Twelve-month outcomes of a randomized trial of a moderate-carbohydrate versus very low-carbohydrate diet in overweight adults with type 2 diabetes mellitus or prediabetes.
42
2017
Twelve-month outcomes of a randomized trial of a moderate-carbohydrate versus very low-carbohydrate diet in overweight adults with type 2 diabetes mellitus or prediabetes. LR Saslow, JL Daubenmier, JT Moskowitz et al, Nutrition and Diabetes 2017 7(12):304.
US
1
To compare a low-carb ketogenic (LCK) diet to a moderate-carb, calorie-restricted (MCCR) diet.
34
29
19%
74
12mo
Y
29
"LCK diet Targets E: no restriction Carb: 20-50g/day excluding fiber (""net carbs"") Protein: none Fat: none Intake E: 1534.8kcal/d Carb: (net carbs) 73.7g/d Protein: 97.6g/d Fat: 105.4g/d "
"MCCR diet Targets E: -500kcal/d than E needed for maintenance Carb: 45-50%E/day Protein: none Fat: encouraged to reduce Intake: E: 1681.1kcal/d Carb: (net carbs) 149.8g/d Protein: 68.8g/d Fat: 75.4g/d "
"Metabolic outcomes: HbA1c, lipids, weight, BMI, insulin, insulin resistance, and blood pressure. "
"Those assigned to LCK diet compared to MCCR: greater reductions in HbA1c and BMI; lost more weight, and reduced more medications; greater improvement in TG:HDL ratio. Those on MCCR diet had SS greater reduction in LDL at 6 mo compared to LCK group. "
"HOMA-IR WG: NR BG: N BG NSS"
*
0
"C-reactive protein WG: NR BG: N BG NSS"
*
0
"WG: NR BG: Y LCK arm reduced use of some diabete related medications more than MCCR arm. SS BG for 2 of 3 medications."
"No participants experienced diabetic ketoacidosis "
"LCK: 14/16 (87.5%) MCCR: 15/18 (83.3%) "
"TG:HDL ratio WG: NR BG: Y baseline→12 mo LCK diet 2.2→1.7 MCCR 3.5→3.6 BG SS p=.022"
"""The results suggest that adults with prediabetes or noninsulin-dependent T2D may be able to improve glycemic control with less medication by following an ad libitum very LCK diet compared to a moderate-carbohydrate, calorie-restricted low-fat diet."" Benefits from LCK may likely be due in part to ""novel supportive psychological strategies."""
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