Journal Name:
Am J Clin Nutr
Article Title:
High monounsaturated fat diets for patients with diabetes mellitus: a meta-analysis.
Date Written:
1998
Volume:
76(suppl)
Number:
n/a
Page:
577s
Author(s):
Garg, A.
Article:
A meta-analysis of studies which compared low-saturated-fat, high-carbohydrate diets or high-monounsaturated-fat diets in patients with type 2 diabetes is described. The basis of the analysis was the American Diabetes Association (ADA) recommendation that an individualized approach that takes into consideration patient preferences and control of hyperglycemia and dyslipidemia through either dietary type. Obese patients with normal serum lipid concentrations are recommended to consume a high-carbohydrate diet with < 30% of energy from fat. Patients with elevated triacylglycerol and VLDL-cholesterol concentrations are recommended to consume more energy from fat in the form of cis-monounsaturated fat (>20%), <10% of energy each from saturated and polyunsaturated fats, 10–15% of energy from protein, and a more moderate proportion of energy from carbohydrate. The ADA recommends dividing <60–70% of total energy between carbohydrate and monounsaturated fat depending on patient preference and nutritional goals.
The study findings revealed that high monounsaturated-fat diets reduce fasting plasma triacylglycerol and VLDL-cholesterol concentrations by 19% and 22%, respectively, and caused a modest increase in HDL-cholesterol concentrations without adversely affecting LDL-cholesterol concentrations. The improvement in the glycemic profile with high-monounsaturated-fat diets may be related to a reduction in the carbohydrate load, which patients with type 2 diabetes may not be able to handle because of severe insulin resistance and beta cell defects. High-monounsaturated-fat diets may also reduce the susceptibility of LDL particles to oxidation and thereby reduce their atherogenic potential. There was no evidence that high-monounsaturated-fat diets induced weight gain in patients with diabetes mellitus provided that energy intake is controlled. Therefore, a diet rich in cis-monounsaturated fat can be advantageous for both patients with type 1 or type 2 diabetes who are trying to maintain or lose weight.
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