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Prevention of type 2 diabetes mellitus by changes in diet among subjects with abnormal glucose metabolism: a randomized clinical trial

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Abstract

Previous studies demonstrated that changes in lifestyle slow the progression of impaired glucose tolerance to overt diabetes but few trials examined the effect of diet alone without weight loss on the prevention of diabetes. We investigated the efficacy of two types of diet with different macronutrients, on preventing or delaying the onset of type 2 diabetes in subjects with either impaired fasting glucose or impaired glucose tolerance. Three hundred and twenty-two subjects with prediabetes were randomly assigned to a high monounsaturated fat diet, normal fat diet, or control groups and followed for 2 years. For calculating the daily energy requirement in subjects with BMI ≥ 25 kg/m2, the weight was adjusted with the use of 110% of the ideal body weight with no attempt for losing body weight. There was no difference in body weight decrease among the three groups after 2 years. The cumulative incidence of diabetes was 9.3% (95% CI, 3.6–14%) in the high monounsaturated fat diet (HMD) group, 13.2% (95% CI, 6.4–19%) in the normal fat diet (NFD) group, and 18.3% (95% CI, 10–25%) in the control group. The cumulative incidence of diabetes was 57% lower in the HMD group than that in the control group (95% CI, 0.1–0.9%; P = 0.03). This value was not significant in the NFD group (RR, 0.60; 95% CI, 0.2–1.2%; P = 0.1). Type 2 diabetes can be prevented by a high-monounsaturated fat, low-carbohydrate diet and receiving energy based on the adjusted ideal body weight without a weight loss program. Trial registration number: NCT02250066

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Abbreviations

HMD:

High-monounsaturated fat diet

MUFA:

Monounsaturated Fatty Acid

NFD:

Normal fat diet

PUFA:

Polyunsaturated fatty acid

SFA:

Saturated fatty acid

WHIDMT:

Women’s Health Initiative Dietary Modification Trial

References

  1. Mohtasham-Amiri Z, Barzigar A, Rahimi Kolamroudi H, Hoseini S, Rezvani SM, Jafari Shakib R. Prevalence, awareness and control of diabetes in urban area of north of Iran, 2009. International Journal of Diabetes in Developing Countries. 2015;35(3):346–50.

    Article  Google Scholar 

  2. Janani Narayanan, J Pranisha, Patricia Trueman, Sriram Ramachandran, S. Saigopal, Vijay Viswanathan. Regular exercise with an active lifestyle improves the lipid profile of individuals with diabetes mellitus. International journal of diabetes in developing countries. First online: 30 April 2016

  3. Orozco LJ, Buchleitner AM, Gimenez-Perez G, Roqué I Figuls M, Richter B, Mauricio D. Exercise or exercise and diet for preventing type 2 diabetes mellitus. Cochrane Database Syst Rev. 2008;16(3):CD003054.

    Google Scholar 

  4. Knowler WC, Barrett-Connor E, Fowler SE, Hamman RF, Lachin JM, Walker EA, et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002;346(6):393–403.

    Article  CAS  PubMed  Google Scholar 

  5. Hu G, Lindström J, Valle TT, Eriksson JG, Jousilahti P, Silventoinen K, et al. Physical activity, body mass index, and risk of type 2 diabetes in patients with normal or impaired glucose regulation. Arch Intern Med. 2004;164:892.

    Article  PubMed  Google Scholar 

  6. Tinker LF, Bonds DE, Margolis KL. Low-fat dietary pattern and risk of treated diabetes mellitus in postmenopausal women: the Women’s Health Initiative randomized controlled dietary modification trial. Arch Intern Med. 2008;168:1500.

    Article  PubMed  Google Scholar 

  7. Vahdat Shariatpanahi Z, Shahbazi S. Prevalence of diabetes mellitus and pre-diabetes in Sarableh City. Ilam Thrita. 2014;3(2):e17773.

    Google Scholar 

  8. Basevi V, Di Mario S, Morciano C, Nonino F, Magrini N. Comment on American Diabetes Association. Standards of medical care in diabetes. Diabetes Care. 2011;34(Suppl. 1):S11–61.

    Google Scholar 

  9. Momenan AA, Delshad M, Sarbazi N, Gh R, Ghanbarian A, Azizi F. Reliability and validity of the Modifiable Activity Questionnaire (MAQ) in an Iranian urban adult population. Archives of Iranian Medicine. 2011;15(5):279–82.

    Google Scholar 

  10. Pan XR, Li GW, Hu YH, et al. Effects of diet and exercise in preventing NIDDM in people with impaired glucose tolerance: the Da Qing IGT and Diabetes Study. Diabetes Care. 1997;20(4):537–44.

    Article  CAS  PubMed  Google Scholar 

  11. Tuomilehto J, Lindstro MJ, Eriksson JG, Valle TT, Hämäläinen H, Ilanne-Parikka P, et al. Finnish Diabetes Prevention Study Group. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med. 2001;344(18):1343–50.

