Lower Carb Diet and Nutrition Literature Review


Comparison of low- and high-carbohydrate diets for type 2 diabetes management: a randomized trial

Tay J, Luscombe-Marsh N, Thompson C et al. Comparison of low- and high-carbohydrate diets for type 2 diabetes management: a randomized trial. Am J Clin Nutr. 2015;102(4):780-790. doi: 10.3945/ajcn.115.112581
We compared the effects of a very-low-carbohydrate, high–unsaturated fat, low–saturated fat (LC) diet with a high-carbohydrate, low-fat (HC) diet on glycemic control and cardiovascular disease risk factors in T2D after 52 wk, in an RCT with 115 obese adults with T2D.

The effect of a low-carbohydrate, ketogenic diet versus a low-glycemic index diet on glycemic control in type 2 diabetes mellitus

Westman E, Yancy W, Mavropoulos J, Marquart M, McDuffie J. The effect of a low-carbohydrate, ketogenic diet versus a low-glycemic index diet on glycemic control in type 2 diabetes mellitus. Nutr Metab (Lond). 2008;5(1). doi: 10.1186/1743-7075-5-36
Eighty-four community volunteers with obesity and type 2 diabetes were randomized to either a low-carbohydrate, ketogenic diet (<20 g of carbohydrate daily; LCKD) or a low-glycemic, reduced-calorie diet (500 kcal/day deficit from weight maintenance diet; LGID). Both groups received group meetings, nutritional supplementation, and an exercise recommendation. The main outcome was glycemic control, measured by hemoglobin A1c.

A Very Low-Carbohydrate, Low–Saturated Fat Diet for Type 2 Diabetes Management: A Randomized Trial

Tay J, Luscombe-Marsh N, Thompson C et al. A Very Low-Carbohydrate, Low–Saturated Fat Diet for Type 2 Diabetes Management: A Randomized Trial. Diabetes Care. 2014;37(11):2909-2918. doi:10.2337/dc14-0845doi: 10.2337/dc14-0845
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 (HbA1c), glycemic variability (GV; assessed by 48-h continuous glucose monitoring), antiglycemic medication changes (antiglycemic medication effects score [MES]), and blood lipids and pressure.

Short-term effects of severe dietary carbohydrate-restriction advice in Type 2 diabetes-a randomized controlled trial.

Daly M, Paisey R, Paisey R et al. Diabetic Medicine. 2006;23(1):15-20. doi: 10.1111/j.1464-5491.2005.01760.x
One hundred and two patients with Type 2 diabetes were recruited across three centres and randomly allocated to receive group education and individual dietary advice. Weight, glycaemic control, lipids and blood pressure were assessed at baseline and 3 months. Dietary quality was assessed at the end of study.

A randomized controlled trial of 130 g/day low-carbohydrate diet in type 2 diabetes with poor glycemic control.

Sato J, Kanazawa A, Makita S et al. Clinical Nutrition. 2017;36(4):992-1000. doi:10.1016/j.clnu.2016.07.0030.1016/j.clnu.2016.07.003
This prospective, randomized, open-label, comparative study included 66 T2DM patients with HbA1c >7.5% even after receiving repeated education programs on CRD. They were randomly allocated to either the 130g/day LCD group (n = 33) or CRD group (n = 33). Patients received personal nutrition education of CRD or LCD for 30 min at baseline, 1, 2, 4, and 6 months. Patients of the CRD group were advised to maintain the intake of calories and balance of macronutrients (28× ideal body weight calories per day). Patients of the LCD group were advised to maintain the intake of 130 g/day carbohydrate without other specific restrictions. Several parameters were assessed at baseline and 6 months after each intervention. The primary endpoint was a change in HbA1c level from baseline to the end of the study.

