High Carbohydrate Consumption Research Articles

Profile Development of Noncommunicable Chronic Diseases in a Brazilian Rural Town

Objective: To assess the relationship between socioeconomic and anthropometric data, frequency of food consumption, and the development of noncommunicable diseases (NCDs) in patients from a small rural town in northeastern Brazil.Methods: A cross-sectional questionnaire study was performed on patients from the Lagarto City Hospital (n = 50) and from family health units (n = 370).Results: The 420 patients in the study had one or more NCDs such as hypertension, type 2 diabetes mellitus, and dyslipidemia. The mean age was 63.1 ± 8.7 years for both sexes. The typical patient was of mixed or black descent (66%), a farmer, and of low socioeconomic status and education; 100% of men and 84% of women were illiterate or had less than 4 years of schooling. Approximately 50% of women and 89% of men were married and most had never used tobacco or were ex-smokers. The body mass index (BMI) of the study population was 29.4 ± 5.5 kg/m2, where 70% of the patients were type 2 diabetic with waist circumferences of 99.8 ± 21.2 cm for men and 98.1 ± 13.9 cm for women. The correlation between BMI and waist circumference was r = 0.88. Even with the use of medication, total cholesterol levels of above 240 mg/dL were recorded in 10% of women and about 5% of men. Likewise, 10% of women and 100% of men had triglyceride levels above 200 mg/dL; glucose levels were 133.6 ± 47.4 mg/dL in men and 110.8 ± 38.8 mg/dL in women. Blood pressure values were high, even in patients using one or more antihypertensive drugs for at least 2 years (systolic pressure = 128.5 ± 18.2; diastolic pressure = 86.3 ± 8.9 mmHg). Indices considered above the limit recommended by the World Health Organization (WHO) were obtained for 60% of women and 100% of men. Our research revealed that this population is characterized by a relatively low intake of fats and oils. Nevertheless, 100% of patients consumed meat every day, 57.6% never consumed processed foods such as candy or soft drinks, and 89% consumed coffee daily. Furthermore, the consumption of fruits was very low: 46.6% of respondents never ate fruit and 7.8% rarely consumed fruit. Likewise, 68.2% reported never eating milk and dairy products. Vegetables were consumed by only 51.4% of the population and 38.5% rarely or never consumed green vegetables. Products made from wheat, maize, cassava, beans, and rice were often consumed by 59.2% of the population.Conclusions: Our results indicate that the studied population is affected by nutritional transition, in which the greater access to carbohydrates and animal proteins is associated with high BMI, with the vast majority overweight and suffering from uncontrolled hypertension despite the use of medications. The high consumption of carbohydrates and animal protein, rapid urbanization, and sedentary lifestyle are the main factors responsible for the epidemic of noncommunicable diseases, especially among people with low income and education. Men are particularly affected, with increased visceral fat characterized by an increased waist circumference.

Restoration of autophagy alleviates hepatic ER stress and impaired insulin signalling transduction in high fructose-fed male mice.

High-carbohydrate (mainly fructose) consumption is a major dietary factor for hepatic insulin resistance, involving endoplasmic reticulum (ER) stress and lipid accumulation. Because autophagy has been implicated in ER stress, the present study investigated the role of autophagy in high-fructose (HFru) diet-induced hepatic ER stress and insulin resistance in male C57BL/6J mice. The results show that chronic HFru feeding induced glucose intolerance and impaired insulin signaling transduction in the liver, associated with ER stress and the accumulation of lipids. Intriguingly, hepatic autophagy was suppressed as a result of activation of mammalian target of rapamycin. The suppressed autophagy was detected within 6 hours after HFru feeding along with activation of both inositol-requiring enzyme 1 and protein kinase RNA-like endoplasmic reticulum kinase pathways. These events occurred prior to lipid accumulation or lipogenesis and were sufficient to blunt insulin signaling transduction with activation of c-Jun N-terminal kinase/inhibitory-κB kinase and serine phosphorylation of insulin receptor substrate 1. The stimulation of autophagy attenuated ER stress- and c-Jun N-terminal kinase/inhibitory-κB kinase-associated impairment in insulin signaling transduction in a mammalian target of rapamycin -independent manner. Taken together, our data suggest that restoration of autophagy functions disrupted by fructose is able to alleviate ER stress and improve insulin signaling transduction.

