Advice to follow a low-carbohydrate diet has a favourable impact on low-grade inflammation in type 2 diabetes compared with advice to follow a low-fat diet Effect of low-calorie versus low-carbohydrate ketogenic diet in type 2 diabetes. Decrease of aminotransferase levels in obese women is related to body weight reduction, irrespective of type of diet. Randomization to a low-carbohydrate diet advice improves health related quality of life compared with a low-fat diet at similar weight-loss in Type 2 diabetes mellitus. Two diets with different haemoglobin A1c and antiglycaemic medication effects despite similar weight loss in type 2 diabetes. The effect of a low-carbohydrate, ketogenic diet versus a low-glycemic index diet on glycemic control in type 2 diabetes mellitus In type 2 diabetes, randomisation to advice to follow a low-carbohydrate diet transiently improves glycaemic control compared with advice to follow a low-fat diet producing a similar weight loss Change in food cravings, food preferences, and appetite during a low-carbohydrate and low-fat diet.
Abstract Background . Inflammation may play an important role in type 2 diabetes . It has been proposed that dietary strategies can modulate inflammatory activity . Methods . We investigated the effects of diet on inflammation in type 2 diabetes by comparing a traditional low-fat diet ( LFD ) with a low-carbohydrate diet ( LCD ) .  Patients with type 2 diabetes were r and omized to follow either LFD aim ing for 55–60 energy per cent ( E% ) from carbohydrates ( n = 30 ) or LCD aim ing for 20 E% from carbohydrates ( n = 29 ) . Plasma was collected at baseline and after 6 months . C-reactive protein ( CRP ) , interleukin-1 receptor antagonist ( IL-1Ra ) , IL-6 , tumour necrosis factor receptor ( TNFR ) 1 and TNFR2 were determined . Results . Both LFD and LCD led to similar reductions in body weight , while beneficial effects on glycaemic control were observed in the LCD group only . After 6 months , the levels of IL-1Ra and IL-6 were significantly lower in the LCD group than in the LFD group , 978 ( 664–1385 ) versus 1216 ( 974–1822 ) pg/mL and 2.15 ( 1.65–4.27 ) versus 3.39 ( 2.25–4.79 ) pg/mL , both P < 0.05 . Conclusions . To conclude , advice to follow LCD or LFD had similar effects on weight reduction while effects on inflammation differed . Only LCD was found significantly to improve the sub clinical inflammatory state in type 2 diabetes . Trial registration : Clinical Trials.gov identifier : NCT01005498 OBJECTIVE Effective diabetic management requires reasonable weight control . Previous studies from our laboratory have shown the beneficial effects of a low-carbohydrate ketogenic diet ( LCKD ) in patients with type 2 diabetes after its long term administration . Furthermore , it favorably alters the cardiac risk factors even in hyperlipidemic obese subjects . These studies have indicated that , in addition to decreasing body weight and improving glycemia , LCKD can be effective in decreasing antidiabetic medication dosage . Similar to the LCKD , the conventional low-calorie , high nutritional value diet is also used for weight loss . The purpose of this study was to underst and the beneficial effects of LCKD compared with the low-calorie diet ( LCD ) in improving glycemia . METHODS Three hundred and sixty-three overweight and obese participants were recruited from the Al-Shaab Clinic for a 24-wk diet intervention trial ; 102 of them had type 2 diabetes . The participants were advised to choose LCD or LDKD , depending on their preference . Body weight , body mass index , changes in waist circumference , blood glucose level , changes in hemoglobin and glycosylated hemoglobin , total cholesterol , low-density lipoprotein cholesterol , high-density lipoprotein cholesterol , triglycerides , uric acid , urea and creatinine were determined before and at 4 , 8 , 12 , 16 , 20 , and 24 wk after the administration of the LCD or LCKD . The initial dose of some antidiabetic medications was decreased to half and some were discontinued at the beginning of the dietary program in the LCKD group . Dietary counseling and further medication adjustment were done on a biweekly basis . RESULTS The LCD and LCKD had beneficial effects on all the parameters examined . Interestingly , these changes were more significant in subjects who were on the LCKD as compared with those on the LCD . Changes in the level of creatinine were not statistically significant . CONCLUSION This study shows the beneficial effects of a ketogenic diet over the conventional LCD in obese diabetic subjects . The ketogenic diet appears to improve glycemic control . Therefore , diabetic patients on a ketogenic diet should be under strict medical supervision because the LCKD can significantly lower blood glucose levels OBJECTIVE To evaluate the efficacy of low carbohydrate diet ( LCD ) as compared with low fat diet ( LFD ) to decrease aminotransferase levels in obese women with nonalcoholic fatty