| Effect of changing the amount and type of fat and carbohydrate on insulin sensitivity and cardiovascular risk: the RISCK (Reading, Imperial, Surrey, Cambridge, and Kings) trial. | |
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MedLine Citation:
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PMID: 20739418 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Insulin sensitivity (Si) is improved by weight loss and exercise, but the effects of the replacement of saturated fatty acids (SFAs) with monounsaturated fatty acids (MUFAs) or carbohydrates of high glycemic index (HGI) or low glycemic index (LGI) are uncertain. OBJECTIVE: We conducted a dietary intervention trial to study these effects in participants at risk of developing metabolic syndrome. DESIGN: We conducted a 5-center, parallel design, randomized controlled trial [RISCK (Reading, Imperial, Surrey, Cambridge, and Kings)]. The primary and secondary outcomes were changes in Si (measured by using an intravenous glucose tolerance test) and cardiovascular risk factors. Measurements were made after 4 wk of a high-SFA and HGI (HS/HGI) diet and after a 24-wk intervention with HS/HGI (reference), high-MUFA and HGI (HM/HGI), HM and LGI (HM/LGI), low-fat and HGI (LF/HGI), and LF and LGI (LF/LGI) diets. RESULTS: We analyzed data for 548 of 720 participants who were randomly assigned to treatment. The median Si was 2.7 × 10(-4) mL · μU(-1) · min(-1) (interquartile range: 2.0, 4.2 × 10(-4) mL · μU(-1) · min(-1)), and unadjusted mean percentage changes (95% CIs) after 24 wk treatment (P = 0.13) were as follows: for the HS/HGI group, -4% (-12.7%, 5.3%); for the HM/HGI group, 2.1% (-5.8%, 10.7%); for the HM/LGI group, -3.5% (-10.6%, 4.3%); for the LF/HGI group, -8.6% (-15.4%, -1.1%); and for the LF/LGI group, 9.9% (2.4%, 18.0%). Total cholesterol (TC), LDL cholesterol, and apolipoprotein B concentrations decreased with SFA reduction. Decreases in TC and LDL-cholesterol concentrations were greater with LGI. Fat reduction lowered HDL cholesterol and apolipoprotein A1 and B concentrations. CONCLUSIONS: This study did not support the hypothesis that isoenergetic replacement of SFAs with MUFAs or carbohydrates has a favorable effect on Si. Lowering GI enhanced reductions in TC and LDL-cholesterol concentrations in subjects, with tentative evidence of improvements in Si in the LF-treatment group. This trial was registered at clinicaltrials.gov as ISRCTN29111298. |
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Authors:
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Susan A Jebb; Julie A Lovegrove; Bruce A Griffin; Gary S Frost; Carmel S Moore; Mark D Chatfield; Les J Bluck; Christine M Williams; Thomas Ab Sanders; |
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Publication Detail:
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Type: Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't Date: 2010-08-25 |
Journal Detail:
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Title: The American journal of clinical nutrition Volume: 92 ISSN: 1938-3207 ISO Abbreviation: Am. J. Clin. Nutr. Publication Date: 2010 Oct |
Date Detail:
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Created Date: 2010-09-21 Completed Date: 2010-10-27 Revised Date: 2010-12-13 |
Medline Journal Info:
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Nlm Unique ID: 0376027 Medline TA: Am J Clin Nutr Country: United States |
Other Details:
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Languages: eng Pagination: 748-58 Citation Subset: AIM; IM |
Affiliation:
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Medical Research Council Human Nutrition Research, Elsie Widdowson Laboratory, Cambridge, United Kingdom. susan.jebb@mrc-hnr.cam.ac.uk |
| Data Bank Information | |
Bank Name/Acc. No.:
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ISRCTN/ISRCTN29111298 |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Apolipoprotein A-I / blood Apolipoproteins B / blood Cardiovascular Diseases / epidemiology* Cholesterol / blood Cholesterol, HDL / blood Dietary Carbohydrates / pharmacology* Dietary Fats / pharmacology* England / epidemiology Fatty Acids / pharmacology Female Glucose Tolerance Test Humans Insulin / physiology* Male Metabolic Syndrome X / epidemiology Middle Aged Research Design Risk Factors |
| Chemical | |
Reg. No./Substance:
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0/Apolipoprotein A-I; 0/Apolipoproteins B; 0/Cholesterol, HDL; 0/Dietary Carbohydrates; 0/Dietary Fats; 0/Fatty Acids; 11061-68-0/Insulin; 57-88-5/Cholesterol |
| Investigator | |
Investigator/Affiliation:
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Hannah Farrant / ; Claire Lawrence / ; Edel Magee / ; Kit Tsoi / ; Darren Cole / ; Steve Austin / ; Hanneke Mfuni / ; Kate Guberg / ; Anna Gent / ; Celia Greenberg / ; Caroline Stokes / ; Mario Siervo / ; Rosemary Hall / ; Celia Walker / ; Louise Goff / ; Claire Howard / ; Namrata Dhopatkar / ; Bushra Siddiqui / ; Anne Dornhurst / ; Fiona Lewis / ; Samantha Bowen / ; L Chen / ; Robert Gray / ; Nuala Booth / ; Gary Moore / ; Roy Sherwood / ; Anthony Leeds / ; A Shah / ; G Saran / ; J Niehuser-Saran / ; J A Cockburn / ; Rachel Gitau / ; Katie Newens / ; Sean Lovegrove / ; Ana Rodriguez-Mateos / ; John Wright / ; Margaret Griffin / ; Nicola Harman / |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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