Obesity, Diabetes Homeostasis The effect of a short-term low-carbohydrate, high-fat diet with or without postmeal walks on glycemic control and inflammation in type 2 diabetes: a randomized trial

The effect of a short-term low-carbohydrate, high-fat diet with or without postmeal walks on glycemic control and inflammation in type 2 diabetes: a randomized trial. Am J Physiol Regul Integr Comp Physiol 315: carbohydrate consump-tion effectively lowers glucose, but impacts on inflammation are unclear. The objectives of this study were to: 1 ) determine whether reducing hyperglycemia by following a low-carbohydrate, high-fat (LC) diet could lower markers of innate immune cell activation in type 2 diabetes (T2D) and 2 ) examine if the combination of an LC diet with strategically timed postmeal walking was superior to an LC diet alone. Participants with T2D ( n (cid:2) 11) completed a randomized crossover study involving three 4-day diet interventions: 1 ) low-fat low-glycemic index (GL), 2 ) and 3 ) LC with 15-min postmeal walks (LC (cid:3) Ex). Four-day mean glucose was significantly lower in the LC (cid:3) Ex group as compared with LC ( (cid:4) 5%, P (cid:5) 0.05), whereas both LC (cid:3) Ex ( (cid:4) 16%, P (cid:5) 0.001) and LC ( (cid:4) 12%, P (cid:5) 0.001) conditions were lower than GL. A significant main effect of time was observed for peripheral blood mononuclear cells phosphorylated c-Jun N-ter-minal kinase ( P (cid:5) 0.001), with decreases in all three conditions (GL: (cid:4) 32%, LC: (cid:4) 45%, and LC (cid:3) Ex: (cid:4) 44%). A significant condition by time interaction was observed for monocyte microparticles ( P (cid:2) 0.040) with a significant decrease in GL ( (cid:4) 76%, P (cid:2) 0.035) and a tendency for a reduction in LC ( (cid:4) 70%, P (cid:2) 0.064), whereas there was no significant change in LC (cid:3) Ex (0.5%, P (cid:2) 0.990). Both LC ( (cid:4) 27%, P (cid:2) 0.001) and LC (cid:3) Ex ( (cid:4) 35%, P (cid:2) 0.005) also led to significant reductions in circulating proinsulin. An LC diet improved 4-day glycemic control and fasting proinsulin levels when compared with GL, with added glucose-lowering benefits when LC was combined with postmeal walking. gating for pro- pidium iodide CD14 (cid:3) and confirmed to be monocytes a characteristic scatter profile. TLR2 and TLR4 median fluorescence were then determined on CD14 (cid:3) monocytes with fluorescence one used to determine positive and negative populations. Total gran- ulocyte, monocyte, and lymphocyte were determined based on characteristic scatter profiles.

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