Tohoku J. Exp. Med., 2017 September, 243(1)

Postprandial Glucose Surges after Extremely Low Carbohydrate Diet in Healthy Adults

KOJI KANAMORI,1,2 NORIKO IHANA-SUGIYAMA,3 RITSUKO YAMAMOTO-HONDA,3,4,5 TOMOKA NAKAMURA,3 CHIE SOBE,6 SHIGEMI KAMIYA,1 MIYAKO KISHIMOTO,7 HIROSHI KAJIO,3 KIMIKO KAWANO8 and MITSUHIKO NODA9

1Nutrition Management Department, National Center for Global Health and Medicine Center Hospital, Tokyo, Japan
2Nutrition Management Department, National Hospital Organization East Saitama National Hospital, Hasuda, Saitama, Japan
3Department of Diabetes, Endocrinology and Metabolism, National Center for Global Health and Medicine Center Hospital, Tokyo, Japan
4Health Management Center, Toranomon Hospital, Tokyo, Japan
5Department of Endocrinology and Metabolism, Toranomon Hospital, Tokyo, Japan
6Nutrition Management Department, National Hospital Organization Chiba Medical Center, Chiba, Chiba, Japan
7Department of Internal Medicine, Sanno Hospital, Tokyo, Japan
8Student Affairs Division, Nutrition course, Futaba Nutrition College, Musashino, Tokyo, Japan
9Department of Endocrinology and Diabetes, Saitama Medical University, Iruma-gun, Saitama, Japan

Carbohydrate-restricted diets are prevalent not only in obese people but also in the general population to maintain appropriate body weight. Here, we report that extreme carbohydrate restriction for one day affects the subsequent blood glucose levels in healthy adults. Ten subjects (median age 30.5 years, BMI 21.1 kg/m2, and HbA1c 5.5%), wearing with a continuous glucose monitoring device, were given isoenergetic test meals for 4 consecutive days. On day 1, day 2 (D2), and day 4 (D4), they consumed normal-carbohydrate (63-66% carbohydrate) diet, while on day 3, they took low-carbohydrate/high-fat (5% carbohydrate) diet. The daily energy intake was 2,200 kcal for males and 1,700 kcal for females. On D2 and D4, we calculated the mean 24-hr blood glucose level (MEAN/24h) and its standard deviation (SD/24h), the area under the curve (AUC) for glucose over 140 mg/dL within 4 hours after each meal (AUC/4h/140), the mean amplitude of the glycemic excursions (MAGE), the incremental AUC of 24-hr blood glucose level above the mean plus one standard deviation (iAUC/MEAN+SD). Indexes for glucose fluctuation on D4 were significantly greater than those on D2 (SD/24h; p = 0.009, MAGE; p = 0.013, AUC/4h/140 after breakfast and dinner; p = 0.006 and 0.005, and iAUC/MEAN+SD; p = 0.007). The value of MEAN/24h and AUC/4h/140 after lunch on D4 were greater than those on D2, but those differences were not statistically significant. In conclusion, consumption of low-carbohydrate/high-fat diet appears to cause higher postprandial blood glucose on subsequent normal-carbohydrate diet particularly after breakfast and dinner in healthy adults.

keywords —— continuous glucose monitoring system; glucose fluctuations; insulin resistance; low carbohydrate diet; postprandial hyperglycemia

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Tohoku J. Exp. Med., 2017, 243, 35-39

Correspondence: Ritsuko Yamamoto-Honda, M.D., Ph.D., Department of Diabetes, Endocrinology and Metabolism, National Center for Global Health and Medicine Center Hospital, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan.

e-mail: rithonda@toranomon.gr.jp