Abstract
Diabetic dyslipidemia with elevated postprandial triglyceride (TG) responses is characteristic in type 2 diabetes (T2D). Diet and meal timing can modify postprandial lipemia (PPL). The impact of a pre-meal of whey proteins (WP) on lipid metabolism is unidentified. We determined whether a WP pre-meal prior to a fat-rich meal influences TG and apolipoprotein B-48 (ApoB-48) responses differentially in patients with and without T2D. Two matched groups of 12 subjects with and without T2D accomplished an acute, randomized, cross-over trial. A pre-meal of WP (20 g) or water (control) was consumed 15 min before a fat-rich meal (supplemented with 20 g WP in case of water pre-meal). Postprandial responses were examined during a 360-min period. A WP pre-meal significantly increased postprandial concentrations of insulin (P < 0.0001), glucagon (P < 0.0001) and glucose-dependent insulinotropic peptide (GIP) (P < 0.0001) in subjects with and without T2D. We detected no effects of the WP pre-meal on TG, ApoB-48, or non-esterified fatty acids (NEFA) responses to the fat-rich meal in either group. Paracetamol absorption i.e., gastric emptying was delayed by the WP pre-meal (P = 0.039). In conclusion, the WP pre-meal induced similar hormone and lipid responses in subjects with and without T2D. Thus, the WP pre-meal enhanced insulin, glucagon and GIP responses but did not influence lipid or glucose responses. In addition, we demonstrated that a WP pre-meal reduced gastric emptying in both groups.
Highlights
Persons with type 2 diabetes (T2D) have a 2-3-fold increased risk of developing cardiovascular disease (CVD) [1,2]
We suggested that whey proteins (WP) as a pre-meal is more advantageous in this respect than as part of the main meal
We investigated the impact of a WP pre-meal consumed prior to a fat-rich meal on responses of TG and apolipoprotein B-48 (ApoB-48) in subjects with and without T2D
Summary
Persons with type 2 diabetes (T2D) have a 2-3-fold increased risk of developing cardiovascular disease (CVD) [1,2]. PPL with increased chylomicron levels, reflected by apolipoprotein B-48 (ApoB-48), is an independent risk factor for CVD in persons with and without T2D [4,5,6]. Lipolysis of triglycerides (TG) in chylomicrons generates TG-rich remnant lipoproteins that can accumulate in the arterial intima and lead to atherosclerosis [7]. The quality of both dietary protein and fat influence the magnitude of PPL in persons with and without T2D [8]. WP is a potent insulinotropic substance that lowers postprandial blood glucose responses to a carbohydrate-rich
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