Improvement of insulin sensitivity by isoenergy high carbohydrate traditional Asian diet: a randomized controlled pilot feasibility study

PLoS One. 2014 Sep 16;9(9):e106851. doi: 10.1371/journal.pone.0106851. eCollection 2014.

Abstract

The prevalence of diabetes is rising dramatically among Asians, with increased consumption of the typical Western diet as one possible cause. We explored the metabolic responses in East Asian Americans (AA) and Caucasian Americans (CA) when transitioning from a traditional Asian diet (TAD) to a typical Western diet (TWD), which has not been reported before. This 16-week randomized control pilot feasibility study, included 28AA and 22CA who were at risk of developing type 2 diabetes. Eight weeks of TAD were provided to all participants, followed by 8 weeks of isoenergy TWD (intervention) or TAD (control). Anthropometric measures, lipid profile, insulin resistance and inflammatory markers were assessed. While on TAD, both AA and CA improved in insulin AUC (-960.2 µU/mL × h, P = 0.001) and reduced in weight (-1.6 kg; P<0.001), body fat (-1.7%, P<0.001) and trunk fat (-2.2%, P<0.001). Comparing changes from TAD to TWD, AA had a smaller weight gain (-1.8 to 0.3 kg, P<0.001) than CA (-1.4 to 0.9 kg, P = 0.001), but a greater increase in insulin AUC (AA: -1402.4 to 606.2 µU/mL × h, P = 0.015 vs CA: -466.0 to 223.5 µU/mL × h, P = 0.034) and homeostatic static model assessment-insulin resistance (HOMA-IR) (AA: -0.3 to 0.2, P = 0.042 vs CA: -0.1 to 0.0, P = 0.221). Despite efforts to maintain isoenergy state and consumption of similar energy, TAD induced weight loss and improved insulin sensitivity in both groups, while TWD worsened the metabolic profile.

Trial registration: ClinicalTrials.gov NCT00379548.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Asian Americans
  • Carbohydrate Metabolism*
  • Diabetes Mellitus, Type 2 / epidemiology
  • Diabetes Mellitus, Type 2 / etiology
  • Diabetes Mellitus, Type 2 / metabolism
  • Diet*
  • Dietary Carbohydrates*
  • Feasibility Studies
  • Female
  • Health Surveys
  • Humans
  • Insulin Resistance*
  • Male
  • Pilot Projects
  • Risk Factors
  • Whites

Substances

  • Dietary Carbohydrates

Associated data

  • ClinicalTrials.gov/NCT00379548

Grant support

This study was funded by Asian American Diabetes Initiative, Joslin Diabetes Center and Sunstar, Inc. M. Matsumoto is a paid member of Sunstar, Inc. and was responsible in conducting the research. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.