Deleterious metabolic effects of high-carbohydrate, sucrose-containing diets in patients with non-insulin-dependent diabetes mellitus

Coulston, Ann M.; Hollenbeck, C. B.; Swislocki, Arthur L; Chen, Y-D. Ida; Reaven, Gerald M.

doi:10.1016/0002-9343(87)90058-1

Cited by 150 publications

(68 citation statements)

References 31 publications

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“…The trend of improved glucose tolerance or increased insulin sensitivity after high-carbohydrate, low-fat diets was also recorded with diabetic subjects (Table 6) (Brunzell et al 1971(Brunzell et al , 1974Anderson, 1977;Hjollund et al 1983;Hughes et al 1995). Other studies reported no difference between diabetics consuming high-and low-carbohydrate diets (Coulston et al 1987;Garg et al 1992). The latter studies, reporting a lack of effect of a high-carbohydrate diet on insulin resistance in diabetes, may reflect differences in the degree of initial insulin sensitivity (and thus lack of effect of short-term high-carbohydrate intervention in severe insulin resistance) in population or age groups and perhaps also different genetic backgrounds.…”

Section: Intervention Studies Considering Dietary Carbohydrate Intakementioning

confidence: 81%

Determining the relationship between dietary carbohydrate intake and insulin resistance

McClenaghan

2005

Nutr. Res. Rev.

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Insulin resistance underlies type 2 diabetes, CVD and the metabolic syndrome, driven by changes in diet, lifestyle, energy over-consumption and obesity. Nutritional recommendations for insulin resistance remain an area of controversy, particularly the quantity and types of dietary carbohydrate. The present review gives an overview of insulin resistance, its relationship to impaired insulin secretion and the metabolic syndrome, research methodologies used to measure insulin action and the epidemiological and intervention studies on the relationship between dietary carbohydrate and insulin resistance. Epidemiological studies provide little evidence to suggest that total dietary carbohydrate predicts risk of type 2 diabetes, and high-carbohydrate, high-fibre diets with low-glycaemic index (GI) may even contribute to diabetes prevention. Despite inherent limitations associated with techniques used to measure insulin resistance and dietary assessment, most intervention studies reveal an increase in glucose tolerance or insulin sensitivity with highcarbohydrate, low-fat diets in non-diabetic and diabetic individuals. When energy is restricted the source or reduced content of carbohydrate does not appear to be as important as fat for body weight. Thus, low energy intake is key to weight loss and augmentation of insulin sensitivity. Given this, widespread adoption of popular low-carbohydrate high-fat diets highlights the necessity to evaluate dietary interventions regarding safety and metabolic effects. While current evidence supports FAO/WHO recommendations to maintain a highcarbohydrate diet with low-GI foods, the relationships between carbohydrate and insulin sensitivity remains an important research area. Emerging technologies should further enhance understanding of gene -diet interactions in insulin resistance, providing useful information for future nutrition policy decisions.

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Section: Intervention Studies Considering Dietary Carbohydrate Intakementioning

confidence: 81%

Determining the relationship between dietary carbohydrate intake and insulin resistance

McClenaghan

2005

Nutr. Res. Rev.

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“…For many years the dietary recommendations of the American Diabetes Association (ADA) advocated restriction of sucrose intake. A number of studies in animals [36] and humans [37,38] have supported the idea that sucrose consumption is associated with adverse effects on insulin sensitivity and glucose intolerance. However, the most recent ADA nutritional guidelines removed this restriction on sucrose consumption in response to a growing number of clinical trials which failed to demonstrate adverse effects on glucose control in those with diabetes [8,6].…”

Section: Discussionmentioning

confidence: 99%

High saturated fat and low starch and fibre are associated with hyperinsulinaemia in a non-diabetic population: The San Luis Valley Diabetes Study

1997

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“…High-carbohydrate, high-®bre diets have been recommended in the prevention and treatment of diabetes (Trowell, 1975, Wolever et al, 1992, but concern has been expressed that these diets may not improve blood glucose control, and may exacerbate the lipoprotein abnormalities typical of diabetes (Coulston et al, 1987;Hollenbeck & Coulston, 1991). Evidence that high-carbohydrate, high®bre diets contribute to improved insulin sensitivity in nondiabetic subjects is con¯icting (Fugakawa et al, 1990;Borkman et al, 1991) but Salmeron et al (1997) suggested that diets with a high glycaemic load and low cereal ®bre content contributed to the risk of type 2 diabetes.…”

Section: Diet and Glycated Haemoglobin MC Gulliford And Oc Ukoumunnementioning

confidence: 99%

Determinants of glycated haemoglobin in the general population: associations with diet, alcohol and cigarette smoking

Gulliford

Ukoumunne

2001

Eur J Clin Nutr

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Objective: We evaluated cigarette smoking, alcohol intake and consumption of different foods as determinants of glycated haemoglobin in a general population sample. Design: Cross-sectional survey. Setting: England. Subjects: Representative sample of 15 809 adults aged 16 y and older. Data analysed for 9772 non-diabetic, white European subjects. Main outcome measures: Glycated haemoglobin (GHb). Analyses were adjusted for age, sex, body mass index (BMI), waist ± hip circumference ratio, activity level, and educational attainment. Results: After adjusting for confounding, GHb was 0.277% (95% con®dence interval 0.218 to 0.336) higher in current smokers of 20 or more per day, compared with non-smokers. GHb was 0.189% (0.101 to 0.277) lower in those drinking 42 or more units of alcohol per week than in non-drinkers. GHb was not associated with frequency of consumption of pulses, fruit, vegetables and salads, cakes, bread or confectionery. GHb was higher in subjects who took sugar in tea (0.051%, 0.015 to 0.087%) or in coffee (0.069%, 0.034 to 0.105%). GHb was higher in subjects who used solid fat for cooking (0.082%, 0.022 to 0.142%), or who drank whole rather than reduced-fat milk (0.088%, 0.036 to 0.140%), or used butter or hard margarine rather than low-fat spreads (0.075%, 0.029 to 0.121%). Conclusions: In the general population, higher GHb may be associated with cigarette smoking, or frequent consumption of fat-containing foods. Consumption of alcohol may be associated with lower GHb.

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Deleterious metabolic effects of high-carbohydrate, sucrose-containing diets in patients with non-insulin-dependent diabetes mellitus

Cited by 150 publications

References 31 publications

Determining the relationship between dietary carbohydrate intake and insulin resistance

Determining the relationship between dietary carbohydrate intake and insulin resistance

High saturated fat and low starch and fibre are associated with hyperinsulinaemia in a non-diabetic population: The San Luis Valley Diabetes Study

Determinants of glycated haemoglobin in the general population: associations with diet, alcohol and cigarette smoking

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