Title:
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Dietary effects on insulin resistance and vascular risk .
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Chapter one provides an overview of the regulation of insulin secretion/action,
details normal insulin action, and, describes the concept of insulin resistance and its
assessment. It specifically focuses on obesity (as the most important contributor to
insulin resistance) and reviews dietary effects on insulin resistance and plasma lipids.
Chapter two describes methods which are common to chapters 3, 4 and 5:
assessment of habitual diet; formulation/practical administration of intervention
diets; blood sampling; and assessment of body composition, insulin sensitivity, and
vascular compliance.
Chapter three compares the effects of a high versus low sucrose diet (25 vs. 10 %,
respectively, oftotal energy intake) in 13 healthy subjects, in a randomised crossover
design with sequential 6 week dietary interventions separated by a 4 week washout.
Diets were weight maintaining with identical macronutrient and fibre content. The
results demonstrated that a high sucrose intake, as part of an isocaloric weight
maintaining diet, had no detrimental effect oninsulin resistance.
Chapter four investigates the effects of a low carbohydrate versus low fat weight
reduction diet (0.5 kg/week) on insulin sensitivity and cardiovascular risk in
overweight/obese subjects (n = 24) using a parallel group randomised controlled trial
design. Following similar weight loss, both diets were equally effective in improving
insulin sensitivity. The low fat diet also had beneficial effects on augmentation index
(a measure of arterial stiffness), a finding which was not evident within the low
carbohydrate group.
Chapter five explores whether adipokines (leptin, adiponectin and retinol binding
protein 4) potentially mediate the effects of weight loss (induced by hypocaloric
dieting in study 2) on insulin sensitivity. Results demonstrated that diet induced
changes in adipokines did not correlate with the change in insulin sensitivity.
Chapter six provides a general discussion and concluding remarks for the main body
of the thesis.
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