Insuln Response to HiCarb vs LoCarb?

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Insuln Response to HiCarb vs LoCarb? jay 02-08-2010
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Posted by jay on February 8, 2010, 12:56 pm


I was under the impression that a high-fat meal would cause a lower
insulin response than a high-carb meal. If so, why does the following
study seem to indicate the opposite?

Meal composition affects insulin secretion in women with type 2
diabetes: a comparison with healthy controls. The Hoorn prandial
study.

BACKGROUND/OBJECTIVE: Early insulin secretion following a meal is
representative for normal physiology and may depend on meal
composition. To compare the effects of a fat-rich and a carbohydrate-
rich mixed meal on insulinogenic index as a measure of early insulin
secretion in normoglycemic women (NGM) and in women with type 2
diabetes mellitus (DM2), and to assess the relationship of
anthropometric and metabolic factors with insulinogenic index.
SUBJECTS/METHODS: Postmenopausal women, 76 with NGM and 64 with DM2,
received a fat-rich meal and a carbohydrate-rich meal on separate
occasions. Early insulin response was estimated as insulinogenic index
( big up tri, Deltainsulin(0-30 min)/ big up tri, Deltaglucose(0-30
min)) for each meal. Associations of fasting and postprandial
triglycerides, body mass index, waist and hip circumference and
alanine aminotransferase with insulinogenic indices were determined.
RESULTS: Women with NGM present with higher insulinogenic index than
women with DM2. The insulinogenic index following the fat-rich meal
( big up tri, DeltaI(30)/ big up tri, DeltaG(30) (fat)) was higher
than the index following the carbohydrate-rich meal (big up tri,
DeltaI(30)/ big up tri, DeltaG(30) (CH)) (P<0.05 in women with DM2,
and not significant in women with NGM). In women with DM2, homeostasis
model assessment for insulin resistance was positively associated with
big up tri, DeltaI(30)/ big up tri, DeltaG(30) (CH). In women with
NGM, waist circumference was independently and inversely associated
with big up tri, DeltaI(30)/ big up tri, DeltaG(30) (fat) and with big
up tri, DeltaI(30)/ big up tri, DeltaG(30) (CH); hip circumference was
positively associated with big up tri, DeltaI(30)/ big up tri,
DeltaG(30) (fat). CONCLUSIONS: The insulinogenic index following the
fat-rich meal was higher than following the isocaloric carbohydrate-
rich meal, which might favorably affect postprandial glucose
excursions, especially in women with DM2. The association between a
larger waist circumference and a lower meal-induced insulinogenic
index in women with NGM requires further mechanistic studies. PMID:
17987050

Posted by Susan on February 8, 2010, 3:52 pm


x-no-archive: yes

Protein causes the strongest, long lasting insulin release after a meal.
How much protein was in the meals the study subjects ate?

Susan

jay wrote:
> I was under the impression that a high-fat meal would cause a lower
> insulin response than a high-carb meal. If so, why does the following
> study seem to indicate the opposite?
>
> Meal composition affects insulin secretion in women with type 2
> diabetes: a comparison with healthy controls. The Hoorn prandial
> study.
>
> BACKGROUND/OBJECTIVE: Early insulin secretion following a meal is
> representative for normal physiology and may depend on meal
> composition. To compare the effects of a fat-rich and a carbohydrate-
> rich mixed meal on insulinogenic index as a measure of early insulin
> secretion in normoglycemic women (NGM) and in women with type 2
> diabetes mellitus (DM2), and to assess the relationship of
> anthropometric and metabolic factors with insulinogenic index.
> SUBJECTS/METHODS: Postmenopausal women, 76 with NGM and 64 with DM2,
> received a fat-rich meal and a carbohydrate-rich meal on separate
> occasions. Early insulin response was estimated as insulinogenic index
> ( big up tri, Deltainsulin(0-30 min)/ big up tri, Deltaglucose(0-30
> min)) for each meal. Associations of fasting and postprandial
> triglycerides, body mass index, waist and hip circumference and
> alanine aminotransferase with insulinogenic indices were determined.
> RESULTS: Women with NGM present with higher insulinogenic index than
> women with DM2. The insulinogenic index following the fat-rich meal
> ( big up tri, DeltaI(30)/ big up tri, DeltaG(30) (fat)) was higher
> than the index following the carbohydrate-rich meal (big up tri,
> DeltaI(30)/ big up tri, DeltaG(30) (CH)) (P<0.05 in women with DM2,
> and not significant in women with NGM). In women with DM2, homeostasis
> model assessment for insulin resistance was positively associated with
> big up tri, DeltaI(30)/ big up tri, DeltaG(30) (CH). In women with
> NGM, waist circumference was independently and inversely associated
> with big up tri, DeltaI(30)/ big up tri, DeltaG(30) (fat) and with big
> up tri, DeltaI(30)/ big up tri, DeltaG(30) (CH); hip circumference was
> positively associated with big up tri, DeltaI(30)/ big up tri,
> DeltaG(30) (fat). CONCLUSIONS: The insulinogenic index following the
> fat-rich meal was higher than following the isocaloric carbohydrate-
> rich meal, which might favorably affect postprandial glucose
> excursions, especially in women with DM2. The association between a
> larger waist circumference and a lower meal-induced insulinogenic
> index in women with NGM requires further mechanistic studies. PMID:
> 17987050

