Please use this identifier to cite or link to this item: https://hdl.handle.net/2440/89968
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Type: Journal article
Title: A very low-carbohydrate, low-saturated fat diet for type 2 diabetes management: a randomized trial
Author: Tay, J.
Luscombe-Marsh, N.
Thompson, C.
Noakes, M.
Buckley, J.
Wittert, G.
Yancy, W.
Brinkworth, G.
Citation: Diabetes Care, 2014; 37(11):2909-2918
Publisher: American Diabetes Association
Issue Date: 2014
ISSN: 0149-5992
1935-5548
Statement of
Responsibility: 
Jeannie Tay, Natalie D. Luscombe-Marsh, Campbell H. Thompson, Manny Noakes, Jon D. Buckley, Gary A. Wittert, William S. Yancy Jr., and Grant D. Brinkworth
Abstract: OBJECTIVE: 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). RESEARCH DESIGN AND METHODS: Obese adults (n = 115, BMI 34.4 ± 4.2 kg/m², age 58 ± 7 years) with T₂DM were randomized to a hypocaloric LC diet (14% carbohydrate [<50 g/day], 28% protein, and 58% fat [<10% saturated fat]) or an energy-matched HC diet (53% carbohydrate, 17% protein, and 30% fat [<10% saturated fat]) combined with structured exercise for 24 weeks. The outcomes measured were as follows: glycosylated hemoglobin (HbA₁ₑ), glycemic variability (GV; assessed by 48-h continuous glucose monitoring), antiglycemic medication changes (antiglycemic medication effects score [MES]), and blood lipids and pressure. RESULTS: A total of 93 participants completed 24 weeks. Both groups achieved similar completion rates (LC 79%, HC 82%) and weight loss (LC -12.0 ± 6.3 kg, HC -11.5 ± 5.5 kg); P ≥ 0.50. Blood pressure (-9.8/-7.3 ± 11.6/6.8 mmHg), fasting blood glucose (-1.4 ± 2.3 mmol/L), and LDL cholesterol (-0.3 ± 0.6 mmol/L) decreased, with no diet effect (P ≥ 0.10). LC achieved greater reductions in triglycerides (-0.5 ± 0.5 vs. -0.1 ± 0.5 mmol/L), MES (-0.5 ± 0.5 vs. -0.2 ± 0.5), and GV indices; P ≤ 0.03. LC induced greater HbA₁ₑ reductions (-2.6 ± 1.0% [-28.4 ± 10.9 mmol/mol] vs. -1.9 ± 1.2% [-20.8 ± 13.1 mmol/mol]; P = 0.002) and HDL cholesterol (HDL-C) increases (0.2 ± 0.3 vs. 0.05 ± 0.2 mmol/L; P = 0.007) in participants with the respective baseline values HbA₁ₑ >7.8% (62 mmol/mol) and HDL-C <1.29 mmol/L. CONCLUSIONS: Both diets achieved substantial improvements for several clinical glycemic control and CVD risk markers. These improvements and reductions in GV and antiglycemic medication requirements were greatest with the LC compared with HC. This suggests an LC diet with low saturated fat may be an effective dietary approach for T₂DM management if effects are sustained beyond 24 weeks.
Keywords: Humans
Cardiovascular Diseases
Diabetes Mellitus, Type 2
Obesity
Weight Loss
Blood Glucose
Lipids
Dietary Fats
Triglycerides
Diet, Fat-Restricted
Blood Pressure
Adult
Aged
Middle Aged
Female
Male
Diet, Carbohydrate-Restricted
Cholesterol, LDL
Cholesterol, HDL
Glycated Hemoglobin A
Rights: Copyright © 2014, American Diabetes Association
DOI: 10.2337/dc14-0845
Grant ID: http://purl.org/au-research/grants/nhmrc/1030415
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