assigned to 1 of 3 diets after > or = 8 % weight loss : 1 ) MUFA diet ( n = 16 ) : moderate in fat ( 35 - 45 % of energy ) and high in monounsaturated fatty acids ( > 20 % of energy ) ; 2 ) LF diet ( n = 18 ) : low-fat diet ( 20 - 30 % of energy ) , and 3 ) control diet ( n = 12 ) : 35 % of energy as fat ( > 15 % of energy as saturated fatty acids ) . Protein accounted for 15 % of energy in all 3 diets . A 2-h oral-glucose-tolerance test ( OGTT ) was performed before and after the 6-mo dietary intervention . All foods were provided by a purpose -built supermarket . RESULTS After 6 mo , the MUFA diet reduced fasting glucose ( -3.0 % ) , insulin ( -9.4 % ) , and the homeostasis model assessment of insulin resistance score ( -12.1 % ) . Compared with the MUFA diet , the control diet increased these variables [ 1.4 % ( P = 0.014 ) , 21.2 % ( P = 0.030 ) , and 22.8 % ( P = 0.015 ) , respectively ] , as did the LF diet [ 1.4 % ( P = 0.090 ) , 13.1 % ( P = 0.078 ) , and 15.5 % ( P = 0.095 ) , respectively ] . No significant group differences were detected in glucose or insulin concentrations during the OGTT , in the Matsudas index , in body weight , or in body composition . CONCLUSION A diet high in monounsaturated fat has a more favorable effect on glucose homeostasis than does the typical Western diet in the short term and may also be more beneficial than the official recommended low-fat diet during a period of weight regain subsequent to weight loss BACKGROUND Results of 6-wk studies suggest that high-carbohydrate diets are deleterious for people with type 2 diabetes . OBJECTIVE Our objective was to see whether long-term replacement of dietary monounsaturated fatty acids ( MUFAs ) with carbohydrate from breakfast cereals with either a high or a low glycemic index ( GI ) affected blood glucose and lipids in subjects with type 2 diabetes . DESIGN Subjects with type 2 diabetes ( n = 91 ) were r and omly assigned to receive approximately 10 % of energy from a low-GI breakfast cereal , a high-GI cereal , or oil or margarine containing MUFA for 6 mo . Eating breakfast cereal was prohibited for subjects in the MUFA group . RESULTS Seventy-two subjects completed the trial . The subjects who received cereals consumed approximately 10 % more energy from carbohydrate than did the subjects in the MUFA group . Changes in glycated hemoglobin , body weight , and fasting cholesterol and triacylglycerol did not differ significantly among groups . HDL cholesterol increased by approximately 10 % in the MUFA group compared with subjects who consumed either high- or low-GI cereals ( P = 0.002 ) . The ratio of total to HDL cholesterol was higher in the subjects who consumed the high-GI cereal than in the MUFA group at 3 mo but not at 6 mo ( diet x time interaction , P = 0.041 ) . During 8-h metabolic profiles , mean plasma insulin was higher and mean free fatty acids were lower in the 2 cereal groups than in the MUFA group ( P < 0.05 ) . CONCLUSIONS A 10 % increase in carbohydrate intake associated with breakfast cereal consumption had no deleterious effects on glycemic control or blood lipids over 6 mo in subjects with type 2 diabetes . The increase in plasma insulin and the reduction in free fatty acids associated with higher carbohydrate intake may reduce the rate of progression of diabetes BACKGROUND The optimal dietary content and type of fat and carbohydrate for weight management has been debated for decades . OBJECTIVE The objective was to compare the effects of 3 ad libitum diets on the maintenance of an initial weight loss of > or=8 % and risk factors for CVD and diabetes during a 6-mo controlled dietary intervention . DESIGN Nondiabetic overweight or obese [ mean + /- SD body mass index ( in kg/m(2 ) ) : 31.5 + /- 2.6 ] men ( n = 55 ) and women ( n = 76 ) aged 28.2 + /- 4.8 y were r and omly assigned to a diet providing a moderate amount of fat ( 35 - 45 % of energy ) and > 20 % of fat as monounsaturated fatty acids ( MUFA diet ; n = 54 ) , to a low-fat ( 20 - 30 % of energy ) diet ( LF diet ; n = 51 ) , or to a control diet ( 35 % of energy as fat ; n = 26 ) . Protein constituted 10 - 20 % of energy in all 3 diets . All foods were provided free of charge from a purpose -built supermarket . RESULTS More subjects dropped out of the MUFA ( 28 % ) group than out of the LF group ( 16 % ) and control group ( 8 % ) ( MUFA compared with control : P < 0.05 ) . All groups regained weight ( MUFA : 2.5 + /- 0.7 kg ; LF : 2.2 + /- 0.7 kg ; and control : 3.8 + /- 0.8 kg ; NS ) . Body fat regain was lower in the LF ( 0.6 + /- 0.6 % ) and MUFA ( 1.6 + /- 0.6 % ) groups than in the control group ( 2.6 + /- 0.5 % ) ( P < 0.05 ) . In the MUFA group , fasting insulin decreased by 2.6 + /- 3.5 pmol/L , the homeostasis model assessment of insulin resistance by 0.17 + /- 0.13 , and the ratio of LDL to HDL by 0.33 + /- 0.13 ; in the LF group , these variables increased by 4.3 + /- 3.0 pmol/L ( P < 0.08 ) and 0.17 + /- 0.10 ( P < 0.05 ) and decreased by 0.02 + /- 0.09 ( P = 0.005 ) , respectively ; and in the control group , increased by 14.0 + /- 4.3 pmol/L ( P < 0.001 ) , 0.57 + /- 0.17 ( P < 0.001 ) , and 0.05 + /- 0.14 ( P = 0.036 ) , respectively . Dietary adherence was high on the basis of fatty acid changes in adipose tissue . CONCLUSIONS Diet composition had no major effect on preventing weight regain . However , both the LF and MUFA diets produced less body fat regain than did the control diet , and the dropout rate was lowest in the LF diet group , whereas fasting insulin decreased and the homeostasis model assessment of insulin resistance and ratio of LDL to HDL improved with the MUFA diet . This trial was registered at clinical trials.gov as NCT00274729 We investigated the effects of high-monounsaturated fatty acid ( MUFA ) versus high-carbohydrate enteral formula on post-pr and ial plasma glucose concentration and insulin response in Japanese patients with type 2 diabetes mellitus and healthy Japanese volunteers . Ten healthy volunteers aged 20.8 ± 1.2 years and 12 diabetic patients with good glycaemic control ( glycosylated haemoglobulin < 7 % ) aged 58.6 ± 7.7 years were r and omly assigned to take high-MUFA or high-carbohydrate formula after a 12-h overnight fast . The patients switched to the other formula after 7 days . Post-pr and ial plasma glucose and insulin response were significantly lower in all subjects after taking high-MUFA formula compared with high-carbohydrate formula . No differences were observed in free fatty acids , triglycerides and plasma glucagon between the two diet groups . In conclusion , a high-MUFA enteral formula  suppresses post-pr and ial hyperglycaemia without exaggerated insulin secretion compared with a high-carbohydrate enteral diet in patients with type 2 diabetes and healthy subjects BACKGROUND Reducing the glycemic load ( GL ) is considered beneficial for managing insulin resistance . The GL can be reduced either by reducing carbohydrate intake or by reducing the glycemic index ( GI ) . OBJECTIVE We studied whether these 2 dietary maneuvers have the same long-term effects on postpr and ial plasma glucose , insulin , triacylglycerol , and free fatty acid ( FFA ) concentrations in subjects with impaired glucose tolerance ( IGT ) . DESIGN Thirty-four subjects with IGT were r and omly assigned to high-carbohydrate , high-GI ( high-GI ) ; high-carbohydrate , low-GI ( low-GI ) ; and low-carbohydrate , high-monounsaturated fatty acid ( MUFA ) diets for 4 mo . Plasma glucose , insulin , and FFAs were measured from 0800 to 1600 at baseline in response to high-GI meals ( 60 % carbohydrate , GI = 61 , GL = 63 ) and after 4 mo in response to meals representative of the study diet . RESULTS Carbohydrate intake ( % of energy ) , GI , and GL in the high-GI , low-GI , and MUFA groups ( breakfast and lunch meals combined ) , respectively , were 60 % , 61 , and 63 ; 60 % , 53 , and 55 ; and 49 % , 61 , and 52 . Compared with the change after 4 mo of the high-GI diet , both the low-GI and MUFA diets reduced 0 - 8-h mean plasma glucose concentrations by 0.35 mmol/L ( P < 0.05 ) . Mean plasma insulin was approximately 20 % higher ( P < 0.05 ) and FFAs approximately 12 % lower ( P < 0.05 ) after the low-GI diet than after the high-GI diet , with no significant effect of MUFA . Changes in 0 - 8-h mean plasma triacylglycerols in the 3 treatment groups differed significantly : -0.14 , 0.04 , and 0.18 mmol/L , respectively , with the high-GI , MUFA , and low-GI diets . CONCLUSIONS In subjects with IGT , reducing the GI of the diet for 4 mo reduced postpr and ial plasma glucose by the same amount as did reducing carbohydrate intake . The 2 dietary maneuvers had different effects on postpr and ial plasma insulin , triacylglycerols , and FFAs BACKGROUND Previously published research that examined the effects of high egg consumption in people with type 2 diabetes ( T2D ) produced conflicting results leading to recommendations to limit egg intake . However , people with T2D may benefit from egg consumption because eggs are a nutritious and convenient way of improving protein and micronutrient contents of the diet , which have importance for satiety and weight management . OBJECTIVE In this r and omized controlled study , we aim ed to determine whether a high-egg diet ( 2 eggs/d for 6 d/wk ) compared with a low-egg diet ( < 2 eggs/wk ) affected circulating lipid profiles , in particular high-density lipoprotein ( HDL ) cholesterol , in overweight or obese people with prediabetes or T2D . DESIGN A total of 140 participants were r and omly assigned to one of the 2 diets as part of a 3-mo weight maintenance study . Participants attended the clinic monthly and were instructed on the specific types of foods and quantities to be consumed . RESULTS There was no significant difference in the change in HDL cholesterol from screening to 3 mo between groups ; the mean difference ( 95 % CI ) between high- and low-egg groups was + 0.02 mmol/L ( -0.03 , 0.08 mmol/L ; P = 0.38 ) . No between-group differences were shown for total cholesterol , low-density lipoprotein cholesterol , triglycerides , or glycemic control . Both groups were matched for protein intake , but the high-egg group reported less hunger and greater satiety postbreakfast . Polyunsaturated fatty acid ( PUFA ) and monounsaturated fatty acid ( MUFA ) intakes significantly increased from