Glycemic Control and Metabolic Adaptation in Response to High-Fat versus High-Carbohydrate Diets-Data from a Randomized Cross-Over Study in Healthy Subjects

Nutrients. 2021 Sep 23;13(10):3322. doi: 10.3390/nu13103322.

Abstract

Granular study of metabolic responses to alterations in the ratio of dietary macro-nutrients can enhance our understanding of how dietary modifications influence patients with impaired glycemic control. In order to study the effect of diets enriched in fat or carbohydrates, fifteen healthy, normal-weight volunteers received, in a cross-over design, and in a randomized unblinded order, two weeks of an iso-caloric high-fat diet (HFD: 60E% from fat) and a high-carbohydrate diet (HCD: 60E% from carbohydrates). A mixed meal test (MMT) was performed at the end of each dietary period to examine glucose clearance kinetics and insulin and incretin hormone levels, as well as plasma metabolomic profiles. The MMT induced almost identical glycemia and insulinemia following the HFD or HCD. GLP-1 levels were higher after the HFD vs. HCD, whereas GIP did not differ. The HFD, compared to the HCD, increased the levels of several metabolomic markers of risk for the development of insulin resistance, e.g., branched-chain amino acid (valine and leucine), creatine and α-hydroxybutyric acid levels. In normal-weight, healthy volunteers, two weeks of the HFD vs. HCD showed similar profiles of meal-induced glycemia and insulinemia. Despite this, the HFD showed a metabolomic pattern implying a risk for a metabolic shift towards impaired insulin sensitivity in the long run.

Keywords: diet; glucagon-like peptide-1; glucose; high-carbohydrate; high-fat; insulin; metabolism.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adaptation, Physiological
  • Adult
  • Appetite
  • Blood Glucose / metabolism
  • Cross-Over Studies
  • Diabetes Mellitus / blood
  • Diet, High-Fat
  • Dietary Carbohydrates
  • Discriminant Analysis
  • Female
  • Gastric Inhibitory Polypeptide / blood
  • Glucagon-Like Peptide 1 / blood
  • Glycemic Control
  • Healthy Volunteers*
  • Humans
  • Incretins / blood
  • Insulin / blood
  • Insulin Resistance
  • Least-Squares Analysis
  • Male
  • Metabolome
  • Risk Factors

Substances

  • Blood Glucose
  • Dietary Carbohydrates
  • Incretins
  • Insulin
  • Gastric Inhibitory Polypeptide
  • Glucagon-Like Peptide 1