November 14, 2014
Food Plan Study Of Interest
In a short 24-week study, HbA1c levels improved and cholesterol levels were reduced to the point of reduced need for statins. Type 2 diabetes patients are normally advised by dietitians to make dietary decisions that are high in carbohydrates and low in fat and protein. This increase in carbohydrates leads to high postprandial blood glucose levels. Because of this, there is more interest in food plans low in carbohydrates with higher amounts of fat and protein for type 2 diabetes management. Past studies have been done with food plans that are low in both carbohydrates and fat. Both have proved successful in lowering body weight, blood pressure, and insulin concentrations. Most of these prior studies have ignored the role of physical activity and glycemic variability.
This new study was designed to compare the use of a high carbohydrate, low fat diet (53% carbohydrate, 17% protein, and 30% fat) to a very low carbohydrate, high unsaturated fat diet (14% carbohydrate, 28% protein, and 58% fat). This would be used with measurements taken at baseline and end of trail to see what their impact was on glycemic control and risk factors associated with cardiovascular disease in type 2 diabetes patients.
A total of 115 obese type diabetes patients were randomly assigned to one of the two diet groups. In addition, they both participated in a supervised exercise program. The primary outcome was a change in HbA1c. Secondary outcomes included effects on glycemic variability, and changes in anti-glycemic medications, lipid profile, and blood pressure readings.
Those in the low carbohydrate diet group showed a larger decrease in HbA1c when compared to the high carbohydrate diet group and changes in anti-glycemic medications were also more likely in this group as seen by the changes in the medication effects score. Differences in the diets were not seen in weight loss, and no diet effect was observed in the fasting blood glucose, LDL reduction, or blood pressure.
The results of this study show the impact that diet selection can have on managing type 2 diabetes. While both of the diets studied in this trial showed some positive results, the very low carbohydrate diet was more effective in lowering HbA1c, reducing anti-glycemic medication requirements, and improving HDL cholesterol. And of course, they made the statement that larger trials with a similar design can be used to determine if a low carbohydrate, high unsaturated fat diet continues to have an impact on managing diabetes beyond a 24-week timeframe.
For this short of a trial or study, the few conclusions show that people with type 2 diabetes need to make lifestyle changes in both diet and exercise. While both diets showed improvements in weight, a very low carbohydrate, high unsaturated fat diet showed more beneficial in lowering HbA1c, anti-glycemic medication requirements and increasing HDL cholesterol.