baseline in both groups . CONCLUSIONS High egg consumption did not have an adverse effect on the lipid profile of people with T2D in the context of increased MUFA and PUFA consumption . This study suggests that a high-egg diet can be included safely as part of the dietary management of T2D , and it may provide greater satiety . This trial was registered at the Australia New Zeal and Clinical Trials Registry ( http://www.anzctr.org.au/ ) as ACTRN12612001266853 OBJECTIVE —The purpose of this study was to compare the effects of high – monounsaturated fatty acid ( MUFA ) and high-carbohydrate ( CHO ) diets on body weight and glycemic control in men and women with type 2 diabetes . RESEARCH DESIGN AND METHODS —Overweight/obese participants with type 2 diabetes ( n = 124 , age = 56.5 ± 0.8 years , BMI = 35.9 ± 0.3 kg/m2 , and A1C = 7.3 ± 0.1 % ) were r and omly assigned to 1 year of a high-MUFA or high-CHO diet . Anthropometric and metabolic parameters were assessed at baseline and after 4 , 8 , and 12 months of dieting . RESULTS —Baseline characteristics were similar between the treatment groups . The overall retention rate for 1 year was 77 % ( 69 % for the high-MUFA group and 84 % for the high-CHO group ; P = 0.06 ) . Based on food records , both groups had similar energy intake but a significant difference in MUFA intake . Both groups had similar weight loss over 1 year ( −4.0 ± 0.8 vs. −3.8 ± 0.6 kg ) and comparable improvement in body fat , waist circumference , diastolic blood pressure , HDL cholesterol , A1C , and fasting glucose and insulin . There were no differences in these parameters between the groups . A follow-up assessment of a subset of participants ( n = 36 ) was conducted 18 months after completion of the 52-week diet . These participants maintained their weight loss and A1C during the follow-up period . CONCLUSIONS —In individuals with type 2 diabetes  , high-MUFA diets are an alternative to conventional lower-fat , high-CHO diets with comparable beneficial effects on body weight , body composition , cardiovascular risk factors , and glycemic control OBJECTIVE To determine whether the lipoprotein response to 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 monounsaturated 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 sample s 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 result ed 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 Controversy exists about the optimal amount and source of dietary carbohydrate for managing insulin resistance . Therefore , we compared the effects on insulin sensitivity ( SI ) , pancreatic responsivity ( AIRglu ) and glucose disposition index of dietary advice aim ed at reducing the amount or altering the source of dietary carbohydrate in subjects with impaired glucose tolerance ( IGT ) . Subjects were r and omized to high-carbohydrate-high-glycaemic index ( GI ) ( high-GI , n 11 ) , high-carbohydrate-low-GI ( low-GI , n 13 ) , or low-carbohydrate-high-monounsaturated fat ( MUFA , n 11 ) dietary advice , with SI , AIRglu and DI measured using a frequently sample d , intravenous glucose tolerance test before and after 4 months treatment . Carbohydrate and fat intakes and diet GI , respectively , were : high-GI , 53 % , 28 % , 83 ; low-GI , 55 % , 25 % , 76 ; MUFA , 47 % , 35 % , 82 . Weight changes on each diet differed significantly from each other : high-GI , -0.49 ( sem 0.29 ) kg ; low-GI , -0.19 ( sem 0.40 ) kg ; MUFA + 0.27 ( sem 0.45 ) kg . Blood lipids did not change , but glycated haemoglobin increased significantly on MUFA , 0.02 ( sem 0.11 ) % , relative to low-GI , -0.19 ( sem 0.08 ) % , and high-GI , -0.13 ( sem 0.14 ) % . Diastolic blood pressure fell by 8 mmHg on low-GI relative to MUFA ( P=0.038 ) . Although SI and AIRglu did not change significantly , DI , a measure of the ability of beta-cells to overcome insulin resistance by increasing insulin secretion , increased on low-GI by > 50 % ( P=0.02 ) . After adjusting for baseline values , the increase in DI on low-GI , 0.17 ( sem 0.07 ) , was significantly greater than those on MUFA , -0.09 ( sem 0.08 ) and high-GI , -0.03 ( sem 0.02 ) ( P=0.019 ) . Thus , the long-term effects of altering the source of dietary carbohydrate differ from those of altering the amount . High-carbohydrate-low-GI dietary advice improved beta-cell function in subjects with IGT , and may , therefore , be useful in the management of IGT Saturated fatty acids ( SFA ) and monounsaturated fatty acids ( MUFA ) show different effects on the development of insulin resistance . In this study , we compared the effect of dietary SFA and MUFA on the insulin signaling pathway in the skeletal muscle of a type 2 diabetic animal model . Twenty-nine-week-old male Otsuka Long-Evans Tokushima fatty ( OLETF ) rats were r and omly divided into three groups and fed one of the following diets for 3 weeks ; a normal chow diet , an SFA ( lard oil ) enriched or a MUFA ( olive oil ) enriched high-fat diet . The vastus lateralis muscle was used for analyses . Insulin tolerance test showed improved insulin sensitivity in rats fed the MUFA diet , as compared to those fed the SFA diet ( p < 0.001 ) . The SFA diet reduced IRS-1 