liver disease . MATERIAL AND METHODS A total of 59 women were r and omly enrolled in a non-controlled clinical intervention study to receive either LCD or LFD during six months . Apparently healthy non-pregnant obese women aged 20 to 65 years were eligible to participate . Previous diagnosis of hepatic disease , serum creatinine level ≥ 1.5 mg/dL , severe life-limiting medical illness , pregnancy , active participation in other dietary program , use of weight loss drugs , or alcohol consumption ≥ 30 g per day were exclusion criteria . RESULTS A total of 31 obese women who received LCD were compared with 28 women allocated in the LFD group . There were 3 ( LCD group ) and 2 ( LFD group ) women with lost of follow-up . No differences in the proportion of type 2 diabetes , hypertension and hyperlipidemia were noted between women in the LCD and LFD groups . At end of follow-up , there were not significant statistical differences in the anthropometric and biochemical characteristics between women in both groups . The weight loss was 5.7 and 5.5 % for women in the LCD LFD groups . Although the decrease of AST ( 31.7 and 22.4 % ) and ALT ( 41 and 33.3 % ) levels was more elevated in the women of LCD group , as compared with the LFD group , there were not significant statistical differences . CONCLUSIONS Our results show that weight loss , irrespective of the type of diet , reduces aminotransferase levels in obese women with NAFLD AIMS To compare the effects on health-related quality of life ( HRQoL ) of a 2-year intervention with a low-fat diet ( LFD ) or a low-carbohydrate diet ( LCD ) based on four group-meetings to achieve compliance . To describe different aspects of taking part in the intervention following the LFD or LCD . METHODS Prospect i ve , r and omized trial of 61 adults with Type 2 diabetes mellitus . The SF-36 question naire was used at baseline , 6 , 12 and 24 months . Patients on LFD aim ed for 55 - 60 energy percent ( E% ) and those on LCD for 20 E% from carbohydrates . The patients were interviewed about their experiences of the intervention . RESULTS Mean body-mass-index was 32.7 ± 5.4 kg/m(2 ) at baseline . Weight-loss did not differ between groups and was maximal at 6 months , LFD : -3.99 ± 4.1 kg , LCD : -4.31 ± 3.6 kg ( p<0.001 within groups ) . There was an increase in the physical component score of SF-36 from 44.1 ( 10.0 ) to 46.7 ( 10.5 ) at 12 months in the LCD group ( p < 0.009 ) while no change occurred in the LFD group ( p < 0.03 between groups ) . At 12 months the physical function , bodily pain and general health scores improved within the LCD group ( p values 0.042 - 0.009 ) while there was no change within the LFD group . CONCLUSIONS Weight-changes did not differ between the diet groups while improvements in HRQoL only occurred after one year during treatment with LCD . No changes of HRQoL occurred in the LFD group in spite of a similar reduction in body weight We analysed participants with type 2 diabetes ( n = 46 ) within a larger weight loss trial ( n = 146 ) who were r and omized to 48 weeks of a low-carbohydrate diet ( LCD ; n = 22 ) or a low-fat diet + orlistat ( LFD + O ; n = 24 ) . At baseline , mean body mass index ( BMI ) was 39.5 kg/m(2 ) ( s.d . 6.5 ) and haemoglobin A1c ( HbA1c ) 7.6 % ( s.d . 1.3 ) . Although the interventions reduced BMI similarly ( LCD -2.4 kg/m(2 ) ; LFD + O -2.7 kg/m(2 ) , p = 0.7 ) , LCD led to a relative improvement in HbA1c : -0.7 % in LCD versus + 0.2 % in LFD + O [ difference -0.8 % , 95 % confidence interval ( CI ) = -1.6 , -0.02 ; p = 0.045 ] . LCD also led to a greater reduction in antiglycaemic medications using a novel medication effect score ( MES ) based on medication potency and total daily dose ; 70.6 % of LCD versus 30.4 % LFD + O decreased their MES by ≥50 % ( p = 0.01 ) . Lowering dietary carbohydrate intake demonstrated benefits on glycaemic control beyond its weight loss effects , while at the same time lowering antiglycaemic medication requirements Objective Dietary carbohydrate is the major determinant of postpr and ial glucose levels , and several clinical studies have shown that low-carbohydrate diets improve glycemic control . In this study , we tested the hypothesis that a diet lower in carbohydrate would lead to greater improvement in glycemic control over a 24-week period in patients with obesity and type 2 diabetes mellitus . Research design and methods Eighty-four community volunteers with obesity and type 2 diabetes were r and omized 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 . Results Forty-nine ( 58.3 % ) participants completed the study . Both interventions led to improvements in hemoglobin A1c , fasting glucose , fasting insulin , and weight loss . The LCKD group had greater improvements in hemoglobin A1c ( -1.5 % vs. -0.5 % , p = 0.03 ) , body weight ( -11.1 kg vs. -6.9 kg , p = 0.008 ) , and high density lipoprotein cholesterol ( + 5.6 mg/dL vs. 0 mg/dL , p < 0.001 ) compared to the LGID