Dental Caries and Obesity in Children of Age Groups 5–9 Years: A Preliminary Study

Aim : The aim of the study is to evaluate the relationship between childhood obesity and dental caries in paediatric subjects of age group 5-9 years. Background : There exists a positive correlation between dental caries and Body Mass Index (BMI). Food habits, more specifically high consumption of carbohydrates has been reported to be the reason for increasing obesity and dental ociation between dental caries and obesity is influenced by many factors such as biological, genetic, socioeconomic, cultural , dietary and lifestyle. Materials and methods: The survey is to be done for a sample of 200 school children in the 5-9 years age group. A dental and overall examination is done to calculate basic parameters such as weight, height and DMFT score. The participants are categorised as underweight, normal, overweight and obese after calculating the BMI. The relationship between DMFT and BMI is assessed with appropriate sample weighting. Reason : This survey will provide a better understanding between the relation between obesity and dental caries.

Pre-transplant predictors of one yr weight gain after kidney transplantation.

Clinically useful predictors of weight gain could be used to reduce the epidemic of post-kidney transplant obesity and resulting co-morbidities. The purpose of this study was to identify predictors of weight gain at 12 months following kidney transplant in a cohort of 96 recipients. Demographic, clinical, and environmental data were obtained at transplant and 12 months. Descriptive, correlational, and Bayesian network analysis were used to identify predictors. For the 52 (55.9%) recipients who gained weight, the average amount gained was 9.18±6.59kg. From the 15 baseline factors that met inclusion criteria, Bayesian network modeling identified four baseline predictors for weight gain: younger age, higher carbohydrate consumption, higher trunk fat percentage, and higher perception of mental health quality of life. Three are modifiable through either pre- or immediate post-transplant clinical intervention programs.

SĄSAJOS TARP SUAUGUSIŲJŲ MITYBOS ĮPROČIŲ BEI ĖDUONIES SUSIDARYMO

Straipsnyje pristatomo tyrimo metu buvo siekiama nustatyti sąsajas tarp suaugusiųjų mitybos įpročių ir ėduonies susidarymo. Tyrime dalyvavo atsitiktinai atrinkti, savanoriškai norintys atsakyti į anketos klausimus 153 Kauno kolegijos ir privačios odontologijos klinikos suaugusieji - nuo 18 iki 65 metų. Tyrimas parodė, kad dantų ėduonies paplitimas tarp suaugusiųjų siekė 100 proc. KPI indekso vidurkio reikšmė – 5,6. Pusės suaugusiųjų mitybos įpročiai nėra sveiki. Tarp tirtų suaugusiųjų (67%) angliavandeniai sudarė didžiąją mitybos dalį. Iš jų tik 10 proc. raciono sudarė pieno produktai. Daržovės (3%) ir žuvis (5%) sudarė mažąją mitybos raciono dalį. Nustatyta, kad didelis angliavandenių vartojimas ir nesubalansuotas daržovių, žuvies, mėsos ir pieno produktų vartojimas yra reikšmingai susiję su dideliu ėduonies intensyvumu.

Abstract 444: Angiotensinogen Inhibition Reduces Atherosclerosis and Body Weight Gain Induced by High-Carbohydrate Diet

Background and Objective: Angiotensinogen (AGT) is the unique precursor of the renin angiotensin system. Our previous studies demonstrated that inhibition of AGT markedly reduced development of atherosclerosis and ablated body weight gain induced by a saturated fat-enriched diet. In addition to high fat intake, high carbohydrate consumption is an important component of contemporary diets. The purpose of this study was to determine whether AGT inhibition prevented atherosclerosis and obesity in LDL receptor -/- mice fed a high carbohydrate diet. Methods and Results: Eight week old male LDL receptor -/- mice were randomized to receive either control or AGT antisense oligonucleotides (ASO; 50 mg/kg/week intraperitoneal injection; N = 10 mice/group). Feeding a high carbohydrate diet was initiated after 6 weeks of ASO injection, and maintained for 12 weeks with continuous ASO injection. AGT-ASO administration profoundly reduced plasma AGT concentrations (Control vs AGT ASO: 3582 ± 117 vs 227 ± 15 ng/ml; P<0.001). High carbohydrate diet feeding resulted in profound increases of plasma cholesterol concentrations in both groups. Atherosclerotic lesions in aortic arches were measured using an en face method after termination. AGT inhibition led to significant decreases (P<0.001) in percentage lesion areas of aortic arches. Prior to high carbohydrate diet feeding, there was no difference of body weight between the two groups (Control vs AGT ASO: 26.6 ± 0.6 vs 25.9 ± 0.7 g; P=0.4). Although high carbohydrate diet only increased body weight modestly, mice injected with AGT ASO had less increases of body weight compared to mice injected with control ASO (Control vs AGT ASO: 28.5 ± 0.6 vs 26.8 ± 0.6 g; P<0.05). Echo MRI analyses demonstrated that the lower body weight in mice administered AGT ASO was attributed to less fat mass gain, whereas lean mass was comparable between the two groups. Additionally, AGT inhibition resulted in lower blood hemoglobin A1c (5.5 ± 0.1 vs 5.1 ± 0.1%; P=0.005). Conclusions: AGT inhibition reduces high carbohydrate diet-induced atherosclerosis and body weight gain.