expression and phosphorylated PI3 K levels in skeletal muscle , as compared with a chow diet ( p < 0.001 , respectively ) . On the contrary , muscle IRS-2 expression and phosphorylated ERK1/2 was significantly increased in rats fed the SFA diet ( p < 0.001 , respectively ) . Membrane translocation of glucose transporter type 4 decreased in the skeletal muscle of rats fed the SFA diet , as compared to those fed a chow diet ( p < 0.001 ) . These changes in insulin signaling pathway in skeletal muscle were not observed in rats fed the MUFA diet . In conclusion , the beneficial effect of dietary MUFA on insulin sensitivity is associated with a conserved IRS-1/PI3 K insulin signaling pathway which was altered by dietary SFA BACKGROUND Current dietary guidelines recommend the replacement of saturated fatty acids ( SAFAs ) with carbohydrates or monounsaturated fatty acids ( MUFAs ) based on evidence on lipid profile alone , the chronic effects of the mentioned replacements on insulin secretion and insulin sensitivity are however unclear . OBJECTIVE To assess the chronic effects of the substitution of refined carbohydrate or MUFA for SAFA on insulin secretion and insulin sensitivity in central ly obese subjects . METHODS Using a crossover design , r and omized controlled trial in abdominally overweight men and women , we compared the effects of substitution of 7 % energy as carbohydrate or MUFA for SAFA for a period of 6 weeks each . Fasting and postpr and ial blood sample s in response to corresponding SAFA , carbohydrate , or MUFA-enriched meal-challenges were collected after 6 weeks on each diet treatment for the assessment of outcomes . RESULTS As expected , postpr and ial nonesterified fatty acid suppression and elevation of C-peptide , insulin and glucose secretion were the greatest with high-carbohydrate ( CARB ) meal . Interestingly , CARB meal attenuated postpr and ial insulin secretion corrected for glucose response ; however , the insulin sensitivity and disposition index were not affected . SAFA and MUFA had similar effects on all markers except for fasting glucose-dependent insulinotropic peptide concentrations , which increased after MUFA but not SAFA when compared with CARB . CONCLUSION In conclusion , a 6-week lower-fat/higher-carbohydrate ( increased by 7 % refined carbohydrate ) diet may have greater adverse effect on insulin secretion corrected for glucose compared with isocaloric higher-fat diets . In contrast , exchanging MUFA for SAFA at 7 % energy had no appreciable adverse impact on insulin secretion Objective : To study the effects of three weight-maintenance diets with different macronutrient composition on carbohydrate , lipid metabolism , insulin and incretin levels in insulin-resistant subjects . Methods : A prospect i ve study was performed in eleven ( 7 W , 4 M ) offspring of obese and type 2 diabetes patients . Subjects had a BMI > 25 Kg/m2 , waist circumference ( men/women ) > 102/88 , HBA1c < 6.5 % and were regarded as insulin-resistant after an OGTT ( Matsuda ISIm < 4 ) . They were r and omly divided into three groups and underwent three dietary periods each of 28 days in a crossover design : a ) diet high in saturated fat ( SAT ) , b ) diet rich in monounsaturated fat ( MUFA ; Mediterranean diet ) and c ) diet rich in carbohydrate ( CHO ) . Results : Body weight and resting energy expenditure did not changed during the three dietary periods . Fasting serum glucose concentrations fell during MUFA-rich and CHO-rich diets compared with high-SAT diets ( 5.02 ± 0.1 , 5.03 ± 0.1 , 5.50 ± 0.2 mmol/L , respectively . Anova < 0.05 ) . The MUFA-rich diet improved insulin sensitivity , as indicated by lower homeostasis model analysis -insulin resistance ( HOMA-ir ) , compared with CHO-rich and high-SAT diets ( 2.32 ± 0.3 , 2.52 ± 0.4 , 2.72 ± 0.4 , respectively , Anova < 0.01 ) . After a MUFA-rich and high-SAT breakfasts ( 443 kcal ) the postpr and ial integrated area under curve ( AUC ) of glucose and insulin were lowered compared with isocaloric CHO-rich breakfast ( 7.8 ± 1.3 , 5.84 ± 1.2 , 11.9 ± 2.7 mmol · 180 min/L , Anova < 0.05 ; and 1004 ± 147 , 1253 ± 140 , 2667 ± 329 pmol · 180 min/L , Anova < 0.01 , respectively ) ; while the integrated glucagon-like peptide-1 response increased with MUFA and SAT breakfasts compared with isocaloric CHO-rich meals ( 4.22 ± 0.7 , 4.34 ± 1.1 , 1.85 ± 1.1 , respectively , Anova < 0.05 ) . Fasting and postpr and ial HDL cholesterol concentrations rose with MUFA-rich diets , and the AUCs of triacylglycerol fell with the CHO-rich diet . Similarly fasting proinsulin ( PI ) concentration fell , while stimulated ratio PI/I was not changed by MUFA-rich diet . Conclusions : Weight maintenance with a MUFA-rich diet improves HOMA-ir and fasting proinsulin levels in insulin-resistant subjects . Ingestion of a virgin olive oil-based breakfast decreased postpr and ial glucose and insulin concentrations , and increased HDL-C and GLP-1 concentrations as compared with CHO-rich diet AIMS To compare the effects of a high-carbohydrate ( CHO ) diet and a high-monounsaturated fatty acid ( MUFA ) diet on LDL oxidative resistance in free-living individuals with Type 2 diabetes