Cross-sectional association between the isocaloric replacement of carbohydrates with protein and fat in relation to fat compartments distribution and hepatic lipid content in recent-onset type 1 and type 2 diabetes
Abstract Background Diets restricted in carbohydrates may be beneficial for diabetes management. However, without reducing energy intake, carbohydrate restriction results in increased protein and fat intake. Understanding how this macronutrient substitution is associated with adipose tissue distribu...
Saved in:
| Main Authors: | , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2025-05-01
|
| Series: | Nutrition Journal |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12937-025-01145-1 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850278146331377664 |
|---|---|
| author | Alexander Lang Edyta Schaefer Yuliya Kupriyanova Janina Goletzke Katharina S. Weber Anette E. Buyken Sabine Kahl Oana-Patricia Zaharia Christian Herder Vera B. Schrauwen-Hinderling Oliver Kuss Robert Wagner Michael Roden Sabrina Schlesinger German Diabetes Study Group |
| author_facet | Alexander Lang Edyta Schaefer Yuliya Kupriyanova Janina Goletzke Katharina S. Weber Anette E. Buyken Sabine Kahl Oana-Patricia Zaharia Christian Herder Vera B. Schrauwen-Hinderling Oliver Kuss Robert Wagner Michael Roden Sabrina Schlesinger German Diabetes Study Group |
| author_sort | Alexander Lang |
| collection | DOAJ |
| description | Abstract Background Diets restricted in carbohydrates may be beneficial for diabetes management. However, without reducing energy intake, carbohydrate restriction results in increased protein and fat intake. Understanding how this macronutrient substitution is associated with adipose tissue distribution is important to prevent diabetes progression. Therefore, the aim was to investigate the isocaloric substitution of carbohydrates with fat and protein in relation to subcutaneous (SAT) and visceral adipose tissue (VAT) and hepatic lipid (HL) content in individuals with recent-onset type 1 (T1D) and type 2 diabetes (T2D), accounting for macronutrient quality. Methods This cross-sectional analysis includes participants with T1D (n = 137) and T2D (n = 170) from the German Diabetes Study (GDS). Dietary macronutrient intake was derived from dietary information assessed with a validated food frequency questionnaire. SAT and VAT were measured with magnetic resonance (MR) imaging, while HL content with 1H MR spectroscopy. Isocaloric substitution analyses based on multivariable linear regression models were conducted to examine the replacement of total and higher glycemic index (GI) carbohydrates in energy percent (En%) with total fat, monounsaturated (MUFA), polyunsaturated (PUFA), and saturated fatty acids (SFA), and protein in regard to SAT, VAT and HL content. Results In individuals with T1D, substituting carbohydrates with total fat was not associated with SAT, while substituting carbohydrates with protein demonstrated higher SAT [β (95% CI) per 5 En%: 3100 cm3 (25, 6200)]. In individuals with T2D, replacing carbohydrates with total fat or protein showed no association with SAT and VAT. However, substituting carbohydrates with PUFA was associated with lower VAT [-970 cm3 (-1900, -40)] and HL content [-3.3% (-6.9, 0.4)], while replacing carbohydrates with SFA was associated with higher HL content [2.4% (-0.6, 5.4)]. Substituting carbohydrates with protein was associated with lower HL content in individuals with T2D [-2.4% (-4.9, 0.0)], mainly driven by plant-based protein. There were no substantial differences between the replacement of total and higher GI carbohydrates. Conclusions The quality of substituted nutrients may play an important role for adipose tissue and HL accumulation in individuals with T2D. Particularly, integrating PUFAs and plant-based proteins into the diet seems beneficial for VAT and HL content. |
| format | Article |
| id | doaj-art-87df1103241f40cf9a229031b1da4752 |
| institution | OA Journals |
| issn | 1475-2891 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | BMC |
| record_format | Article |
| series | Nutrition Journal |
