Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2023 Aug 17;22(1):212.
doi: 10.1186/s12933-023-01956-8.

A six-month low-carbohydrate diet high in fat does not adversely affect endothelial function or markers of low-grade inflammation in patients with type 2 diabetes: an open-label randomized controlled trial

Eva M Gram-Kampmann  1   2   3 , Thomas B Olesen  1   2 , Camilla D Hansen  2   4 , Mie B Hugger  4 , Jane M Jensen  4 , Aase Handberg  5   6 , Henning Beck-Nielsen  1   2 , Aleksander Krag  4 , Michael H Olsen  7   8 , Kurt Højlund  9   10
Affiliations
Randomized Controlled Trial

A six-month low-carbohydrate diet high in fat does not adversely affect endothelial function or markers of low-grade inflammation in patients with type 2 diabetes: an open-label randomized controlled trial

Eva M Gram-Kampmann et al. Cardiovasc Diabetol. .

Abstract

Background: While a low-carbohydrate diet (LCD) reduces HbA1c in patients with type 2 diabetes (T2D), the associated high intake of fat may adversely affect cardiovascular risk factors. To address this, we examined the effect of a non-calorie-restricted LCD high in fat on endothelial function and markers of low-grade inflammation in T2D over 6 months.

Methods: In an open-label randomized controlled trial, 71 patients with T2D were randomized 2:1 to either a LCD (< 20 E% carbohydrates, 50-60 E% fat) or a control diet (50-60 E% carbohydrates, 20-30 E% fat) for six months. Flow-mediated vasodilation (FMD) and nitroglycerine-induced vasodilation (NID) were assessed by ultrasound in the brachial artery together with plasma interleukin-6 (IL-6) and serum high-sensitivity C-reactive protein (hsCRP) in the participants at baseline (n = 70) and after six months (n = 64).

Results: The FMD and NID were unaltered in both groups after six months, and there were no between-group differences in change of either FMD (p = 0.34) or NID (p = 0.53) in response to the interventions. The circulating hsCRP and IL-6 levels decreased only in response to LCD (both p < 0.05). However, comparing changes over time with the control diet, the LCD did not reduce either IL-6 (p = 0.25) or hsCRP (p = 0.07) levels. The lack of changes in FMD and NID in response to LCD persisted after adjustment for cardiovascular risk factors.

Conclusion: A LCD high in fat for six months does not adversely affect endothelial function or selected markers of low-grade inflammation, which suggests that this nutritional approach does not increase the risk of cardiovascular disease. Trial registration ClinicalTrials.gov (NCT03068078).

Keywords: Cardiovascular risk; Endothelial function; Flow-mediated vasodilation; Low-carbohydrate diet; Low-grade inflammation; Type 2 diabetes.

PubMed Disclaimer

Conflict of interest statement

AK reports speaker honorarium from Norgine, Siemens and Nordic Bioscience, outside the submitted work.

Figures

Fig. 1
Fig. 1
Individual changes in A flow-mediated vasodilation (FMD) and B nitroglycerine-induced dilation (NID) from baseline to 6 months in patients with type 2 diabetes randomized to either a LCD (red circles/lines) or a control diet (blue circles/lines)
Fig. 2
Fig. 2
Changes in A plasma IL-6 and B serum hsCRP from baseline to 6 months in patients with type 2 diabetes randomized to either a LCD (red boxplots) or a control diet (blue bloxplots). *p < 0.05, within group change
See this image and copyright information in PMC

References

    1. International Diabetes Federation (IDF). Diabetes and cardiovascular disease. https://idf.org/our-activities/care-prevention/cardiovascular-disease/cv....
    1. Sattar N, Rawshani A, Franzén S, et al. Age at diagnosis of type 2 diabetes mellitus and associations with cardiovascular and mortality risks. Circulation. 2019;139(19):2228–2237. - PubMed
    1. Disease C, Management R. Standards of medical care in diabetes-2021. Diabetes Care. 2021;44(Suppl 1):S125–S150. - PubMed
    1. Calle MC, Fernandez ML. Inflammation and type 2 diabetes. Diabetes Metab. 2012;38(3):183–191. - PubMed
    1. Halcox JP, Schenke WH, Zalos G, et al. Prognostic value of coronary vascular endothelial dysfunction. Circulation. 2002;106(6):653–658. - PubMed

Publication types

Associated data