Impact of glycemic index and of the quality of the ingested diet in the levels of inflammatory markers associated with type 2 diabetes / Impacto do índice glicêmico e da qualidade da dieta ingerida nos marcadores inflamatórios associados ao diabetes Mellitus Tipo 2

AUTOR(ES)
DATA DE PUBLICAÇÃO

2008

RESUMO

Recente studies indicate that low intensity chronic inflammation is associated with the physiopathology of non- transimmisble chronic diseases, such as type 2 diabetes mellitus (DM2). The adoption of inadequate dietary patterns seems to be involved with the establishment of inflammatory process, favoring the manifestation non-transimmisble chronic diseases. Therefore, this study the effect of the consumption of two daily meals differing in glycemic index (GI) on body composition, biochemical parameters, and inflammatory markers was evaluated in type 2 diabetics. It was also assessed the association between the profile of the diet ingested by such diabetics and the levels of inflammatory biomarkers. Eighteen volunteers, with mean 49.4 + 6.1 years of age and body mass índex (BMI) of 29.2 + 4.79kg/m2 were randomly allocated in the high glycemic index (HGI) or low glycemic index (LGI) groups. Two daily HGI or LGI test meals were consumed in the laboratory. The other meals were ingested under free living conditions, when the participants were instructed to ingest preferentially foods presenting GI similar to the group in which they were allocated. Food intake at baseline and at the end of the study was evaluated through three days dietary records. Dietary global quality was evaluated through the dietary quality index (DQI), adapted from the Healthy Eating Index. The anthropometric data (body weight, height, BMI, waist and wrist circumference), body fat percentage, and levels of inflammatory biomarkers (interleucin-6 (IL-6), TNF-alfa, high molecular weight adiponectin, fibrinogen, and high-sensitivity C reactive protein (hs-PCR) levels) were evaluated before and after the study intervention. There were no changes in body weight or body composition in both groups. However, there was a trend (p=0.051) for body fat percentage reduction in the LGI group. There was an increase in fructosamine (p=0.028) and free fatty acids (p=0.03) concentrations at the end of the study in the HGI group. IL-6 e TNF-alfa expressions were higher at the end of the study in both groups. The levels of TNF-alfa (p=0.047) were significantly higher in the HGI compared to the LGI group. According to the dietary variables analysed, at the end of the study there was an increase (p=0.028) in the ingestion of carbohydrate in the HGI group. In both groups, the dietary parameters that differed the most from the recommendations were the calories, saturated fatty acids, cholesterol, and sucrose. At the end of the study, the HGI subjects increased the ingestion of vitamin A and C. According to the DQI scores obtained, the diet ingested by the study participants was considered inappropriate, especially in terms of the consumption of Fruits, Vegetables, and Milk/milk products. There was a negative correlation between adiponectin levels and energy ingestion. Hs-PCR concentrations correlated negatively with ascorbic acid and positively with fat ingestion. The results of this study suggest that, compared to HGI meals, the ingestion of two daily LGI meals favors the reduction in the inflammatory response and an improvement in the metabolic profile of type 2 diabetic patients. It was verified that it is essential to provide nutritional orientation to diabetics, once they presented many inappropriate dietetic habits. In the present study, it is hypothezised the the levels of inflammatory markers were reduced by the increase in the antioxidant micronutrient content of the HGI diet.

ASSUNTO(S)

diabetes glycemic index diet composição corporal proteína c-reativa glicemia c-reactive protein Índice glicêmico body composition nutricao inflammation dieta inflamação diabetes glycemy

ACESSO AO ARTIGO

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