Targeting dietary fat or glycemic load in the treatment of obesity and type 2 diabetes: a randomized controlled trial |
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Authors: | Fabricatore A N Wadden T A Ebbeling C B Thomas J G Stallings V A Schwartz S Ludwig D S |
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Institution: | a Department of Psychiatry, University of Pennsylvania School of Medicine, United States b Nutrisystem, Inc., United States c Department of Medicine, Children's Hospital Boston and Department of Pediatrics, Harvard Medical School, United States d Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown, The Miriam Hospital, United States e Department of Pediatrics, Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, United States f Department of Medicine, Penn Presbyterian Medical Center, University of Pennsylvania School of Medicine, United States |
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Abstract: | AimsTo compare the effects of lifestyle modification programs that prescribe low-glycemic load (GL) vs. low-fat diets in a randomized trial.MethodsSeventy-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, HbA1c, and other metabolic parameters were compared at weeks 20 and 40.ResultsWeight 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 HbA1c 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).ConclusionsResults suggest that targeting GL, rather than dietary fat, in a low-calorie diet can significantly enhance the effect of weight loss on HbA1c in patients with type 2 diabetes. |
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Keywords: | Glycemic load Dietary fat Obesity Type 2 diabetes Lifestyle modification Diet |
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