Whether the lipoprotein response to weight loss in obese patients with
type 2 diabetes can be improved by modifying the macronutrient
composition of the commonly prescribed low-fat, high-carbohydrate (CHO)
hypocaloric diet. In the investigation of nine obese patients with type 2
diabetes treated with a monounsaturated fatty acid (MUFA)-enriched
weight-reducing formula diet and compared with eight obese patients with
type 2 diabetes treated with a low-fat, high-CHO weight-reducing
formula diet. Weight loss ensued for 6 weeks, followed by 4 weeks of
refeeding using isocaloric formulas enriched with MUFA or CHO,
respectively, conducted by Indiana University Center for Weight
Management, National Institute for Fitness and Sport(1), the result
showed that there were no differences between the groups in plasma
lipids, lipoproteins, or LDL susceptibility to oxidation. Weight loss
was similar between the groups. Dieting resulted in decreases in total
plasma cholesterol, LDL, HDL, triglycerides, and apolipoproteins A and B
(P < 0.05), but the MUFA group manifested a greater decrease in
total cholesterol, triglycerides, and apolipoprotein B and a smaller
decrease in HDL and apolipoprotein A than the CHO group (P < 0.05).
Improvements in these parameters were sustained during refeeding. After
dieting, lag time was prolonged in the MUFA group (208 +/- 10 min)
compared with the CHO group (146 +/- 11 min; P < 0.05). Lag time was
prolonged further during refeeding in the MUFA group (221 +/- 13 min, P =
0.10), while the CHO group remained unchanged (152 +/- 9 min, P <
0.05). Lag time correlated strongly with the oleic acid content of LDL
after dieting and refeeding (r = 0.74 and r = 0.93, respectively; both P
< 0.001).
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(1) "Effects of a
monounsaturated fatty acid-enriched hypocaloric diet on cardiovascular
risk factors in obese patients with type 2 diabetes" by Gumbiner B, Low CC, Reaven PD., posted in PubMed
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