Insulin resistance is central for the aetiology of the metabolic syndrome cluster of disease: blood lipid disorders, hypertension, propensity for thrombus formation, abdominal obesity and Type II (insulin-dependent) diabetes mellitus [1]. Although genetic predisposition is a factor, the prevalence of obesity and diabetes is increasing rapidly in both developed and developing countries [2] arguing that lifestyle factors such as dietary and physical activity patterns, which are amenable to change, modulate insulin action and hence disease development.Experimental and clinical data suggest that the amount and quality of fat in the diet could be important for the development of insulin resistance and related metabolic disorders [3]. A high proportion of Diabetologia (2001)
AbstractAims/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
A b b re v i a t i o n s : GDM, gestational diabetes mellitus; IGT, glucose intolerance; NGT, normal glucose tolerance; O G T T, oral glucose tolerance test; P:S, polyunsaturated:saturated fat ratio; PUFA, polyunsaturated fatty acid.A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.
D i e t a ry Variables and GlucoseTo l e r a n c e in Pre g n a n c yO B J E C T I V E -To investigate relationships between dietary macronutrient intakes and glucose tolerance in pre g n a n c y.RESEARCH DESIGN AND METHODS -N u l l i p a rous pregnant Chinese women diagnosed with gestational diabetes mellitus (GDM) (n = 56) were compared to age-, gestational age-, height-, and parity-matched groups with normal glucose tolerance (n = 77) and glucose intolerance (IGT) (n = 38) based on the results of an oral glucose tolerance test (National Diabetes Data Group criteria), perf o rmed between 24 and 28 weeks of pre g n a n c y. A 24-h re c a l l d i e t a ry assessment was also obtained at the time of scre e n i n g .
R E S U LT S -Subjects withIGT and GDM were significantly heavier (66.1 ± 1.4 and 68.6 ± 1.2 kg, re s p e c t i v e l y, mean ± SEM) (P 0.0001) than the normal group (61.2 ± 1.8 kg) and had a higher BMI. Overall energy intake was similar between groups, as were the intakes of each m a c ronutrient (%kcal). However, there was a highly significant reduction in polyunsaturated fat intake in the IGT and GDM groups whether expressed as %kcal, % of total fat, or fat kcal. This effect was independent of body weight or BMI whether assessed by ordinal logistic re g re ssion or by analysis of a weight-and BMI-matched subgroup of the subjects (P = 0.002 for %kcal; n = 47 normal, 26 IGT, and 43 GDM subjects). In logistic re g ression analysis of the complete data set, increased body weight (P 0.0001) and decreased polyunsaturated fat intake (P = 0.0014) were both independent predictors of glucose intolerance (IGT and GDM), as were i n c reased body weight and a low dietary polyunsaturated to saturated fat ratio.
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