Evaluation of the dietary pattern of patients with type 2 diabetes in Northern Jordan: An inconvenient truth!

This cross-sectional study aimed to evaluate the dietary profile of patients with type 2 diabetes in northern Jordan. 750 patients aged between 22 and 84 years were recruited from the endocrinology clinics at King Abdulla University Hospital in northern Jordan. Dietary assessment was performed using valid semi-quantitative food frequency questionnaire (FFQ). Glycosylated hemoglobin, height, body weight and waist circumference were measured. Both, males and females, failed to meet the recommended target of glycosylated hemoglobin, BMI, and waist circumference. Patients reported high intakes of fruits (~4.5 servings/day) and grains (~17 servings/day); enough intakes of vegetables (~4 servings/day) and low intakes of milk (~1.5 servings/day), meat and beans (~1 serving/day). High intakes of fiber, simple sugar and sodium were observed. Macronutrient contribution to daily caloric consumption was 65 % from carbohydrates, 13 % protein, and 29 % fat (distributed as 8 % from saturated fat, 14 % from monounsaturated fat, and 3.5 % from polyunsaturated fat). In conclusion, the dietary profile for diabetic patients in Jordan failed to meet the recommendations in several aspects including, high consumption of carbohydrates, sugar, and sodium; and low intake of PUFA.

Mediterranean Diet and Minimizing Neurodegeneration

Neurodegenerative diseases, a complex of diseases that ranges from cognitive decline, dementia, to Alzheimer’s disease represent, to date, a public health priority all over the world. Recently, an increasing interest for a possible relationship between diet and cognitive health has been reported. Several models of diet have been proposed but, until now, the highest attention of researchers, clinicians, and institutions has been focused on the Mediterranean diet. Mediterranean diet is a model of diet characterized by a high consumption of complex carbohydrates, fruit and vegetables, legumes, with olive oil as the principal source of fats. Mediterranean diet has been extensively reported to be associated with a favorable health outcome and a better quality of life, but inconsistencies on the possible association with neurodegenerative diseases have been reported. The purpose of this review was to examine the most updated evidence of the beneficial effects of Mediterranean diet on the occurrence of neurodegenerative diseases.

High carbohydrate–low protein consumption maximizes Drosophila lifespan

Dietary restriction extends lifespan in a variety of organisms, but the key nutritional components driving this process and how they interact remain uncertain. In Drosophila, while a substantial body of research suggests that protein is the major dietary component affecting longevity, recent studies claim that carbohydrates also play a central role. To clarify how nutritional factors influence longevity, nutrient consumption and lifespan were measured on a series of diets with varying yeast and sugar content. We show that optimal lifespan requires both high carbohydrate and low protein consumption, but neither nutrient by itself entirely predicts lifespan. Increased dietary carbohydrate or protein concentration does not always result in reduced feeding—the regulation of food consumption is best described by a constant daily caloric intake target. Moreover, due to differences in food intake, increased concentration of a nutrient within the diet does not necessarily result in increased consumption of that particular nutrient. Our results shed light on the issue of dietary effects on lifespan and highlight the need for accurate measures of nutrient intake in dietary manipulation studies.

Is the Cost of the Mediterranean Diet a Barrier for its Promotion in the Communities?

