Low-energy diets differing in fibre, red meat and coffee intake equally improve insulin sensitivity in type 2 diabetes: a randomised feasibility trial
Nowotny B, Zahiragic L, Bierwagen A, Kabisch S, Groener JB, Nowotny PJ, Fleitmann AK, Herder C, Pacini G, Erlund I, Landberg R, Haering HU, Pfeiffer AF, Nawroth PP, Roden M
Diabetologia · 36 citas
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Cómo se estudió
- Diseño
- Ensayo controlado aleatorizado (indexado por PubMed)
- Estudiado en
- Personas
- Resultado principal
- Marcadores de salud y funcionamiento
- Consumo medido con
- No se indica
Quién lo pagó
- Financiación
- Financiación independiente
- Organización sin fines de lucro
- American Diabetes Association
- Gobierno
- Bundesministerium für Bildung und Forschung
- Gobierno
- Bundesministerium für Gesundheit
Según 3 financiadores declarados.
Publicación
- Publicado
- 2014-11-26 · Diabetologia · vol. 58 · número 2 · págs. 255–264
- Editorial
- Springer Science+Business Media
- Citado
- 42 citas · más que el 92% de estudios similares · 3.4× el promedio de su campo
- Impacto
- Entre el 10 % más citado de su campo
- Referencias
- 37 trabajos
- Acceso
- Lectura gratuita
- Áreas de investigación
- Nutritional Studies and Diet · Diabetes, Cardiovascular Risks, and Lipoproteins · Diabetes Treatment and Management
- Palabras clave
- type 2 diabetes, hypocaloric diet, dietary fiber, red meat, coffee consumption, whole grains, insulin sensitivity, insulin secretion, hepatic insulin sensitivity, hepatic fat content, subcutaneous adipose tissue, visceral fat, weight loss, obesity, hyperinsulinemic-euglycemic clamp, magnetic resonance imaging, magnetic resonance spectroscopy
- MeSH
- animals, cattle, humans, diabetes mellitus, type 2, insulin resistance, obesity, weight loss, body mass index, glucose clamp technique, treatment outcome, caloric restriction, follow-up studies, feasibility studies, coffee, dietary fiber, meat, adult, aged, middle aged, female, male, edible grain
15 autores
- Bettina Nowotny🇩🇪Deutsches Diabetes-Zentrum e.V.; Heinrich Heine University Düsseldorf
- Lejla Zahiragic🇩🇪Deutsches Diabetes-Zentrum e.V.; German Center for Diabetes Research; Heinrich Heine University Düsseldorf
- Alessandra Bierwagen🇩🇪Deutsches Diabetes-Zentrum e.V.; German Center for Diabetes Research; Heinrich Heine University Düsseldorf
- Stefan Kabisch🇩🇪German Center for Diabetes Research; German Institute of Human Nutrition; Charité - Universitätsmedizin Berlin
- Jan Benedikt Groener🇩🇪Heidelberg University; University Hospital Heidelberg
- P. Nowotny🇩🇪Deutsches Diabetes-Zentrum e.V.; German Center for Diabetes Research; Heinrich Heine University Düsseldorf
- Ann Kristin Fleitmann🇩🇪Deutsches Diabetes-Zentrum e.V.; German Center for Diabetes Research; Heinrich Heine University Düsseldorf
- Christian Herder🇩🇪Deutsches Diabetes-Zentrum e.V.; German Center for Diabetes Research; Heinrich Heine University Düsseldorf
- Giovanni Pacini🇮🇹National Research Council
- Iris Erlund
- Rikard Landberg🇸🇪Karolinska Institutet; Swedish University of Agricultural Sciences
- Hans-Ulrich Haering🇩🇪Universitätsklinikum Tübingen; German Center for Diabetes Research; University of Tübingen
- Andreas F. H. Pfeiffer🇩🇪German Center for Diabetes Research; German Institute of Human Nutrition; Charité - Universitätsmedizin Berlin
- Peter Paul Nawroth🇩🇪Heidelberg University; University Hospital Heidelberg
- Michael Roden🇩🇪 · autor de correspondenciaDeutsches Diabetes-Zentrum e.V.; German Center for Diabetes Research; Heinrich Heine University Düsseldorf
Resumen
El texto original del estudio, en el idioma en que se publicó.
Aims/hypothesis
Epidemiological studies have found that a diet high in fibre and coffee, but low in red meat, reduces the risk for type 2 diabetes. We tested the hypothesis that these nutritional modifications differentially improve whole-body insulin sensitivity (primary outcome) and secretion.
Methods
Inclusion criteria were: age 18-69 years, BMI ≥ 30 kg/m(2), type 2 diabetes treated with diet, metformin or acarbose and known disease duration of ≤ 5 years. Exclusion criteria were: HbA1c >75 mmol/mol (9.0%), type 1 or secondary diabetes types and acute or chronic diseases including cancer. Patients taking any medication affecting the immune system or insulin sensitivity, other than metformin, were also excluded. Of 59 patients (randomised using randomisation blocks [four or six patients] with consecutive numbers), 37 (54% female) obese type 2 diabetic patients completed this controlled parallel-group 8-week low-energy dietary intervention. The participants consumed either a diet high in cereal fibre (whole grain wheat/rye: 30-50 g/day) and coffee (≥ 5 cups/day), and free of red meat (L-RISK, n = 17) or a diet low in fibre (≤ 10 g/day), coffee-free and high in red meat (≥ 150 g/day) diet (H-RISK, n = 20). Insulin sensitivity and secretion were assessed by hyperinsulinaemic-euglycaemic clamp and intravenous glucose tolerance tests with isotope dilution. Whole-body and organ fat contents were measured by magnetic resonance imaging and spectroscopy.
Results
Whole-body insulin sensitivity increased in both groups (mean [95% CI]) (H-RISK vs L-RISK: 0.8 [0.2, 1.4] vs 1.0 [0.4, 1.7]mg kg(-1) min(-1), p = 0.59), while body weight decreased (-4.8% [-6.1%, -3.5%] vs -4.6% [-6.0%, -3.3%], respectively). Hepatic insulin sensitivity remained unchanged, whereas hepatocellular lipid content fell in both groups (-7.0% [-9.6%, -4.5%] vs -6.7% [-9.5%, -3.9%]). Subcutaneous fat mass (-1,553 [-2,767, -340] cm(3) vs -751 [-2,047; 546] cm(3), respectively) visceral fat mass (-206 [-783, 371] cm(3) vs -241 [-856, 373] cm(3), respectively) and muscle fat content (-0.09% [-0.16%, -0.02%] vs -0.02% [-0.10%, 0.05%], respectively) decreased similarly. Insulin secretion remained unchanged, while the proinflammatory marker IL-18 decreased only after the L-RISK diet.
Conclusions/interpretation
No evidence of a difference between both low-energy diets was identified. Thus, energy restriction per se seems to be key for improving insulin action in phases of active weight loss in obese type 2 diabetic patients, with a potential improvement of subclinical inflammation with the L-RISK diet.
Trial registration
Clinicaltrials.gov NCT01409330.
Funding
This study was supported by the Ministry of Science and Research of the State of North Rhine-Westphalia (MIWF NRW), the German Federal Ministry of Health (BMG), the Federal Ministry for Research (BMBF) to the Center for Diabetes Research (DZD e.V.) and the Helmholtz Alliance Imaging and Curing Environmental Metabolic Diseases (ICEMED).
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