Doctor of Philosophy
University of Wollongong. Medical Research Unit
Fanaian, Mahnaz, Factors influencing the effects of diet on insulin resistance and metabolic parameters in NIDDM, Doctor of Philosophy thesis, University of Wollongong. Medical Research Unit, University of Wollongong, 1997. http://ro.uow.edu.au/theses/2093
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.