A persuasive body of evidence from prospective cohort studies suggests that the Mediterranean diet (MD) is protective against the occurrence of several different health outcomes [1]. The diet refers to a dietary profile commonly available in the early 1960s in the Mediterranean regions and characterized by a high consumption of fruit, vegetables, legumes, and complex carbohydrates, with a moderate consumption of fish, and the consumption of olive oil as the main source of fats, a low-to-moderate amount of red wine during meals and a rare consumption of red meat. Thus, its adoption is very important among people of all ages. However, the higher cost per calorie of some recommended healthful foods included in the MD, such as fruit and vegetables, may restrict their use by people with limited resources [2]. Regarding studies investigating the MD in relation to its cost, a cohort study of Spanish university graduates showed that a Mediterranean dietary pattern is more expensive to follow than a western dietary pattern [3]. A more recent cross-sectional study on a sample of Italian subjects revealed that a higher income was independently associated with a greater adherence to MD-like eating patterns [4]. On the other hand, a nutritional intervention study conducted in a group of North American women showed that promoting a Mediterranean dietary pattern need not necessarily be associated with higher overall dietary costs [5]. Educating consumers about lower cost foods while selectively purchasing limited amounts of higher cost ones would be one solution for avoiding increased food expenses in the frame of a healthy diet. Another way to improve food preferences in communities and especially in those of low-income would be to increase the price of unhealthy foods in parallel with subsidies on healthy foods. Further studies on whether cost should be considered or not as a barrier in the adoption of the MD would shed more light on this issue.

Assessment of monosodium glutamate (MSG) intake in a rural Thai community: questioning the methodological approach

We examined the methodological approach to the assessment of monosodium glutamate intake. The high carbohydrate and low fat consumption characteristic of this study population would be conducive to the development of metabolic syndrome. However, anomalies in the assessment of dietary information limits conclusion to a causal link of monosodium glutamate to metabolic syndrome and overweight because the study lacks data on the main dietary patterns of consumption. Given the current paucity of data from human studies on monosodium glutamate intake and risk, more studies with robust methodology are required to assess causal links to disease.

Effects of ethanol on CYP2E1 levels and related oxidative stress using a standard balanced diet

Expression of cytochrome P4502E1 (CYP2E1) is very much influenced by nutritional factors, especially carbohydrate consumption, and various results concerning the expression of CYP2E1 were obtained with a low-carbohydrate diet. This study describes the effects of ethanol treatment on CYP2E1 levels and its relationship with oxidative stress using a balanced standard diet to avoid low or high carbohydrate consumption. Rats were fed for 1, 2, 3, or 4 weeks a commercial diet plus an ethanol-sucrose solution. The results have shown that ethanol administration was associated with CYP2E1 induction and stabilization without related oxidative stress. Our findings suggest that experimental models with a low-carbohydrate/high-fat diet produce some undesirable CYP2E1 changes that are not present when a balanced standard diet is given.

Carbohydrates for Physical Activity

Intake of carbohydrates above the dietary guidelines to support performance of physical activity is common but may be unnecessary and counterproductive. Sports nutrition guidelines have not been designed to incorporate characteristics that may make high carbohydrate consumption a source of metabolic stress that may increase oxidative stress, inflammation, and lipogenesis. This metabolic stress is linked to the physiology underlying the development of insulin resistance, type 2 diabetes mellitus, and cardiovascular diseases. This review describes research-based evidence to aid in bridging the gap between dietary guidelines for overall health and those to support physical activity. Characteristics that increase the likelihood of metabolic stress resulting from carbohydrate intake include overweight and obesity, central/visceral adiposity, older age, sedentary lifestyle, and caloric state. Carbohydrate-based foods that provide the most health benefits are whole grains, beans and legumes, fruits, and vegetables. Carbohydrate-based foods that most readily elicit metabolic stress are those with added sugars and refined grains or that have a high glycemic index. A checklist that incorporates both the number of these characteristics and prevailing guidelines for nutrition and physical activity is presented. This may be useful in determining whether additional carbohydrates are needed to support the physical activity level of the individual.

An exploratory mixed method assessment of low income, pregnant Hispanic women’s understanding of gestational diabetes and dietary change

Objective: To describe and assess low income, healthy, pregnant Hispanic women’s understanding of gestational diabetes (GDM) and willingness to change aspects of their diet. Design: One-on-one, in-person interviews conducted in Spanish with 94 women (primarily Mexican). Setting: Federal Qualified Community Health Center’s prenatal clinic. Method: Exploratory two-phased mixed method with a survey of knowledge and attitudes towards gestational diabetes and dietary change, and interviews. In phase two, participants were shown a flyer with the amount of carbohydrates in tortillas and fruit juice in comparison to a candy bar and told of the importance of drinking one glass of water before each meal. Results: Interest in having a healthy baby was high for all participants. Review of a 24-hour dietary recall identified high consumption of carbohydrates and low intake of green and leafy vegetables and water. Family involvement, especially involvement of the husband, was central to almost all the participants’ views about food purchase, preparation and consumption. In the phase two follow-up, most women tried to improve their water intake but no-one reported being able to decrease the number of tortillas eaten. Conclusion: The overall profile of attitudes, knowledge, diet and willingness to change aspects of a diet offers additional direction on how to counsel this patient group on ways to decrease risk of GDM. Given Hispanic women’s elevated risk for GDM, small dietary changes presented in culturally relevant, straightforward messages about commonly eaten foods might result in improved health for the mother and the broader family.

