Year

1997

Degree Name

Doctor of Philosophy

Department

University of Wollongong. Medical Research Unit

Abstract

This is a randomised prospective controlled study on the effectiveness of two dietprograms, one an orthodox high carbohydrate low fat diet (Control) and the other a high mono unsaturated fat diet (HMUFA) (also containing n-3 a-linolenic acid) on insulin resistance, serum lipids and other variables in 50 adult patients with non-insulindependent diabetes mellitus (NIDDM) during one year. Patients were randomly allocated to the two dietary groups. The HMUFA group were given a diet program (using canola and olive oils and margarines, nuts, farmers best milk, avocado) to maintain body weight,aimed at providing 40% of energy intake as carbohydrate (CHO) and 38% as fat (21%mono unsaturated). The Control group were given a diet program containing 50% of energy intake as CHO and 24% as fat. A 4 day food record was analysed every 3 months. Insulin resistance was measured in a subgroup of 28 participants by the hyper insulinemic euglycemic clamp technique. After 12 months the following changes had occurred. The HMUFA group had 34% of energy intake as fat (16%monounsaturated, 10% saturated), and the Control group 31% (13% and 11%respectively). The HMUFA group had significant reductions in systolic (p=0.038) and diastolic blood pressure (BP) (p=0.009), fasting plasma glucose (p=0.026), triglyceride(p=0.050), and significant increases in HDL-cholesterol (p=0.011) and insulin sensitivity(p=0.005), compared to Control group. In HMUFA mean BP fell from 135/83 to 127/73in 12 months: there was no change in the Control group. The mean fasting blood glucose fell from 9.2 to 8.3 mmol/L in the HMUFA group, and rose from 8.5 to 9.5 mmol/L in the Control group. The mean insulin sensitivity rose significantly from 111 to 160 mg.2.min_1 in the HMUFA group, and fell from 130 to 91 mg.m^.min"1 in the Control group.This study concludes that after one year the mono unsaturated-enriched diet (containing also n-3 a-linolenic acid) program was associated with a better metabolic profile in NIDDM patients than a high carbohydrate low fat diet.

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