Abstract
Background: Inflammation is considered as a predictor of cardiovascular diseases in type 2 diabetes mellitus. No previous studies have investigated the effect of low glycemic index (LGI) recipes of South Indian cuisine on the risk factors of cardiovascular disease in patients with diabetes. Aim: The aim of this randomized controlled trial was to evaluate the improvement in cardiovascular risk factors and blood glucose control, in patients with type 2 diabetes, after intervention with recipes of Kerala cuisine, from locally available whole grain cereals, low in glycemic index. Method: This was a prospective and randomized controlled study that was conducted over a period of 24 weeks. A total of 80 participants were recruited from the Department of Endocrinology and Diabetes Outpatient in Kerala, South India. All 80 patients had type 2 diabetes, and were aged between 35 and 65 years. Participants were randomly assigned and advised to follow either a LGI diet plan (n = 40) or their usual diet, which served as a control group (n = 40). The advice was reinforced throughout the study period. Anthropometric, biochemical parameters which included glycemic and cardio-metabolic parameters were measured according to standard procedures. T-tests were conducted to compare the differences between intervention and control groups, and the Pearson correlation coefficient was used to evaluate associations between the variables. Results: There were significant differences (p < 0.05) between the intervention and control groups with respect to weight, HbA1c, insulin, triglycerides, Homeostatic Model Assessment of Insulin Resistance (HOMA-IR), high sensitivity C-reactive protein (hs-CRP) and apolipoprotein B (ApoB). There was also a positive correlation between weight and blood glucose variables. ApoB was positively correlated with lipid profile and insulin levels. Conclusions: The long-term implementation of LGI diet of Kerala cuisine has been found to promote weight loss, enhance insulin sensitivity and reduce the cardiovascular risk.
Highlights
Diabetes mellitus is a well-established risk factor for cardiovascular disease, and an increased incidence of coronary artery disease and cardiovascular mortality has been strongly associated with the presence of metabolic syndrome [1] This linkage has been corroborated by the notably higher morbidity and mortality rate in patients with diabetes compared to non-diabetic individuals
Some of the factors associated with the increased risks of cardiovascular disease in diabetes mellitus are higher levels of low density lipoprotein (LDL) cholesterol, elevated blood pressure, lower levels of high density lipoprotein (HDL) cholesterol, insulin resistance, hyperglycemia, inflammation, hypertension, dyslipidemia and obesity [2]
South Indian Kerala cuisine were significant improvements in glycated hemoglobin and cardiovascular risk factors such as high sensitivity C-reactive protein (hs-C-reactive protein (CRP)), fasting insulin, Homeostatic Model Assessment of Insulin Resistance (HOMA-IR), triglycerides and weight in the intervention group compared with the control group and non-significant reductions in systolic blood pressure, total cholesterol and HDL
Summary
Diabetes mellitus is a well-established risk factor for cardiovascular disease, and an increased incidence of coronary artery disease and cardiovascular mortality has been strongly associated with the presence of metabolic syndrome [1] This linkage has been corroborated by the notably higher morbidity and mortality rate in patients with diabetes compared to non-diabetic individuals. Some of the factors associated with the increased risks of cardiovascular disease in diabetes mellitus are higher levels of low density lipoprotein (LDL) cholesterol, elevated blood pressure, lower levels of high density lipoprotein (HDL) cholesterol, insulin resistance, hyperglycemia, inflammation, hypertension, dyslipidemia and obesity [2]. Inflammatory-response proteins are considered as predictors of cardiovascular events. Inflammation is considered as a predictor of cardiovascular diseases in type 2 diabetes mellitus. Recipes of South Indian cuisine on the risk factors of cardiovascular disease in patients with diabetes
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