PDM: Prediabetes (2013)

PDM: Prediabetes (2013)

• Assessment
  In individuals with prediabetes, what is the impact of macronutrient distribution, independent of weight loss, on glycemic-related outcomes (such as fasting blood glucose, random blood glucose, two-hour post prandial blood glucose, A1C)?

  • Conclusion

    Research is inconclusive on the effect of macronutrient distribution (as a percentage of energy), independent of weight loss, on glycemic-related outcomes in individuals with prediabetes, related to the varying macronutrient distributions in study diets (15% protein; 25% to 45% fat; 40% to 60% carbohydrate).

    Additional longer-term intervention studies are needed to quantify specific macronutrient intake ranges in individuals with prediabetes.

     

  • Grade: II
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: In individuals with prediabetes, what is the impact of macronutrient distribution, independent of weight loss, on glycemic-related outcomes (such as fasting blood glucose, random blood glucose, two-hour post-prandial blood glucose, A1C)?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Feskens EJM, Virtanen SM, Rasanen L, Tuomilehto J, Stengard J, Pekkanen J, Nissinen A, Kromhout D. Dietary factors determining diabetes and impaired glucose intolerance: a 20-year follow-up of the Finnish and Dutch cohorts of the Seven Countries Study. Diabetes Care, 1995; 18 (8): 1,104-1,112.
      • Melton CE, Tucker PS, Fisher-Wellman KH, Schilling BK, Bloomer RJ. Acute exercise does not attenuate postprandial oxidative stress in prediabetic women. Phys Sportsmed. 2009; 37(1): 27-36.
      • Sarkkinen E, Schwab U, Niskanen L, Hannuksela M, Savolainen M, Kervinen K, Kesaniemi A, Uusitupa MIJ. The effect of monounsaturated-fat enriched diet and polyunsaturated-fat enriched diet on lipid and glucose metabolism in subjects with impaired glucose tolerance. Eur J Clin Nutr. 1996; 50(9): 592-598.
      • Wolever TM, Mehling C. Long-term effect of varying the source or amount of dietary carbohydrate on postprandial plasma glucose, insulin, triacylglycerol and free fatty acid concentrations in subjects with impaired glucose tolerance. Am J Clin Nutr. 2003; 77: 612-621.
  • Search Plan and Results: PDM: Macronutrient Distribution and Prediabetes 2012
     
  In individuals with prediabetes, what is the impact of macronutrient distribution, independent of weight loss, on lipid outcomes (TG, HDL)?

  • Conclusion

    Research is inconclusive on the effect of macronutrient distribution (as a percentage of energy), independent of weight loss, on lipid outcomes in individuals with prediabetes, related to the varying macronutrient distributions in study diets (15% protein; 30% to 40% fat; 40% to 55% carbohydrate).

    Additional longer-term intervention studies are needed to quantify specific macronutrient intake ranges in individuals with prediabetes.

  • Grade: II
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: In individuals with prediabetes, what is the impact of macronutrient distribution, independent of weight loss, on lipid outcomes (TG, HDL)?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Melton CE, Tucker PS, Fisher-Wellman KH, Schilling BK, Bloomer RJ. Acute exercise does not attenuate postprandial oxidative stress in prediabetic women. Phys Sportsmed. 2009; 37(1): 27-36.
      • Sarkkinen E, Schwab U, Niskanen L, Hannuksela M, Savolainen M, Kervinen K, Kesaniemi A, Uusitupa MIJ. The effect of monounsaturated-fat enriched diet and polyunsaturated-fat enriched diet on lipid and glucose metabolism in subjects with impaired glucose tolerance. Eur J Clin Nutr. 1996; 50(9): 592-598.
      • Wolever TM, Mehling C. Long-term effect of varying the source or amount of dietary carbohydrate on postprandial plasma glucose, insulin, triacylglycerol and free fatty acid concentrations in subjects with impaired glucose tolerance. Am J Clin Nutr. 2003; 77: 612-621.
  • Search Plan and Results: PDM: Macronutrient Distribution and Prediabetes 2012
     
  In individuals with prediabetes, what is the impact of macronutrient distribution, independent of weight loss, on anthropometric outcomes (WC, WHR)?

  • Conclusion

    Research is inconclusive on the effect of macronutrient distribution (as a percentage of energy), independent of weight loss, on anthropometric outcomes in individuals with prediabetes, related to the varying macronutrient distributions in study diets (less than 30% of calories from fat).

    Additional longer-term intervention studies are needed to ascertain an effect of macronutrient distribution on anthropometric outcomes in individuals with prediabetes.

      

     

  • Grade: III
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: In individuals with prediabetes, what is the impact of macronutrient distribution, independent of weight loss, on anthropometric outcomes (WC, WHR)?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Lindstrom J, Peltonen M, Eriksson JG, Louheranta A, Fogelholm M, Uusitupa M, Tuomilehto J. High-fibre, low-fat diet predicts long-term weight loss and decreased type 2 diabetes risk: The Finnish Diabetes Prevention Study. Diabetologia, 2006; 49: 912-920.
  • Search Plan and Results: PDM: Macronutrient Distribution and Prediabetes 2012
     
  In individuals with prediabetes, what is the impact of macronutrient distribution, independent of weight loss, on blood pressure?

  • Conclusion

    Research is inconclusive on the effect of macronutrient distribution (as a percentage of energy), independent of weight loss, on blood pressure in individuals with prediabetes, related to the varying macronutrient distributions in study diets (comparing 40% carbohydrate and 45% fat vs. 60% carbohydrate and 25% fat).

    Additional longer-term intervention studies are needed to ascertain an effect of macronutrient distribution on blood pressure in individuals with prediabetes.  

  • Grade: III
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: In individuals with prediabetes, what is the impact of macronutrient distribution, independent of weight loss, on blood pressure?
    • Detail
  • Search Plan and Results: PDM: Macronutrient Distribution and Prediabetes 2012