Effects of Saturated Fat, Polyunsaturated Fat, Monounsaturated Fat, and Carbohydrate on Glucose-Insulin Homeostasis: A Systematic Review and Meta-analysis of Randomised Controlled Feeding Trials
Publication Date
July 19, 2016
Journal
PLOS Medicine
Authors
Fumiaki Imamura, Renata Micha, Jason H. Y. Wu, Marcia C. De Oliveira Otto, et al
Volume
13
Issue
7
Pages
e1002087
DOI
http://doi.org/10.1371/journal.pmed.1002087
Publisher URL
http://journals.plos.org/plosmedicine/article?id=10.1371%2Fjournal.pmed.1002087
Web of Science
000383354300014
Scopus
84979640426
Mendeley
http://www.mendeley.com/research/effects-saturated-fat-polyunsaturated-fat-monounsaturated-fat-carbohydrate-glucoseinsulin-homeostasi
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{"title"=>"Effects of Saturated Fat, Polyunsaturated Fat, Monounsaturated Fat, and Carbohydrate on Glucose-Insulin Homeostasis: A Systematic Review and Meta-analysis of Randomised Controlled Feeding Trials", "type"=>"journal", "authors"=>[{"first_name"=>"Fumiaki", "last_name"=>"Imamura", "scopus_author_id"=>"56890773000"}, {"first_name"=>"Renata", "last_name"=>"Micha", "scopus_author_id"=>"25632461800"}, {"first_name"=>"Jason H.Y.", "last_name"=>"Wu", "scopus_author_id"=>"8511954600"}, {"first_name"=>"Marcia C.", "last_name"=>"de Oliveira Otto", "scopus_author_id"=>"45661078500"}, {"first_name"=>"Fadar O.", "last_name"=>"Otite", "scopus_author_id"=>"55866807600"}, {"first_name"=>"Ajibola I.", "last_name"=>"Abioye", "scopus_author_id"=>"56003242400"}, {"first_name"=>"Dariush", "last_name"=>"Mozaffarian", "scopus_author_id"=>"56751007100"}], "year"=>2016, "source"=>"PLoS Medicine", "identifiers"=>{"doi"=>"10.1371/journal.pmed.1002087", "sgr"=>"84979640426", "isbn"=>"1549-1676", "pmid"=>"27434027", "issn"=>"15491676", "scopus"=>"2-s2.0-84979640426", "pui"=>"611541387"}, "id"=>"df8ec3a6-b53f-37b7-9a3d-c13536cc97d5", "abstract"=>"BACKGROUND Effects of major dietary macronutrients on glucose-insulin homeostasis remain controversial and may vary by the clinical measures examined. We aimed to assess how saturated fat (SFA), monounsaturated fat (MUFA), polyunsaturated fat (PUFA), and carbohydrate affect key metrics of glucose-insulin homeostasis. METHODS AND FINDINGS We systematically searched multiple databases (PubMed, EMBASE, OVID, BIOSIS, Web-of-Knowledge, CAB, CINAHL, Cochrane Library, SIGLE, Faculty1000) for randomised controlled feeding trials published by 26 Nov 2015 that tested effects of macronutrient intake on blood glucose, insulin, HbA1c, insulin sensitivity, and insulin secretion in adults aged ≥18 years. We excluded trials with non-isocaloric comparisons and trials providing dietary advice or supplements rather than meals. Studies were reviewed and data extracted independently in duplicate. Among 6,124 abstracts, 102 trials, including 239 diet arms and 4,220 adults, met eligibility requirements. Using multiple-treatment meta-regression, we estimated dose-response effects of isocaloric replacements between SFA, MUFA, PUFA, and carbohydrate, adjusted for protein, trans fat, and dietary fibre. Replacing 5% energy from carbohydrate with SFA had no significant effect on fasting glucose (+0.02 mmol/L, 95% CI = -0.01, +0.04; n trials = 99), but lowered fasting insulin (-1.1 pmol/L; -1.7, -0.5; n = 90). Replacing carbohydrate with MUFA lowered HbA1c (-0.09%; -0.12, -0.05; n = 23), 2 h post-challenge insulin (-20.3 pmol/L; -32.2, -8.4; n = 11), and homeostasis model assessment for insulin