The acute effects of dietary carbohydrate reduction on postprandial responses of non-esterified fatty acids and triglycerides: a randomized trial
Abstract Background Postprandial non-esterified fatty acid (NEFA) and triglyceride (TG) responses are increased in subjects with type 2 diabetes mellitus (T2DM) and may impair insulin action and increase risk of cardiovascular disease and death. Dietary carbohydrate reduction has been suggested as n...
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| Format: | Article |
| Language: | English |
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BMC
2018-12-01
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| Series: | Lipids in Health and Disease |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12944-018-0953-8 |
| _version_ | 1818309600023150592 |
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| author | Amirsalar Samkani Mads J. Skytte Christian Anholm Arne Astrup Carolyn F. Deacon Jens J. Holst Sten Madsbad Ray Boston Thure Krarup Steen B. Haugaard |
| author_facet | Amirsalar Samkani Mads J. Skytte Christian Anholm Arne Astrup Carolyn F. Deacon Jens J. Holst Sten Madsbad Ray Boston Thure Krarup Steen B. Haugaard |
| author_sort | Amirsalar Samkani |
| collection | DOAJ |
| description | Abstract Background Postprandial non-esterified fatty acid (NEFA) and triglyceride (TG) responses are increased in subjects with type 2 diabetes mellitus (T2DM) and may impair insulin action and increase risk of cardiovascular disease and death. Dietary carbohydrate reduction has been suggested as non-pharmacological therapy for T2DM, but the acute effects on NEFA and TG during subsequent meals remain to be investigated. Methods Postprandial NEFA and TG responses were assessed in subjects with T2DM by comparing a carbohydrate-reduced high-protein (CRHP) diet with a conventional diabetes (CD) diet in an open-label, randomized, cross-over study. Each diet was consumed on two consecutive days, separated by a wash-out period. The iso-caloric CRHP/CD diets contained 31/54 E% from carbohydrate, 29/16 E% energy from protein and 40/30 E% from fat, respectively. Sixteen subjects with well-controlled T2DM (median HbA1c 47 mmol/mol, (37–67 mmol/mol) and BMI 30 ± 4.4 kg/m2) participated in the study. NEFA and TG were evaluated following breakfast and lunch. Results NEFA net area under curve (AUC) was increased by 97 ± 38 μmol/Lx270 min (p = 0.024) after breakfast but reduced by 141 ± 33 μmol/Lx180 min (p < 0.001) after lunch on the CRHP compared with CD diet. Likewise, TG net AUC was increased by 80 ± 28 μmol/Lx270 min (p = 0.012) after breakfast but reduced by 320 ± 60 μmol/Lx180 min (p < 0.001) after lunch on the CRHP compared with CD diet. Conclusions In well-controlled T2DM a modest reduction of dietary carbohydrate with a corresponding increase in protein and fat acutely reduced postprandial serum NEFA suppression and increased serum TG responses after a breakfast meal but had the opposite effect after a lunch meal. The mechanism behind this second-meal phenomenon of CRHP diet on important risk factors for aggravating T2DM and cardiovascular disease awaits further investigation. Trial registration The study was registered at clinicaltrials.gov ID: NCT02472951. https://clinicaltrials.gov/ct2/show/NCT02472951. Registered June 16, 2015. |
| first_indexed | 2024-12-13T07:32:44Z |
| format | Article |
| id | doaj.art-614571e2eae149efa279ef827707437a |
| institution | Directory Open Access Journal |
| issn | 1476-511X |
| language | English |
| last_indexed | 2024-12-13T07:32:44Z |
| publishDate | 2018-12-01 |
| publisher | BMC |
| record_format | Article |
| series | Lipids in Health and Disease |