Increased hepatic fat in overweight Hispanic youth influenced by interaction between genetic variation in PNPLA3 and high dietary carbohydrate and sugar consumption

Recently, a genetic variant (rs738409; C→G) of the PNPLA3 gene was identified to be associated with increased hepatic fat deposition, and the effect was more pronounced in Hispanics. Animal models have also shown that PNPLA3 expression can be regulated by dietary carbohydrate. The aim of this study was to examine whether the influence of PNPLA3 genotype on hepatic fat is modulated by dietary factors in Hispanic children. PNPLA3 was genotyped in 153 Hispanic children (75% female, ages 8-18 y) by using the TaqMan method. Dietary intake was assessed by using three 24-h dietary recalls or diet records. Visceral adipose tissue (VAT), subcutaneous abdominal adipose tissue (SAAT), and hepatic fat fraction (HFF) were assessed in multiple abdominal slices by magnetic resonance imaging. Analysis of covariance was used to assess the diet × genotype interaction in liver fat, with the following a priori covariates: sex, age, energy, VAT, and SAAT. HFF was influenced by a significant interaction between genotype and diet (genotype × carbohydrate, P = 0.04; genotype × total sugar, P = 0.01). HFF was positively related to carbohydrate (r = 0.31, P = 0.04) and total sugar (r = 0.34, P = 0.02) intakes but only in the GG group, independent of covariates. Dietary variables were not related to HFF in the CC or CG group or to other fat depots in all genotype groups. These findings suggest that Hispanic children carrying the GG genotype are susceptible to increased hepatic fat when dietary carbohydrate intake, specifically sugar, is high. Specific dietary interventions based on genetic predisposition in this population may lead to more effective therapeutic outcomes for fatty liver. This trial was registered at clinicaltrials.gov as NCT00697580, 195-1642394A1, and NCT00693511.

Effects of Exercise-Induced Muscles Damage on Regulation of Glucose Metabolism and Cytokines Regulation

This study was aimed to investigate the effects of exercise-induced muscle damage on the changes in blood glucose, serum insulin, creatine kinase (CK) and cytokines during five days post recovery period. Ten male elite swimmers of a school team were recruited as subjects in this study. All the subjects were under detraining for ten days, and the blood samples were collected before the single training as baseline levels. Subjects were asked to be trained under a designed program with an experienced trainer and the blood samples were collected after training and also one day, three days and five days after training. Blood glucose metabolism, bio-indicators such as CK, interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) were analyzed as the indexes in post recovery period. One-way ANOVA has been used to determine the significance between baseline and different recovery time periods. In the analysis of glucose metabolism test, fasting blood glucose, serum insulin, and HOMAIR which were seen as insulin resistance indexes were significantly higher (p＜.05) on the first day of the post recovery period. But the insulin resistance status was not continuously found in the third and fifth day after training. Meanwhile, the CK levels were truly higher (p＜.05) from the first day to the fifth day of recovery period. The pro-inflammatory cytokine IL-6 known as energy sensor in muscle was elevated significantly (p＜.05) from the first day to the end of the recovery period, and TNF-α was increased significantly (p＜.05) as IL-6 after single bout of high intensity training. These results conclude that acute intense training-induced muscle damage causes a short term of insulin resistance from exhausting of muscle glycogen. Monitoring of cytokines such as IL-6 and TNF-α could be biomarkers that indicated the recovery status of during the post training period. In the beginning of the muscle damage, high quality protein intakes should promote the muscle repairing, and then high carbohydrate consumption could help with glycogen replenish in the recovery period.