mellitus . METHODS Twenty-two men and women out- patients with Type 2 diabetes , with mean age 61 years and in fair metabolic control ( HbA1c<8.0 % ) , were enrolled at a university hospital lipid clinic in a r and omized , crossover feeding trial comparing two isocaloric diets for 6 weeks each : CHO ( fat , 28 % energy ) and MUFA ( fat , 40 % energy ) based on virgin olive oil . Outcome measurements were changes in LDL susceptibility to oxidation , body weight , glycaemic control , and lipoprotein profiles . RESULTS Planned and observed diets were well matched . Participants preferred the MUFA diet over the CHO diet . The lag time of conjugated diene formation during Cu2 + -induced LDL oxidation was similar after the CHO and MUFA diets ( 36.4 + /- 12.2 min and 36.0 + /- 13.7 min , respectively ) . Body weight , glycaemic control , total triglycerides , and total , LDL- and HDL-cholesterol levels also were similar after the two diets . Compared with the CHO diet , the MUFA diet lowered VLDL-cholesterol by 35 % ( P=0.023 ) and VLDL triglyceride by 16 % ( P=0.016 ) . CONCLUSIONS Natural food-based high-CHO and high-MUFA diets have similar effects on LDL oxidative resistance and metabolic control in subjects with Type 2 diabetes . A MUFA diet is a good alternative to high-CHO diets for nutrition therapy of diabetes because it also has a beneficial effect on the lipid profile and superior patient acceptance BACKGROUND AND AIMS Diets high in monounsaturated fatty acids ( MUFA ) such as a Mediterranean diet may reduce the risk of cardiovascular diseases by improving insulin sensitivity and serum lipids . Besides being high in MUFA , a Mediterranean diet also contains abundant plant foods , moderate wine and low amounts of meat and dairy products , which may also play a role . We compared the effects of a high MUFA-diet with a diet high in saturated fatty acids ( SFA ) and the additional effect of a Mediterranean diet on insulin sensitivity and serum lipids . METHODS AND RESULTS A r and omized parallel controlled-feeding trial was performed , in 60 non-diabetics ( 40 - 65 y ) with mild abdominal obesity . After a two week run-in diet high in SFA ( 19 energy-% ) , subjects were allocated to a high MUFA-diet ( 20 energy-% ) , a Mediterranean diet ( MUFA 21 energy-% ) , or the high SFA-diet , for eight weeks . The high MUFA and the Mediterranean diet did not affect fasting insulin concentrations . The high MUFA-diet reduced total cholesterol ( -0.41 mmol/L , 95 % CI -0.74 , -0.09 ) and LDL-cholesterol ( -0.38 mmol/L , 95 % CI -0.65 , -0.11 ) compared with the high SFA-diet , but not triglyceride concentrations . The Mediterranean diet increased HDL-cholesterol concentrations ( + 0.09 mmol/L , 95 % CI 0.0 , 0.18 ) and reduced the ratio of total cholesterol/HDL-cholesterol ( -0.39 , 95 % CI -0.62 , -0.16 ) compared with the high MUFA-diet . CONCLUSION Replacing a high SFA-diet with a high MUFA or a Mediterranean diet did not affect insulin sensitivity , but improved serum lipids . The Mediterranean diet was most effective , it reduced total and LDL-cholesterol , and also increased HDL-cholesterol and reduced total cholesterol/HDL-cholesterol ratio BACKGROUND Polyunsaturated fatty acids ( PUFAs ) and monounsaturated fatty acids ( MUFAs ) have been shown to positively affect blood lipids ; however , their comparative effects on insulin sensitivity are unclear . OBJECTIVE Our objective was to investigate whether chronic intake of MUFAs or PUFAs improves insulin sensitivity in people with type 2 diabetes via stimulation of the endogenous gut hormone glucagon-like peptide 1 [ 7 - 36 ] amide ( GLP-1 ) . DESIGN Nine overweight people with type 2 diabetes received isoenergetic high-MUFA ( 20.3 + /- 3.5 % of total energy ) or high-PUFA ( 13.4 + /- 1 . 3 % ) diets for 24 d in a r and omized , double-blind crossover design . RESULTS Weight and glycemic control remained stable throughout the study . Despite a significant change in the plasma triacylglycerol linoleic-oleic acid ratio ( L : O ) with both diets ( MUFA : from 0.46 + /- 0.03 to 0.29 + /- 0.02 , P : < 0.005 ; PUFA : from 0.36 + /- 0.04 to 0.56 + /- 0.05 , P : < 0.05 ) and the phospholipid L : O ( 1.7 + /- 0.1 to 2.0 + /- 0.3 ; P : = 0.04 ) during consumption of the PUFA diet , this change was not associated with a change in insulin sensitivity , measured by the short-insulin-tolerance test . There was a significant reduction in the ratio of total to HDL cholesterol during consumption of the PUFA diet ( 5.2 + /- 0.4 compared with 4.7 + /- 0.3 ; P : = 0.005 ) but no change with the MUFA diet . There was no change in the fasting or postpr and ial incremental area under the curve in response to an identical st and ard test meal for glucose , insulin , triacylglycerol , nonesterified fatty acids , or GLP-1 . CONCLUSIONS Over the 3-wk intervention period , diet-induced change in the triacylglycerol or phospholipid L : O was not associated with either increased stimulation of GLP-1 or a change in insulin sensitivity in people with type 2 diabetes Aims /hypothesis . The amount and quality of fat in the diet could be of importance for development of insulin resistance and related metabolic