Effectiveness and Safety of a Novel Care Model for the Management of Type 2 Diabetes at 1 Year: An Open-Label, Non-Randomized, Controlled Study

Hallberg, S.J., McKenzie, A.L., Williams, P.T. et al. Diabetes Ther 9, 583–612 (2018). doi: 10.1007/s13300-018-0373-9
We conducted an open-label, non-randomized, controlled, before-and-after 1-year study of this continuous care intervention (CCI) and usual care (UC). Primary outcomes were glycosylated hemoglobin (HbA1c), weight, and medication use. Secondary outcomes included fasting serum glucose and insulin, HOMA-IR, blood lipids and lipoproteins, liver and kidney function markers, and high-sensitivity C-reactive protein (hsCRP).

Clinical Use of a Real-World Low Carbohydrate Diet Resulting in Reduction of Insulin Dose, Hemoglobin A1c, and Weight

Wolver S, Fadel K, Fieger E et al. Front Nutr. 2021;8. doi: 10.3389/fnut.2021.690855
A prospective cohort study was conducted via an Electronic Medical Record search for patients attending the Virginia Commonwealth University Medical Weight Loss Program from 2014 to 2020 with Type 2 Diabetes Mellitus who initially presented on insulin. Data was extracted for 1 year after enrollment. The weight loss program focuses on a LCD.

A Randomized Pilot Trial of a Moderate Carbohydrate Diet Compared to a Very Low Carbohydrate Diet in Overweight or Obese Individuals with Type 2 Diabetes Mellitus or Prediabetes

Saslow L, Kim S, Daubenmier J et al. PLoS One. 2014;9(4):e91027. doi: 10.1371/journal.pone.0091027

We compared the effects of two diets on glycated hemoglobin (HbA1c) and other health-related outcomes in overweight or obese adults with type 2 diabetes or prediabetes (HbA1c>6%). We randomized participants to either a medium carbohydrate, low fat, calorie-restricted, carbohydrate counting diet (MCCR) consistent with guidelines from the American Diabetes Association (n = 18) or a very low carbohydrate, high fat, non calorie-restricted diet whose goal was to induce nutritional ketosis (LCK, n = 16).

A Non-calorie-restricted Low-carbohydrate Diet is Effective as an Alternative Therapy for Patients with Type 2 Diabetes

Yamada Y, Uchida J, Izumi H et al. Internal Medicine. 2014;53(1):13-19. doi: 10.2169/internalmedicine.53.0861
The enrolled patients were randomly allocated to receive a conventional calorie-restricted diet or low-carbohydrate diet. The patients received consultations every two months from a registered dietician for six months. We compared the effects of the two dietary interventions on glycaemic control and metabolic profiles.

Comparative Study of the Effects of a 1-Year Dietary Intervention of a Low-Carbohydrate Diet Versus a Low-Fat Diet on Weight and Glycemic Control in Type 2 Diabetes

Davis N, Tomuta N, Schechter C et al. Diabetes Care. 2009;32(7):1147-1152. doi: 10.2337/dc08-2108
This study is a randomized clinical trial of 105 overweight adults with type 2 diabetes. Primary outcomes were weight and A1C. Secondary outcomes included blood pressure and lipids. Outcome measures were obtained at 3, 6, and 12 months.

The effect of a low carbohydrate energy-unrestricted diet on weight loss in obese type 2 diabetes patients – A randomized controlled trial

Goldstein T, Kark J, Berry E, Adler B, Ziv E, Raz I. e-SPEN, the European e-Journal of Clinical Nutrition and Metabolism. 2011;6(4):e178-e186. doi: 10.1016/j.eclnm.2011.04.003
52 type 2 diabetes patients, aged 35–75, BMI 30–39.9 kg/m2, HbA1c > 7%, treated by diet or oral medication, were initially placed on a DASH diet for one month, then randomly assigned to a modified Atkins diet (ATK) with unrestricted calorie intake or a standard American Diabetes Association (ADA) calorie-restricted diet. Weight, fasting blood glucose, lipid profile, blood pressure, and microalbuminuria were measured at baseline and after 1.5, 3, 6 and 12 months, and compliance with the diets was assessed.


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