Background/objectives: Cardioprotective effects of Mediterranean-style diet have been shown. Instead of excluding\nfoods, replacement or addition may facilitate compliance with impact on glucose metabolism of individuals at\ncardiometabolic risk. This study investigated the effect of changing selected nutrients intake on glucose metabolism\nduring a lifestyle intervention tailored to living conditions of prediabetic Brazilians.\nSubjects/methods: 183 prediabetic adults treated under the Brazilian public health system underwent an 18-month\nintervention on diet and physical activity. Dietary counseling focused on reducing saturated fat replaced by unsaturated\nfatty acids. Data were collected at baseline and after follow-up. ANOVA and multiple linear regression were used to test\nassociation of changes in nutrients intake with changes in plasma glucose.\nResults: Changes in fasting and 2-h plasma glucose but not in weight, HOMA-IR or C-reactive protein decreased after\nintervention across tertiles of MUFA changes (p-trend 0.017 and 0.024, respectively). Regression models showed that\nincrease in MUFA intake was independently associated with reduction in fasting (? -1.475, p = 0.008) and 2-h plasma\nglucose (? -3.321, p = 0.007). Moreover, increase in soluble fibers intake was associated with decrease in fasting plasma\nglucose (? -1.579, p = 0.038). Adjustment for anthropometric measurements did not change the results but did after\nincluding change in insulin in the models.\nConclusions: Increases of MUFA and soluble fibers intakes promote benefits on glucose metabolism, independently of\nadiposity, during a realistic lifestyle intervention in at-risk individuals. Mechanisms mediating these processes may\ninclude mainly insulin sensitivity improvement.
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