Tags

Type your tag names separated by a space and hit enter

A very low-carbohydrate, low-saturated fat diet for type 2 diabetes management: a randomized trial.
Diabetes Care 2014; 37(11):2909-18DC

Abstract

OBJECTIVE

To comprehensively compare the effects of a very low-carbohydrate, high-unsaturated/low-saturated fat diet (LC) with those of a high-unrefined carbohydrate, low-fat diet (HC) on glycemic control and cardiovascular disease (CVD) risk factors in type 2 diabetes (T2DM).

RESEARCH DESIGN AND METHODS

Obese adults (n = 115, BMI 34.4 ± 4.2 kg/m(2), age 58 ± 7 years) with T2DM were randomized to a hypocaloric LC diet (14% carbohydrate [<50 g/day], 28% protein, and 58% fat [<10% saturated fat]) or an energy-matched HC diet (53% carbohydrate, 17% protein, and 30% fat [<10% saturated fat]) combined with structured exercise for 24 weeks. The outcomes measured were as follows: glycosylated hemoglobin (HbA1c), glycemic variability (GV; assessed by 48-h continuous glucose monitoring), antiglycemic medication changes (antiglycemic medication effects score [MES]), and blood lipids and pressure.

RESULTS

A total of 93 participants completed 24 weeks. Both groups achieved similar completion rates (LC 79%, HC 82%) and weight loss (LC -12.0 ± 6.3 kg, HC -11.5 ± 5.5 kg); P ≥ 0.50. Blood pressure (-9.8/-7.3 ± 11.6/6.8 mmHg), fasting blood glucose (-1.4 ± 2.3 mmol/L), and LDL cholesterol (-0.3 ± 0.6 mmol/L) decreased, with no diet effect (P ≥ 0.10). LC achieved greater reductions in triglycerides (-0.5 ± 0.5 vs. -0.1 ± 0.5 mmol/L), MES (-0.5 ± 0.5 vs. -0.2 ± 0.5), and GV indices; P ≤ 0.03. LC induced greater HbA1c reductions (-2.6 ± 1.0% [-28.4 ± 10.9 mmol/mol] vs. -1.9 ± 1.2% [-20.8 ± 13.1 mmol/mol]; P = 0.002) and HDL cholesterol (HDL-C) increases (0.2 ± 0.3 vs. 0.05 ± 0.2 mmol/L; P = 0.007) in participants with the respective baseline values HbA1c >7.8% (62 mmol/mol) and HDL-C <1.29 mmol/L.

CONCLUSIONS

Both diets achieved substantial improvements for several clinical glycemic control and CVD risk markers. These improvements and reductions in GV and antiglycemic medication requirements were greatest with the LC compared with HC. This suggests an LC diet with low saturated fat may be an effective dietary approach for T2DM management if effects are sustained beyond 24 weeks.

Authors+Show Affiliations

Preventative Health National Research Flagship, Commonwealth Scientific and Industrial Research Organisation (CSIRO), Animal, Food and Health Sciences, Adelaide, Australia Discipline of Medicine, University of Adelaide, Adelaide, Australia Agency for Science, Technology and Research (A*STAR), Singapore.Preventative Health National Research Flagship, Commonwealth Scientific and Industrial Research Organisation (CSIRO), Animal, Food and Health Sciences, Adelaide, Australia.Discipline of Medicine, University of Adelaide, Adelaide, Australia.Preventative Health National Research Flagship, Commonwealth Scientific and Industrial Research Organisation (CSIRO), Animal, Food and Health Sciences, Adelaide, Australia.Nutritional Physiology Research Centre, Sansom Institute for Health Research, University of South Australia, Adelaide, Australia.Discipline of Medicine, University of Adelaide, Adelaide, Australia.Division of General Internal Medicine, Department of Medicine, Duke University Medical Center, Durham, NC Center for Health Services Research in Primary Care, Veterans Affairs Medical Center, Durham, NC.Preventative Health National Research Flagship, Commonwealth Scientific and Industrial Research Organisation (CSIRO), Animal, Food and Health Sciences, Adelaide, Australia grant.brinkworth@csiro.au.