Posted by Susan on February 8, 2010, 4:19 pm


x-no-archive: yes

Susan wrote:
> x-no-archive: yes
>
> Protein causes the strongest, long lasting insulin release after a meal.
> How much protein was in the meals the study subjects ate?
>

This points to the fact that it's not the total amount of insulin
secreted after a meal that is undesirable, it's sudden and very high
secretion, apparently. Fat does not stimulate insulin secretion.
Glycemic carbs induce a sharp, sudden increase in insulin secretion.
Protein induces a longer/stronger, and steady secretion.

Susan

Posted by Jarod on February 14, 2010, 2:57 am


Susan wrote:

> A recent meta analysis indicates that saturated fat has no causal
> relationship to CVD.

Do you probably have a link which points me directly to this analysis?
(I have full access to nearly all the public medical databases).

Thanks!


Posted by Susan on February 14, 2010, 11:14 am


x-no-archive: yes

Jarod wrote:
> Susan wrote:
>
>> A recent meta analysis indicates that saturated fat has no causal
>> relationship to CVD.
>
> Do you probably have a link which points me directly to this analysis?
> (I have full access to nearly all the public medical databases).
>
> Thanks!
>

Am J Clin Nutr. 2010 Jan 13. [Epub ahead of print]
Meta-analysis of prospective cohort studies evaluating the association
of saturated fat with cardiovascular disease.
Siri-Tarino PW, Sun Q, Hu FB, Krauss RM.
Children's Hospital Oakland Research Institute Oakland CA Harvard School
of Public Health Boston MA.
BACKGROUND: A reduction in dietary saturated fat has generally been
thought to improve cardiovascular health. OBJECTIVE: The objective of
this meta-analysis was to summarize the evidence related to the
association of dietary saturated fat with risk of coronary heart disease
(CHD), stroke, and cardiovascular disease (CVD; CHD inclusive of stroke)
in prospective epidemiologic studies. DESIGN: Twenty-one studies
identified by searching MEDLINE and EMBASE databases and secondary
referencing qualified for inclusion in this study. A random-effects
model was used to derive composite relative risk estimates for CHD,
stroke, and CVD. RESULTS: During 5-23 y of follow-up of 347,747
subjects, 11,006 developed CHD or stroke. Intake of saturated fat was
not associated with an increased risk of CHD, stroke, or CVD. The pooled
relative risk estimates that compared extreme quantiles of saturated fat
intake were 1.07 (95% CI: 0.96, 1.19; P = 0.22) for CHD, 0.81 (95% CI:
0.62, 1.05; P = 0.11) for stroke, and 1.00 (95% CI: 0.89, 1.11; P =
0.95) for CVD. Consideration of age, sex, and study quality did not
change the results. CONCLUSIONS: A meta-analysis of prospective
epidemiologic studies showed that there is no significant evidence for
concluding that dietary saturated fat is associated with an increased
risk of CHD or CVD. More data are needed to elucidate whether CVD risks
are likely to be influenced by the specific nutrients used to replace
saturated fat.
PMID: 20071648 [PubMed - as supplied by publisher]

And some bonus citations:

Am J Clin Nutr. 2010 Jan 13. [Epub ahead of print]
Meta-analysis of prospective cohort studies evaluating the association
of saturated fat with cardiovascular disease.
Siri-Tarino PW, Sun Q, Hu FB, Krauss RM.
Children's Hospital Oakland Research Institute Oakland CA Harvard School
of Public Health Boston MA.
BACKGROUND: A reduction in dietary saturated fat has generally been
thought to improve cardiovascular health. OBJECTIVE: The objective of
this meta-analysis was to summarize the evidence related to the
association of dietary saturated fat with risk of coronary heart disease
(CHD), stroke, and cardiovascular disease (CVD; CHD inclusive of stroke)
in prospective epidemiologic studies. DESIGN: Twenty-one studies
identified by searching MEDLINE and EMBASE databases and secondary
referencing qualified for inclusion in this study. A random-effects
model was used to derive composite relative risk estimates for CHD,
stroke, and CVD. RESULTS: During 5-23 y of follow-up of 347,747
subjects, 11,006 developed CHD or stroke. Intake of saturated fat was
not associated with an increased risk of CHD, stroke, or CVD. The pooled
relative risk estimates that compared extreme quantiles of saturated fat
intake were 1.07 (95% CI: 0.96, 1.19; P = 0.22) for CHD, 0.81 (95% CI:
0.62, 1.05; P = 0.11) for stroke, and 1.00 (95% CI: 0.89, 1.11; P =
0.95) for CVD. Consideration of age, sex, and study quality did not
change the results. CONCLUSIONS: A meta-analysis of prospective
epidemiologic studies showed that there is no significant evidence for
concluding that dietary saturated fat is associated with an increased
risk of CHD or CVD. More data are needed to elucidate whether CVD risks
are likely to be influenced by the specific nutrients used to replace
saturated fat.
PMID: 20071648 [PubMed - as supplied by publisher]

Int J Environ Res Public Health. 2009 Oct;6(10):2626-38. Epub 2009 Oct 12.
Food choices and coronary heart disease: a population based cohort study
of rural Swedish men with 12 years of follow-up.
Holmberg S, Thelin A, Stiernström EL.
Research and Development Centre, Kronoberg County Council, Box 1223,
SE-351 12 Växjö, Sweden. sara.holmb...@ltkronoberg.se
Coronary heart disease is associated with diet. Nutritional
recommendations are frequently provided, but few long term studies on
the effect of food choices on heart disease are available. We followed
coronary heart disease morbidity and mortality in a cohort of rural men
(N = 1,752) participating in a prospective observational study. Dietary
choices were assessed at baseline with a 15-item food questionnaire. 138
men were hospitalized or deceased owing to coronary heart disease during
the 12 year follow-up.
**************Daily intake of fruit and vegetables was associated with a
lower risk of coronary heart disease when combined with a high dairy fat
consumption (odds ratio 0.39, 95% CI 0.21-0.73), but not when combined
with a low dairy fat consumption (odds ratio 1.70, 95% CI 0.97-2.98).
Choosing wholemeal bread or eating fish at least twice a week showed no
association with the outcome.*****************8


Date:12/3/2007[Outline] [RSS & Subscription]
> Metabolic syndrome is a condition afflicting one quarter to one third
> of adult men and women and is an established pre-cursor to diabetes,
> coronary heart disease, and other serious illnesses. Patients have
> long been advised to eat a low-fat diet even though carbohydrate
> restriction has been found to be more effective at reducing specific
> markers, such as high triglycerides, characteristic of the syndrome.
> *********Now, a new study indicates that a diet low in carbohydrates
> is also more effective than a diet low in fat in reducing saturated
> fatty acids in the blood and reducing markers of inflammation.****
> While there have been contradictory and confusing messages directed at
> health conscious consumers about dietary recommendations, most
> researchers agree on the need to limit inflammatory agents. In a
> report published in the on-line version of the journal Lipids,
> researchers at the University of Connecticut with co-authors from
> SUNY Downstate Medical Center in Brooklyn, the University of
> Minnesota, and the University of California show much greater
> improvement in inflammatory markers in patients with metabolic
> syndrome on a very low carbohydrate approach compared to a low fat
> diet.
> Lead researcher Jeff S. Volek, PhD, RD, associate professor of
> kinesiology at the University of Connecticut, describes the study as
> adding to the evolving picture of improvement in general health beyond
> simple weight loss in keeping blood glucose and insulin under control.
> The work is part of a larger study (currently under review) showing
> numerous improvements in blood lipids.
>

******The current work concludes that lowering total and saturated fat
> only had a small effect on circulating inflammatory markers whereas
> reducing carbohydrate led to considerably greater reductions in a
> number of pro-inflammatory cytokines, chemokines, and adhesion
> molecules.*****
> ****


These data implicate dietary carbohydrate rather than fat as a
> more significant nutritional factor contributing to inflammatory
> processes.
> Contact: Jeff Volek
> jeff.vo...@uconn.edu
> 860-486-6712
> SUNY Downstate Medical Center
> Source:Eurekalert

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