disorders . Our aim was to determine whether a change in dietary fat quality alone could alter insulin action in humans . Methods . The KANWU study included 162 healthy subjects chosen at r and om to receive a controlled , isoenergetic diet for 3 months containing either a high proportion of saturated ( SAFA diet ) or monounsaturated ( MUFA diet ) fatty acids . Within each group there was a second assignment at r and om to supplements with fish oil ( 3.6 g n-3 fatty acids/d ) or placebo . Results . Insulin sensitivity was significantly impaired on the saturated fatty acid diet ( -10 % , p = 0.03 ) but did not change on the monounsaturated fatty acid diet ( + 2 % , NS ) ( p = 0.05 for difference between diets ) . Insulin secretion was not affected . The addition of n-3 fatty acids influenced neither insulin sensitivity nor insulin secretion . The favourable effects of substituting a monounsaturated fatty acid diet for a saturated fatty acid diet on insulin sensitivity were only seen at a total fat intake below median ( 37E % ) . Here , insulin sensitivity was 12.5 % lower and 8.8 % higher on the saturated fatty acid diet and monounsaturated fatty acid diet respectively ( p = 0.03 ) . Low density lipoprotein cholesterol ( LDL ) increased on the saturated fatty acid diet ( + 4.1 % , p < 0.01 ) but decreased on the monounsaturated fatty acid diet ( MUFA ) ( –5.2 , p < 0.001 ) , whereas lipoprotein ( a ) [ Lp(a ) ] increased on a monounsaturated fatty acid diet by 12 % ( p < 0.001 ) . Conclusions /interpretation . A change of the proportions of dietary fatty acids , decreasing saturated fatty acid and increasing monounsaturated fatty acid , improves insulin sensitivity but has no effect on insulin secretion . A beneficial impact of the fat quality on insulin sensitivity is not seen in individuals with a high fat intake ( > 37E % ) . [ Diabetologia ( 2001 ) 44 : 312–319 The goal of this study was to determine whether the type of fat plays a role in the glucose response to a meal , independent of the carbohydrate content . Ten gestational diabetic women ( gestational weeks 29 - 34 ) who were well controlled on diet alone were r and omized as to the order in which they would eat a meal , after overnight fast , containing saturated fat ( SF ) or monounsaturated fat ( MUFA ) . Blood was drawn at 0 , 60 , 120 , and 180 min for plasma glucose , insulin , lipid profile ( triglycerides , total cholesterol , HDL-cholesterol , LDL-cholesterol , VLDL-cholesterol ) and free fatty acids . After 2 weeks , each patient received the other type of meal . The test meal was composed of 20 % of the total daily caloric needs based on ideal body weight . The area under the curve showed a significantly lower glucose concentration for SF meal ( p = 0.001 ) . Serum insulin concentrations followed the glucose response with the peak at the 60-min time point and a significantly lower concentration at the 180-min time point in the SF than in the MUFA group . The present study demonstrated that the addition of SF to the meal result ed in lower postpr and ial glucose and insulin than when the meal contained MUFA . Thus , SF may be useful in controlling postpr and ial glucose OBJECTIVE To compare concentrations of factor VII coagulant activity ( factor VIIc ) , fibrinogen , plasminogen activator inhibitor-1 , and blood lipids on a saturated fat-rich diet with one rich in monounsaturated fat . DESIGN Subjects were r and omly allocated to two groups . The study design was an ABB/BAA extra-period crossover . One group consumed a diet rich in saturated fatty acid ( SFA ) with fat making up 20.8 % of total energy , for 5 weeks and then one rich in monounsaturated fatty acid ( MUFA ) , with fat making up 20.3 % of total energy for 10 weeks . The other group consumed the MUFA diet for 5 weeks followed by the SFA diet for 10 weeks . SUBJECTS/ SETTING Men and women aged 35 to 69 years who were nonsmokers with no chronic illness and not on any medication were recruited to participate . Eighteen subjects were recruited and 15 ( 5 men , 10 women ) completed the community-based study . INTERVENTION Blood was sample d at the beginning and end point of each 5-week diet period for analysis of coagulation and fibrinolysis factors and blood lipids . Subjects kept 3-day food diaries twice during each of the three diet periods and were weighed on each visit for blood collection . Analysis of plasma fatty acids was used to indicate dietary compliance . MAIN OUTCOME MEASURES Differences in fasting factor VIIc , fibrinogen , plasminogen activator inhibitor-1 , insulin , low-density lipoprotein cholesterol , high-density lipoprotein cholesterol , triglycerides , apolipoproteins A-1 and B , and plasma oleic acid levels while receiving the SFA diet vs MUFA diet . STATISTICAL ANALYSIS A general linear model allowing for the ABB/BAA extra-period crossover , was used for each of the outcome measures . RESULTS Factor VIIc was lower on the MUFA diet ( P < .05 ) but fibrinogen and insulin concentrations and plasminogen activator inhibitor-1 activity did not differ between diets . Low-density lipoprotein cholesterol ( P < .001 ) and triglyceride ( P < .01 ) levels were lower