RCT Results: Low-Carb High-Fat Diet vs a High-Carb Low-Fat Diet for Type 2 Diabetes?
BACKGROUND AND PURPOSE:
Hansen et al. (Ann Intern Med, 2022) compared the effects of a low-carbohydrate, high-fat (LCHF) diet vs high-carbohydrate, low-fat (HCLF) diet on type 2 diabetes (T2D) and nonalcoholic fatty liver disease (NAFLD)
6-month randomized controlled trial
University hospital in Denmark
50 to 60 energy percent (E%) fat | <20E% carbohydrates | 25E% to 30E% proteins
50E% to 60E% carbohydrates | 20E% to 30E% fats | 20E% to 25E% proteins
Intervention lasted 6 months | Follow-up at 9 months
Both dietary interventions were calorie unrestricted
Serum lipid levels
Liver biopsies (to assess NAFLD)
Mean age: 56 (SD, 10) years; 58% women
After 6 months, participants on the LCHF diet
Had greater improvements in hemoglobin A1c
Mean difference in change −6.1 mmol/mol (95% CI, −9.2 to −3.0)
Lost more weight
Mean difference in change −3.8 kg (95% CI, −6.2 to −1.4)
Both groups had higher high-density lipoprotein cholesterol and lower triglycerides at 6 months
Changes in low-density lipoprotein cholesterol were less favorable in the LCHF diet
Mean difference in change 0.37 mmol/L (95% CI, 0.17 to 0.58)
There were no statistically significant between-group changes in NAFLD
Findings not sustained at the 9-month follow-up
After 6 months of intervention, participants in the LCHF diet group had improved glycemic control and achieved better weight loss than those in the HCLF diet group
However, these changes were not sustained 3 months after the dietary intervention was completed
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