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Veganism and its relationship with insulin resistance and intramyocellular lipid

Abstract

Objective: To test the hypothesis that dietary factors in the vegan diet lead to improved insulin sensitivity and lower intramyocellular lipid (IMCL) storage.

Design: Case–control study.

Setting: Imperial College School of Medicine, Hammersmith Hospital Campus, London, UK.

Subjects: A total of 24 vegans and 25 omnivores participated in this study; three vegan subjects could not be matched therefore the matched results are shown for 21 vegans and 25 omnivores. The subjects were matched for gender, age and body mass index (BMI).

Interventions: Full anthropometry, 7-day dietary assessment and physical activity levels were obtained. Insulin sensitivity (%S) and beta-cell function (%B) were determined using the homeostatic model assessment (HOMA). IMCL levels were determined using in vivo proton magnetic resonance spectroscopy; total body fat content was assessed by bioelectrical impedance.

Results: There was no difference between the groups in sex, age, BMI, waist measurement, percentage body fat, activity levels and energy intake. Vegans had a significantly lower systolic blood pressure (−11.0 mmHg, CI −20.6 to −1.3, P=0.027) and higher dietary intake of carbohydrate (10.7%, CI 6.8–14.5, P<0.001), nonstarch polysaccharides (20.7 g, CI 15.8–25.6, P<0.001) and polyunsaturated fat (2.8%, CI 1.0–4.6, P=0.003), with a significantly lower glycaemic index (−3.7, CI −6.7 to −0.7, P=0.01). Also, vegans had lower fasting plasma triacylglycerol (−0.7 mmol/l, CI −0.9 to −0.4, P<0.001) and glucose (−0.4 mmol/l, CI −0.7 to −0.09, P=0.05) concentrations. There was no significant difference in HOMA %S but there was with HOMA %B (32.1%, CI 10.3–53.9, P=0.005), while IMCL levels were significantly lower in the soleus muscle (−9.7, CI −16.2 to −3.3, P=0.01).

Conclusion: Vegans have a food intake and a biochemical profile that will be expected to be cardioprotective, with lower IMCL accumulation and beta-cell protective.

Sponsorship: MRC PhD studentship.

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References

  • Albano JD, Ekins RP, Maritz G & Turner RC (1972): A sensitive, precise radioimmunoassay of serum insulin relying on charcoal separation of bound and free hormone moieties. Acta. Endocrinol. 70, 487–509.

    Article  CAS  Google Scholar 

  • Appleby PN, Thorogood M, Mann JI & Key TJ (1999): The Oxford Vegetarian Study: an overview. Am. J. Clin. Nutr. 70, 525S–531S.

    Article  CAS  Google Scholar 

  • Baecke JA, Burema J & Frijters JE (1982): A short questionnaire for the measurement of habitual physical activity in epidemiological studies. Am. J. Clin. Nutr. 36, 936–942.

    Article  CAS  Google Scholar 

  • Brechtel K, Dahl DB, Machann J, Bachmann OP, Wenzel I, Maier T, Claussen CD, Haring HU, Jacob S & Schick F (2001): Fast elevation of the intramyocellular lipid content in the presence of circulating free fatty acids and hyperinsulinemia: A Dynamic 1H-MRS Study. Mag. Res. Med. 45, 179–183.

    Article  CAS  Google Scholar 

  • Burr ML & Sweetnam PM (1982): Vegetarianism, dietary fiber, and mortality. Am. J. Clin. Nutr. 36, 873–877.

    Article  CAS  Google Scholar 

  • Coulston AM, Hollenbeck CB, Donner CC, Williams R, Chiou YA & Reaven GM (1985): Metabolic effects of added dietary sucrose in individuals with noninsulin-dependent diabetes mellitus (NIDDM). Metabolism 34, 962–966.

    Article  CAS  Google Scholar 

  • Department of Health (1991): Dietary reference values for food energy and nutrients for the United Kingdom. Report of the Panel on Dietary Reference Values of the Committee on Medical Aspects of Food Policy. London: HMSO.

  • Dwyer JT (1988): Health aspects of vegetarian diets. Am. J. Clin. Nutr. 48, 712–738.

