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A randomised four-intervention crossover study investigating the effect of carbohydrates on daytime profiles of insulin, glucose, non-esterified fatty acids and triacylglycerols in middle-aged men

Published online by Cambridge University Press:  09 March 2007

Audrey E. Brynes ,
C. Mark Edwards ,
Mohammed A. Ghatei ,
Anne Dornhorst ,
Linda M. Morgan ,
Stephen R. Bloom  and
Gary S. Frost
Audrey E. Brynes
Affiliation:
Nutrition and Dietetic Research Group, Hammersmith Hospital, Du Cane Road, London W12 0HS, UK
C. Mark Edwards
Affiliation:
Endocrine Unit, Imperial College School of Medicine, Hammersmith Hospital, Du Cane Road, London W12 OHS, UK
Mohammed A. Ghatei
Affiliation:
Endocrine Unit, Imperial College School of Medicine, Hammersmith Hospital, Du Cane Road, London W12 OHS, UK
Anne Dornhorst
Affiliation:
Endocrine Unit, Imperial College School of Medicine, Hammersmith Hospital, Du Cane Road, London W12 OHS, UK
Linda M. Morgan
Affiliation:
School of Biomedical and Life Sciences, University of Surrey, Guildford GU2 7XH, UK
Stephen R. Bloom
Affiliation:
Endocrine Unit, Imperial College School of Medicine, Hammersmith Hospital, Du Cane Road, London W12 OHS, UK
Gary S. Frost*
Affiliation:
Nutrition and Dietetic Research Group, Hammersmith Hospital, Du Cane Road, London W12 0HS, UK
*
*Corresponding author: Dr Gary Frost, fax +44 20 8383 3379, email g.frost@ic.ac.uk
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Abstract

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Postprandial concentrations of glucose, insulin and triacylglycerols (TG) correlate to risk for CHD. Carbohydrates affect many metabolites that could have a potential effect on cardiovascular risk factors. The objective of the present study was to examine, using a randomised prospective study, the acute (day 1) and ad libitum medium-term (day 24) effects of four diets: a high-fat diet (HIGH-FAT; 50 % fat, >34 % monounsaturated fatty acids); a low-glycaemic index (GI) diet (LOW-GI; high-carbohydrate, low-GI); a high-sucrose diet (SUCROSE; high carbohydrate increase of 90 g sucrose/d); a high-GI diet (HIGH-GI; high-carbohydrate, high-GI). Daytime profiles (8 h) (breakfast, lunch and tea) of lipid and carbohydrate metabolism were completed during day 1 and day 24. Seventeen middle-aged men with one or more cardiac risk factors completed the study. There was no change from day 1 or between diets in fasting glucose, lipids or homeostatic assessment model (HOMA) on day 24. The HIGH-FAT compared with the three high-carbohydrate diets was associated with lower postprandial insulin and glucose but higher postprandial TG and non-esterified fatty acids (NEFA). There was a significant increase in the 6 h (15.00 hours) TG concentration (day 1, 2·6 (SEM 0·3) MMOL/L v. DAY 24, 3·3 (sem 0·3) mmol/l; P<0·01) on the SUCROSE diet. Postprandial HOMA (i.e. incremental area under the curve (IAUC) glucose (mmol/l per min)×IAUC insulin/22·5 (mU/l per min)) median changes from day 1 to day 24 were −61, −43, −20 and +31 % for the HIGH-FAT, LOW-GI, SUCROSE and HIGH-GI diets respectively. The HIGH-GI percentage change was significantly different from the other three diets (P<0·001). Despite being advised to maintain an identical energy intake there was a significant weight change (−0·27 (sem 0·3) kg; P<0·02) on the LOW-GI diet compared with the SUCROSE diet (+0·84 (sem 0·3) kg). In conclusion the HIGH-FAT diet had a beneficial effect on postprandial glucose and insulin over time but it was associated with higher postprandial concentrations of TG and NEFA. Conversely the HIGH-GI diet appeared to increase postprandial insulin resistance over the study period.

Keywords

Insulin resistancePostprandial homeostatic assessment modelHigh-sucrose dietHigh-fat dietGlycaemic index
Type
Research Article
Information
British Journal of Nutrition , Volume 89 , Issue 2 , February 2003 , pp. 207 - 218
Copyright
Copyright © The Nutrition Society 2003

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