The trial was conducted over a two year period and was led by Dr Hans Guldbrand and Professor Fredrik H Nystrom. In the present study, published in the journal Annals of Medicine the effects of diets on inflammation were studied in collaboration with cardiologist Professor Lena Jonasson.
In summary, the presented clinical trial resulted in a similar weight loss comparing low-carbohydrate diet and low-fat diet, but only the low-carbohydrate diet had a favourable impact on inflammation in patients with type 2 diabetes. Current nutritional recommendations for type 2 diabetics suggest a diet based on high-fibre carbohydrate foods such as wholegrain breads and cereals, beans, lentils, vegetables and fruits (Diabetes Australia, 2015). Accordingly, I wanted to discover if there is any research with type 2 diabetics (participants) comparing a low-carbohydrate diet (intervention) to the conventional, low-fat (high-carbohydrate) diet (comparison) and the impact the diets have on the symptoms of diabetes (outcome).
I decided to use glycated haemoglobin levels (HbA1c) as the outcome to be tested for since it is considered to be the gold standard for monitoring chronic glycaemia of type 2 diabetics (Makris & Spanou, 2011). Of the 16 remaining articles I came across an interesting article from the Cochrane database (Nield et al., 2007), which was a systematic review of 36 articles (18 trials) comparing low-carbohydrate diets with low-fat diets and using type 2 diabetics as the subjects. As a result of this systematic review I decided to remove all studies that were conducted prior to 2007. One of the remaining articles compared a low-carbohydrate diet alone with a low-fat diet plus medication.
Six out of the seven remaining articles found that a low-carbohydrate diet was more effective than a low-fat diet at lowering glycated haemoglobin levels. As a result of this review, there is no doubt that the best type of diet for a person with type 2 diabetes to follow is a reduced or low-carbohydrate diet.
Even though there were several studies that supported the fact that a low-carb diet is best for type 2 diabetics, there was one paper in particular that stood out the most and supported the argument well. Even though the other studies (except for one) supported the argument, there were some flaws in the studies making them not as good as (Tay et al., 2014). Rock et al., (2014) compared both a higher and lower carbohydrate intake to the usual care for diabetes sufferers. Davis et al., (2009) found that there was no difference between either the low-carbohydrate group or the low-fat group. Esposito et al., (2009) concluded that a low-carbohydrate, Mediterranean-style diet led to more favourable changes in glycated haemoglobin levels compared to the low-fat diet. Despite these minor issues with the other articles, there is definitely enough good-quality research to suggest that a low-carbohydrate diet is the best type of diet for type 2 diabetics to follow.
This entry was posted in Food & IR and tagged glycated haemoglobin, low carbohydrate diet, Mediterranean diet, type 2 diabetes, type 2 diabetics. In a clinical trial at Linkoping University a low-carbohydrate diet was compared with a traditional low-fat diet in 61 patients with type 2 diabetes. The patients were randomly assigned to a low-carbohydrate diet or a traditional low-fat diet and were given menu suggestions and advices by a dietician during three occasions of the first year.
Compared with healthy individuals without diabetes, the patients exhibited significantly higher levels of inflammatory markers at baseline.
However, based on my personal experience in dealing with this sub-group of the population I feel that these nutritional recommendations are incorrect and require an urgent revision. The authors found that the data was not of high quality (high risk of bias) and therefore no conclusion regarding the comparison could be made. Also, some of the remaining articles were systemic reviews which were likely to include the biased research articles mentioned previously so they were also discarded.
Since medication was used with the low-fat diet only and not the low-carbohydrate diet a true comparison could not be made.
Glycated haemoglobin levels in both intervention groups were lower than the usual care, but a comparison wasn’t clearly made between the intervention groups. However, the article did not specify how the diets were structured, which means they may have been set up incorrectly. Only patients in the low-carbohydrate group exhibited reduced levels of inflammatory markers in blood, despite the fact that weight loss was similar in both groups. The effects on blood glucose, blood lipids and weight were recently published in the journal Diabetologia 2012. A very low-carbohydrate, low-saturated fat diet for type 2 diabetes management: a randomized trial.
Weight reduction in both groups was similar, around 4 kg, whereas glucose levels decreased more in the low-carbohydrate group (who had lowered their carbohydrate intake to 25% of total energy intake). After six months, inflammation was significantly reduced in the low-carbohydrate group while no changes were observed in the low-fat diet group. Weight loss, glycemic control, and cardiovascular disease risk factors in response to differential diet composition in a weight loss program in type 2 diabetes: a randomized controlled trial.
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