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December 21, 1994

Varying Carbohydrate Intake in NIDDM

Author Affiliations

Pritikin Systems, Inc Santa Monica, Calif
University of California—Los Angeles UCLA School of Medicine

JAMA. 1994;272(23):1817-1818. doi:10.1001/jama.1994.03520230027018

To the Editor.  —The study design and results in the article by Dr Garg and colleagues1 do not support their conclusion that most patients with NIDDM would benefit, at least in the short term, by preferentially consuming a diet high in monounsaturated fatty acids (45% of energy from fat, 40% from carbohydrate) in lieu of a diet high in complex carbohydrates (30% of energy from fat, 55% from carbohydrates). The uncontrolled energy manipulations in the middle of the trial vitiated the original experiment. In light of the changes in energy intake required of the study participants in order to maintain constant body weight, it is reasonable and more parsimonious to speculate that the plasma triglyceride changes observed in this trial might be attributed largely to energy restriction (especially carbohydrate energy restriction) in the higher-fat condition2 and/or consumption of energy (specifically, the carbohydrate energy) in excess of appetite in

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