Long-Term, Randomized Clinical Trial of Two Diets in the Metabolic Syndrome and Type 2 Diabetes

The best dietary balance of fatty acids, protein, and carbohydrate in patients with both glucose and lipid metabolism disorders remains unclear (1). Substitution of carbohydrates for saturated fatty acids frequently leads to increased triglyceride and decreased HDL cholesterol (2), adverse effects not seen with increased dietary monounsaturated fatty acids (MUFAs) (3). Moderate hyperglycemia can contribute to increased turnover of protein, suggesting increased need for protein in type 2 diabetes (4). Between January 2000 and February 2001, we randomized 35 patients with the metabolic syndrome or type 2 diabetes to the contemporary American Heart Association (AHA) diet (15% of calories from protein, 30% fat, and 15% MUFAs) or a diet higher in protein, total fat, and MUFAs …