High-Carbohydrate Diet Can Increase Blood Pressure in Type 2 Patients

Diets rich in monounsaturated fats are associated with reduced triglyceride levels and very low-density lipoprotein levels when compared with high-carbohydrate diets among patients with diabetes.

Long-term adherence to a high-carbohydrate diet increases blood pressure compared with a high–cis-monounsaturated fat diet.
"It has been well established that replacing a high-carbohydrate diet with a diet rich in cis-monounsaturated fatty acids improves lipids and lipoproteins," write Meena Shah, PhD, from the University of Texas Southwestern Medical Center at Dallas, and colleagues. "Whether high–monounsaturated fat diets also improve blood pressure compared with high carbohydrate diets is controversial."

In a four-center, randomized, crossover study on blood pressure, 42 patients with type 2 diabetes received a carefully controlled isoenergic high-carbohydrate (55% energy as carbohydrate, 30% as fat, and 10% as monounsaturated fat) and high–monounsaturated fat (45% energy as fat, 25% as monounsaturated fat, and 40% as carbohydrate) diet for six weeks each. During the second phase, 21 patients continued the diet they received for an additional eight weeks.

Blood pressure during the last three days of each phase was similar after six weeks of the high-carbohydrate and high–monounsaturated fat diets (systolic blood pressure, 128 ± 16 vs 127 ± 15 mm Hg; P = .90; diastolic blood pressure, 75 ± 7 vs 75 ± 8 mm Hg; P = .70). After 14 weeks of the high-carbohydrate diet (n = 13), blood pressure increased compared with blood pressure after six weeks of the high–monounsaturated fat diet (systolic blood pressure, 132 ± 13 vs 126 ± 11 mm Hg; P = .04; diastolic blood pressure, 83 ± 6 vs 76 ± 7 mm Hg; P = .002).

After 14 weeks of the high–monounsaturated fat diet (n = 8), blood pressure did not decrease significantly compared with blood pressure after six weeks of the high-carbohydrate diet (systolic blood pressure, 118 ± 14 vs 121 ± 16 mm Hg; P = .40; diastolic blood pressure, 71 ± 8 vs 75 ± 10 mm Hg; P = .30).

"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," the authors write.
Diabetes Care. 2005;28:2607-2612

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