    Article  CAS  PubMed  Google Scholar 

  12. Ramachandran A, Snehalatha C, Mary S, Mukesh B, Bhaskar AD, Vijay V. Indian Diabetes Prevention Programme (IDPP). The Indian Diabetes Prevention Programme shows that lifestyle modification and metformin prevent type 2 diabetes in Asian Indian subjects with impaired glucose tolerance (IDPP-1). Diabetologia. 2006;49(2):289–97.

    Article  CAS  PubMed  Google Scholar 

  13. Kosaka K, Noda M, Kuzuya T. Prevention of type 2 diabetes by lifestyle intervention: a Japanese trial in IGT males. Diabetes Res Clin Pract. 2005;67(2):152–62.

    Article  PubMed  Google Scholar 

  14. Saito T, Watanabe M, Nishida J, Izumi T, Omura M, Takagi T, et al. Lifestyle modification and prevention of type 2 diabetes in overweight Japanese with impaired fasting glucose levels: a randomized controlled trial. Arch Intern Med. 2011;171(15):1352–60.

    Article  PubMed  Google Scholar 

  15. Boden G. Free fatty acid and insulin secretion in humans. Curr Diab Rep. 2005;5:167–1248.

    Article  CAS  PubMed  Google Scholar 

  16. Zhou YP, Grill VE. Long-term exposure of rat pancreatic islets to fatty acids inhibits glucose-induced insulin secretion and biosynthesis through a glucose fatty acid cycle. J Clin Invest. 1994;93:870–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Maedler K, Oberholzer J, Bucher P, Spinas GA, Donath MY. Monounsaturated fatty acids prevent the deleterious effects of palmitate and high glucose on human pancreatic beta-cell turnover and function. Diabetes. 2003;52:726–33.

    Article  CAS  PubMed  Google Scholar 

  18. Chavez JA, Summers SA. Characterizing the effects of saturated fatty acids on insulin signaling and ceramide and diacylglycerol accumulation in 3T3–L1 adipocytes and C2C12 myotubes. Arch Biochem Biophys. 2003;419:101–9.

    Article  CAS  PubMed  Google Scholar 

  19. Garg A. High-monounsaturated-fat diets for patients with diabetes mellitus. A meta-analysis. Am J ClinNutr. 1998;67(Suppl.3):577S–82S.

    CAS  Google Scholar 

  20. Esposito K, Marfella R, Ciotola M, Di Palo C, Giugliano F, Giugliano G, Armiento D, et al. Effect of a Mediterranean-style diet on endothelial dysfunction and markers of vascular inflammation in the metabolic syndrome: a randomized trial. JAMA. 2004;292:1440–6.

    Article  CAS  PubMed  Google Scholar 

  21. Brehm BJ, Lattin BL, Summer S, Boback JA, Gilchrist GM, Jandacek RJ, D’alessio DA. One-year comparison of a high-monounsaturated fat diet with a high-carbohydrate diet in type 2 diabetes. Diabetes Care. 2009;32:215–20.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Guldbrand H, Dizdar B, Bunjaku B, Lindström T, Bachrach-Lindström M, Fredrikson M, Östgren CJ, Nystrom FH. In type 2 diabetes, randomization to advice to follow a low-carbohydrate diet transiently improves glycemic control compared with advice to follow a low-fat diet producing a similar weight loss. Diabetologia. 2012;55:2118–27.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

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Acknowledgments

We convey our gratitude to the Ilam University of Medical Sciences, Ilam, Iran. The contributions of the authors to the present study were as follows: Zahra Vahdat Shariatpanahi for the design of the experiment and analysis and interpretation of data; Shaahin Shahbazi for the design of the experiment and writing of the manuscript.

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Authors and Affiliations

  1. Faculty of Medicine, Department of Internal Medicine, Ilam University of Medical Sciences, Ilam, Iran

    Shaahin Shahbazi & Zahra Vahdat Shariatpanahi

  2. Department of Nutrition, National Nutrition and Food Technology Research Institute, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Banganjab Avenue, Tehran, Iran

    Zahra Vahdat Shariatpanahi

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  1. Shaahin Shahbazi
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  2. Zahra Vahdat Shariatpanahi
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Correspondence to Zahra Vahdat Shariatpanahi.

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Funding of this study was provided by the Ilam University of Medical Sciences. The manuscript has been read and approved by all the authors. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

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The authors declare that they have no conflict of interest.

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Shahbazi, S., Vahdat Shariatpanahi, Z. Prevention of type 2 diabetes mellitus by changes in diet among subjects with abnormal glucose metabolism: a randomized clinical trial. Int J Diabetes Dev Ctries 38, 69–74 (2018). https://doi.org/10.1007/s13410-017-0548-3

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  • DOI: https://doi.org/10.1007/s13410-017-0548-3

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