    Article  CAS  Google Scholar 

  • Falholt K, Jensen I, Lindkaer Jensen S, Mortensen H, Volund A, Heding LG, Noerskov Petersen P & Falholt W (1988): Carbohydrate and lipid metabolism of skeletal muscle in type 2 diabetic patients. Diabet. Med. 5, 27–31.

    Article  CAS  Google Scholar 

  • Feskens EJ, Virtanen SM, Rasanen L, Tuomilehto J, Stengard J, Pekkanen J, Nissinen A & Kromhout D (1995): Dietary factors determining diabetes and impaired glucose tolerance. A 20-year follow-up of the Finnish and Dutch cohorts of the Seven Countries Study. Diabet. Care 18, 1104–1112.

    Article  CAS  Google Scholar 

  • Forouhi NG, Jenkinson G, Thomas EL, Mullick S, Mierisova S, Bhonsle U, McKeigue PM & Bell JD (1999): Relation of triacylglycerol stores in skeletal muscle cells to central obesity and insulin sensitivity in European and South Asian men. Diabetologia 42, 932–935.

    Article  CAS  Google Scholar 

  • Foster PK & Miller JB (1995): International tables of glycemic index. Am. J. Clin. Nutr. 62, 871S–890S.

    Article  Google Scholar 

  • Frentzel-Beyme R, Claude J & Eilber U (1988): Mortality among German vegetarians: first results after five years of follow-up. Nutr. Cancer 11, 117–126.

    Article  CAS  Google Scholar 

  • Friedwald WT, Levy RI & Frederickson DS (1972): Estimation of the concentration of low density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin. Chem. 18, 499–502.

    Google Scholar 

  • Frost G, Keogh B, Smith D, Akinsanya K & Leeds A (1996): The effect of low-glycemic carbohydrate on insulin and glucose response in vivo and in vitro in patients with coronary heart disease. Metabolism 45, 669–672.

    Article  CAS  Google Scholar 

  • Hermans MP, Levy JC, Morris RJ & Turner RC (1999): Comparison of insulin sensitivty tests across a range of glucose tolerance from normal to diabetes. Diabetologia 42, 678–687.

    Article  CAS  Google Scholar 

  • Jacob S, Machann J, Rett K, Brechtel K, Volk A, Renn W, Maerker E, Matthael S, Schick F, Claussen CD & Haring HU (1999): Association of increased myocellular lipid content with insulin resistance in lean nondiabetic offspring of type II diabetic subjects. Diabetes 48, 1113–1119.

    Article  CAS  Google Scholar 

  • Key TJ, Davey GK & Appleby PN (1999a): Health benefits of a vegetarian diet. Proc. Nutr. Soc. 58, 271–275.

    Article  CAS  Google Scholar 

  • Key TJ, Fraser GE, Thorogood M, Appelby PN, Beral V, Reeves G, Burr ML, Chang-Claude J, Frentzel-Beyme R, Kuzma JW, Mann J & McPherson K (1999b): Mortality in vegetarians and nonvegetarians: detailed findings from a collaborative analysis of 5 prospective studies. Am. J. Clin. Nutr. 70, 516S–524S.

    Article  CAS  Google Scholar 

  • Krssak M, Falk Petersen K, Dresner A, DiPietro L, Vogel SM, Rothman DL, Roden M & Shulman GI (1999): Intramyocellular lipid concentrations are correlated with insulin sensitivity in humans: a H-1 NMR spectroscopy study. Diabetologia 42, 113–116.

    Article  CAS  Google Scholar 

  • Krssak M, Krebs M, Stingl H, Mlynarik V, Gruber S, Moser E & Roden M (2000): Intramyocellular lipid (IMCL) stores before and after lipid infusion. Proc. Int. Soc. Mag. Reson. Med. 8, (abstract).

  • Marshall JA, Hoag S, Shetterly S & Hamman RF (1994): Dietary fat predicts conversion from impaired glucose tolerance to NIDDM. The San Luis Valley Diabetes Study. Diabet. Care 17, 50–56.

    Article  CAS  Google Scholar 

  • McGarry JD & Dobbins RL (1999): Fatty acids, lipotoxicity and insulin secretion. Diabetologia 42, 128–138.

    Article  CAS  Google Scholar 

  • McGarry JD (2002): Banting Lecture 2001. Dysregulation of fatty acid metabolism in the etiology of type 2 diabetes. Diabetes 51, 7–18.

