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Effects of Changing the Amount and Source of Dietary Carbohydrates on Symptoms and Dietary Satisfaction Over a 1-Year Period in Subjects with Type 2 Diabetes: Canadian Trial of Carbohydrates in Diabetes (CCD).
Can J Diabetes 2017; 41(2):164-176CJ

Abstract

OBJECTIVES

To determine the long-term effects of changing the amount or source of dietary carbohydrate on quality of life (QOL), symptoms and dietary satisfaction in people with type 2 diabetes.

METHODS

Subjects with diabetes treated by diet alone (n=162) were randomly assigned to high-carbohydrate/high-glycemic-index (HGI) diets; high-carbohydrate/low-glycemic-index (LGI) diets; or lower-carbohydrate/high-monounsaturated-fat (LC) diets for 1 year. We measured QOL at baseline and at study's end, and we measured symptoms and dietary satisfaction quarterly.

RESULTS

The HGI, LGI and LC diets contained, respectively, 47±1, 52±1 and 40±1% energy carbohydrate; 30±1, 27±1 and 40±1% fat with GI 64±0.4, 55±0.4 and 59±0.4. Significantly more participants reported increased flatulence on LGI than on LC and HGI diets at 3 months (41%, 19%, 14%; p<0.05), but not at 12 months (29%, 17%, 17%; ns). Abdominal distension was more severe (46% vs. 14%, 19%; p<0.05), and headache less severe (8% vs. 22%, 23%; p<0.05) on LGI than on both other diets. Increased appetite was more severe on LC (33%) than on HGI diets (14%, p<0.05). Joint/limb pains were less severe on LGI (16%) than HGI (28%) diets. LC elicited more severe gloomy thoughts (23%) than LGI (4%; p<0.05) but greater dietary-satisfaction (70%; p<0.05) than LGI (40%) and HGI (48%) diets. For all diets, glycated hemoglobin (A1C) levels increased less in those who gained less weight, had less increased appetite and were more satisfied with the enjoyment obtained from eating.

CONCLUSIONS

Each diet elicited increased severity of 1 or more symptoms than the other diets. Although overall dietary satisfaction was greater on the 40% carbohydrate diet than on the 50% carbohydrate diet, the LGI diet was no less satisfying than the HGI diet. Changes in appetite and dietary satisfaction may influence body weight and glycemic control, or vice-versa.

Authors+Show Affiliations

Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada; Department of Medicine, St. Michael's Hospital, Toronto, Ontario, Canada. Electronic address: thomas.wolever@utoronto.ca.Research Center (CHUM) Hôtel-Dieu de Montréal, University of Montréal, Montréal, Québec, Canada.Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada; Department of Medicine, St. Michael's Hospital, Toronto, Ontario, Canada.Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada; Department of Medicine, St. Michael's Hospital, Toronto, Ontario, Canada.Department of Medicine, University of Sherbrooke, Sherbrooke, Québec, Canada.IRCM (Institut de Recherches Cliniques de Montréal), Montréal, Québec, Canada.Department of Medicine, St. Joseph's Health Centre, Western University, London, Ontario, Canada.Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