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

25071075

Citation

Tay, Jeannie, et al. "A Very Low-carbohydrate, Low-saturated Fat Diet for Type 2 Diabetes Management: a Randomized Trial." Diabetes Care, vol. 37, no. 11, 2014, pp. 2909-18.
Tay J, Luscombe-Marsh ND, Thompson CH, et al. A very low-carbohydrate, low-saturated fat diet for type 2 diabetes management: a randomized trial. Diabetes Care. 2014;37(11):2909-18.
Tay, J., Luscombe-Marsh, N. D., Thompson, C. H., Noakes, M., Buckley, J. D., Wittert, G. A., ... Brinkworth, G. D. (2014). A very low-carbohydrate, low-saturated fat diet for type 2 diabetes management: a randomized trial. Diabetes Care, 37(11), pp. 2909-18. doi:10.2337/dc14-0845.
Tay J, et al. A Very Low-carbohydrate, Low-saturated Fat Diet for Type 2 Diabetes Management: a Randomized Trial. Diabetes Care. 2014;37(11):2909-18. PubMed PMID: 25071075.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A very low-carbohydrate, low-saturated fat diet for type 2 diabetes management: a randomized trial. AU - Tay,Jeannie, AU - Luscombe-Marsh,Natalie D, AU - Thompson,Campbell H, AU - Noakes,Manny, AU - Buckley,Jon D, AU - Wittert,Gary A, AU - Yancy,William S,Jr AU - Brinkworth,Grant D, Y1 - 2014/07/28/ PY - 2014/7/30/entrez PY - 2014/7/30/pubmed PY - 2015/4/29/medline SP - 2909 EP - 18 JF - Diabetes care JO - Diabetes Care VL - 37 IS - 11 N2 - OBJECTIVE: To comprehensively compare the effects of a very low-carbohydrate, high-unsaturated/low-saturated fat diet (LC) with those of a high-unrefined carbohydrate, low-fat diet (HC) on glycemic control and cardiovascular disease (CVD) risk factors in type 2 diabetes (T2DM). RESEARCH DESIGN AND METHODS: Obese adults (n = 115, BMI 34.4 ± 4.2 kg/m(2), age 58 ± 7 years) with T2DM were randomized to a hypocaloric LC diet (14% carbohydrate [<50 g/day], 28% protein, and 58% fat [<10% saturated fat]) or an energy-matched HC diet (53% carbohydrate, 17% protein, and 30% fat [<10% saturated fat]) combined with structured exercise for 24 weeks. The outcomes measured were as follows: glycosylated hemoglobin (HbA1c), glycemic variability (GV; assessed by 48-h continuous glucose monitoring), antiglycemic medication changes (antiglycemic medication effects score [MES]), and blood lipids and pressure. RESULTS: A total of 93 participants completed 24 weeks. Both groups achieved similar completion rates (LC 79%, HC 82%) and weight loss (LC -12.0 ± 6.3 kg, HC -11.5 ± 5.5 kg); P ≥ 0.50. Blood pressure (-9.8/-7.3 ± 11.6/6.8 mmHg), fasting blood glucose (-1.4 ± 2.3 mmol/L), and LDL cholesterol (-0.3 ± 0.6 mmol/L) decreased, with no diet effect (P ≥ 0.10). LC achieved greater reductions in triglycerides (-0.5 ± 0.5 vs. -0.1 ± 0.5 mmol/L), MES (-0.5 ± 0.5 vs. -0.2 ± 0.5), and GV indices; P ≤ 0.03. LC induced greater HbA1c reductions (-2.6 ± 1.0% [-28.4 ± 10.9 mmol/mol] vs. -1.9 ± 1.2% [-20.8 ± 13.1 mmol/mol]; P = 0.002) and HDL cholesterol (HDL-C) increases (0.2 ± 0.3 vs. 0.05 ± 0.2 mmol/L; P = 0.007) in participants with the respective baseline values HbA1c >7.8% (62 mmol/mol) and HDL-C <1.29 mmol/L. CONCLUSIONS: Both diets achieved substantial improvements for several clinical glycemic control and CVD risk markers. These improvements and reductions in GV and antiglycemic medication requirements were greatest with the LC compared with HC. This suggests an LC diet with low saturated fat may be an effective dietary approach for T2DM management if effects are sustained beyond 24 weeks. SN - 1935-5548 UR - https://www.unboundmedicine.com/medline/citation/25071075/A_very_low_carbohydrate_low_saturated_fat_diet_for_type_2_diabetes_management:_a_randomized_trial_ L2 - http://care.diabetesjournals.org/cgi/pmidlookup?view=long&amp;pmid=25071075 DB - PRIME DP - Unbound Medicine ER -