    Article  CAS  Google Scholar 

  • Nelson M, Atkinson M & Meyer J (1997): A Photographic Atlas of Food Portion Sizes. London: Ministry of Agriculture, Fisheries and Food.

    Google Scholar 

  • Nicholson AS, Sklar M, Barnard ND, Gore S, Sullivan R & Browning S (1999): Toward improved management of NIDDM: a randomized, controlled, pilot intervention using a low fat, vegetarian diet. Prev. Med. 29, 87–91.

    Article  CAS  Google Scholar 

  • Pan DA, Lillioja S, Kriketos AD, Milner MR, Baur LA, Bogardus C, Jenkins AB & Storlien LH (1997): Skeletal muscle triacylglycerol levels are inversely related to insulin action. Diabetes 46, 983–988.

    Article  CAS  Google Scholar 

  • Phillips DI, Caddy S, Ilic V, Fielding BA, Frayn KN, Borthwick AC & Taylor R (1996): Intramuscular triacylglycerol and muscle insulin sensitivity: evidence for a relationship in nondiabetic subjects. Metabolism 45, 947–950.

    Article  CAS  Google Scholar 

  • Randle PJ, Hales CN, Garland PB & Newsholme EA (1963): The glucose fatty-acid cycle. It's role in insulin sensitivity and the metabolic disturbances of Diabetes Mellitus. Lancet 1, 785–789.

    Article  CAS  Google Scholar 

  • Reiser S, Handler HB, Gardner LB, Hallfrisch JG, Michaelis OE & Prather ES (1979): Isocaloric exchange of dietary starch and sucrose in humans. II. Effect on fasting blood insulin, glucose, and glucagon and on insulin and glucose response to a sucrose load. Am. J. Clin. Nutr. 32, 2206–2216.

    Article  CAS  Google Scholar 

  • Reiser S, Bohn E, Hallfrisch J, Michaelis OE, Keeney M & Prather ES (1981): Serum insulin and glucose in hyperinsulinemic subjects fed three different levels of sucrose. Am. J. Clin. Nutr. 34, 2348–2358.

    Article  CAS  Google Scholar 

  • Rico-Sanz J, Hajnal JV, Thomas EL, Mierisova S, Ala-Korpela M & Bell JD (1998): Intracellular and extracellular skeletal muscle triacylglycerol metabolism during alternating intensity exercise in humans. J. Physiol. 510, 615–622.

    Article  CAS  Google Scholar 

  • Salmeron J, Ascherio A, Rimm EB, Colditz GA, Spiegelman D, Jenkins DJ, Stampfer MJ, Wing AL & Willett WC (1997a): Dietary fiber, glycemic load, and risk of NIDDM in men. Diabet. Care 20, 545–550.

    Article  CAS  Google Scholar 

  • Salmeron J, Manson JE, Stampfer MJ, Colditz GA, Wing AL & Willett WC (1997b): Dietary fiber, glycemic load, and risk of non-insulin-dependent diabetes mellitus in women. JAMA 277, 472–477.

    Article  CAS  Google Scholar 

  • Sinha R, Dufour S, Petersen KF, LeBon V, Enoksson S, Ma YZ, Savoye M, Rothman DL, Shulman GI & Caprio S (2002): Assessment of skeletal muscle triacylglycerol content by (1)H nuclear magnetic resonance spectroscopy in lean and obese adolescents: relationships to insulin sensitivity, total body fat, and central adiposity. Diabetes 51, 1022–1027.

    Article  CAS  Google Scholar 

  • Snowdon DA (1988): Animal product consumption and mortality because of all causes combined, coronary heart disease, stroke, diabetes, and cancer in Seventh-day Adventists. Am. J. Clin. Nutr. 48, 739–748.

    Article  CAS  Google Scholar 

  • Szczepaniak LS, Babcock EE, Schick F, Dobbins RL, Garg A, Burns DK, McGarry JD & Stein DT (1999): Measurement of intracellular triacylglycerol stores by H spectroscopy: validation in vivo. Am. J. Physiol. 276, E977–E989.