| spelling | doaj-art-87df1103241f40cf9a229031b1da47522025-08-20T01:49:36ZengBMCNutrition Journal1475-28912025-05-0124111210.1186/s12937-025-01145-1Cross-sectional association between the isocaloric replacement of carbohydrates with protein and fat in relation to fat compartments distribution and hepatic lipid content in recent-onset type 1 and type 2 diabetesAlexander Lang0Edyta Schaefer1Yuliya Kupriyanova2Janina Goletzke3Katharina S. Weber4Anette E. Buyken5Sabine Kahl6Oana-Patricia Zaharia7Christian Herder8Vera B. Schrauwen-Hinderling9Oliver Kuss10Robert Wagner11Michael Roden12Sabrina Schlesinger13German Diabetes Study GroupGerman Diabetes Center, Institute for Biometrics and Epidemiology, Research Group Systematic Reviews, Leibniz Center for Diabetes Research at Heinrich Heine University DüsseldorfGerman Diabetes Center, Institute for Biometrics and Epidemiology, Research Group Systematic Reviews, Leibniz Center for Diabetes Research at Heinrich Heine University DüsseldorfGerman Center for Diabetes Research (DZD), Partner DüsseldorfDepartment of Sports and Health, Institute of Nutrition, Consumption and Health, Paderborn UniversityInstitute of Epidemiology, Kiel UniversityDepartment of Sports and Health, Institute of Nutrition, Consumption and Health, Paderborn UniversityInstitute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University DüsseldorfGerman Center for Diabetes Research (DZD), Partner DüsseldorfGerman Center for Diabetes Research (DZD), Partner DüsseldorfGerman Center for Diabetes Research (DZD), Partner DüsseldorfGerman Diabetes Center, Institute for Biometrics and Epidemiology, Research Group Systematic Reviews, Leibniz Center for Diabetes Research at Heinrich Heine University DüsseldorfGerman Center for Diabetes Research (DZD), Partner DüsseldorfDivision of Endocrinology and Diabetology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University DüsseldorfGerman Diabetes Center, Institute for Biometrics and Epidemiology, Research Group Systematic Reviews, Leibniz Center for Diabetes Research at Heinrich Heine University DüsseldorfAbstract Background Diets restricted in carbohydrates may be beneficial for diabetes management. However, without reducing energy intake, carbohydrate restriction results in increased protein and fat intake. Understanding how this macronutrient substitution is associated with adipose tissue distribution is important to prevent diabetes progression. Therefore, the aim was to investigate the isocaloric substitution of carbohydrates with fat and protein in relation to subcutaneous (SAT) and visceral adipose tissue (VAT) and hepatic lipid (HL) content in individuals with recent-onset type 1 (T1D) and type 2 diabetes (T2D), accounting for macronutrient quality. Methods This cross-sectional analysis includes participants with T1D (n = 137) and T2D (n = 170) from the German Diabetes Study (GDS). Dietary macronutrient intake was derived from dietary information assessed with a validated food frequency questionnaire. SAT and VAT were measured with magnetic resonance (MR) imaging, while HL content with 1H MR spectroscopy. Isocaloric substitution analyses based on multivariable linear regression models were conducted to examine the replacement of total and higher glycemic index (GI) carbohydrates in energy percent (En%) with total fat, monounsaturated (MUFA), polyunsaturated (PUFA), and saturated fatty acids (SFA), and protein in regard to SAT, VAT and HL content. Results In individuals with T1D, substituting carbohydrates with total fat was not associated with SAT, while substituting carbohydrates with protein demonstrated higher SAT [β (95% CI) per 5 En%: 3100 cm3 (25, 6200)]. In individuals with T2D, replacing carbohydrates with total fat or protein showed no association with SAT and VAT. However, substituting carbohydrates with PUFA was associated with lower VAT [-970 cm3 (-1900, -40)] and HL content [-3.3% (-6.9, 0.4)], while replacing carbohydrates with SFA was associated with higher HL content [2.4% (-0.6, 5.4)]. Substituting carbohydrates with protein was associated with lower HL content in individuals with T2D [-2.4% (-4.9, 0.0)], mainly driven by plant-based protein. There were no substantial differences between the replacement of total and higher GI carbohydrates. Conclusions The quality of substituted nutrients may play an important role for adipose tissue and HL accumulation in individuals with T2D. Particularly, integrating PUFAs and plant-based proteins into the diet seems beneficial for VAT and HL content.https://doi.org/10.1186/s12937-025-01145-1Isocaloric substitutionFood frequency questionnaireCarbohydratesFatProteinGlycemic index |
| spellingShingle | Alexander Lang Edyta Schaefer Yuliya Kupriyanova Janina Goletzke Katharina S. Weber Anette E. Buyken Sabine Kahl Oana-Patricia Zaharia Christian Herder Vera B. Schrauwen-Hinderling Oliver Kuss Robert Wagner Michael Roden Sabrina Schlesinger German Diabetes Study Group Cross-sectional association between the isocaloric replacement of carbohydrates with protein and fat in relation to fat compartments distribution and hepatic lipid content in recent-onset type 1 and type 2 diabetes Nutrition Journal Isocaloric substitution Food frequency questionnaire Carbohydrates Fat Protein Glycemic index |
