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Cited by 120Nutritional Studies and DietDiabetes, Cardiovascular Risks, and LipoproteinsDiet, Metabolism, and Disease

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The Effects of Carbohydrate, Unsaturated Fat, and Protein Intake on Measures of Insulin Sensitivity

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Gadgil, Meghana D., Appel, Lawrence J., Yeung, Edwina, Anderson, Cheryl A.M., Sacks, Frank M., Miller, Edgar R.·2013·Diabetes Care
DOI 10.2337/dc12-0869PMC PMC3631872
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Abstract

OBJECTIVE: Impaired insulin sensitivity increases the risk of cardiovascular disease. Although calorie restriction and weight loss increase insulin sensitivity, the effects of modifying macronutrient composition on insulin sensitivity are uncertain. The purpose of this study is to determine the effects on insulin sensitivity of a carbohydrate-rich diet (CARB; similar to the Dietary Approaches to Stop Hypertension [DASH] diet), a protein-rich diet (PROT; protein predominantly from plant sources), and an unsaturated fat–rich diet (UNSAT; predominantly monounsaturated). RESEARCH DESIGN AND METHODS: This study was a randomized, controlled, three-period, crossover feeding study. The study participants were 164 individuals with prehypertension or stage 1 hypertension without diabetes. Diets were administered for 6 weeks each, with a washout period between diets of 2–4 weeks. Weight was held constant throughout the study. For our primary outcome, we calculated the quantitative insulin sensitivity check index (QUICKI) using the end-of-period fasting serum glucose and insulin. QUICKI is a validated measure of insulin sensitivity. The primary analyses used generalized estimating equations. RESULTS: At baseline, mean (SD) BMI was 30.2 (6.1) kg/m2, and mean (SD) QUICKI was 0.35 (0.04). The UNSAT diet increased QUICKI by 0.005, more than the CARB diet (P = 0.04). PROT had no significant effect compared with CARB. CONCLUSIONS: A diet that partially replaces carbohydrate with unsaturated fat may improve insulin sensitivity in a population at risk for cardiovascular disease. Given the well-recognized challenges of sustaining weight loss, our results suggest an alternative approach for improving insulin sensitivity.

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Figure 1 Between-diet comparisons of change in QUICKI measure. Change in QUICKI determined by generalized estimating equations. Error bars indicate 95% CIs.
Figure 1 Between-diet comparisons of change in QUICKI measure. Change in QUICKI determined by generalized estimating equations. Error bars indicate 95% CIs.CC BY-NC-ND · PubMed Central

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Metadata

Authors
Gadgil, M. D., Appel, L. J., Yeung, E., Anderson, C. A. M., Sacks, F. M., & Miller, E. R.
Affiliations
  • Johns Hopkins University (US)
  • National Institutes of Health (US)
  • Brigham and Women's Hospital (US)
Corresponding author
Gadgil, Meghana D.
ORCID
Venue
Diabetes Care
Publisher
American Diabetes Association
Published
2013-04-13
Volume
36
Issue
5
Pages
1132-1137
ISSN
  • 0149-5992 (ISSN-L)
  • 1935-5548
DOI
10.2337/dc12-0869
PMC
PMC3631872
OpenAlex
W2114840155
Cited by
120
References
42
Citations by year
2026: 6 · 2025: 9 · 2024: 8 · 2023: 6 · 2022: 10 · 2021: 7 · 2020: 8 · 2019: 7 · 2018: 17 · 2017: 9 · 2016: 11 · 2015: 12 · 2014: 8 · 2013: 1
FWCI
6.80
Type
journal article
Language
en
Open access
Licence
Locations
  • Diabetes Care (publishedVersion, cc-by-nc-nd)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • Digital Access to Scholarship at Harvard (DASH) (Harvard University) (submittedVersion, cc-by)
Funders
  • National Institutes of Health (5t32hl007180-45)
  • National Heart, Lung, and Blood Institute (T32-HL-007180, HL67098, K23HL068712, HL-68712, R01HL067098)
  • National Institute of Diabetes and Digestive and Kidney Diseases (DK63214, K24DK063214, P30DK079637)
  • National Center for Research Resources (RR02635, M01RR002635)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diet, Metabolism, and Disease
Keywords
insulin sensitivity, macronutrient composition, high-carbohydrate diet, unsaturated fat, high-protein diet, plant proteins, monounsaturated fatty acids, hypertension, prehypertension, cardiovascular risk, QUICKI, dietary intervention
MeSH terms
Adult, Body Weight, Cardiovascular Diseases, Dietary Carbohydrates, Dietary Fats, Unsaturated, Dietary Proteins, Fats, Unsaturated, Female, Humans, Insulin Resistance, Male, Middle Aged, Cross-Over Studies, Diet, High-Fat

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