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

William C Hsu,Ka Hei Karen Lau,Motonobu Matsumoto,George L King,Dalia Moghazy,Hillary Keenan,Francesca D'Addio

doi:10.1371/journal.pone.0106851

William C Hsu, Ka Hei Karen Lau + Show 5 more

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https://doi.org/10.1371/journal.pone.0106851

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Journal: PloS one	Publication Date: Sep 16, 2014
Citations: 58	License type: CC BY 4.0

Affiliation: Joslin Diabetes Center, Harvard University

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

Highlights

Over the last decade, the prevalence of diabetes has drastically increased in Asia
Twenty-three (71.9%) and 20 (62.5%) felt that traditional Asian diet (TAD) and typical Western diet (TWD) were easy or very easy to follow, respectively. For both TAD and TWD, 28 (87.5%) felt satisfied after eating the meals. In this randomized control pilot feasibility study using isoenergy TAD and TWD, the results showed that the macronutrient composition of TAD improved insulin sensitivity in both AA and Caucasian Americans (CA)
Steady activity level, and the strenuous effort to adjust energy every two weeks to maintain an isoenergy state, a modest weight loss (2–3%) was observed in both AA and CA during TAD, which was not observed during TWD

Summary

Introduction

The prevalence of diabetes has drastically increased in Asia. In 2011, over 50% of the world’s diabetes cases amongst adults were from South East Asia and the Western Pacific [1]. Diabetes prevalence increased from 2.5% in 1994 to 9.7% recently in China, with similar trends observed in Japan, India and Vietnam. The prevalence of diabetes is higher in urban areas than rural regions in Asia by 2–3 fold, correlating to their exposure to Western culture [2]. The progression of the diabetes epidemic among Asian Americans (AA) reflects a similar trend as reported in the New York City Health and Nutrition Examination Survey conducted in 2004. Compared to non-Hispanic white, black and Hispanic subjects, Asians have the highest prevalence of diabetes and impaired fasting glucose (IFG) [2,3]

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