Journal of Clinical Endocrinology & Metabolism, Vol 73, 156-165, Copyright © 1991 by Endocrine Society

ARTICLES

Deterioration in carbohydrate metabolism and lipoprotein changes induced by modern, high fat diet in Pima Indians and Caucasians

BA Swinburn, VL Boyce, RN Bergman, BV Howard and C Bogardus
Clinical Diabetes and Nutrition Section, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, Arizona 85016.

The transition from a high carbohydrate to a high fat diet may explain in part the dramatic increase in the prevalence of noninsulin-dependent diabetes mellitus among Pima Indians over the last century. In this study, 12 Pimas and 12 caucasians, all nondiabetic, were admitted to a metabolic ward and, in random order, fed 2 14-day weight-maintaining diets: a traditional Pima diet (percentage of calories: carbohydrate, 70% fat, 15%; protein, 15%) and a high fat modern diet (carbohydrate, 30%; fat, 50%; protein, 20%). Carbohydrate metabolism was characterized using the modified iv glucose tolerance test (minimal model), the acute insulin responses to arginine during a 3-step glycemic clamp, and the oral glucose tolerance test. Compared with the traditional diet, the modern diet was associated with a decrease in oral glucose tolerance (P less than 0.01) and higher plasma cholesterol concentrations (P less than 0.02). The decline in glucose tolerance was associated with similar insulin-mediated, but 23% lower glucose-mediated (P less than 0.001), glucose disposal, a 17% lower acute insulin response to glucose (P less than 0.03), a 9% lower beta-cell sensitivity to glucose (P less than 0.02), and similar beta-cell capacities. Pimas and caucasians responded similarly, except for larger changes in plasma lipids among the Pimas. Since glucose-mediated glucose disposal, beta-cell function, and glucose tolerance deteriorated on the modern diet, it is likely that diet composition affects the prevalence of noninsulin-dependent diabetes mellitus in both Pimas and caucasians.

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