Combined low-saturated fat intake and high fitness may counterbalance diabetogenic effects of obesity: the DR’s EXTRA Study

Abstract

We report associations of saturated fat (SF) intake with impaired fasting glucose (IFG), impaired glucose tolerance (IGT), concurrent IFG+IGT and type 2 diabetes (T2DM) at different levels of cardiorespiratory fitness and body mass index (BMI). In a population-based sample (n=1261, age 58-78 years), oral glucose tolerance, 4-day food intake and maximal oxygen uptake were measured. High intake of SF (>11.4 E%) was associated with elevated risk for IFG (4.36; 1.93-9.88), concurrent IFG+IGT (6.03; 1.25-29.20) and T2DM (4.77; 1.93-11.82) in the category of high BMI (>26.5) and high fitness, whereas there was no significantly elevated risk in individuals reporting low intake of SF. Concurrent high BMI and low fitness were associated with elevated risks. In general, SF intake and fitness did not differentiate the risk of abnormal glucose metabolism among subjects with low BMI. Limited intake of SF may protect from diabetogenic effects of adiposity, but only in individuals with high level of fitness.

Diet, insulin secretion and insulin sensitivity – the Dose–Responses to Exercise Training (DR's EXTRA) Study (ISRCTN45977199)

“…Our data suggest that the DI30 is the most sensitive of the studied markers regarding lifestyle-mediated homeostasis of glucose metabolism. Our findings expand on our previous short report that SF intake and fitness may modulate the adiposity-related risk of elevated fasting plasma glucose ( 9 ) . Plasma glucose concentrations remain normal as long as the maximum capacity to secrete insulin is not reached (hyperbolic law) ( 13 ) .…”

“…report that SF intake and fitness may modulate the adiposityrelated risk of elevated fasting plasma glucose (9) . Plasma glucose concentrations remain normal as long as the maximum capacity to secrete insulin is not reached (hyperbolic law) (13) .…”

“…A high intake of SF has been associated with impaired insulin sensitivity ( 6 ) , predominantly hepatic ( 7 , 8 ) according to some studies. In addition, subjects with a low intake of SF and high fitness have a lower adiposity-related risk of elevated fasting plasma glucose concentrations ( 9 ) . In contrast, dietary fibre intake has been associated with both increased insulin sensitivity ( 10 ) and increased insulin secretion ( 11 , 12 ) .…”