Deterioration in carbohydrate metabolism and lipoprotein changes induced by modern, high fat diet in Pima Indians and Caucasians

J Clin Endocrinol Metab. 1991 Jul;73(1):156-65. doi: 10.1210/jcem-73-1-156.


The transition from a high carbohydrate to a high fat diet may explain in part the dramatic increase in the prevalence of noninsulin-dependent diabetes mellitus among Pima Indians over the last century. In this study, 12 Pimas and 12 caucasians, all nondiabetic, were admitted to a metabolic ward and, in random order, fed 2 14-day weight-maintaining diets: a traditional Pima diet (percentage of calories: carbohydrate, 70% fat, 15%; protein, 15%) and a high fat modern diet (carbohydrate, 30%; fat, 50%; protein, 20%). Carbohydrate metabolism was characterized using the modified iv glucose tolerance test (minimal model), the acute insulin responses to arginine during a 3-step glycemic clamp, and the oral glucose tolerance test. Compared with the traditional diet, the modern diet was associated with a decrease in oral glucose tolerance (P less than 0.01) and higher plasma cholesterol concentrations (P less than 0.02). The decline in glucose tolerance was associated with similar insulin-mediated, but 23% lower glucose-mediated (P less than 0.001), glucose disposal, a 17% lower acute insulin response to glucose (P less than 0.03), a 9% lower beta-cell sensitivity to glucose (P less than 0.02), and similar beta-cell capacities. Pimas and caucasians responded similarly, except for larger changes in plasma lipids among the Pimas. Since glucose-mediated glucose disposal, beta-cell function, and glucose tolerance deteriorated on the modern diet, it is likely that diet composition affects the prevalence of noninsulin-dependent diabetes mellitus in both Pimas and caucasians.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Arginine
  • Blood Glucose / metabolism*
  • Cholesterol / blood
  • Dietary Carbohydrates / administration & dosage*
  • Dietary Fats / administration & dosage*
  • Dietary Proteins / administration & dosage
  • Energy Intake
  • Female
  • Glucose Clamp Technique
  • Glucose Tolerance Test
  • Humans
  • Indians, North American*
  • Insulin / blood
  • Lipoproteins / blood*
  • Lipoproteins, HDL / blood
  • Lipoproteins, LDL / blood
  • Male
  • Triglycerides / blood
  • White People


  • Blood Glucose
  • Dietary Carbohydrates
  • Dietary Fats
  • Dietary Proteins
  • Insulin
  • Lipoproteins
  • Lipoproteins, HDL
  • Lipoproteins, LDL
  • Triglycerides
  • Arginine
  • Cholesterol