To test the hypothesis that a diet lower in carbohydrate would lead to greater improvement in glycemic control over a 24-week period in patients with obesity and T2D.
29
2008
1
To test the hypothesis that a diet lower in carbohydrate would lead to greater improvement in glycemic control over a 24-week period in patients with obesity and T2D.
N
49
"LCK diet Targets E: none Carb: <20g/d Protein: none except for cheeses (hard, 4 oz/d; soft, 2 oz/d) Fat: none Intake E: 1550kcal/d Carb: 49g/d, 12.6%E Protein: 108g/d, 28%E Fat: 101g/d, 58.6%E"
"Low-glycemic index (LGI) diet Targets E: ~ -500kcal/d reduction based on individual need Carb: 55%E Protein: none Fat: none Intake E: 1335kcal/d Carb: 149g/d, 44%E Protein: 67g/d, 20%E Fat: 55g/d, 36%E"
"Primary: HbA1c Secondary: weight, blood pressure, glomerular filtration rate, serum albumin, creatinine, blood urea nitrogen, adverse effects, urinary ketones. "
"Both diets resulted in SS improvements in HbA1c, fasting glucose, fasting insulin, BMI, and weight loss. The LCK diet group had greater improvements in HbA1c (-1.5% vs. -0.5%), body weight (-11.1 kg vs. -6.9 kg, p=0.008), and HDL-C (+5.6 mg/dL vs. 0 mg/dL, p<0.001) compared to the LGI diet group. Diabetes medications were reduced or eliminated in 95.2% of LCK diet group vs. 62% of LGI diet subjects."
"WG: Y BG: N Improved in both diets Baseline→24 weeks LCK: 178.1→158.2mg/dL WG SS p<0.05 LGI: 166.8→150.8mg/dL WG SS p<0.05 BG NSS"
1
0
"WG: Y BG: Y Improved in both diets Baseline→24 weeks LCK: 8.8→7.3% WG SS p<0.05 LGI: 8.3→7.8% WG NSS BG SS p=0.03"
1
1
"Total C and total C:HDL ratio WG: N BG: N Both WG NSS"
0
0
"WG: Y BG: Y Baseline→24 weeks LCK: 44.0mg/dL→49.6 WG SS p<0.05 LGI: 0 change WG NSS BG SS p<0.05"
1
1
"LDL-C WG: N BG: N BG NSS VLDL WG: Y BG: N Improved in both diets BG NSS LCK: 37.3mg/dL→27.3 WG SS p<0.05 LGI: 27.7mg/dL→24.4 WG SS p<0.05 BG NSS "
0
0
"TG and TG:HDL-C ratio WG: Y BG: N TG Baseline→24 weeks LCK: 210.4mg/dL→142.9 WG SS p<0.05 LGI: 167.1mg/dL→147.8 WG NSS BG NSS TG:HDL-C ratio LCK: 5.2→3.4 WG SS p<0.05 LGI: 3.9→3.3 WG NSS BG NSS"
1
0
1
0
"Weight and BMI WG: Y BG: Y Improved in both diets Baseline→24 weeks Weight LCK: 108.4kg→97.3 WG SS p<0.05 LGI: 105.2kg→98.3 WG SS p<0.05 BG SS p=0.008 BMI LCK: 37.8→33.9 WG SS p<0.05 LGI: 37.9→35.2 WG SS p<0.05 BG SS p=0.05 "
1
1
"WG: Y BG: N Improved in both diets Baseline→24 weeks LCK: 144.4mgHg→127.8 WG SS p<0.05 LGI: 140.8mmHg→130.1 WG SS p<0.05 BG NSS "
1
0
"WG: Y BG: N Improved in both diets Baseline→24 weeks LCK: 83.9mgHg→75.8 WG SS p<0.05 LGI: 84.1mmHg→78.5 WG SS p<0.05 BG NSS "
1
0
"WG: Y BG: N Improved in both diets LCK: 20.4uU/mL→14.4 WG SS p<0.05 LGI: 14.8uU/mL→12.6 WG SS p<0.05 BG NSS "
1
0
NR
*
*
NR
*
*
"WG: NR BG: Y n (%) taking meds at baseline; n (%) reducing or eliminating meds at 24 weeks LC: 20 (95.2%); 20 (95.2%) (100% of those taking meds eliminated med or reduced dose) Low GI: 22(75.9%); 18(62.1%) (81.8% of those taking meds eliminated med or reduced dose) BG SS p<0.01 "
"Most common - headache, constipation, diarrhea, insomnia (more common in LC group) - back pain (more common in Low GI group) All BG NSS"
"Completion rates LC diet - 55.3% Control - 63.0%"
"Both diets led to improvements in glycemic control and medication reduction/elimination in motivated volunteers with T2D. The diet lower in carbohydrate led to greater improvements in glycemic control, and more frequent medication reduction/ elimination than the low glycemic index diet. Lifestyle modification using low carbohydrate interventions is effective for improving and reversing T2D."
Abbreviations:
AHA - American Heart Association;
ALT - alanine aminotransferase;
AMDR - acceptable macronutrient distribution range;
AST - aspartate aminotransferase;
BG - between study groups;
BHOB - beta-hydroxybutyrate;
DBP - diastolic blood pressure;
E- energy, caloric intake;
eGFR - estimated glomerular filtration rate;
FBG - fasting blood glucose;
GGT - gamma-glutamyl transferase;
HDL-C - high-density lipoprotein cholesterol;
iGFR - isotope glomerurar filtration rate;
LDL-C - low-density lipoprotein cholesterol;
NAFLD - non-alcoholic fatty liver disease;
NR - not reported (or data needed for calculation not available);
N - no;
NA - not applicable;
NS - not specified;
NSS - not statistically significant;
SBP - systolic blood pressure;
SS - statistically significant;
TG - triglyceride;
total C - total cholesterol;
V - varied, mixed;
WG - within a study group;
WMD - weighted mean difference;
Y - yes
Number of People in Studies:
3,296 Enrolled in randomized controlled trials on 25% or less carbohydrates
2,626 Completed randomized controlled trials on 25% or less carbohydrates
79.67% 82% completion of studies
Duration of Trial
<6 Months
6-9 Months
1 -2 years
>2 years
# of Trials
36
6
9s
1