| spelling | doaj.art-614571e2eae149efa279ef827707437a2022-12-21T23:55:09ZengBMCLipids in Health and Disease1476-511X2018-12-011711910.1186/s12944-018-0953-8The acute effects of dietary carbohydrate reduction on postprandial responses of non-esterified fatty acids and triglycerides: a randomized trialAmirsalar Samkani0Mads J. Skytte1Christian Anholm2Arne Astrup3Carolyn F. Deacon4Jens J. Holst5Sten Madsbad6Ray Boston7Thure Krarup8Steen B. Haugaard9Department of Endocrinology, Copenhagen University Hospital BispebjergDepartment of Endocrinology, Copenhagen University Hospital BispebjergDepartment of Internal Medicine, Copenhagen University HospitalDepartment of Nutrition, Exercise and Sports, University of CopenhagenEndocrinology Research Section, Department of Biomedical SciencesEndocrinology Research Section, Department of Biomedical SciencesDepartment of Endocrinology, Copenhagen University Hospital, Amager HvidovreSchool of Medicine, Department of Medicine, University of MelbourneDepartment of Endocrinology, Copenhagen University Hospital BispebjergDepartment of Endocrinology, Copenhagen University Hospital BispebjergAbstract Background Postprandial non-esterified fatty acid (NEFA) and triglyceride (TG) responses are increased in subjects with type 2 diabetes mellitus (T2DM) and may impair insulin action and increase risk of cardiovascular disease and death. Dietary carbohydrate reduction has been suggested as non-pharmacological therapy for T2DM, but the acute effects on NEFA and TG during subsequent meals remain to be investigated. Methods Postprandial NEFA and TG responses were assessed in subjects with T2DM by comparing a carbohydrate-reduced high-protein (CRHP) diet with a conventional diabetes (CD) diet in an open-label, randomized, cross-over study. Each diet was consumed on two consecutive days, separated by a wash-out period. The iso-caloric CRHP/CD diets contained 31/54 E% from carbohydrate, 29/16 E% energy from protein and 40/30 E% from fat, respectively. Sixteen subjects with well-controlled T2DM (median HbA1c 47 mmol/mol, (37–67 mmol/mol) and BMI 30 ± 4.4 kg/m2) participated in the study. NEFA and TG were evaluated following breakfast and lunch. Results NEFA net area under curve (AUC) was increased by 97 ± 38 μmol/Lx270 min (p = 0.024) after breakfast but reduced by 141 ± 33 μmol/Lx180 min (p < 0.001) after lunch on the CRHP compared with CD diet. Likewise, TG net AUC was increased by 80 ± 28 μmol/Lx270 min (p = 0.012) after breakfast but reduced by 320 ± 60 μmol/Lx180 min (p < 0.001) after lunch on the CRHP compared with CD diet. Conclusions In well-controlled T2DM a modest reduction of dietary carbohydrate with a corresponding increase in protein and fat acutely reduced postprandial serum NEFA suppression and increased serum TG responses after a breakfast meal but had the opposite effect after a lunch meal. The mechanism behind this second-meal phenomenon of CRHP diet on important risk factors for aggravating T2DM and cardiovascular disease awaits further investigation. Trial registration The study was registered at clinicaltrials.gov ID: NCT02472951. https://clinicaltrials.gov/ct2/show/NCT02472951. Registered June 16, 2015.http://link.springer.com/article/10.1186/s12944-018-0953-8Dietary carbohydrate reductionPostprandial triglyceridesNon-esterified fatty acids |
| spellingShingle | Amirsalar Samkani Mads J. Skytte Christian Anholm Arne Astrup Carolyn F. Deacon Jens J. Holst Sten Madsbad Ray Boston Thure Krarup Steen B. Haugaard The acute effects of dietary carbohydrate reduction on postprandial responses of non-esterified fatty acids and triglycerides: a randomized trial Lipids in Health and Disease Dietary carbohydrate reduction Postprandial triglycerides Non-esterified fatty acids |
| title | The acute effects of dietary carbohydrate reduction on postprandial responses of non-esterified fatty acids and triglycerides: a randomized trial |
| title_full | The acute effects of dietary carbohydrate reduction on postprandial responses of non-esterified fatty acids and triglycerides: a randomized trial |
| title_fullStr | The acute effects of dietary carbohydrate reduction on postprandial responses of non-esterified fatty acids and triglycerides: a randomized trial |
| title_full_unstemmed | The acute effects of dietary carbohydrate reduction on postprandial responses of non-esterified fatty acids and triglycerides: a randomized trial |
| title_short | The acute effects of dietary carbohydrate reduction on postprandial responses of non-esterified fatty acids and triglycerides: a randomized trial |
| title_sort | acute effects of dietary carbohydrate reduction on postprandial responses of non esterified fatty acids and triglycerides a randomized trial |
| topic | Dietary carbohydrate reduction Postprandial triglycerides Non-esterified fatty acids |
| url | http://link.springer.com/article/10.1186/s12944-018-0953-8 |
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