BACKGROUND AND AIMS: Fatty acids are important cellular constituents that may affect many metabolic processes relevant for the development of diabetes and its complications. We showed previously that vegetarian diet leads to greater increase in metabolic clearance rate of glucose (MCR) than conventional hypocaloric diet. The aim of this secondary analysis was to explore the role of changes in fatty acid composition of serum phospholipids in diet- and exercise-induced changes in MCR in subjects with type 2 diabetes (T2D). METHODS: Subjects with T2D (n=74) were randomly assigned into a vegetarian group (VG, n=37) following vegetarian diet or a control group (CG, n=37) following a conventional diet. Both diets were calorie restricted (-500 kcal day(-1)). Participants were examined at baseline, 12 weeks of diet intervention and 24 weeks (subsequent 12 weeks of diet were combined with aerobic exercise). The fatty acid composition of serum phospholipids was measured by gas liquid chromatography. MCR was measured by hyperinsulinemic isoglycemic clamp. Visceral fat (VF) was measured by magnetic resonance imaging. RESULTS: Linoleic acid (LA; 18:2n6) increased in VG (P=0.04), whereas it decreased in CG (P=0.04) in response to dietary interventions. It did not change significantly after the addition of exercise in either group (group × time P<0.001). In VG, changes in 18:2n6 correlated positively with changes in MCR (r=+0.22; P=0.04) and negatively with changes in VF (r=-0.43; P=0.01). After adjustment for changes in body mass index, the association between 18:2n6 and MCR was no longer significant. The addition of exercise resulted in greater changes of phospholipid fatty acids composition in VG than in CG. CONCLUSION: We demonstrated that the insulin-sensitizing effect of a vegetarian diet might be related to the increased proportion of LA in serum phospholipids.

Diabetes Centre Institute for Clinical and Experimental Medicine Prague Czech Republic

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Risérus U. Fatty acids and insulin sensitivity. Curr Opin Clin Nutr Metab Care. 2008;11:100–105. PubMed

Vessby B. Dietary fat, fatty acid composition in plasma and the metabolic syndrome. Curr Opin Lipidol. 2003;14:15–19. PubMed

Field CJ, Ryan EA, Thomson AB, Clandinin MT. Diet fat composition alters membrane phospholipid composition, insulin binding, and glucose metabolism in adipocytes from control and diabetic animals. J Biol Chem. 1990;265:11143–11150. PubMed

Haag M, Dippenaar NG. Dietary fats, fatty acids and insulin resistance: short review of a multifaceted connection. Med Sci Monit. 2005;11:RA359–RA367. PubMed

Wolk A, Furuheim M, Vessby B. Fatty acid composition of adipose tissue and serum lipids are valid biological markers of dairy fat intake in men. J Nutr. 2001;131:828–833. PubMed

Pelikánová T, Kazdová L, Chvojková S, Base J. Serum phospholipid fatty acid composition and insulin action in type 2 diabetic patients. Metab Clin Exp. 2001;50:1472–1478. PubMed

Warensjö E, Risérus U, Vessby B. Fatty acid composition of serum lipids predicts the development of the metabolic syndrome in men. Diabetologia. 2005;48:1999–2005. PubMed

Sjögren P, Sierra-Johnson J, Gertow K, Rosell M, Vessby B, De Faire U, et al. Fatty acid desaturases in human adipose tissue: relationships between gene expression, desaturation indexes and insulin resistance. Diabetologia. 2008;51:328–335. PubMed

Vessby B, Uusitupa M, Hermansen K, Riccardi G, Rivellese AA, Tapsell LC, et al. Substituting dietary saturated for monounsaturated fat impairs insulin sensitivity in healthy men and women: the KANWU Study. Diabetologia. 2001;44:312–319. PubMed

Barnard ND, Cohen J, Jenkins DJA, Turner-McGrievy G, Gloede L, Jaster B, et al. A low-fat vegan diet improves glycemic control and cardiovascular risk factors in a randomized clinical trial in individuals with type 2 diabetes. Diabetes Care. 2006;29:1777–1783. PubMed

Kahleova H, Matoulek M, Malinska H, Oliyarnik O, Kazdova L, Neskudla T, et al. Vegetarian diet improves insulin resistance and oxidative stress markers more than conventional diet in subjects with Type 2 diabetes. Diabet Med. 2011;28:549–559. PubMed PMC

Kuhlmann J, Neumann-Haefelin C, Belz U, Kalisch J, Juretschke H-P, Stein M, et al. Intramyocellular lipid and insulin resistance: a longitudinal in vivo 1H-spectroscopic study in Zucker diabetic fatty rats. Diabetes. 2003;52:138–144. PubMed

Perseghin G, Scifo P, De Cobelli F, Pagliato E, Battezzati A, Arcelloni C, et al. Intramyocellular triglyceride content is a determinant of in vivo insulin resistance in humans: a 1H-13C nuclear magnetic resonance spectroscopy assessment in offspring of type 2 diabetic parents. Diabetes. 1999;48:1600–1606. PubMed

