Article

Beneficial effect of low carbohydrate in low calorie diets on visceral fat reduction in type 2 diabetic patients with obesity

Center of Diabetes, Endocrine and Metabolism, Sakura Hospital, School of Medicine, Toho University, 564-1 Shimoshizu, Sakura-City, Chiba 285-0841, Japan.
Diabetes Research and Clinical Practice (Impact Factor: 2.54). 09/2004; 65(3):235-41. DOI: 10.1016/j.diabres.2004.01.008
Source: PubMed

ABSTRACT The adequate composition of carbohydrate and fat in low calorie diets for type 2 diabetes mellitus patients with obesity is not fully established. The aim of this study was to investigate the effects of low carbohydrate diet on glucose and lipid metabolism, especially on visceral fat accumulation, and comparing that of a high carbohydrate diet. Obese subjects with type 2 diabetes mellitus were randomly assigned to take a low calorie and low carbohydrate diet (n = 11, 1000 kcal per day, protein:carbohydrate:fat = 25:40:35) or a low calorie and high carbohydrate diet (n = 11, 1000 kcal per day, protein:carbohydrate:fat = 25:65:10) for 4 weeks. Similar decreases in body weight and serum glucose levels were observed in both groups. Fasting serum insulin levels were reduced in the low carbohydrate diet group compared to the high carbohydrate diet group (-30% versus -10%, P < 0.05). Total serum cholesterol and triglyceride levels decreased in both groups, but were not significantly different from each other. High-density lipoprotein-cholesterol (HDL-C) increased in the low carbohydrate diet group but not in the high carbohydrate diet group (+15% versus 0%, P < 0.01). There was a larger decrease in visceral fat area measured by computed tomography in the low carbohydrate diet group compared to the high carbohydrate diet group (-40 cm(2) versus -10 cm(2), P < 0.05). The ratio of visceral fat area to subcutaneous fat area did not change in the high carbohydrate diet group (from 0.70 to 0.68), but it decreased significantly in the low carbohydrate diet group (from 0.69 to 0.47, P < 0.005). These results suggest that, when restrict diet was made isocaloric, a low calorie/low carbohydrate diet might be more effective treatment for a reduction of visceral fat, improved insulin sensitivity and increased in HDL-C levels than low calorie/high carbohydrate diet in obese subjects with type 2 diabetes mellitus.

0 Bookmarks
 · 
98 Views
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: De novo lipogenesis and hypercaloric diets are thought to contribute to increased fat mass, particularly in abdominal fat depots. CB1 is highly expressed in adipose tissue, and CB1-mediated signalling is associated with stimulation of lipogenesis and diet-induced obesity, though its contribution to increasing fat deposition in adipose tissue is controversial. Lipogenesis is regulated by transcription factors such as liver X receptor (LXR), sterol-response element binding protein (SREBP) and carbohydrate-responsive-element-binding protein (ChREBP). We evaluated the role of CB1 in the gene expression of these factors and their target genes in relation to lipogenesis in the perirenal adipose tissue (PrAT) of rats fed a high-carbohydrate diet (HCHD) or a high-fat diet (HFD). Both obesity models showed an up-regulated gene expression of CB1 and Lxrα in this adipose pad. The Srebf-1 and ChREBP gene expressions were down-regulated in HFD but not in HCHD. The expression of their target genes encoding for lipogenic enzymes showed a decrease in diet-induced obesity and was particularly dramatic in HFD. In HCHD, CB1 blockade by AM251 reduced the Srebf-1 and ChREBP expression and totally abrogated the remnant gene expression of their target lipogenic enzymes. The phosphorylated form of the extracellular signal-regulated kinase (ERK-p), which participates in the CB1-mediated signalling pathway, was markedly present in the PrAT of obese rats. ERK-p was drastically repressed by AM251 indicating that CB1 is actually functional in PrAT of obese animals, though its activation loses the ability to stimulate lipogenesis in PrAT of obese rats. Even so, the remnant expression levels of lipogenic transcription factors found in HCHD-fed rats are still dependent on CB1 activity. Hence, in HCHD-induced obesity, CB1 blockade may help to further potentiate the reduction of lipogenesis in PrAT by means of inducing down-regulation of the ChREBP and Srebf-1 gene expression, and consequently in the expression of lipogenic enzymes.
    PLoS ONE 02/2014; 9(2):e90016. DOI:10.1371/journal.pone.0090016 · 3.53 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: High-density lipoprotein (HDL) is a lipoprotein which has anti-atherogenic property by reverse cholesterol transport from the peripheral tissues to liver. Low HDL-cholesterol (HDL-C) levels are associated with the development of coronary artery diseases (CADs). Various epidemiological studies have suggested that the development of CAD increase in individuals with less than 40 mg/dL of HDL-C. In spite of accumulation of evidences which suggest a significant association between low HDL-C and cardiovascular diseases, effects of dietary factors on HDL metabolism remained largely unknown. There may be interracial differences in effects of dietary factors on HDL metabolism. Here we reviewed published articles about effects of carbohydrate and dietary fiber intake, glycemic index (GI) and glycemic load (GL), on HDL-C metabolism, regarding meta-analyses and clinical studies performed in Asian population as important articles. Low carbohydrate intake, GI and GL may be beneficially associated with HDL metabolism. Dietary fiber intake may be favorably associated with HDL metabolism in Asian populations.
    Journal of Clinical Medicine Research 10/2014; 6(5):321-6. DOI:10.14740/jocmr1884w
    This article is viewable in ResearchGate's enriched format
  • [Show abstract] [Hide abstract]
    ABSTRACT: Bereits seit mehr als 30 Jahren ist bekannt, dass kurz nach der Umstellung auf eine hypokalorische Ernährung eine signifikante Reduktion der Nüchternglucose- und der Insulinkonzentration sowie eine Steigerung der Insulinsensitivität erreicht werden können.Der Beitrag beschreibt die vielversprechenden Auswirkungen von niedrig-kalorischen bzw. Formuladiäten in der Behandlung des Typ-2-Diabetes.Hierzu wird ein Überblick über die Studienergebnisse zur Behandlung des Typ-2-Diabetes mithilfe von niedrig-kalorischen bzw. Formuladiäten gegeben. Der Einfluss auf Stoffwechselveränderungen, diabetesrelevante Parameter und die Lebensqualität von Typ-2-Diabetes-Patienten wird diskutiert. Des Weiteren wird die Vergleichbarkeit von bariatrischer Chirurgie und Formuladiäten behandelt.Die schnellen Effekte auf metabolische Parameter, die zeitlich deutlich vor der Körpergewichtsreduktion auftreten, sind vergleichbar mit den Ergebnissen, die sich durch bariatrische Operationen erzielen lassen.Die erfolgreiche und langfristige Integration von kalorienreduzierter Ernährung in den Alltag ist schwierig, da bisher das Hauptaugenmerk der Typ-2-Diabetes-Behandlung primär auf pharmakologischen Therapien lag. Formuladiäten bieten jedoch ein bisher ungenutztes Potenzial, durch die zu Beginn schnell erzielte Verbesserung der Stoffwechsellage bei den Betroffenen einen Motivationsschub auszulösen.
    Der Diabetologe 03/2014; 10(2). DOI:10.1007/s11428-013-1112-5 · 0.06 Impact Factor

Preview

Download
1 Download
Available from