group . Diabetes medications were reduced or eliminated in 95.2 % of LCKD vs. 62 % of LGID participants ( p < 0.01 ) . Conclusion Dietary modification led to improvements in glycemic control and medication reduction/elimination in motivated volunteers with type 2 diabetes . The diet lower in carbohydrate led to greater improvements in glycemic control , and more frequent medication reduction/elimination than the low glycemic index diet . Lifestyle modification using low carbohydrate interventions is effective for improving and reversing type 2 diabetes Aims /hypothesisThe study aim ed to compare the effects of a 2 year intervention with a low-fat diet ( LFD ) or a low-carbohydrate diet ( LCD ) , based on four group meetings to achieve compliance . Methods This was a prospect i ve r and omised parallel trial involving 61 adults with type 2 diabetes consecutively recruited in primary care and r and omised by drawing ballots . Patients that did not speak Swedish could not be recruited . The primary outcomes in this non-blinded study were weight and HbA1c . Patients on the LFD aim ed for 55–60 energy per cent ( E% ) and those on LCD for 20 E% from carbohydrate . Results The mean BMI and HbA1c of the participants were 32.7 ± 5.4 kg/m2 and 57.0 ± 9.2 mmol/mol , respectively . No patients were lost to follow-up . Weight loss did not differ between groups and was maximal at 6 months : LFD −3.99 ± 4.1 kg ( n = 31 ) ; LCD −4.31 ± 3.6 kg ( n = 30 ) ; p < 0.001 within groups . At 24 months , patients on the LFD had lost −2.97 ± 4.9 kg and those on LCD −2.34 ± 5.1 kg compared with baseline ( p = 0.002 and p = 0.020 within groups , respectively ) . HbA1c fell in the LCD group only ( LCD at 6 months −4.8 ± 8.3 mmol/mol , p = 0.004 , at 12 months −2.2 ± 7.7 mmol/mol , p = 0.12 ; LFD at 6 months −0.9 ± 8.8 mmol/mol , p = 0.56 ) . At 6 months , HDL-cholesterol had increased with the LCD ( from 1.13 ± 0.33 mmol/l to 1.25 ± 0.47 mmol/l , p = 0.018 ) while LDL-cholesterol did not differ between groups . Insulin doses were reduced in the LCD group ( 0 months , LCD 42 ± 65 E , LFD 39 ± 51 E ; 6 months , LCD 30 ± 47 E , LFD 38 ± 48 E ; p = 0.046 for between-group change ) . Conclusions /interpretationWeight changes did not differ between the diet groups , while insulin doses were reduced significantly more with the LCD at 6 months , when compliance was good . Thus , aim ing for 20 % of energy intake from carbohydrates is safe with respect to cardiovascular risk compared with the traditional LFD and this approach could constitute a treatment alternative . Trial registration : Clinical Trials.gov NCT01005498 Funding : University Hospital of Linköping Research Funds , Linköping University , the County Council of Östergötl and , and the Diabetes Research Centre of Linköping The study objective was to evaluate the effect of prescribing a low-carbohydrate diet ( LCD ) and a low-fat diet ( LFD ) on food cravings , food preferences , and appetite .  Obese adults were r and omly assigned to a LCD ( n = 134 ) or a LFD ( n = 136 ) for 2 years . Cravings for specific types of foods ( sweets , high-fats , fast-food fats , and carbohydrates/starches ) ; preferences for high-sugar , high-carbohydrate , and low-carbohydrate/high-protein foods ; and appetite were measured during the trial and evaluated during this secondary analysis of trial data . Differences between the LCD and LFD on change in outcome variables were examined with mixed linear models . Compared to the LFD , the LCD had significantly larger decreases in cravings for carbohydrates/starches and preferences for high-carbohydrate and high-sugar foods . The LCD group reported being less bothered by hunger compared to the LFD group . Compared to the LCD group , the LFD group had significantly larger decreases in cravings for high-fat foods and preference for low-carbohydrate/high-protein foods . Men had larger decreases in appetite ratings compared to women . Prescription of diets that promoted restriction of specific types of foods result ed in decreased cravings and preferences for the foods that were targeted for restriction . The results also indicate that the LCD group was less bothered by hunger compared to the LFD group and that men had larger reductions in appetite compared to women
The longest trial intervention studies did not show a difference in weight change .
This review shows that there are no consistent differences in weight and A1C changes over the long-term treatment with LCD and LFD , UCD or LGID
INTRODUCTION Low carbohydrate diets ( LCD ) have shown beneficial effects on short-term weight reduction programs for obese individuals without diabetes , but the long-term evidence of efficacy on individuals with type 2 diabetes is not conclusive .
OBJECTIVE To evaluate , the effectiveness of 12 or more weeks of LCD compared to Low Fat Diet ( LFD ) , Usual Care Diet ( UCD ) or Low Glycemic Index Diet ( LGID ) on weight reduction and AIC on type 2 diabetes individuals .