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Can dietary intervention produce long-term reductionin insulin resistance?

Published online by Cambridge University Press:  09 March 2007

Jim I. Mann*
Affiliation:
Department of Human Nutrition, University of Otago, PO Box 56, Dunedin, New Zealand
*
Corresponding author: J. I. Mann, fax +64 3 479 7958, email [email protected]
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Abstract

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Insulin sensitivity is potentially enhanced by a range of diet-related changes including reduction of visceral adiposity, a reduction in saturated fatty acids, and possibly a redistribution of the proportions of various unsaturated fatty acids. While there is evidence to suggest that lifestyle changes can reduce the risk of progression of impaired glucose tolerance to type 2 diabetes, there are no clinical trials which have conclusively demonstrated that any measure can reduce insulin resistance in the long term to an extent that can prevent the development of type 2 diabetes and other clinical complications. Evidence concerning the possibilities for reducing visceral adiposity and altering the nature of dietary fat are therefore considered. Attempts to achieve prolonged and substantial weight reduction in adults have not been encouraging, and it may be that preventing further weight gain is the most realistic target in this age group. In childhood the attempts have been more successful. The development of new approaches to achieving behavioural change and an environment which facilitates physical activity and appropriate food choices will be essential for more successful individual and population attempts to facilitate reduction in insulin resistance by weight loss. Changes in the nature of dietary fat appear to be more easily achieved. This is already a component of dietary advice aimed at cardiovascular risk reduction, and should be reinforced now with a view to also achieving a reduction in insulin resistance.

Type
Research Article
Copyright
Copyright © The Nutrition Society 2000

References

Baranowski, T, Perry, CL & Parcel, G (1997) How individuals, environments and health behaviour interact: Social Cognitive Theory. In Health Behaviour & Health Education: Theory, Research & Practice, 2nd edn, pp. 4159 [K, Glanz, et, al., editors]. San Francisco, CA: Jossey-Bass.Google Scholar
Borkman, M, Storlein, LH, Pan, DA, Jenkins, AB, Chisholm, DJ, Campbell, LV (1993) The relation between insulin sensitivity and the fatty-acid composition of skeletal-muscle phospholipids New England Journal of Medicine 328, 238244.CrossRefGoogle Scholar
Campbell, MK, DeVellis, BM, Stecher, VJ, Ammerman, AS, DeVellis, RF, Sandler, RS (1994) Improving dietary behaviour: the effectiveness of tailored messages in primary care settings American Journal of Public Health 84, 783787.CrossRefGoogle Scholar
Connor, WE, Connor, SL (1997) The case for a low-fat high-carbohydrate diet New England Journal of Medicine 337, 562563, 566–567.CrossRefGoogle Scholar
Cook, VV, Hurley, JS (1998) Prevention of type 2 diabetes in children Clinical Pediatrics 37, 123130.CrossRefGoogle Scholar
Eriksson, K-F, Lindgärde, F (1991) Prevention of type 2 (non-insulin-dependent) diabetes mellitus by diet and physical exercise: the 6-year Malmö feasibility study Diabetologia 34, 891898.CrossRefGoogle Scholar
Eriksson, J, Lindström, J, Valle, T (1999) Prevention of type II diabetes in subjects with impaired glucose tolerance: the Diabetes Prevention Study (DPS) in Finland: study design and 1-year interim report of the feasibility of the lifestyle intervention programme Diabetologia 42, 793801.CrossRefGoogle Scholar
Flodmark, CE, Ohlsson, T, Ryden, O, Sveger, T (1993) Prevention of progression to severe obesity in a group of obese school-children treated with family therapy Pediatrics 91, 880884.Google Scholar
FAO/WHO (1998) Carbohydrates in Human Health. FAO Food and Nutrition Paper 66, Report of a Joint FAO/WHO Expert Consultation.Rome:Food and Agriculture Organization and World Health Organisation.Google Scholar
Glenny, A-M, O'Meara, S, Melville, A, Sheldon, TA, Wilson, C (1997) The treatment and prevention of obesity: a systematic review of the literature International Journal of Obesity 21, 715737.CrossRefGoogle Scholar
Goodpaster, BH, Kelley, DE, Wing, RR, Meier, A, Thaete, FL (1999) Effects of weight loss on regional fat distribution and insulin sensitivity in obesity Diabetes 48, 839847.Google Scholar
Gortmaker, SL, Peterson, K, Wiecha, J, Sobol, AM, Dixit, S, Fox, MK, Laird, N (1999) Reducing obesity via a school-based interdisciplinary intervention among youth: Planet Health Archives of Pediatric Adolescent Medicine 153, 409418.CrossRefGoogle Scholar
Horwath, CC (1999) Applying the Transtheoretical Model to eating behaviour change: challenges and opportunities Nutrition Research Reviews 12, 138.Google Scholar
Katan, MB, Grundy, SM, Willett, WC (1997) Beyond low-fat diets New England Journal of Medicine 337, 563566.Google Scholar
de Lorgeril, M, Renaud, S, Mamelle, N, Salen, P, Martin, J-L, Monjaud, I, Guidollet, J, Touboul, P, Delaye, J (1994) Mediterranean alpha-linolenic acid-rich diet in secondary prevention of coronary heart disease Lancet 343, 14541459.CrossRefGoogle Scholar
Miller, WC, Koceja, DM, Hamilton, EJ (1997) A meta-analysis of the past 25 years of weight loss research using diet, exercise or diet plus exercise intervention International Journal of Obesity 21, 941947.CrossRefGoogle Scholar
Pan, X-R, Li, G-W, Hu, Y-H (1997) Effects of diet and exercise in preventing NIDDM in people with impaired glucose tolerance: the Da Qing IGT and Diabetes Study Diabetes Care 20, 537544.CrossRefGoogle Scholar
Ray, L, Lim, LH, Ling, SL (1994) Obesity in preschool children: an intervention programme in primary health care in Singapore Annals of Academic Medicine, Singapore 23, 335341.Google Scholar
Rocchini, AP, Marker, P, Cervenka, T (1997) Time course of insulin resistance associated with feeding dogs a high-fat diet Endocrinology Metabolism 35, E147-E154.CrossRefGoogle Scholar
Simmons, D, Fleming, C, Voyle, J, Fou, F, Feo, S, Gatland, B (1998) A pilot urban church-based programme to reduce risk factors for diabetes among Western Samoans in New Zealand Diabetic Medicine 15, 136142.3.0.CO;2-P>CrossRefGoogle Scholar
Storlien, LH, Baur, LA, Kritetos, AD, Pan, DA, Cooney, GJ, Jenkins, AB, Calvert, GD, Campbell, LV (1996) Dietary fats and insulin action Diabetologia 39, 621631.CrossRefGoogle Scholar
Torjesen, PA, Birkeland, KI, Anderssen, SA, Hjermann, I, Holme, I, Urdal, P (1997) Lifestyle changes may reverse development of the insulin resistance syndrome Diabetes Care 20, 2631.Google Scholar
Vessby, B (1999) Effects of dietary fat on insulin sensitivity and insulin secretion - the KANWU Study Diabetologia 42 (Suppl. 1), A168.Google Scholar
Vessby, B, Tengblad, S, Lithell, H (1994) Insulin sensitivity is related to the fatty acid composition of serum lipids and skeletal muscle phospholipids in 70-year-old men Diabetologia 37, 10441050.CrossRefGoogle Scholar
Wing, RR, Venditti, E, Jakicic, JM, Polley, BA, Lang, W (1998) Lifestyle intervention in overweight individuals with a family history of diabetes Diabetes Care 21, 350359.CrossRefGoogle Scholar