Dietary Sugars and Lipid Metabolism

Higher carbohydrate consumption is associated with lower HDL cholesterol (HDL-C) and higher LDL cholesterol (LDL-C) levels. Now, investigators have

Integrating resource utilization and temperature in metabolic scaling of riverine bacterial production

The study of metabolic scaling in stream ecosystems is complicated by their openness to external resource inputs. For heterotrophic bacteria, which are a large component of stream metabolism, it may be possible to integrate the effects of resource availability and temperature on production using metabolic scaling theory and the kinetics of extracellular enzyme activity (EEA) associated with the degradation of major nutrient pools. With this goal, we analyzed previously published data on EEA and bacterial production for two rivers in northwestern Ohio, USA. The EEA data included estimates of apparent Vmax, a measure of catalytic capacity, and apparent Km, a measure of available substrate concentration, for six extracellular enzymes (alpha-glucosidase, beta-glucosidase, aminopeptidase, protease, phosphatase, and acetyl esterase). Sampling was done over an annual cycle with a temperature range of 4 31 degrees C, while EEA assays were conducted at 20 degrees C. The EEA kinetic measures were scaled to ambient stream temperature using an activation energy (Ea) of 0.5 eV (8.01 x 10(-20) J) and converted to estimates of the turnover rate (St) of their associated substrate pools. The St values associated with protein utilization, the largest substrate pool, had the strongest relationship to bacterial production (r2 = 0.49-0.52); those for carbohydrate utilization, the smallest substrate pool, had the weakest (r2= 0.09-0.15). Comparisons of apparent Ea over the annual cycle showed that the trophic basis of bacterial production switched from relatively high carbohydrate consumption in autumn and winter to relatively high protein consumption in spring and summer, corresponding to seasonal dynamics in plant litter inputs and algal production, respectively. Over the annual cycle, the summed substrate generation rate of the six enzymes was similar in magnitude and strongly correlated with bacterial production (r2 = 0.56). This approach combines effects of substrate pool size, catalytic capacity, and temperature on bacterial production and could be used to compare ecosystems along latitudinal gradients where resource, rather than temperature, effects on metabolic scaling are of greater magnitude.

Prevalence of the metabolic syndrome and its influencing factors among adolescent girls in Mashhad, Iran.

This study sought to determine the prevalence of the metabolic syndrome, one of the major public-health challenges worldwide, and its influencing factors among 15 to 17 years old adolescent girls in Mashhad, Iran. A total of 622 high school adolescents participated in a cross-sectional study. A self-administered questionnaire was used to assess socio-demographic characteristics and dietary habits. Anthropometric assessments, blood pressure measurement and biochemical assessment were done. Applying BMI Z-score for age and gender (WHO 2007), 14.6 % and 3.4 % of subjects were classified as overweight and obese, respectively. Enlarged WC (> 80 cm) was seen in 9.5% of subjects. The prevalence of combined hypertension was 6.1% which was increased by the severity of obesity. A total of 24.5% of subjects had hypertriglyceridemia and 57% of them had low level of HDL-cholesterol. Hyperglycemia was present in 16.7% of subjects. Based on the NCEP ATP III (2001) criteria, the prevalence of the metabolic syndrome was 6.5% and increased to 45.1% in obese subjects. Increasing BMI or WC, led to significant increment in the number of metabolic syndrome features (p < 0.001). High socioeconomic status of family, medical history of parents and dietary habits especially high consumption of carbohydrates were influencing factors in the prevalence of the metabolic syndrome. Approximately 6.5% of all and 45% of obese subjects met the criteria for the metabolic syndrome. Dietary habits especially carbohydrate consumption, socioeconomic status of family and medical history of parents can be influential factors in the prevalence of the metabolic syndrome.

Role of diet and fuel overabundance in the development and progression of heart failure

Under physiological conditions, the human heart derives energy from glucose, fatty acids, and/or lactate depending upon substrate availability, circulating hormone levels, and nutritional status. Circulating free fatty acid and glucose levels often exceed the normal range, as observed with type 2 diabetes, obesity, or physical inactivity. Chronic exposure of the heart to high plasma levels of free fatty acids may cause accumulation of toxic lipid intermediates within cardiomyocytes. Furthermore, suppression of glucose oxidation by increased fatty acid uptake shunts glucose into the oxidative pentose phosphate and hexosamine biosynthetic pathways, both of which yield potentially harmful products. Noxious derivatives of aberrant glucose and fatty acid oxidation can activate signalling cascades leading to myocyte dysfunction or death, processes termed 'glucotoxicity' and 'lipotoxicity'. This review discusses the effects of dietary extremes (e.g. high fat and high carbohydrate consumption) and substrate overabundance in the context of heart failure (HF) development and progression. Emerging data suggest that substrate excess leads to cardiac dysfunction and HF, which may be prevented or slowed by maintaining low body fat and high insulin sensitivity and consuming a diet of low glycaemic load that is high in mono- and polyunsaturated fatty acids.