The Role of Vegan Diets in Lipotoxicity-Induced Beta-Cell Dysfunction in Type-2-Diabetes
Main Article Content
Keywords
Vegan, Diet, Fat, Saturated, Polyunsaturated, Weight, Obesity, Beta Cell, Lipotoxicity, Lipoapoptosis, Type-2-Diabetes
Abstract
Type-2-diabetes is considered the new plague of the current century and both, its incidence and prevalence are rapidly increasing. Chronic insulin resistance and a progressive decline in beta-cell function are discussed as the root causes of type-2-diabetes. Both were associated with obesity and pathologically elevated concentrations of circulating free fatty acids in the blood.
The harmful effects of chronically elevated free fatty acid levels on glucose homeostasis and non-adipose tissues are referred to as lipotoxicity. Pancreatic beta-cells appear to be particularly vulnerable and both, dietary fat quantity and quality may impact beta-cell function.
Diets high in saturated fats are especially harmful to beta-cells while (poly-)unsaturated fatty acids were associated with beta-cell protective effects. This review examined how a dietary modification towards a low-fat vegan diet, which is particularly low in saturated and trans-fats, could help to prevent or reduce lipotoxicity-induced beta cell dysfunction.
Several potential mechanisms of action were identified including: (1) reduced total fat intake (fat quantity), (2) a more favorable polyunsaturated fatty acid to saturated fatty acid ratio (fat quality), (3) improved body weight and a reduction in adipose tissue mass, and finally (4) improved glycemic control. The latter appears of paramount importance in light of the accumulating evidence that lipotoxic events are tightly coupled to excess glucose levels.
All four mechanisms are likely to contribute complementarily to improved beta-cell function in individuals with type-2-diabetes and may reduce the likelihood of lipotoxic events to occur. Physicians must consider these findings when counseling patients on lifestyle and nutrition.
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11. Estadella D, da Penha Oller do Nascimento CM, et al. Lipotoxicity: Effects of dietary saturated and transfatty acids. Mediators Inflamm [Internet]. 2013 [cited 2020 Jun 27];2013. Available from:
https://www.ncbi.nlm.nih.gov/pmc/articles/ PMC3572653/
12. Ye R, Onodera T, Scherer PE. Lipotoxicity and ? cell maintenance in obesity and type 2 diabetes. J Endocr Soc. 2019 Feb 4;3(3):617–31. https://doi. org/10.1210/js.2018-00372
13. Cunha DA, Igoillo-Esteve M, Gurzov EN, et al. Death protein 5 and p53-upregulated modulator of apoptosis mediate the endoplasmic reticulum stress–mitochondrial dialog triggering lipotoxic rodent and human ?-cell apoptosis. Diabetes. 2012 Nov;61(11):2763–75. https://doi.org/10.1210/ js.2018-00372
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15. Acosta-Montaño P, Rodríguez-Velázquez E, Ibarra-López E, et al. Fatty acid and lipopolysaccharide effect on beta cells proteostasis and its impact on insulin secretion. Cells. 2019 Aug;8(8):884. https:// doi.org/10.3390/cells8080884
16. Hagman DK, Hays LB, Parazzoli SD, Poitout V. Palmitate inhibits insulin gene expression by altering PDX-1 nuclear localization and reducing MafA expression in isolated rat islets of Langerhans. J Biol Chem. 2005 Sep 16;280(37):32413–18. https://doi.org/10.1074/jbc.M506000200
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Storz, M. A. (2020). The Role of Vegan Diets in Lipotoxicity-Induced Beta-Cell Dysfunction in Type-2-Diabetes. Journal of Population Therapeutics and Clinical Pharmacology, 27(SP2), e22-e38. https://doi.org/10.15586/jptcp.v27iSP2.744
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