Participants and Diets
105 People aged > 18, with T2D for at least 6 months, BMI ≥ 25 and A1c 6-11%
were randomly allocated to a low carb group or a low fat group. In this trial, 82 of the participants were
female and 67 were classified as black. The groups were similar at baseline
|
Diet Group
|
Diet Advice
|
|
Low Carb
|
2 Week phase of 20-25g carbs, 5g carb increments each week
|
|
Low Fat
|
Fat gram goal (25% of total calories)
|
“At randomization, all participants received 45 min of
individual dietary instruction by a registered dietitian and were given a
specific gram allowance of carbohydrates or fat to achieve a 1-pound weight
loss each week. Structured menus that provided meal choices and recipes were
used for the first 2 weeks. After the first 2 weeks, participants were
instructed on selecting foods that met their dietary goals without using the
menus. During the 12-month study, participants had a total of six scheduled, 30-min
visits with the dietitian for additional dietary counseling.”
“We provided participants with general recommendations to
achieve 150 min of physical activity each week, but physical activity was not
an emphasis of the study.”
|
Pro:Fat:Carb
|
Low Carb
|
Low Fat
|
|
Baseline
|
20:36:44
|
19:39:41
|
|
6 Months
|
23:43:34
|
21:31:48
|
|
12 Months
|
23:44:33
|
19:31:50
|
|
Reduction in
Calories
|
Low Carb
|
Low Fat
|
|
6 Months
|
-331
|
-341
|
|
12 Months
|
-210
|
-53
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Results
The LC group lost more weight and had better improvements in metabolic
markers at 3 months (not sure if significant), but regained some of the weight
loss and didn’t maintain those improvements at 12 months (see table 2)
|
|
3 months
|
6 months
|
12 months
|
|
|
HbA1c (%)
|
Low Carb
|
−0.64
|
−0.29
|
−0.02
|
|
Low Fat
|
−0.26
|
−0.15
|
0.24
|
|
|
Systolic blood pressure (mmHg)
|
Low Carb
|
−5.80
|
−0.78
|
2.00
|
|
Low Fat
|
−0.98
|
−3.70
|
−1.80
|
|
|
Diasystolic blood pressure (mmHg)
|
Low Carb
|
−2.20
|
−0.93
|
−2.90
|
|
Low Fat
|
−0.40
|
0.95
|
−2.20
|
|
Overall, there were no significant improvements in systolic blood pressure,
diastolic blood pressure HbA1c and blood lipids in either group, except that
the low carb group had a significant increase in HDL-C at both 6 and 12 months (see
table 2)
There was no difference in the number of participants who completed the
trial (44/50 (88%) in low fat group, 47/55 (85%) in low carb group).
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