DIETARY CARBOHYDRATES AND INSULIN SENSITIVITY - A REVIEW OF THE EVIDENCE AND CLINICAL IMPLICATIONS

Insulin resistance is associated with diabetes mellitus, ischemic hear t disease, and hypertension both independently and as part of syndrome X. Environmental influences on S-I are incompletely understood. Exerc ise has a strong beneficial effect and obesity a strong adverse effect . The balance of evidence suggests that a high-fat diet is likely to r educe insulin sensitivity but the effects of dietary carbohydrates are more controversial. Extensive studies in animals showed a detrimental effect of diets very high in fructose or sucrose, particularly in ass ociation with induction of hypertriglyceridemia. The more limited stud ies in humans had conflicting results, partly because of heterogeneity of design. Certain groups of subjects may be more sensitive to advers e effects of high intakes of dietary sucrose or fructose. More careful ly controlled studies in humans are needed to provide evidence on whic h to base public health policies with respect to dietary carbohydrates and S-I.