Abstract
BackgroundThe intake of meat, particularly processed meat, is a dietary risk factor for diabetes. Meat intake impairs insulin sensitivity and leads to increased oxidative stress. However, its effect on postprandial gastrointestinal hormone (GIH) secretion is unclear. We aimed to investigate the acute effects of two standardized isocaloric meals: a processed hamburger meat meal rich in protein and saturated fat (M-meal) and a vegan meal rich in carbohydrates (V-meal). We hypothesized that the meat meal would lead to abnormal postprandial increases in plasma lipids and oxidative stress markers and impaired GIH responses.MethodsIn a randomized crossover study, 50 patients suffering from type 2 diabetes (T2D) and 50 healthy subjects underwent two 3-h meal tolerance tests. For statistical analyses, repeated-measures ANOVA was performed.ResultsThe M-meal resulted in a higher postprandial increase in lipids in both groups (p<0.001) and persistent postprandial hyperinsulinemia in patients with diabetes (p<0.001). The plasma glucose levels were significantly higher after the V-meal only at the peak level. The plasma concentrations of glucose-dependent insulinotropic peptide (GIP), peptide tyrosine-tyrosine (PYY) and pancreatic polypeptide (PP) were higher (p<0.05, p<0.001, p<0.001, respectively) and the ghrelin concentration was lower (p<0.001) after the M-meal in healthy subjects. In contrast, the concentrations of GIP, PYY and PP were significantly lower after the M-meal in T2D patients (p<0.001). Compared with the V-meal, the M-meal was associated with a larger increase in lipoperoxidation in T2D patients (p<0.05).Conclusion/InterpretationOur results suggest that the diet composition and the energy content, rather than the carbohydrate count, should be important considerations for dietary management and demonstrate that processed meat consumption is accompanied by impaired GIH responses and increased oxidative stress marker levels in diabetic patients.Trial RegistrationClinicalTrials.gov NCT01572402
Highlights
The current guidelines for the treatment of diabetic patients focus primarily on carbohydrate counts [1]
The objective of our study was to examine whether the acute intake of different types of isocaloric meals consumed in amounts typical of normal eating would be associated with different postprandial changes in glucose, lipid, immunoreactive insulin (IRI), gastrointestinal hormone (GIH) and oxidative stress marker levels in patients with type 2 diabetes (T2D) compared with healthy subjects
In both the diabetic and healthy subjects, the postprandial plasma levels of glucose were significantly higher after the vegan meal rich in carbohydrates (V-meal) at only one time point – at peak blood glucose level, after 30 min in healthy subjects and 60 min in patients with T2D
Summary
The current guidelines for the treatment of diabetic patients focus primarily on carbohydrate counts [1]. Studies of patients suffering from diabetes have revealed that dietary fat delays gastric emptying, leading to a lag in glucose absorption [3,4]. Studies suggest that in patients suffering from diabetes, higher fat meals acutely increase the glucose concentration and the requirement for insulin compared with meals containing similar carbohydrate but lower fat contents [5]. Meat intake impairs insulin sensitivity and leads to increased oxidative stress. We aimed to investigate the acute effects of two standardized isocaloric meals: a processed hamburger meat meal rich in protein and saturated fat (M-meal) and a vegan meal rich in carbohydrates (V-meal). We hypothesized that the meat meal would lead to abnormal postprandial increases in plasma lipids and oxidative stress markers and impaired GIH responses
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