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Randomized Controlled Trial
. 2023 May-Jun;21(3):256-263.
doi: 10.1370/afm.2968.

Comparing Very Low-Carbohydrate vs DASH Diets for Overweight or Obese Adults With Hypertension and Prediabetes or Type 2 Diabetes: A Randomized Trial

Laura R Saslow  1 , Lenette M Jones  2 , Ananda Sen  3   4 , Julia A Wolfson  5   6 , Heidi L Diez  7   8 , Alison O'Brien  2 , Cindy W Leung  9 , Hovig Bayandorian  2 , Jennifer Daubenmier  10 , Amanda L Missel  2 , Caroline Richardson  3
Affiliations
Randomized Controlled Trial

Comparing Very Low-Carbohydrate vs DASH Diets for Overweight or Obese Adults With Hypertension and Prediabetes or Type 2 Diabetes: A Randomized Trial

Laura R Saslow et al. Ann Fam Med. 2023 May-Jun.

Abstract

Purpose: Adults with a triple multimorbidity (hypertension, prediabetes or type 2 diabetes, and overweight or obesity), are at increased risk of serious health complications, but experts disagree on which dietary patterns and support strategies should be recommended.

Methods: We randomized 94 adults from southeast Michigan with this triple multimorbidity using a 2 × 2 diet-by-support factorial design, comparing a very low-carbohydrate (VLC) diet vs a Dietary Approaches to Stop Hypertension (DASH) diet, as well as comparing results with and without multicomponent extra support (mindful eating, positive emotion regulation, social support, and cooking).

Results: Using intention-to-treat analyses, compared with the DASH diet, the VLC diet led to greater improvement in estimated mean systolic blood pressure (-9.77 mm Hg vs -5.18 mm Hg; P = .046), greater improvement in glycated hemoglobin (-0.35% vs -0.14%; P = .034), and greater improvement in weight (-19.14 lb vs -10.34 lb; P = .0003). The addition of extra support did not have a statistically significant effect on outcomes.

Conclusions: For adults with hypertension, prediabetes or type 2 diabetes, and overweight or obesity, the VLC diet resulted in greater improvements in systolic blood pressure, glycemic control, and weight over a 4-month period compared with the DASH diet. These findings suggest that larger trials with longer follow-up are warranted to determine whether the VLC diet might be more beneficial for disease management than the DASH diet for these high-risk adults.

Trial registration: ClinicalTrials.gov NCT03729479.

Keywords: DASH diet; diet; hypertension; obesity; type 2 diabetes; very low-carbohydrate diet.

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Figures

Figure 1.
Figure 1.
Participant CONSORT flow diagram. CONSORT = Consolidated Standards of Reporting Trials; COVID-19 = coronavirus disease 2019; DASH = Dietary Approaches to Stop Hypertension; VLC = very low-carbohydrate.
See this image and copyright information in PMC

References

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