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Original Research Communications |
1 From the Department of Nutritional Sciences, Faculty of Medicine, and the Department of Statistics, University of Toronto; the Kellogg Company, Battle Creek, MI; and the Clinical Nutrition and Risk Factor Modification Centre and the Division of Endocrinology and Metabolism, St Michael's Hospital, Toronto.
Background: Results of 6-wk studies suggest that high-carbohydrate diets are deleterious for people with type 2 diabetes.
Objective: Our objective was to see whether long-term replacement of dietary monounsaturated fatty acids (MUFAs) with carbohydrate from breakfast cereals with either a high or a low glycemic index (GI) affected blood glucose and lipids in subjects with type 2 diabetes.
Design: Subjects with type 2 diabetes (n = 91) were randomly assigned to receive 
10% of energy from a low-GI breakfast cereal, a high-GI cereal, or oil or margarine containing MUFA for 6 mo. Eating breakfast cereal was prohibited for subjects in the MUFA group.
Results: Seventy-two subjects completed the trial. The subjects who received cereals consumed 10% more energy from carbohydrate than did the subjects in the MUFA group. Changes in glycated hemoglobin, body weight, and fasting cholesterol and triacylglycerol did not differ significantly among groups. HDL cholesterol increased by 10% in the MUFA group compared with subjects who consumed either high- or low-GI cereals (P = 0.002). The ratio of total to HDL cholesterol was higher in the subjects who consumed the high-GI cereal than in the MUFA group at 3 mo but not at 6 mo (diet x time interaction, P = 0.041). During 8-h metabolic profiles, mean plasma insulin was higher and mean free fatty acids were lower in the 2 cereal groups than in the MUFA group (P < 0.05).
Conclusions: A 10% increase in carbohydrate intake associated with breakfast cereal consumption had no deleterious effects on glycemic control or blood lipids over 6 mo in subjects with type 2 diabetes. The increase in plasma insulin and the reduction in free fatty acids associated with higher carbohydrate intake may reduce the rate of progression of diabetes.
Key Words: Type 2 diabetes • monounsaturated fat • carbohydrate • cereal • glycemic index • cholesterol
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