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Cited by 1,119Fatty Acid Research and HealthDiet, Metabolism, and DiseaseNutritional Studies and Diet

Substituting dietary saturated for monounsaturated fat impairs insulin sensitivity in healthy men and women: the KANWU Study

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Vessby, B., Uusitupa, M., Hermansen, K., Riccardi, G., Rivellese, A. A., Tapsell, L. C., Nälsén, C., Berglund, L. +7 more·2001·Diabetologia
DOI 10.1007/s001250051620
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Abstract

Aims/hypothesis The amount and quality of fat in the diet could be of importance for development of insulin resistance and related metabolic disorders. Our aim was to determine whether a change in dietary fat quality alone could alter insulin action in humans.Methods The KANWU study included 162 healthy subjects chosen at random to receive a controlled, isoenergetic diet for 3 months containing either a high proportion of saturated (SAFA diet) or monounsaturated (MUFA diet) fatty acids. Within each group there was a second assignment at random to supplements with fish oil (3.6 g n-3 fatty acids/d) or placebo.Results Insulin sensitivity was significantly impaired on the saturated fatty acid diet (-10%, p = 0.03) but did not change on the monounsaturated fatty acid diet (+2%, NS) (p = 0.05 for difference between diets). Insulin secretion was not affected. The addition of n-3 fatty acids influenced neither insulin sensitivity nor insulin secretion. The favourable effects of substituting a monounsaturated fatty acid diet for a saturated fatty acid diet on insulin sensitivity were only seen at a total fat intake below median (37E%). Here, insulin sensitivity was 12.5% lower and 8.8% higher on the saturated fatty acid diet and monounsaturated fatty acid diet respectively (p = 0.03). Low density lipoprotein cholesterol (LDL) increased on the saturated fatty acid diet (+4.1%, p < 0.01) but decreased on the monounsaturated fatty acid diet (MUFA) (-5.2, p < 0.001), whereas lipoprotein (a) [Lp(a)] increased on a monounsaturated fatty acid diet by 12% (p < 0.001).Conclusions/interpretation A change of the proportions of dietary fatty acids, decreasing saturated fatty acid and increasing monounsaturated fatty acid, improves insulin sensitivity but has no effect on insulin secretion. A beneficial impact of the fat quality on insulin sensitivity is not seen in individuals with a high fat intake (> 37E%).

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  • Consuming unsaturated fatty acids enhances insulin sensitivity in people with type 2 diabetes or obesity and in healthy people.

    “Consuming unsaturated fatty acids has been shown to enhance insulin sensitivity in people with type 2 diabetes or obesity and in healthy people [99, 100].”

    From Nutritional and herbal interventions for polycystic ovary syndrome (PCOS): a comprehensive review of dietary approaches, macronutrient impact, and herbal medicine in management (2025) · cites this paper as [100]

    The Discussion says that replacing saturated with monounsaturated fat improved insulin sensitivity in healthy humans. The Subjects section says participants with diabetes were excluded; the paper does not establish the claimed effect in people with type 2 diabetes or obesity, or for unsaturated fatty acids generally. (LLM, conf=0.90)

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  • Beneficial effects of high-quality fat on insulin sensitivity are demonstrated when people ingest 5-37% of total calorie intake as fat.

    “Nevertheless, people who ingested 5–37% of their total calorie intake as fat demonstrated the beneficial effects of high-quality fat on insulin sensitivity [100].”

    From Nutritional and herbal interventions for polycystic ovary syndrome (PCOS): a comprehensive review of dietary approaches, macronutrient impact, and herbal medicine in management (2025) · cites this paper as [100]

    The Discussion reports improved insulin sensitivity when saturated fat was replaced with monounsaturated fat, including at fat intakes up to 37% of calories. The fat-intake analysis reports a median of 37% and refers to the 5% of participants with the lowest intakes—not an intake of 5% of calories. The claimed 5–37% range is therefore not supported. (LLM, conf=0.90)

    Experimental — accuracy not yet measured

  • A diet high in monounsaturated fat improves insulin sensitivity significantly more than a diet high in saturated fat.

    “A high monounsaturated fat diet significantly improves insulin sensitivity compared with a high saturated fat diet. 170”

    From 2016 ESC/EAS Guidelines for the Management of Dyslipidaemias (2016) · cites this paper as [170]

  • Diets high in saturated fat have been linked with the onset of both obesity and type 2 diabetes.

    “In particular, diets high in saturated fat have been linked with the onset of both obesity and T2D [12,13].”

    From Omega-3 Fatty Acids and Skeletal Muscle Health (2015) · cites this paper as [12]

  • A high monounsaturated fat diet significantly improves insulin sensitivity compared with a high saturated fat diet.

    “A high monounsaturated fat diet significantly improves insulin sensitivity compared with a high saturated fat diet.170”

    From 2016 ESC/EAS Guidelines for the Management of Dyslipidaemias (2016) · cites this paper as [170]

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Authors
Vessby, B., Uusitupa, M., Hermansen, K., Riccardi, G., Rivellese, A. A., Tapsell, L. C., Nälsén, C., Berglund, L., Louheranta, A., Rasmussen, B. M., Calvert, G. D., Maffetone, A., Pedersen, E., Gustafsson, I.-B., & Storlien, L. H.
Affiliations
  • Uppsala University (SE)
  • University of Eastern Finland (FI)
  • Aarhus University (DK)
  • Federico II University Hospital (IT)
  • University of Wollongong (AU)
ORCID
Venue
Diabetologia
Publisher
Springer Science and Business Media LLC
Published
2001-03-09
Volume
44
Issue
3
Pages
312-319
ISSN
  • 0012-186X (ISSN-L)
  • 1432-0428
DOI
10.1007/s001250051620
OpenAlex
W1968693059
Cited by
1,119
References
29
Citations by year
2026: 8 · 2025: 18 · 2024: 21 · 2023: 23 · 2022: 30 · 2021: 28 · 2020: 40 · 2019: 34 · 2018: 26 · 2017: 44 · 2016: 52 · 2015: 51 · 2014: 58 · 2013: 62 · 2012: 54
FWCI
42.74
Type
journal article
Language
en
Open access
Licence
www.springer.com/tdm (tdm)
Locations
  • Diabetologia (publishedVersion)
  • PubMed (publishedVersion)
  • Research Online (University of Wollongong) (submittedVersion)
Funders
  • Sundhed og Sygdom, Det Frie Forskningsråd
  • Skogs- och Jordbrukets Forskningsråd
  • Medical Research Council
Topics
  • Health Sciences › Nursing › Nutrition and Dietetics › Fatty Acid Research and Health
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diet, Metabolism, and Disease
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
Keywords
dietary saturated fatty acids, monounsaturated fatty acids, insulin sensitivity, insulin resistance, fish oil supplementation, omega-3 fatty acids, insulin secretion, dietary fat quality, total fat intake, LDL cholesterol, lipoprotein(a)
MeSH terms
Insulin Secretion, Adult, Aged, Apolipoproteins B, Blood Glucose, Cholesterol, Dietary Fats, Dietary Fats, Unsaturated, Fatty Acids, Monounsaturated, Female, Fish Oils, Glucose Tolerance Test, Humans, Insulin, Cholesterol, HDL, Cholesterol, LDL, Male, Middle Aged, Phospholipids, Reference Values, Triglycerides, Fatty Acids, Omega-3, Apolipoprotein A-I, Lipoprotein(a)

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