A carbohydrate-reduced high-protein diet improves HbA1c and liver fat content in weight stable participants with type 2 diabetes: a randomised controlled trial

Abstract

Aims/hypothesis Dietary recommendations for treating type 2 diabetes are unclear but a trend towards recommending a diet reduced in carbohydrate content is acknowledged. We compared a carbohydrate-reduced high-protein (CRHP) diet with an isoenergetic conventional diabetes (CD) diet to elucidate the effects on glycaemic control and selected cardiovascular risk markers during 6 weeks of full food provision of each diet. Methods The primary outcome of the study was change in HbA 1c. Secondary outcomes reported in the present paper include glycaemic variables, ectopic fat content and 24 h blood pressure. Eligibility criteria were: men and women with type 2 diabetes, HbA 1c 48-97 mmol/mol (6.5-11%), age >18 years, haemoglobin >6/>7 mmol/l (women/men) and eGFR >30 ml min −1 (1.73 m) −2. Participants were randomised by drawing blinded ballots to 6 + 6 weeks of an iso-energetic CRHP vs CD diet in an open label, crossover design aiming at body weight stability. The CRHP/CD diets contained carbohydrate 30/50 energy per cent (E%), protein 30/17E% and fat 40/33E%, respectively. Participants underwent a meal test at the end of each diet period and glycaemic variables, lipid profiles, 24 h blood pressure and ectopic fat including liver and pancreatic fat content were assessed at baseline and at the end of each diet period.

Lifestyle modification in NAFLD/NASH: Facts and figures

“…21 However, short-term interventional studies have demonstrated that increasing dietary animal or plant protein to 30% of energy requirements (with carbohydrates 40% and fat 30%) reduces hepatic fat by 36-48% over 6 weeks, perhaps by altering peripheral adipose metabolism. 22 Similarly, in weight stable patients with T2DM, a high-protein (30%) diet with 30% carbohydrate and 40% fat led to a reduction in hepatic steatosis over 6 weeks, 23 suggesting that replacing fat or carbohydrate with protein intake may be a successful strategy to reduce hepatic steatosis.…”

Influence of Nutritional Education on the Diet and Nutritional Behaviors of Elderly Women at the University of the Third Age

“…The lack of adequate quality and quantity of nutrients, even of a macronutrient like fat, contributes to negative changes in their body composition [1]. Excess carbohydrate and fat consumption, in particular, promotes the development of obesity and diabetes [6].…”

“…A balanced diet should include an appropriate proportion of each macronutrient and adequate caloric content, adapted to age, sex, and lifestyle [6,11,12]. As people age, they undergo physiological changes that are reflected by decreases in total energy intake, compared with what is recommended, while consuming inappropriate amounts of macronutrients [4][5][6][13][14][15][16]. A lower calorie intake has been associated with lower consumption of protein, calcium, iron, zinc, B vitamins, and vitamin E and D, which can advance the aging process and other diseases [4,8,[17][18][19].…”

“…A lower calorie intake has been associated with lower consumption of protein, calcium, iron, zinc, B vitamins, and vitamin E and D, which can advance the aging process and other diseases [4,8,[17][18][19]. Many factors, such as education, socioeconomic factors, and marital status, may influence a decline in energy intake [6,13]. Recent epidemiological studies indicate that changes in the diets of older women result from dissatisfaction with their bodies; there is evidence that this phenomenon is similar in girls and young women [6,20,21].…”

“…Many factors, such as education, socioeconomic factors, and marital status, may influence a decline in energy intake [6,13]. Recent epidemiological studies indicate that changes in the diets of older women result from dissatisfaction with their bodies; there is evidence that this phenomenon is similar in girls and young women [6,20,21]. Partially, physiological changes in the digestive track (e.g., slower gastric emptying, slower intestinal peristalsis, and altered taste and smell) may also contribute to lower energy intake [10,21,22].…”