July 5, 2000 -- Eating monounsaturated fats such as olive oil, canola oil, and peanut oil instead of saturated fats like butter could help teenagers with type 1 diabetes control their disease, as long as they keep being careful about calories, a study from Australia suggests.
One thing the Australian researchers found was that getting teens to stick to a diet plan -- any diet plan -- is difficult at best. But they found that even the small, incremental change of substituting monounsaturated fats for animal fats improved their conditions.
The idea of increasing monounsaturated fat began with type 2 diabetics. Their blood fat and sugar levels have been found to improve when they consume a diet higher in monounsaturated fat and lower in carbohydrates. This works in type 2 diabetics because of a condition known as insulin resistance, a phrase that has been much touted lately with regard to the high-protein diet fad.
And there may indeed be something to the idea that reducing carbohydrates can help people who have trouble controlling their blood sugar -- by improving the efficiency of insulin, whether it occurs naturally in the body or is given through injection.
Experts had not thought that type 1 diabetics had this sort of insulin resistance. But Stephenie Lucas, MD, tells WebMD that the Australian researchers might be on to something. This so-called "syndrome-x," or insulin-resistant condition, seems to respond well to a high-fat diet.
"We've always thought of type 1 [diabetes] being an antibody disease and type 2 being more insulin resistant. What this [study] is saying is that insulin resistance also occurs in type 1, especially during puberty," says Lucas, an endocrinologist at St. John Hospital and Medical Center in Detroit. Lucas was not a part of the Australian study.
She explains that this could be because teens produce certain hormones, such as growth, adrenaline, and sex hormones, at a greater intensity, and these substances may interfere with insulin's effects.
For the study, the researchers from the University of Sydney divided teens into two groups. One group was put on a diet in which 43% of the daily calories were to come from fat (with 20% of that being monounsaturated) and less than 50% from carbohydrates. The other group was to eat a more or less normal diet, with 30% of their calories from fat (either saturated or monounsaturated) and 55% of their calories from carbohydrates. Both groups were told to continue their usual levels of activity.
Neither group was able to achieve the dietary goals. But looking at both groups, the researchers noted that for each 10% increase in monounsaturated fatty acid levels in the teens' blood, there was a more than 0.5% decrease in hemoglobin A1c, a measurement of blood-sugar control.
The researchers feel that even this small dietary change could improve the teenagers' response to the insulin they take daily to help control their disease.
Lucas cautions that it is important that monounsaturated fat be used in place of saturated or other fat, not in addition to it. "My only concern is that people may go overboard, thinking they can eat all the fat they want," she says. She emphasizes that calorie restriction is still very important for these patients, and that saturated fat is not considered good for diabetics.
Also, since the teen years are difficult and some diabetic teens may develop eating disorders, Lucas says: "We need to be careful about the way we approach diet with them. Try to gear them more toward foods that have the unsaturated fat."
Parents can change the oils they cook with, using canola, olive, or peanut oil instead of saturated fat like butter or even some of the polyunsaturated oils, she says.
"Be careful, too, of spreads [such as margarine], as many of them are made from saturated fat," Lucas adds.
The study, which appeared in the journal Diabetes Research and Clinical Practice, was funded by Meadow Lea Foods and the Grains Research Development Corporation of Australia. Meadow Lea provided the monounsaturated foods for the teens' diets.