    CAS  PubMed  Google Scholar 

  • Thorogood M, Carter R, Benfield L, McPherson K & Mann JI (1987): Plasma lipids and lipoprotein cholesterol concentrations in people with different diets in Britain. BMJ 295, 351–353.

    Article  CAS  Google Scholar 

  • Thorogood M, McPherson K & Mann J (1989): Relationship of body mass index, weight and height to plasma lipid levels in people with different diets in Britain. Community Med. 11, 230–233.

    CAS  PubMed  Google Scholar 

  • Thorogood M, Roe L, McPherson K & Mann J (1990): Dietary intake and plasma lipid levels: lessons from a study of the diet of health conscious groups. BMJ 300, 1297–1301.

    Article  CAS  Google Scholar 

  • Thomas EL, Frost G, Harrington T & Bell JD (2000): Validation of ‘In Body’ bioelectrical impedance by whole body MRI. Clinical Nutrition and Metabolism Group of the Nutrition Society & The British Association for Parenteral and Enteral Nutrition. Abstracts of Original Communications:C30 (abstract).

  • van den Boogaart A, van Hecke P, van Huffel S, Graveron-Demilly D, van Ormondt D & de Beer R (1996): MRUI: a graphical user interface for accurate routine MRS data analysis. Proceedings of the ESMRMB (13th Annual Meeting of the ESMRMB) Vol. 318.

  • van Haeften TW (2002): Early disturbances in insulin secretion in the development of type 2 diabetes mellitus. Mol. Cell. Endocrinol. 197, 197–204.

    Article  CAS  Google Scholar 

  • Vessby B, Unsitupa M, Hermansen K, Riccardi G, Rivellese AA, Tapsell LC, Nalsen C, Berglund L, Louheranta A, Rasmussen BM, Calvert GD, Maffetone A, Pedersen E, Gustafsson IB & Storlien LH (2001): Substituting dietary saturated for monounsaturated fat impairs insulin sensitivity in healthy men and women: The KANWU study. Diabetologia 44, 312–319.

    Article  CAS  Google Scholar 

  • Weiss RG, Dufour S & Groszmann A et al (2003): Low adiponectin levels in adolescent obesity: a marker of increased intramyocellular lipid accumulation. J. Clin. Endocrinol. Metab. 88, 2014–2018.

    Article  CAS  Google Scholar 

  • Wolever TM & Jenkins DJ (1986): The use of the glycemic index in predicting the blood glucose response to mixed meals. Am. J. Clin. Nutr. 43, 167–172.

    Article  CAS  Google Scholar 

  • Wolever TM, Jenkins DJ, Vuksan V, Jenkins AL, Buckley GC, Wong GS & Josse RG (1992): Beneficial effect of a low glycaemic index diet in type 2 diabetes. Diabet. Med. 9, 451–458. (abstr).

    Article  CAS  Google Scholar 

  • Zimmet P, Alberti KG & Shaw J (2001): Global and societal implications of the diabetes epidemic. Nature 414, 782–787.

    Article  CAS  Google Scholar 

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Acknowledgements

The authors would like to thank the MRC and Philips (Cleveland, OH, USA) for their assistance during this study. We would also like to thank Ms Cherie Tong for her help with the vegan dietary analysis.

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Correspondence to G S Frost.

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Guarantor: G Frost.

Contributors: LMG was responsible for the design of protocol, recruitment and data collection/analysis and was the principal author of report. JDB contributed to the design of protocol, data collection/analysis and written report. PWS contributed to data analysis and written report. AD was responsible for data collection; and GSF contributed to design of protocol, data collection/analysis and written report.

Conflicts of interest: LMG, JDB and PWS: MRC funding; AD: lecturer for Knoll, NovoNordisk, Novartis, Aventis and GlaxoSmithKline; GSF: receives research funding from Kellogg, Sugar Bureau, Roche and Nutricia.

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Goff, L., Bell, J., So, PW. et al. Veganism and its relationship with insulin resistance and intramyocellular lipid. Eur J Clin Nutr 59, 291–298 (2005). https://doi.org/10.1038/sj.ejcn.1602076

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  • DOI: https://doi.org/10.1038/sj.ejcn.1602076

Keywords

  • intramyocellular lipids
  • insulin resistance
  • insulin sensitivity
  • magnetic resonance spectroscopy
  • glycaemic index
  • vegan

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