Abstract

Diurnal carbohydrate and fat distribution modulates glycaemic control in rodents. In humans, the optimal timing of both macronutrients and its effects on glycaemic control after prolonged consumption are not studied in detail. In this cross-over trial, 29 non-obese men were randomized to two four-week diets: (1) carbohydrate-rich meals until 13.30 and fat-rich meals between 16.30 and 22.00 (HC/HF) versus (2) inverse sequence of meals (HF/HC). After each trial period two meal tolerance tests were performed, at 09.00 and 15.40, respectively, according to the previous intervention. On the HF/HC diet, whole-day glucose level was increased by 7.9% (p = 0.026) in subjects with impaired fasting glucose and/or impaired glucose tolerance (IFG/IGT, n = 11), and GLP-1 by 10.2% (p = 0.041) in normal glucose-tolerant subjects (NGT, n = 18). Diet effects on fasting GLP-1 (p = 0.009) and PYY (p = 0.034) levels were observed in IFG/IGT, but not in NGT. Afternoon decline of glucose tolerance was more pronounced in IFG/IGT and associated with a stronger decrease of postprandial GLP-1 and PYY levels, but not with changes of cortisol rhythm. In conclusion, the HF/HC diet shows an unfavourable effect on glycaemic control in IFG/IGT, but not in NGT subjects. Consequently, large, carbohydrate-rich dinners should be avoided, primarily by subjects with impaired glucose metabolism.

Highlights

  • Diurnal carbohydrate and fat distribution modulates glycaemic control in rodents

  • The HF/HC diet shows an unfavourable effect on the glycaemic control in impaired fasting glucose (IFG)/impaired glucose tolerance (IGT) subjects, but not in normal glucose tolerant (NGT) subjects

  • In IFG/IGT subjects, whole-day glucose level was increased by 7.9% on the HF/HC diet, whereas in NGT subjects it did not differ between the diets

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Summary

Introduction

The optimal timing of both macronutrients and its effects on glycaemic control after prolonged consumption are not studied in detail In this cross-over trial, 29 non-obese men were randomized to two four-week diets: (1) carbohydrate-rich meals until 13.30 and fat-rich meals between 16.30 and 22.00 (HC/HF) versus (2) inverse sequence of meals (HF/HC). Similar results have been reported for liquid sugar and fructose intake[11,12] These observations support the hypothesis that consumption of fat and carbohydrates at certain time windows within the active phase might beneficially modulate metabolic homeostasis[13]. Epidemiological studies propose a beneficial effect of a carbohydrate-rich diet at the beginning of the day: an increasing carbohydrate intake at the expense of fat in the morning was shown to be protective against the development of diabetes[19] and metabolic syndrome[20]

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