Effects of an energy‐restricted low‐carbohydrate, high unsaturated fat/low saturated fat diet versus a high‐carbohydrate, low‐fat diet in type 2 diabetes: A 2‐year randomized clinical trial

Tay, Jeannie; Thompson, Campbell; Luscombe-Marsh, Natalie D.; Wycherley, Thomas P.; Noakes, Manny; Buckley, Jonathan D.; Wittert, Gary; Yancy, William S.; Brinkworth, Grant D.

doi:10.1111/dom.13164

Cited by 169 publications

(249 citation statements)

References 58 publications

(96 reference statements)

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“…Of these, 10/21 purposefully reduced or minimized the intake of saturated fat. Four studies reported their fat type prescriptions in a quantifiable manner ranging from 8% to 10%, 20% to 49%, and 10% to 13% TEI for saturated, monounsaturated, polyunsaturated fat, respectively . One study was a liquid diet in which the fat was derived from monounsaturated‐enriched sunflower oil .…”

Section: Resultsmentioning

confidence: 99%

An evidence‐based approach to developing low‐carbohydrate diets for type 2 diabetes management: A systematic review of interventions and methods

Turton

Brinkworth

Field

et al. 2019

Diabetes Obesity Metabolism

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Aim To identify core diet and delivery components of low‐carbohydrate (CHO) diets that have demonstrated efficacy for type 2 diabetes (T2D) management. Materials and methods MEDLINE, Pre‐MEDLINE, EMBASE, CINAHL and the Cochrane Library of Controlled Trials databases were systematically searched from inception until August 18, 2018. Primary intervention studies of low‐CHO diets (≤130 g/d or 26% total energy intake [TEI]) were included. Content analysis was performed on the low‐CHO diet protocols classified as safe and effective for T2D management. Results A total of 41 studies published between 1963 and 2018 were included, of which 40 were classified as safe and effective for inclusion in the primary analysis. Thirteen studies (13/40) were on very‐low‐CHO diets (<50 g/d), 14/40 included low‐CHO diets (≤130 g/d or 26% TEI), and 13/40 were adapted according to participant progress. Thirty‐one studies reported a total energy prescription, of which 18/31 encouraged ad libitum intakes. Twenty studies reported a prescribed dietary fat amount, of which 18/20 were unrestricted or high‐fat (>35% TEI). Twenty‐six studies reported a prescribed dietary protein amount, of which 22 were unrestricted or were high‐protein (>25% TEI). The types of dietary CHO, fat and protein recommended were predominantly whole foods. Common delivery methods reported were dietician and/or physician involvement, moderate to high frequency of contact (≥1 session/month) and use of participant self‐monitoring. Conclusions Multiple approaches for developing and delivering a low‐CHO diet intervention for T2D management are safe and effective. A comprehensive set of core dietary components to consider in the formulation of low‐CHO diet protocols were identified for use in clinical practice and to inform evidence‐based guidelines for T2D management.

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Section: Resultsmentioning

confidence: 99%

An evidence‐based approach to developing low‐carbohydrate diets for type 2 diabetes management: A systematic review of interventions and methods

Turton

Brinkworth

Field

et al. 2019

Diabetes Obesity Metabolism

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“…Evidence from 30 trials and 10 follow‐up studies shows that a low‐carbohydrate diet is an effective dietary approach for addressing dyslipidaemia. More than half of the studies that reported triglyceride levels found a significant improvement from baseline with a low‐carbohydrate diet; eight also showed superiority over a control diet . Similarly, the evidence consistently showed significant improvements in HDL cholesterol with a low‐carbohydrate diet, with 10 studies finding a significant increase over control diet .…”

Section: Resultsmentioning

confidence: 96%

“…All 12 single‐arm and non‐randomized trials found that a low‐carbohydrate diet significantly improved glycaemic control from baseline to end of study; the two studies that made between‐group comparisons found the low‐carbohydrate diet superior to the control diet . We identified eight longer‐term studies (1‐3 years' duration), of which five found significant glycaemic benefit sustained with a low‐carbohydrate diet; these include two 2‐year trials and a 3‐year trial . Another longer trial also found sustained improvement in glycaemic control at 44 weeks .…”

Section: Resultsmentioning

confidence: 99%

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Improving the scientific rigour of nutritional recommendations for adults with type 2 diabetes: A comprehensive review of the American Diabetes Association guideline‐recommended eating patterns

Hallberg

Dockter²,

Kushner³

et al. 2019

Diabetes Obesity Metabolism

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Aims The global rate of type 2 diabetes (T2D) continues to rise. Guidelines that influence the worldwide treatment of this disease are central to changing this trajectory. We sought in this review to evaluate the appropriateness of sources cited in the American Diabetes Association's (ADA) guidelines on eating patterns for T2D management, identify additional relevant sources, and evaluate the evidence. Materials and Methods We reviewed the evidence behind the ADA's recommendations on eating patterns in the 2018 and 2019 ADA Standards of Care and the 2014 ADA Nutrition Therapy Recommendations for Adults with Diabetes. Additionally, we conducted a comprehensive search to identify any additional studies not included in the cited evidence. To determine appropriateness of inclusion in the guidelines, the following criteria were applied: 1) it was a clinical trial or systematic review/meta‐analysis of clinical trials; 2) it involved persons with T2D; 3) one of the study arms followed one of the eating patterns currently recommended; 4) its reported outcomes included glycaemic control; 5) outcomes were reported separately for persons with T2D. Results We found a wide variation in the evidence for each eating pattern. Issues that have hampered the guideline process include: lack of a rigorous literature review, resulting in the omission of pertinent studies; an overreliance on prospective cohort studies; inconsistent standards for evidence; inclusion of studies not on persons with T2D; and bias. Conclusions The ADA Guidelines recommended eating patterns fall short of rigorous standards of scientific review according to state‐of‐the‐art systematic review and guideline creation practices.

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“…Similar confusion surrounds carbohydrate diets, despite the importance of carbohydrate in glycaemic control. A recent clinical trial found similar reductions in weight and HbA 1c in patients with T2D who were placed on either low or high carbohydrate diets, though an increased reduction in diabetes medication was also seen in the low carbohydrate group . Generally though, ‘there is a lack of long‐term studies on the effect of carbohydrate diets and a lack of clarity on what constitutes the definition of low carbohydrate,’ said Dr Mellor.…”

Section: Foods For Glycaemic Control and Cvd Preventionmentioning

confidence: 99%

Highlights from the Diabetes UK Professional Conference 2018

David¹

2018

Practical Diabetes

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Effects of an energy‐restricted low‐carbohydrate, high unsaturated fat/low saturated fat diet versus a high‐carbohydrate, low‐fat diet in type 2 diabetes: A 2‐year randomized clinical trial

Cited by 169 publications

References 58 publications

An evidence‐based approach to developing low‐carbohydrate diets for type 2 diabetes management: A systematic review of interventions and methods

An evidence‐based approach to developing low‐carbohydrate diets for type 2 diabetes management: A systematic review of interventions and methods

Improving the scientific rigour of nutritional recommendations for adults with type 2 diabetes: A comprehensive review of the American Diabetes Association guideline‐recommended eating patterns

Highlights from the Diabetes UK Professional Conference 2018

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