Lower Carbohydrate/Higher Monounsaturated Diet Works for Type 1's

Dr. Irene Strychar from University of Montreal Hospital Center in Quebec, Canada, stated that, "A referral to a registered dietitian is suggested to ensure that patients understand the principles underlying their diet approach.... For those following the higher monounsaturated fat diet, olive oil is substituted for carbohydrates -- it is not 'an addition' to the diet."

Dr. Strychar and colleagues compared the effects of a eucaloric diet higher in carbohydrate/lower in fat versus one lower in carbohydrate/higher in monounsaturated fat on 24-hour triglyceride and glycemic excursions and other cardiovascular risk factors in a 6-month study of 30 patients with Type 1 diabetes.

Patients randomized to the lower carbohydrate/higher monounsaturated fat diet had a 2% increase in weight (compared to a small loss among patients on the higher carbohydrate/lower fat diet) and a 16% decrease in plasminogen activator inhibitor I levels (compared to an increase among patients on the higher carbohydrate/lower fat diet).

Otherwise there were no significant differences, either at baseline or at 6 months, in clinical and biochemical results between the two groups of patients.

Triglyceride profiles tended to be lower in the lower carbohydrate/higher monounsaturated fat group, and glycemic levels after supper were higher in the higher carbohydrate/lower fat group, the researchers note.

"Our results are in keeping with the American Diabetes Association statement that it is unlikely that an optimal mix of macronutrients exists for the diabetic state," the investigators say.

"As part of a Montreal Diabetes Research Center initiative, we are investigating the effects of the two diets on blood glucose excursions out of the hospital setting, using continuous glucose monitoring systems for three days," noted Dr. Strychar.

As to which dietary approach is better, Dr. Strychar concluded, "Both approaches are recommended and patients can be involved in the decision process."

"Both diets are low in saturated fat," she added. "Maintaining long-term dietary change remains a challenge and should be addressed in future research studies."