High-fat meals increase inflammatory risk in diabetes
MedWire News: Eating a meal rich in saturated fatty acids (SFAs) increases circulating endotoxin levels in diabetic individuals to a much greater extent than has previously been understood, show researchers.
"Our 4-hour postprandial data suggest a much higher inflammatory risk than previous studies have indicated," they say.
As reported in the journal Diabetes Care, Philip McTernan (University of Warwick, UK) and colleagues investigated whether eating a high-fat meal changes levels of circulating endotoxin, and whether this change is influenced by differing metabolic states.
After an overnight fast, 54 individuals consumed a high-fat meal (75 g fat, 5 g carbohydrate, 6 g protein). Fifteen of the individuals were obese (mean body mass index [BMI]: 33.3 kg/m2) but had normal glucose handling, 12 had impaired glucose tolerance (IGT), 18 had Type 2 diabetes, and nine individuals with normal weight and normal glucose handling were included as controls (mean BMI: 24.9 kg/m2).
Blood sampling was performed at baseline (0 hours) and postprandially at 1, 2, 3, and 4 hours.
The authors report that the mean baseline endotoxin levels were 54.5% higher in the obese group and a significant 72.7% and 60.6% higher in the IGT and Type 2 diabetes groups, respectively, than in the control group.
However, 4 hours after eating the high-fat meal, the mean endotoxin level in both the obese and IGT groups was only approximately 20.0% higher than in the control group, whereas among those with Type 2 diabetes, it was 125.4% higher.
Cumulative data showed that individuals with Type 2 diabetes were exposed to 336% more circulating endotoxin than control individuals over the 4-hour postprandial period.
The authors say their findings highlight that consuming five smaller meals per day (as is currently recommended in Type 2 diabetes clinics) may actually increase patients' inflammatory risk.
"These data appear to indicate that a person eating three high-SFA meals each day may encounter endotoxin levels that remain perpetually high, since re-feeding may increase the levels," they write.
The complexity of diet, meal frequency, and its acute effects on inflammatory risk need to be understood so that more detailed guidelines can be given to particular patients, says the team.
"Leaving food intake to individual preferences appears not to represent a beneficial solution to reduce the inflammatory state in metabolic at-risk individuals," conclude McTernan et al.
MedWire (http://www.medwire-news.md/) is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2011
By Sally Robertson