14.1 C
New York
Saturday, May 15, 2021

Low Carb Diets Boost Diabetes Remission Rates, at Least Short Term | Nutrition Fit

Patients with type 2 diabetes who follow a low carbohydrate diet (LCD) for at least 6 months appear to have significantly higher remission rates than those following other diets, although the benefits diminish by 12 months, suggests a new analysis of trial data from over 1300 individuals.

“Based on other evidence, it is likely the degree of weight loss would have been a contributing factor, combined with the lower intake of dietary carbohydrates,” study coauthor Grant D. Brinkworth, PhD, Commonwealth Scientific and Industrial Research Organisation, Sydney, Australia, told Medscape Medical News.

He acknowledged, however, that “Diets in general can be difficult to sustain over the long term…We need to provide patients with easy-to-use support tools and convenient solutions to help them adhere to a low-carb diet long term to gain these greater health improvements.”

“In addition, more long-term, well-controlled, randomized trials are needed to determine the effects of low-carb diets on sustained weight loss, diabetes remission, and health outcomes,” Brinkworth added.

The research was published on January 13 in BMJ by a consortium of international scientists, led by Joshua Z. Goldenberg, PhD, Department of Nutrition, Texas A&M University, College Station.

Confusion as to Best Diet For Those With Diabetes

Type 2 diabetes is a “significant and worsening” worldwide health problem, say Goldenberg and coauthors, in spite of “many pharmaceutical developments and a global emphasis on glycemic control.”

READ  How to Get Rid of Water Bugs From Your Swimming Pool

Although structured diets are “recognized as an essential component of treating diabetes, confusion remains about which diet to choose,” with multiple systemic reviews and meta-analyses of carbohydrate-restricted diets “reporting mixed results,” they note.

READ  Seven years of Syria’s health tragedy | Nutrition Fit

They therefore undertook a systematic review of randomized controlled trials on the efficacy and safety of LCDs and very low carbohydrate diets (VLCDs) using the CENTRAL, Medline, CINAHL, and CAB databases, as well as other literature sources.

Researchers defined LCDs as < 130 g/day of carbohydrates or < 26% of calories from carbohydrates as part of a 2000 kcal/day diet and VLCDs as < 50 g/day or < 10% of daily calories. They focused on interventions that lasted at least 12 weeks in adults with type 2 diabetes.

Overall, 23 trials involving 1357 participants met the inclusion criteria; 52% used VLCDs and the control comparator was a low-fat diet in 78% of the studies. The mean age range of patients was 47-67 years, and treatment duration spanned from 3 months to 2 years.

LCDs were associated with a higher rate of diabetes remission when defined as an A1c < 6.5% compared with control diets at 6 months, at 57% versus 31% — an increase in remission of 32% associated with LCDs (P < .001 for overall effect).

But when defined more tightly as an A1c < 6.5% in the absence of diabetes medications, remission with LCDs was reduced to a nonsignificant 5% versus control diets at 6 months.

At 12 months, data on remission were sparse, ranging from a small effect to a trivial increased risk of diabetes.

READ  Activists Fueling Concerns About Vaccine Safety | Nutrition Fit

Subgroup analysis demonstrated that patients on an LCD achieved greater weight loss at 6 months than those on a control diet, at a mean reduction of 3.46 kg (approximately 7.6 lb). However, the researchers note that, at 12 months, any weight loss benefit was “trivial and nonsignificant.”

READ  Research Links Suicidality, 'High-Potency' Cannabis Products | Nutrition Fit

A similar pattern was seen for reductions in A1c and fasting glucose levels with LCDs: notable reductions at 6 months largely disappeared by 12 months.

LCDs were also associated with “greater reductions in diabetes medication and clinically important benefits” in triglycerides and insulin resistance at 6 and 12 months, the team says.

VLCDs: Adherence Is Key

Finally, the team looked at weight loss achieved with VLCDs.

VLCDs were less effective for weight loss at 6 months than less restrictive LCDs. However, this effect was explained by diet adherence, the researchers note.

Restricting the analysis to “credible” studies, VLCDs were associated with a larger “clinically important” weight loss versus control diets when patients were highly adherent to the diet, at a mean reduction of 4.47 kg (9.9 lb) versus a mean increase of 0.55 kg (1.2 lb) among patients who were less adherent.

The team note that their review has a number of limitations, not least of which is the definition of diabetes remission used, which “is the subject of considerable debate,” as well as the safety concerns raised over LCDs.

Given the latter concerns, “Clinicians might consider short-term LCDs for management of type 2 diabetes, while actively monitoring and adjusting diabetes medication as needed,” they conclude.

This study was funded in part by Texas A&M University. Johnston has reported receiving funding from Texas A&M AgriLife Research for a separate research project. Brinkworth is author of the book “The CSIRO Low Carb Diet,” but does not receive financial royalties or funds either directly or indirectly.

BMJ 2021;372:m4743. Full text

READ  CDC Says 3 Feet of Social Distancing Now OK in Most Classrooms

For more diabetes and endocrinology news, follow us on Twitter and Facebook.

Source link

Related Articles


Please enter your comment!
Please enter your name here

Stay Connected

- Advertisement -

Latest Articles

Read previous post:
US and China Clash at WHO Over Scientific Mission in Wuhan | Nutrition Fit

GENEVA (Reuters) - The United States called on China on Monday to allow an expert team from the World Health...