27884550

Citation

Wolever, Thomas M S., et al. "Effects of Changing the Amount and Source of Dietary Carbohydrates On Symptoms and Dietary Satisfaction Over a 1-Year Period in Subjects With Type 2 Diabetes: Canadian Trial of Carbohydrates in Diabetes (CCD)." Canadian Journal of Diabetes, vol. 41, no. 2, 2017, pp. 164-176.
Wolever TM, Chiasson JL, Josse RG, et al. Effects of Changing the Amount and Source of Dietary Carbohydrates on Symptoms and Dietary Satisfaction Over a 1-Year Period in Subjects with Type 2 Diabetes: Canadian Trial of Carbohydrates in Diabetes (CCD). Can J Diabetes. 2017;41(2):164-176.
Wolever, T. M., Chiasson, J. L., Josse, R. G., Leiter, L. A., Maheux, P., Rabasa-Lhoret, R., ... Ryan, E. A. (2017). Effects of Changing the Amount and Source of Dietary Carbohydrates on Symptoms and Dietary Satisfaction Over a 1-Year Period in Subjects with Type 2 Diabetes: Canadian Trial of Carbohydrates in Diabetes (CCD). Canadian Journal of Diabetes, 41(2), pp. 164-176. doi:10.1016/j.jcjd.2016.08.223.
Wolever TM, et al. Effects of Changing the Amount and Source of Dietary Carbohydrates On Symptoms and Dietary Satisfaction Over a 1-Year Period in Subjects With Type 2 Diabetes: Canadian Trial of Carbohydrates in Diabetes (CCD). Can J Diabetes. 2017;41(2):164-176. PubMed PMID: 27884550.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effects of Changing the Amount and Source of Dietary Carbohydrates on Symptoms and Dietary Satisfaction Over a 1-Year Period in Subjects with Type 2 Diabetes: Canadian Trial of Carbohydrates in Diabetes (CCD). AU - Wolever,Thomas M S, AU - Chiasson,Jean-Louis, AU - Josse,Robert G, AU - Leiter,Lawrence A, AU - Maheux,Pierre, AU - Rabasa-Lhoret,Rémi, AU - Rodger,N Wilson, AU - Ryan,Edmond A, Y1 - 2016/11/21/ PY - 2015/01/07/received PY - 2016/07/20/revised PY - 2016/08/22/accepted PY - 2016/11/26/pubmed PY - 2017/6/1/medline PY - 2016/11/26/entrez KW - diet KW - dietary satisfaction KW - essai clinique à répartition aléatoire KW - glycemic index KW - indice glycémique KW - quality of life KW - qualité de vie KW - randomized controlled clinical trial KW - régime alimentaire KW - satisfaction alimentaire KW - symptoms KW - symptômes SP - 164 EP - 176 JF - Canadian journal of diabetes JO - Can J Diabetes VL - 41 IS - 2 N2 - OBJECTIVES: To determine the long-term effects of changing the amount or source of dietary carbohydrate on quality of life (QOL), symptoms and dietary satisfaction in people with type 2 diabetes. METHODS: Subjects with diabetes treated by diet alone (n=162) were randomly assigned to high-carbohydrate/high-glycemic-index (HGI) diets; high-carbohydrate/low-glycemic-index (LGI) diets; or lower-carbohydrate/high-monounsaturated-fat (LC) diets for 1 year. We measured QOL at baseline and at study's end, and we measured symptoms and dietary satisfaction quarterly. RESULTS: The HGI, LGI and LC diets contained, respectively, 47±1, 52±1 and 40±1% energy carbohydrate; 30±1, 27±1 and 40±1% fat with GI 64±0.4, 55±0.4 and 59±0.4. Significantly more participants reported increased flatulence on LGI than on LC and HGI diets at 3 months (41%, 19%, 14%; p<0.05), but not at 12 months (29%, 17%, 17%; ns). Abdominal distension was more severe (46% vs. 14%, 19%; p<0.05), and headache less severe (8% vs. 22%, 23%; p<0.05) on LGI than on both other diets. Increased appetite was more severe on LC (33%) than on HGI diets (14%, p<0.05). Joint/limb pains were less severe on LGI (16%) than HGI (28%) diets. LC elicited more severe gloomy thoughts (23%) than LGI (4%; p<0.05) but greater dietary-satisfaction (70%; p<0.05) than LGI (40%) and HGI (48%) diets. For all diets, glycated hemoglobin (A1C) levels increased less in those who gained less weight, had less increased appetite and were more satisfied with the enjoyment obtained from eating. CONCLUSIONS: Each diet elicited increased severity of 1 or more symptoms than the other diets. Although overall dietary satisfaction was greater on the 40% carbohydrate diet than on the 50% carbohydrate diet, the LGI diet was no less satisfying than the HGI diet. Changes in appetite and dietary satisfaction may influence body weight and glycemic control, or vice-versa. SN - 2352-3840 UR - https://www.unboundmedicine.com/medline/citation/27884550/Effects_of_Changing_the_Amount_and_Source_of_Dietary_Carbohydrates_on_Symptoms_and_Dietary_Satisfaction_Over_a_1_Year_Period_in_Subjects_with_Type_2_Diabetes:_Canadian_Trial_of_Carbohydrates_in_Diabetes__CCD__ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1499-2671(16)30523-8 DB - PRIME DP - Unbound Medicine ER -