Alterations in the macronutrient content of the diet and the effects on body composition, cardiovascular disease risk and the control of energy metabolism in obese patients with type 2 diabetes mellitus.

Gryka, Anna

Abstract

Several studies have shown that a low-carbohydrate diet (LCHOD) can improve glycaemic control in people diagnosed with type 2 diabetes (T2DM). The objective of the current study was to compare two ways of administration of a LCHOD - self-prepared meals versus ready-made meals. The study examined each method's effect on weight loss, glycaemic control, body composition, cardiovascular risk and resting metabolic rate over 12 months. Forty-one volunteers with the mean body mass index of 38.8 kg/m2 and poorly controlled T2DM (glycosylated haemoglobin, HbA1c > 7.5%) were randomized to either a protein-sparing modified fast diet ("PSMF", involving < 40g of carbohydrate daily, self-cooked) or to a Go Lower diet ("GL", involving ready-made meals). Both groups received multivitamin supplementation and attended monthly visits. The main outcome was weight loss and its composition. Fourteen (34 %) participants completed 12 months of the intervention. There were no differences in the weight or any other changes between the diet groups at 12 months. Overall, body mass and fat mass decreased (-5.5 ± 7.3 kg, P < 0.001 and -5.1 ± 6.7 kg, P < 0.001 respectively), but fat-free mass did not change. There was an overall reduction in HbA1c (-0.4 ± 1.1 %, P < 0.001), an increase in HDL-cholesterol (+0.07 ± 0.18 mmol/L, P < 0.001) and a decrease in triacylglycerol (-0.6 ± 2.4 mmol/L, P = 0.014). Resting metabolic rate significantly decreased (-137 ± 265 kcal/d, P < 0.001). In conclusion, LCHOD led to weight loss and improvements in glycaemic control in obese volunteers with poorly controlled T2DM, independently of the approach taken. The results confirm that lifestyle modification using LCHOD is effective for improving T2DM and suggest that the type of approach to the diet can be matched to an individual's preferences.

Citation

GRYKA, A. 2011. Alterations in the macronutrient content of the diet and the effects on body composition, cardiovascular disease risk and the control of energy metabolism in obese patients with type 2 diabetes mellitus. Robert Gordon University, PhD thesis.

• Thesis Type: Thesis
• Deposit Date: Jan 6, 2012
• Publicly Available Date: Jan 6, 2012
• Keywords: Obesity; Type 2 diabetes; Carbohydrate; Protein; Diet; Body composition
• Public URL: http://hdl.handle.net/10059/703
• Award Date: Oct 31, 2011