High antioxidant diet improves insulin sensitivity in obese men and women
The Endocrine Society's 92nd Annual Meeting held in San Diego was the site of a presentation on June 21, 2010 of the findings of a study involving adults with metabolic syndrome which found an improvement in insulin resistance among participants who received a diet enriched with antioxidant nutrients.
Metabolic syndrome is a cluster of risk factors that includes increases in waist circumference, blood pressure, fasting glucose and triglycerides, and a reduction in high density lipoprotein (HDL) cholesterol. Individuals with three or more of these conditions have a reduced ability to utilize insulin, and are at an increased risk of developing cardiovascular disease and diabetes.
"Oxidative stress could play an important role in metabolic syndrome-related manifestations contributing to insulin resistance," write endocrinology researcher Antonio Mancini, MD and his associates at Rome's Catholic University of the Sacred Heart in the abstract summarizing their research. "The reciprocal influences between oxidative stress and insulin resistance are not clear."
The study included 16 men and 13 women aged 18 to 66 years with insulin resistance and obesity. All participants received a diet that provided 1,500 calories per day for three months. Half of the participants' diets contained fruits and vegetables that provide high amounts of antioxidant nutrients. The subjects were further divided into groups that received or did not receive 1000 milligrams per day of the drug metformin, which improves insulin sensitivity in patients with type 2 diabetes. Body mass index, glucose tolerance and other factors were assessed at the beginning and end of the study.
While all participants experienced similar decreases in body mass index, only those that received the antioxidant-enriched diet had significant reductions in insulin resistance, with the greatest benefits observed in those who also received metformin.
The ability of antioxidants to help reduce oxidative stress may help protect against a number of conditions, including metabolic syndrome. "The beneficial effects of antioxidants are known, but we have revealed for the first time one of their biological bases of action—improving hormonal action in obese subjects with the metabolic syndrome," Dr Mancini stated.
In the early stages of type 2 diabetes, insulin levels are already elevated (hyperinsulinemia). This is because the problem isn’t with insulin production; rather, the underlying defect in type 2 diabetes is a metabolic defect of insulin utilization. The delicate insulin receptors on cell membranes are less responsive to the insulin than are the insulin receptors of people without type 2 diabetes, which means that less glucose is absorbed from the bloodstream than would be normally, and glucose levels slowly rise.
This elevation in glucose upsets the body’s natural balance, prompting the pancreas to discharge copious amounts of insulin to normalize glucose levels. This short-term, biological fix successfully drives glucose into cells, thereby lowering blood glucose levels, but it also hastens the disease’s progress. Eventually, the fragile insulin receptors become less sensitive (insulin resistant), which means that the pancreas must secrete even more insulin to keep clearing the blood of glucose. In later stages of the disease, the pancreas becomes “burned out” and can no longer produce adequate insulin. Insulin levels drop far below normal, allowing blood glucose to rise even higher and inflict greater damage.
The high-carbohydrate, high-plant-fiber (HCF) diet popularized by James Anderson, MD, has substantial support and validation in the scientific literature as the diet of choice in the treatment of diabetes (Anderson JW et al 2004; Hodge AM et al 2004). The HCF diet is high in cereal grains, legumes, and root vegetables and restricts simple sugar and fat intake. The caloric intake consists of 50 to 55 percent complex carbohydrates, 12 to 16 percent protein, and less than 30 percent fat, mostly unsaturated. The total fiber content is between 25 and 50 g daily. The HCF diet produces many positive metabolic effects, including the following: lowered postmeal hyperglycemia and delayed hypoglycemia; increased tissue sensitivity to insulin; reduced low-density lipoprotein (LDL) cholesterol and triglyceride levels and increased high-density lipoprotein (HDL) cholesterol levels; and progressive weight loss.
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