Effect of a High-Carbohydrate Versus a High--cis-Monounsaturated Fat Diet on Blood Pressure in Patients With Type 2 Diabetes

• Published in: Diabetes care Vol. 28; no. 11; pp. 2607 - 2612
• Main Authors: Shah, Meena, Adams-Huet, Beverley, Bantle, John P, Henry, Robert R, Griver, Kay A, Raatz, Susan K, Brinkley, Linda J, Reaven, Gerald M, Garg, Abhimanyu
• Format: Journal Article
• Language: English
• Published: Alexandria, VA American Diabetes Association 01-11-2005
• Subjects: Aged; Analysis of Variance; Biological and medical sciences; Blood Glucose - analysis; Blood pressure; Blood Pressure - physiology; Carbohydrates; Carbohydrates - blood; Cross-Over Studies; Diabetes; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - diet therapy; Diabetes Mellitus, Type 2 - physiopathology; Diabetes. Impaired glucose tolerance; Diet therapy; Effects; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Fatty Acids, Monounsaturated - administration & dosage; Fatty Acids, Monounsaturated - blood; Female; Heart Rate; High-carbohydrate diet; Humans; Male; Medical sciences; Middle Aged; Nutritional aspects; Oils & fats; Risk factors; Time Factors; Type 2 diabetes; United States; Endocrinopathy; Type 2 diabetes; Human; Nutrition; Monounsaturated fatty acid; Metabolic diseases; Feeding; Diet; Fat; Carbohydrate; Blood pressure; Hemodynamics; Comparative study
• ISSN: 0149-5992; 1935-5548
• DOI: 10.2337/diacare.28.11.2607

OBJECTIVE:--To investigate whether blood pressure is different in type 2 diabetic patients on a diet rich in carbohydrates versus a diet rich in cis-monounsaturated fatty acids. Data on the dietary effects on these diets' glucose and lipid metabolism have been previously published. RESEARCH DESIGN AND METHODS--The study compared the effect of feeding 42 type 2 diabetic patients a carefully controlled isoenergic high-carbohydrate (high-carb; 55% energy as carbohydrate, 30% as fat, and 10% as monounsaturated fat) and high-monounsaturated fat (high-mono; 45% energy as fat, 25% as monounsaturated fat, and 40% as carbohydrate) diet for 6 weeks each in a four-center, randomized, cross-over study on blood pressure. Twenty-one patients continued the diet they received during the second phase for an additional 8 weeks. RESULTS:--According to repeated-measures ANOVA, blood pressure during the last 3 days of each phase was similar after 6 weeks of the high-carb and high-mono diets (systolic blood pressure: 128 ± 16 vs. 127 ± 15 mmHg, P = 0.9; diastolic blood pressure: 75 ± 7 vs. 75 ± 8 mmHg, P = 0.7). However, after 14 weeks of the high-carb diet (n = 13), there was a significant increase in blood pressure compared with 6 weeks of the high-mono diet (systolic blood pressure: 132 ± 13 vs. 126 ± 11 mmHg, P = 0.04; diastolic blood pressure: 83 ± 6 vs. 76 ± 7 mmHg, P = 0.002). After 14 weeks of the high-mono diet (n = 8), the reduction in blood pressure was not significant compared with 6 weeks of the high-carb diet (systolic blood pressure: 118 ± 14 vs. 121 ± 16 mmHg, P = 0.4; diastolic blood pressure: 71 ± 8 vs. 75 ± 10 mmHg, P = 0.3). CONCLUSION:--Although the exchange of carbohydrates with monounsaturated fats may not affect blood pressure in the short term, long-term consumption of a high-carbohydrate diet may modestly raise blood pressure in type 2 diabetic patients.