Low carbohydrate diet as effective as low fat diet in lowering adverse events in obese patients with T2D

The study comparing the clinical benefit of low-carbohydrate diets with a low-fat (LF) diet for patients with type 2 diabetes found that an LC diet is equally effective as an LF diet regarding control of cardiometabolic markers and the risk of adverse events.

"Except for reducing body composition measures and HbA1c levels at the short-to-intermediate term and decreasing the need for anti-glycemic medications at intermediate-to-long term, an LC diet is equally effective as LF diet concerning control of cardiometabolic markers and adverse events risk in obese type 2 diabetes patients," Tanefa A. Apekey and colleagues wrote in their study.

The research team performed a meta-analysis of randomized controlled trials (RCTs) to compare the safety and efficacy of low carbohydrate diets with low-fat diets for type 2 diabetes patients using a comprehensive list of cardiometabolic outcomes, including markers of renal and liver function and blood pressure.

The researchers identified RCTs comparing diets in T2D participants from online databases and a manual search of bibliographies. The researchers pooled data for mean differences and relative risks for measures of cardiometabolic parameters, adverse events, and glycemia using the following time points: short-term for three months, intermediate-term for 6 and 12 months, and long-term for 24 months. The study included twenty-two RCTs consisting of 1391 mostly obese participants with T2D.

The study led to the following findings:

• At three months, a low carbohydrate vs. low-fat diet significantly reduced HbA1c levels, mean difference of −0.41%.
• A low carbohydrate diet significantly reduces body weight, BMI, fasting insulin, and triglycerides. It increased total cholesterol and HDL-C levels in the short-to-intermediate term, with a reduction in the need for anti-glycemic medications in the intermediate-to-long period.
• The authors found no significant differences in other parameters and adverse events.

To sum up, other than reducing HbA1c levels and adiposity parameters at short to intermediate terms, a low-carb diet is equally effective as a low-fat diet in terms of risk of adverse events and control of cardiometabolic markers in obese type 2 diabetes patients.

The findings imply that an intermediate-term low-carb diet could be recommended for overweight/obese adults with uncontrolled type 2 diabetes to achieve weight loss and glycemic control.

Reference:

Apekey TA, Maynard MJ, Kittana M, Kunutsor SK. Comparison of the Effectiveness of Low Carbohydrate Versus Low Fat Diets, in Typue 2 Diabetes: Systematic Review and Meta-Analysis of Randomized Controlled Trials. Nutrients. 2022 Oct 19;14(20):4391. doi: 10.3390/nu14204391. PMID: 36297075; PMCID: PMC9609579.