resistance (HOMA-IR) (-2.4%; -4.6, -0.3; n = 30). Replacing carbohydrate with PUFA significantly lowered HbA1c (-0.11%; -0.17, -0.05) and fasting insulin (-1.6 pmol/L; -2.8, -0.4). Replacing SFA with PUFA significantly lowered glucose, HbA1c, C-peptide, and HOMA. Based on gold-standard acute insulin response in ten trials, PUFA significantly improved insulin secretion capacity (+0.5 pmol/L/min; 0.2, 0.8) whether replacing carbohydrate, SFA, or even MUFA. No significant effects of any macronutrient replacements were observed for 2 h post-challenge glucose or insulin sensitivity (minimal-model index). Limitations included a small number of trials for some outcomes and potential issues of blinding, compliance, generalisability, heterogeneity due to unmeasured factors, and publication bias. CONCLUSIONS This meta-analysis of randomised controlled feeding trials provides evidence that dietary macronutrients have diverse effects on glucose-insulin homeostasis. In comparison to carbohydrate, SFA, or MUFA, most consistent favourable effects were seen with PUFA, which was linked to improved glycaemia, insulin resistance, and insulin secretion capacity.", "link"=>"http://www.mendeley.com/research/effects-saturated-fat-polyunsaturated-fat-monounsaturated-fat-carbohydrate-glucoseinsulin-homeostasi", "reader_count"=>88, "reader_count_by_academic_status"=>{"Unspecified"=>5, "Professor > Associate Professor"=>1, "Librarian"=>1, "Student > Doctoral Student"=>4, "Researcher"=>15, "Student > Ph. D. Student"=>16, "Student > Postgraduate"=>6, "Student > Master"=>8, "Other"=>12, "Student > Bachelor"=>16, "Lecturer"=>1, "Lecturer > Senior Lecturer"=>1, "Professor"=>2}, "reader_count_by_user_role"=>{"Unspecified"=>5, "Professor > Associate Professor"=>1, "Librarian"=>1, "Student > Doctoral Student"=>4, "Researcher"=>15, "Student > Ph. D. Student"=>16, "Student > Postgraduate"=>6, "Student > Master"=>8, "Other"=>12, "Student > Bachelor"=>16, "Lecturer"=>1, "Lecturer > Senior Lecturer"=>1, "Professor"=>2}, "reader_count_by_subject_area"=>{"Unspecified"=>5, "Agricultural and Biological Sciences"=>13, "Veterinary Science and Veterinary Medicine"=>1, "Chemistry"=>4, "Computer Science"=>2, "Engineering"=>2, "Nursing and Health Professions"=>13, "Biochemistry, Genetics and Molecular Biology"=>4, "Medicine and Dentistry"=>27, "Neuroscience"=>4, "Sports and Recreations"=>3, "Psychology"=>1, "Social Sciences"=>6, "Immunology and Microbiology"=>2, "Economics, Econometrics and Finance"=>1}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>27}, "Social Sciences"=>{"Social Sciences"=>6}, "Sports and Recreations"=>{"Sports and Recreations"=>3}, "Psychology"=>{"Psychology"=>1}, "Unspecified"=>{"Unspecified"=>5}, "Engineering"=>{"Engineering"=>2}, "Chemistry"=>{"Chemistry"=>4}, "Neuroscience"=>{"Neuroscience"=>4}, "Immunology and Microbiology"=>{"Immunology and Microbiology"=>2}, "Economics, Econometrics and Finance"=>{"Economics, Econometrics and Finance"=>1}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>13}, "Computer Science"=>{"Computer Science"=>2}, "Nursing and Health Professions"=>{"Nursing and Health Professions"=>13}, "Biochemistry, Genetics and Molecular Biology"=>{"Biochemistry, Genetics and Molecular Biology"=>4}, "Veterinary Science and Veterinary Medicine"=>{"Veterinary Science and Veterinary Medicine"=>1}}, "reader_count_by_country"=>{"New Zealand"=>1, "United States"=>1, "Spain"=>1}, "group_count"=>1}

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