Goff LM, Bell JD, So P-W, Dornhorst A, Frost GS. Veganism and its relationship with insulin resistance and intramyocellular lipid. Eur J Clin Nutr. 2005;59:291–298. PubMed

Bird SR, Hawley JA. Exercise and type 2 diabetes: new prescription for an old problem. Maturitas. 2012;72:311–316. PubMed

Berman LJ, Weigensberg MJ, Spruijt-Metz D. Physical activity is related to insulin sensitivity in children and adolescents, independent of adiposity: a review of the literature. Diabetes Metab Res Rev. 2012;28:395–408. PubMed PMC

Arsić A, Vučić V, Tepšić J, Mazić S, Djelić M, Glibetić M. Altered plasma and erythrocyte phospholipid fatty acid profile in elite female water polo and football players. Appl Physiol Nutr Metab. 2012;37:40–47. PubMed

Ferrannini E. The theoretical bases of indirect calorimetry: a review. Metab Clin Exp. 1988;37:287–301. PubMed

Mullerova D, Tychtl Z, Muller L, Brazdova Z. NutriDan 1.2. Danone Institute: Prague, Czech Republic; 2003.

Hagströmer M, Oja P, Sjöström M. The International Physical Activity Questionnaire (IPAQ): a study of concurrent and construct validity. Public Health Nutr. 2006;9:755–762. PubMed

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

Pelikánová T, Kohout M, Válek J, Base J, Kazdová L. Insulin secretion and insulin action related to the serum phospholipid fatty acid pattern in healthy men. Metab Clin Exp. 1989;38:188–192. PubMed

Chabiniok R, Tintěra J.Cardiac MRI data segmentation using the partial differential equation of Allen-Cahn type. Proceedings of Czech Japanese Seminar in Applied Mathematics 2006. Faculty of Mathematics, Kyushu University Fukuoka200737–49.

Folch J, Lees M, Sloane Stanley Gh. A simple method for the isolation and purification of total lipides from animal tissues. J Biol Chem. 1957;226:497–509. PubMed

Eder K. Gas chromatographic analysis of fatty acid methyl esters. J Chromatogr B Biomed Appl. 1995;671:113–131. PubMed

Vessby B, Gustafsson I-B, Tengblad S, Boberg M, Andersson A. Desaturation and elongation of Fatty acids and insulin action. Ann N Y Acad Sci. 2002;967:183–195. PubMed

Li X, Xu Z, Lu X, Yang X, Yin P, Kong H, et al. Comprehensive two-dimensional gas chromatography/time-of-flight mass spectrometry for metabonomics: biomarker discovery for diabetes mellitus. Anal Chim Acta. 2009;633:257–262. PubMed

Vessby B, Aro A, Skarfors E, Berglund L, Salminen I, Lithell H. The risk to develop NIDDM is related to the fatty acid composition of the serum cholesterol esters. Diabetes. 1994;43:1353–1357. PubMed

Feskens EJ. Can diabetes be prevented by vegetable fat. Diabetes Care. 2001;24:1517–1518. PubMed

Crowe FL, Skeaff CM, Green TJ, Gray AR. Serum fatty acids as biomarkers of fat intake predict serum cholesterol concentrations in a population-based survey of New Zealand adolescents and adults. Am J Clin Nutr. 2006;83:887–894. PubMed

Zheng ZJ, Folsom AR, Ma J, Arnett DK, McGovern PG, Eckfeldt JH. Plasma fatty acid composition and 6-year incidence of hypertension in middle-aged adults: the Atherosclerosis Risk in Communities (ARIC) Study. Am J Epidemiol. 1999;150:492–500. PubMed

Sundström J, Lind L, Vessby B, Andrén B, Aro A, Lithell H. Dyslipidemia and an unfavorable fatty acid profile predict left ventricular hypertrophy 20 years later. Circulation. 2001;103:836–841. PubMed

Haugaard SB, Vaag A, Hoy C-E, Madsbad S. Desaturation of skeletal muscle structural and depot lipids in obese individuals during a very-low-calorie diet intervention[ast] Obesity. 2007;15:117. PubMed

Haugaard SB, Madsbad S, Høy C-E, Vaag A. Dietary intervention increases n-3 long-chain polyunsaturated fatty acids in skeletal muscle membrane phospholipids of obese subjects. Implications for insulin sensitivity. Clin Endocrinol (Oxf) 2006;64:169–178. PubMed

Marini M, Abruzzo PM, Bolotta A, Veicsteinas A, Ferreri C. Aerobic training affects fatty acid composition of erythrocyte membranes. Lipids Health Disease. 2011;10:188. PubMed PMC

Wu JHY, Lemaitre RN, Imamura F, King IB, Song X, Spiegelman D, et al. Fatty acids in the de novo lipogenesis pathway and risk of coronary heart disease: the Cardiovascular Health Study. Am J Clin Nutr. 2011;94:431–438. PubMed PMC

Positive effects of voluntary running on metabolic syndrome-related disorders in non-obese hereditary hypertriacylglycerolemic rats