on the MUFA diet compared with the SFA diet . A significant increase in both plasma phospholipid and neutral lipid oleic acid ( P < .0001 ) occurred on the MUFA diet . CONCLUSIONS Substitution of foods rich in saturated fat with foods rich in high-oleic-acid sunflower oil and margarine has favorable outcomes on blood lipids and factor VIIc . This oil presents another useful source of MUFA for diets aim ed at prevention of heart disease SCOPE Insulin resistance , a condition associated with type 2 diabetes mellitus , results from the interaction of environmental and genetic factors . The aim of this study was to explore the influence of the G972R polymorphism at the insulin receptor substrate 1 gene on insulin sensitivity in a healthy young population . Furthermore , we examined whether the presence of this single nucleotide polymorphism ( SNP ; GR or GG ) interacts with dietary fat to modulate insulin sensitivity . METHODS AND RESULTS Fifty-nine healthy volunteers consumed three diets during 4 wk each following a r and omized crossover design : a saturated fatty acid diet , a low-fat and high carbohydrate ( CHO ) diet or a MUFA diet . For each diet , we investigated peripheral insulin sensitivity with the insulin suppression test . Steady-state plasma glucose and plasma-free fatty acids concentrations were significantly lower in GR subjects after the intake of a CHO diet , than did homozygous GG subjects ( p<0.05 ) . However , no differences were observed after consuming the two other diets . CONCLUSIONS Insulin sensitivity increased in GR subjects for the G972R polymorphism at the insulin receptor substrate 1 gene locus , after intake of a CHO diet . Increased knowledge of how these and other genes influence insulin sensitivity should increase the underst and ing of personalized nutrition OBJECTIVE To determine the optimal diet for improving glucose and lipid profiles in obese patients with type 2 diabetes during moderate energy restriction . RESEARCH DESIGN AND METHODS A total of 35 free-living obese patients with type 2 diabetes were assigned to one of three 1,600 kcal/day diets for 12 weeks . The diets were high carbohydrate ( 10 % fat , 4 % saturated ) , high monounsaturated fat ( MUFA ) ( 32 % fat , 7 % saturated ) , or high saturated fat ( SFA ) ( 32 % fat , 17 % saturated ) . RESULTS Diet composition did not affect the magnitude of weight loss , with subjects losing an average of 6.6 + /- 0.9 kg . Energy restriction and weight loss result ed in reductions in fasting plasma glucose ( -14 % ) , insulin ( -27 % ) , GHb ( -14 % ) , and systolic ( -7 % ) and diastolic blood pressure ( -10 % ) levels and the glucose response area ( -17 % ) independent of diet composition . Diet composition did affect the lipoprotein profile . LDL was 10 % and 17 % lower with the high-carbohydrate and high-MUFA diets , respectively , whereas no change was observed with the high-SFA diet ( P < 0.001 for effect of diet ) . HDL was transiently reduced on the high-carbohydrate diet at weeks 1 , 4 , and 8 , whereas higher fat consumption maintained these levels . The total cholesterol : HDL ratio , although significantly reduced on the high-MUFA diet ( P < 0.01 ) , was not different from the other two diets after adjustment for baseline differences . CONCLUSIONS Energy restriction , independent of diet composition , improves glycemic control ; however , reducing SFA intake by replacing SFA with carbohydrate or MUFA reduces LDL maximally during weight loss and to a greater degree than has been shown in weight-stable studies BACKGROUND Low-fat diets increase plasma triacylglycerol and decrease HDL-cholesterol concentrations , thereby potentially adversely affecting cardiovascular disease ( CVD ) risk . High-monounsaturated fatty acid ( MUFA ) , cholesterol-lowering diets do not raise triacylglycerol or lower HDL cholesterol , but little is known about how peanut products , a rich source of MUFAs , affect CVD risk . OBJECTIVE The present study compared the CVD risk profile of an Average American diet ( AAD ) with those of 4 cholesterol-lowering diets : an American Heart Association/National Cholesterol Education Program Step II diet and 3 high-MUFA diets [ olive oil ( OO ) , peanut oil ( PO ) , and peanuts and peanut butter ( PPB ) ] . DESIGN A r and omized , double-blind , 5-period crossover study design ( n = 22 ) was used to examine the effects of the diets on serum lipids and lipoproteins  : AAD [ 34 % fat ; 16 % saturated fatty acids ( SFAs ) , 11 % MUFAs ] , Step II ( 25 % fat ; 7 % SFAs , 12 % MUFAs ) , OO ( 34 % fat ; 7 % SFAs , 21 % MUFAs ) , PO ( 34 % fat ; 7 % SFAs , 17 % MUFAs ) , and PPB ( 36 % fat ; 8 % SFAs , 18 % MUFAs ) . RESULTS The high-MUFA diets lowered total cholesterol by 10 % and LDL cholesterol by 14 % . This response was comparable with that observed for the Step II diet . Triacylglycerol concentrations were 13 % lower in subjects consuming the high-MUFA diets and were 11 % higher with the Step II diet than with the AAD . The high-MUFA diets did not lower HDL cholesterol whereas the Step II diet lowered it by 4 % compared with the AAD . The OO , PO , and PPB diets decreased CVD risk by an estimated 25 % , 16 % , and 21 % , respectively , whereas the Step II diet lowered CVD risk by 12 % . CONCLUSION A high-MUFA , cholesterol-lowering diet may be preferable to a low-fat diet because of more favorable effects on the CVD risk profile Context Increased prevalence of type 2 diabetes mellitus and prediabetes worldwide is attributed in part to an unhealthy diet . Objective To evaluate whether 12 weeks of high monounsaturated fatty acid ( MUFA ) or fiber-rich weight-maintenance diet lowers hepatic fat and improves glucose tolerance in people with prediabetes . Design Subjects underwent a [ 6 , 6 - 2H2]-labeled 75-g oral glucose tolerance test to estimate hepatic insulin sensitivity and liver fat fraction ( LFF ) using magnetic resonance spectroscopy before and after intervention . Setting Mayo Clinic Clinical Research Trials Unit . Participants 43 subjects with prediabetes . Intervention Subjects were r and omized into three isocaloric weight-maintaining diets containing MUFA ( olive oil ) , extra fiber , and st and ard US food ( control-habitual diet ) . Outcome Measures LFF , glucose tolerance , and indices of insulin action and secretion . Results Body weight was maintained constant in all groups during the intervention . Glucose and hormonal concentrations were similar in all groups before , and unchanged after , 12 weeks of intervention . LFF was significantly lower after intervention in the MUFA group ( P < 0.0003 ) but remained unchanged in the fiber ( P = 0.25 ) and control groups ( P = 0.45 ) . After 12 weeks , LFF was significantly lower in the MUFA than in the control group ( P = 0.01 ) , but fiber and control groups did not differ ( P = 0.41 ) . Indices of insulin action and secretion were not significantly different between the MUFA and control groups after intervention ( P ≥ 0.11 ) , but within-group comparison showed higher hepatic ( P = 0.01 ) and total insulin sensitivity ( P < 0.04 ) with MUFA . Conclusions Twelve weeks of a MUFA diet decreases hepatic fat and improves both hepatic and total insulin sensitivity Although moderate weight loss improves glycemic control in obese NIDDM patients , quite often it is not normalized . To determine whether the response to weight loss can be improved by altering the macronutrient composition of hypocaloric diets , 17 obese NIDDM patients were studied at 1 ) baseline , 2 ) after dieting for 6 weeks on a formula diet enriched in either monounsaturated fatty acids ( MUFAs , n = 9 ) or carbohydrates ( CHOs , n = 8) at a 50 % caloric deficit , and 3 ) after 4 weeks of postdiet refeeding on the respective formulas with caloric intake titrated to achieve weight maintenance . Fasting , 24-h , and oral glucose tolerance test ( OGTT ) blood glucose , plasma insulin , and C-peptide levels were measured . All prediet parameters were similar between groups . After dieting , although weight loss was similar between groups , the fasting glucose level decreased significantly more in the MUFA group ( −4.6 ± 0.7 mmol/l ) than in the CHO group ( −2.4 ± 1.0 mmol/l ; P < 0.05 ) . Twenty-four – hour glycemia decreased in both groups after dieting , but the MUFA group had a greater decrease than the CHO group ( P < 0.05 , analysis of variance [ ANOVA ] ) . Although decreases in fasting glycemia were maintained in both groups after refeeding , postpr and ial glycemia deteriorated after refeeding with the CHO- but not the MUFA-enriched formula ( P < 0.05 ) . After dieting and refeeding , fasting C-peptide increased 204 ± 47 pmol/l in the MUFA group , but the CHO group remained at prediet levels ( P < 0.05 ) . Twenty-four-hour C-peptide levels were similar between groups after dieting and refeeding , despite the lower glycemia and CHO content of the MUFA formula . However , when equal amounts of CHO were consumed during the OGTT , the MUFA group had significantly higher C-peptide levels after both dieting and refeeding ( P < 0.05 ) . Fasting , 24-h , and OGTT insulin levels were similar between groups throughout the study . These results indicate that macronutrient composition is an important determinant of the glycemic response to weight-loss therapy in obese NIDDM patients . Based on the C-peptide response during the OGTT , increased CHO-induced insulin secretion is one possible mechanism by which this occurs
In contrast , fasting plasma glucose , fasting plasma insulin as well as the homeostasis model assessment of insulin resistance were not affected by the amounts of MUFA in the dietary protocol s. Conclusions : In summary , this systematic review found that high MUFA diets appear to be effective in reducing HbA1c , and therefore , should be recommended in the dietary regimes of T2D
Background / Aims : In 2008 , the American Diabetes Association recommended low-carbohydrate or low-fat diets for weight management in patients with established type 2 diabetes ( T2D ) , while the amount of monounsaturated fatty acids ( MUFA ) was not specified .
This systematic review focused on the effects of diets high in MUFA versus diets low in MUFA on important risk factors of T2D ( i.e. plasma glucose , insulin , homeostasis model assessment of insulin resistance and glycosylated haemoglobin , HbA1c ) .