| title | Cross-sectional association between the isocaloric replacement of carbohydrates with protein and fat in relation to fat compartments distribution and hepatic lipid content in recent-onset type 1 and type 2 diabetes |
| title_full | Cross-sectional association between the isocaloric replacement of carbohydrates with protein and fat in relation to fat compartments distribution and hepatic lipid content in recent-onset type 1 and type 2 diabetes |
| title_fullStr | Cross-sectional association between the isocaloric replacement of carbohydrates with protein and fat in relation to fat compartments distribution and hepatic lipid content in recent-onset type 1 and type 2 diabetes |
| title_full_unstemmed | Cross-sectional association between the isocaloric replacement of carbohydrates with protein and fat in relation to fat compartments distribution and hepatic lipid content in recent-onset type 1 and type 2 diabetes |
| title_short | Cross-sectional association between the isocaloric replacement of carbohydrates with protein and fat in relation to fat compartments distribution and hepatic lipid content in recent-onset type 1 and type 2 diabetes |
| title_sort | cross sectional association between the isocaloric replacement of carbohydrates with protein and fat in relation to fat compartments distribution and hepatic lipid content in recent onset type 1 and type 2 diabetes |
| topic | Isocaloric substitution Food frequency questionnaire Carbohydrates Fat Protein Glycemic index |
| url | https://doi.org/10.1186/s12937-025-01145-1 |
| work_keys_str_mv | AT alexanderlang crosssectionalassociationbetweentheisocaloricreplacementofcarbohydrateswithproteinandfatinrelationtofatcompartmentsdistributionandhepaticlipidcontentinrecentonsettype1andtype2diabetes AT edytaschaefer crosssectionalassociationbetweentheisocaloricreplacementofcarbohydrateswithproteinandfatinrelationtofatcompartmentsdistributionandhepaticlipidcontentinrecentonsettype1andtype2diabetes AT yuliyakupriyanova crosssectionalassociationbetweentheisocaloricreplacementofcarbohydrateswithproteinandfatinrelationtofatcompartmentsdistributionandhepaticlipidcontentinrecentonsettype1andtype2diabetes AT janinagoletzke crosssectionalassociationbetweentheisocaloricreplacementofcarbohydrateswithproteinandfatinrelationtofatcompartmentsdistributionandhepaticlipidcontentinrecentonsettype1andtype2diabetes AT katharinasweber crosssectionalassociationbetweentheisocaloricreplacementofcarbohydrateswithproteinandfatinrelationtofatcompartmentsdistributionandhepaticlipidcontentinrecentonsettype1andtype2diabetes AT anetteebuyken crosssectionalassociationbetweentheisocaloricreplacementofcarbohydrateswithproteinandfatinrelationtofatcompartmentsdistributionandhepaticlipidcontentinrecentonsettype1andtype2diabetes AT sabinekahl crosssectionalassociationbetweentheisocaloricreplacementofcarbohydrateswithproteinandfatinrelationtofatcompartmentsdistributionandhepaticlipidcontentinrecentonsettype1andtype2diabetes AT oanapatriciazaharia crosssectionalassociationbetweentheisocaloricreplacementofcarbohydrateswithproteinandfatinrelationtofatcompartmentsdistributionandhepaticlipidcontentinrecentonsettype1andtype2diabetes AT christianherder crosssectionalassociationbetweentheisocaloricreplacementofcarbohydrateswithproteinandfatinrelationtofatcompartmentsdistributionandhepaticlipidcontentinrecentonsettype1andtype2diabetes AT verabschrauwenhinderling crosssectionalassociationbetweentheisocaloricreplacementofcarbohydrateswithproteinandfatinrelationtofatcompartmentsdistributionandhepaticlipidcontentinrecentonsettype1andtype2diabetes AT oliverkuss crosssectionalassociationbetweentheisocaloricreplacementofcarbohydrateswithproteinandfatinrelationtofatcompartmentsdistributionandhepaticlipidcontentinrecentonsettype1andtype2diabetes AT robertwagner crosssectionalassociationbetweentheisocaloricreplacementofcarbohydrateswithproteinandfatinrelationtofatcompartmentsdistributionandhepaticlipidcontentinrecentonsettype1andtype2diabetes AT michaelroden crosssectionalassociationbetweentheisocaloricreplacementofcarbohydrateswithproteinandfatinrelationtofatcompartmentsdistributionandhepaticlipidcontentinrecentonsettype1andtype2diabetes AT sabrinaschlesinger crosssectionalassociationbetweentheisocaloricreplacementofcarbohydrateswithproteinandfatinrelationtofatcompartmentsdistributionandhepaticlipidcontentinrecentonsettype1andtype2diabetes AT germandiabetesstudygroup crosssectionalassociationbetweentheisocaloricreplacementofcarbohydrateswithproteinandfatinrelationtofatcompartmentsdistributionandhepaticlipidcontentinrecentonsettype1andtype2diabetes |