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Randomized Controlled Trial
. 2011 Apr;92(1):37-45.
doi: 10.1016/j.diabres.2010.12.016. Epub 2011 Jan 3.

Targeting dietary fat or glycemic load in the treatment of obesity and type 2 diabetes: a randomized controlled trial

A N Fabricatore  1 , T A Wadden, C B Ebbeling, J G Thomas, V A Stallings, S Schwartz, D S Ludwig
Affiliations
Randomized Controlled Trial

Targeting dietary fat or glycemic load in the treatment of obesity and type 2 diabetes: a randomized controlled trial

A N Fabricatore et al. Diabetes Res Clin Pract. 2011 Apr.

Abstract

Aims: To compare the effects of lifestyle modification programs that prescribe low-glycemic load (GL) vs. low-fat diets in a randomized trial.

Methods: Seventy-nine obese adults with type 2 diabetes received low-fat or low-GL dietary instruction, delivered in 40-week lifestyle modification programs with identical goals for calorie intake and physical activity. Changes in weight, HbA(1c), and other metabolic parameters were compared at weeks 20 and 40.

Results: Weight loss did not differ between groups at week 20 (low-fat: -5.7±3.7%; low-GL: -6.7±4.4%, p=.26) or week 40 (low-fat: -4.5±7.5%; low-GL: -6.4±8.2%, p=.28). Adjusting for changes in antidiabetic medications, subjects on the low-GL diet had larger reductions in HbA(1c) than those on the low-fat diet at week 20 (low-fat: -0.3±0.6%; low-GL: -0.7±0.6%, p=.01), and week 40 (low-fat: -0.1±1.2%; low-GL: -0.8±1.3%; p=.01). Groups did not differ significantly on any other metabolic outcomes (p≥.06).

Conclusions: Results suggest that targeting GL, rather than dietary fat, in a low-calorie diet can significantly enhance the effect of weight loss on HbA(1c) in patients with type 2 diabetes.

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Figures

Figure 1
Figure 1
Participant flow through the trial.
Figure 2
Figure 2
Mixed model estimates showing effects of low-fat and low-GL diets on weight change (Panel A) and HbA1c (Panel B). Differences in weight loss were not statistically significant at week 20 or week 40. However, the changes in HbA1c were significantly different at both times.
Figure 3
Figure 3
Comparisons of the percentage of participants in each condition who increased, did not change, or decreased the number or dosage of medications used to treat diabetes during the course of the study. Chi-square analyses showed no differences between groups at week 20 or week 40.
See this image and copyright information in PMC

References

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