Metabolic effects of added dietary sucrose in individuals with noninsulin-dependent diabetes mellitus (NIDDM)

Coulston, Ann M.; Hollenbeck, C. B.; Donner, C. C.; Williams, Robin; Chiou, Yar-Ai M.; Reaven, Gerald M.

doi:10.1016/0026-0495(85)90146-5

Cited by 63 publications

(31 citation statements)

References 24 publications

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“…Our data also suggest that dietary sucrose does not aggravate hyperglycemia in diabetic individuals to a greater extent than other common carbohydrates. Although other studies available in the literature support this conclusion regarding dietary sucrose (16,18), the study by Coulston et al (17) reached an opposite conclusion.…”

Section: Effects Of Sucrose and Fructose On Glycemic Controlcontrasting

confidence: 44%

Clinical Aspects of Sucrose and Fructose Metabolism

Bantle

1989

Diabetes Care

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The per capita consumption of sugars in the United States accounts for -2 1 % of total calorie intake. Most Americans eat and enjoy sugar-containing foods every day, but the use of sugars in the diabetic diet has traditionally been proscribed for fear of aggravating hyperglycemia. However, short-term and most longerterm studies demonstrate that dietary sucrose does not cause a greater postprandial rise in plasma glucose than isocaloric amounts of other common carbohydrates. The available evidence suggests that sucrose has a glycemic effect similar to that of bread, potatoes, and rice. Dietary fructose, in contrast, may produce a lesser postprandial rise in plasma glucose than other common carbohydrates. There is considerable controversy about the effects of dietary sucrose and fructose on serum lipids, and their effects on other metabolic events, such as the nonenzymatic glycosylation of proteins, are uncertain. Nevertheless, it is reasonable to allow diabetic patients to consume sugar-containing foods as long as they do so in a controlled fashion. Diabetes Care 12:56-61, 1989 A ccording to the 1977-1978 United States Department of Agriculture food consumption survey, the per capita consumption of sugars in the United States averages 95 g/day and accounts for 21% of total calorie intake and 48% of total carbohydrate intake (1; Table 1). Average daily per capita consumption of sucrose is 41 g, which represents 9% of total calorie intake. Of these 41 g of sucrose, 13 g occur naturally and 28 g are added to foodstuffs. The consumption of fructose, which has an agreeable taste similar to that of sucrose, has been gradually increasing. If the contribution from high-fructose corn syrup (containing ~43% fructose) is considered, the daily per capita consumption of fructose is 24 g and accounts for 6% of total calorie intake. Although sucrose and fructose are consumed in significant quantities in the U.S., controversy continues regarding their safety. In this article I attempt to focus, for both healthy and diabetic populations, on what is known about the effects of dietary sucrose and fructose on 7) blood glucose control, 2) serum lipid levels, and 3) other potentially important metabolic events such as the rates of nonenzymatic glycosylation of proteins and lactate production.

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Section: Effects Of Sucrose and Fructose On Glycemic Controlcontrasting

confidence: 44%

Clinical Aspects of Sucrose and Fructose Metabolism

Bantle

1989

Diabetes Care

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“…In the studies by Reiser et al (1981a,b) on non-diabetics, the 'gorging' meal pattern may at least partly have been responsible for the outcome, as it is known that this eating style is in itself associated with higher fasting serum insulin and lipid values (Jenkins et al 1989). The study by Coulston et al (1985) assessed the metabolic effects of sucrose in subjects with type 2 diabetes, only demonstrating a decrease in insulin sensitivity-related postprandial parameters, and did not undertake direct measures of insulin sensitivity.…”

Section: Intervention Studies Comparing Effects Of Different Carbohydmentioning

confidence: 99%

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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“…The type of carbohydrate in the diet also appears to affect insulin sensitivity. Sucrose has been shown to be more detrimental than starch (Reiser et al, 1979(Reiser et al, , 1981Coulston et al, 1985), while classifying carbohydrates by their glycaemic index (GI) shows that low GI carbohydrates have a beneficial effect on insulin sensitivity compared to high GI carbohydrates (Wolever et al, 1992;Frost et al, 1996;Salmeron et al, 1997a, b). Taking all this evidence into account, a group of particular interest would be subjects that follow a vegan dietary regimen.…”

Section: Introductionmentioning

confidence: 99%

Veganism and its relationship with insulin resistance and intramyocellular lipid

Goff

Bell

et al. 2004

Eur J Clin Nutr

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Objective: To test the hypothesis that dietary factors in the vegan diet lead to improved insulin sensitivity and lower intramyocellular lipid (IMCL) storage. Design: Case-control study. Setting: Imperial College School of Medicine, Hammersmith Hospital Campus, London, UK. Subjects: A total of 24 vegans and 25 omnivores participated in this study; three vegan subjects could not be matched therefore the matched results are shown for 21 vegans and 25 omnivores. The subjects were matched for gender, age and body mass index (BMI). Interventions: Full anthropometry, 7-day dietary assessment and physical activity levels were obtained. Insulin sensitivity (%S) and beta-cell function (%B) were determined using the homeostatic model assessment (HOMA). IMCL levels were determined using in vivo proton magnetic resonance spectroscopy; total body fat content was assessed by bioelectrical impedance. Results: There was no difference between the groups in sex, age, BMI, waist measurement, percentage body fat, activity levels and energy intake. Vegans had a significantly lower systolic blood pressure (À11.0 mmHg, CI À20.6 to À1.3, P ¼ 0.027) and higher dietary intake of carbohydrate (10.7%, CI 6.8-14.5, Po0.001), nonstarch polysaccharides (20.7 g, CI 15.8-25.6, Po0.001) and polyunsaturated fat (2.8%, CI 1.0-4.6, P ¼ 0.003), with a significantly lower glycaemic index (À3.7, CI À6.7 to À0.7, P ¼ 0.01). Also, vegans had lower fasting plasma triacylglycerol (À0.7 mmol/l, CI À0.9 to À0.4, Po0.001) and glucose (À0.4 mmol/l, CI À0.7 to À0.09, P ¼ 0.05) concentrations. There was no significant difference in HOMA %S but there was with HOMA %B (32.1%, CI 10.3-53.9, P ¼ 0.005), while IMCL levels were significantly lower in the soleus muscle (À9.7, CI À16.2 to À3.3, P ¼ 0.01). Conclusion: Vegans have a food intake and a biochemical profile that will be expected to be cardioprotective, with lower IMCL accumulation and beta-cell protective. Sponsorship: MRC PhD studentship.

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Metabolic effects of added dietary sucrose in individuals with noninsulin-dependent diabetes mellitus (NIDDM)

Cited by 63 publications

References 24 publications

Clinical Aspects of Sucrose and Fructose Metabolism

Clinical Aspects of Sucrose and Fructose Metabolism

Determining the relationship between dietary carbohydrate intake and insulin resistance

Veganism and its relationship with insulin resistance and intramyocellular lipid

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