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      A very low-carbohydrate, low-saturated fat diet for type 2 diabetes management: a randomized trial.

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          Abstract

          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).

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          Statistics notes: Analysing controlled trials with baseline and follow up measurements.

          A J Vickers, D Altman (2001)
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            Mean amplitude of glycemic excursions, a measure of diabetic instability.

            F J Service, G Molnar, J ROSEVEAR … (1970)
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              The effects of low-carbohydrate versus conventional weight loss diets in severely obese adults: one-year follow-up of a randomized trial.

              Linda Stern, Nayyar Iqbal, Prakash Seshadri … (2004)
              A previous paper reported the 6-month comparison of weight loss and metabolic changes in obese adults randomly assigned to either a low-carbohydrate diet or a conventional weight loss diet. To review the 1-year outcomes between these diets. Randomized trial. Philadelphia Veterans Affairs Medical Center. 132 obese adults with a body mass index of 35 kg/m2 or greater; 83% had diabetes or the metabolic syndrome. Participants received counseling to either restrict carbohydrate intake to <30 g per day (low-carbohydrate diet) or to restrict caloric intake by 500 calories per day with <30% of calories from fat (conventional diet). Changes in weight, lipid levels, glycemic control, and insulin sensitivity. By 1 year, mean (+/-SD) weight change for persons on the low-carbohydrate diet was -5.1 +/- 8.7 kg compared with -3.1 +/- 8.4 kg for persons on the conventional diet. Differences between groups were not significant (-1.9 kg [95% CI, -4.9 to 1.0 kg]; P = 0.20). For persons on the low-carbohydrate diet, triglyceride levels decreased more (P = 0.044) and high-density lipoprotein cholesterol levels decreased less (P = 0.025). As seen in the small group of persons with diabetes (n = 54) and after adjustment for covariates, hemoglobin A1c levels improved more for persons on the low-carbohydrate diet. These more favorable metabolic responses to a low-carbohydrate diet remained significant after adjustment for weight loss differences. Changes in other lipids or insulin sensitivity did not differ between groups. These findings are limited by a high dropout rate (34%) and by suboptimal dietary adherence of the enrolled persons. Participants on a low-carbohydrate diet had more favorable overall outcomes at 1 year than did those on a conventional diet. Weight loss was similar between groups, but effects on atherogenic dyslipidemia and glycemic control were still more favorable with a low-carbohydrate diet after adjustment for differences in weight loss.
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                Author and article information

                Journal
                Journal ID (iso-abbrev): Diabetes Care
                Title: Diabetes care
                ISSN (Electronic): 1935-5548
                ISSN (Print): 0149-5992
                Publication date (Electronic): Nov 2014
                Volume: 37
                Issue: 11
                Affiliations
                [1 ] 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.
                [2 ] Preventative Health National Research Flagship, Commonwealth Scientific and Industrial Research Organisation (CSIRO), Animal, Food and Health Sciences, Adelaide, Australia.
                [3 ] Discipline of Medicine, University of Adelaide, Adelaide, Australia.
                [4 ] Nutritional Physiology Research Centre, Sansom Institute for Health Research, University of South Australia, Adelaide, Australia.
                [5 ] 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.
                [6 ] Preventative Health National Research Flagship, Commonwealth Scientific and Industrial Research Organisation (CSIRO), Animal, Food and Health Sciences, Adelaide, Australia grant.brinkworth@csiro.au.
                Article
                Publisher Item ID: dc14-0845
                DOI: 10.2337/dc14-0845
                PubMed ID: 25071075
                SO-VID: 21b255d6-4fcc-40ee-a770-422d2e5aebc6
                Copyright © © 2014 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.
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