The low-carb diet may help people with diabetes achieve better short-term weight loss and glucose control compared to a low-fat diet
Effect of low-carb, high-fat diet without calorie restriction versus high-carbohydrate, low-fat diet on type 2 diabetes and fatty liver disease non-alcoholic
Abstract
Background
It is unclear whether a low-carbohydrate, high-fat diet (LCHF) is a possible treatment strategy for type 2 diabetes mellitus (T2DM), and the effect on non-alcoholic fatty liver disease (NAFLD) has not been investigated.
Objective:
To investigate the effect of an uncalorie-restricted LCHF diet, with no intention of losing weight, on T2DM and NAFLD compared to a high-carbohydrate, low-fat diet (HCLF).
Design:
6-month randomized controlled trial with 3-month follow-up.(ClinicalTrials.gov: NCT03068078). Odense University Hospital in Denmark from November 2016 to June 2020.
Participants:
165 participants with DM2.
Intervention:
Two diets without calorie restrictions: LCHF diet with 50 to 60 percent energy (E%) fat, less than 20E% carbohydrates and 25E% to 30E% protein, and HCLF diet with 50E% to 60E% carbohydrates, 20E% to 30E% fat, and 20E% to 25E% protein.
Measurements:
Glycemic control, serum lipid levels, metabolic markers, and liver biopsies to evaluate NAFLD.
Results:
The mean age was 56 years (SD, 10) and 58% were women. Compared with the HCLF diet, participants on the LCHF diet had greater improvements in hemoglobin A1c (mean difference in change, −6.1 mmol/mol [95% CI, −9.2 to −3.0 mmol/mol] or −0.59% [CI, −0.87% to -0.30%]) and lost more weight (mean difference in change, -3.8 kg [CI, -6.2 to -1.4 kg]).
Both groups had higher high-density lipoprotein cholesterol and lower triglycerides at 6 months.
Changes in low-density lipoprotein cholesterol were less favourable in the LCHF diet group than in the HCLF diet group (mean difference in change, 0.37 mmol/L [CI, 0.17 to 0.58 mmol/L] or 14.3 mg/dL [CI, 6.6 to 22.4 mg/dL]).
No statistically significant between-group changes were detected in the NAFLD assessment.The changes were not maintained at the 9-month follow-up.
Limitation:
Open-label trial, self-reported compliance, unwanted weight loss, and lack of fit for multiple comparisons.
Conclusion:
People with T2DM who followed an LCHF diet without calorie restrictions for 6 months had greater clinically significant improvements in glycemic control and weight compared to those who followed an HCLF diet, but the changes were not maintained 3 months after the intervention.
Source — https://www.intramed.net/102834