Re: Low-Fat or Low-Carb Diet? It Doesn't Really Matter

On Wed, 23 Sep 2009 00:18:48 -0700 (PDT), Kurt
<kurtwheeling1965@xxxxxxxxxxx> wrote:

http://www.diabetes.org/diabetes-research/summaries/low-fat-or-low-carb-diet-it-doesnt-really-matter.jsp

(excerpt)

Comparative study of the effects of a 1-year dietary intervention of a
low-carbohydrate diet versus a low-fat diet on weight and glycemic
control in type 2 diabetes, by Nichola J. Davis and colleagues.
Diabetes Care 32:1147?1152, 2009

What is the problem and what is known about it so far?
Type 2 diabetes is closely linked to overweight and obesity. For
people who are overweight, losing weight is one of the most important
ways to prevent diabetes or delay its development. There are many
different strategies for losing excess weight. For people with
diabetes, the best strategy for losing weight and controlling blood
glucose is unclear. Research studies in people without diabetes have
shown that low-carbohydrate diets result in weight losses similar to
those achieved with other types of diets, such as low-fat diets. Based
on this research, the American Diabetes Association states that either
a low-carb or a low-fat diet may be effective for short-term weight
loss. Because carbohydrates affect blood glucose levels, low-carb
diets may be particularly good for people with diabetes. However,
studies of low-carb diets in people with type 2 diabetes have been
small, short-term, or poorly designed. More research in this area is
needed.

What are the implications of the study?

The long-term effectiveness of low-fat and low-carb diets seems to be
similar. Although one may result in quicker weight loss at the
beginning, there are no real differences by the end of a year. People
with diabetes can follow any weight loss plan that works for them as
long as it provides adequate nutrition and does not worsen their
diabetes control or other conditions.

Considering the other ADA "report" you just posted on the benefits of
a good HDL, I'm surprised you snipped this point:

"The low-carb diet increased HDL ("good") cholesterol levels more than
the low-fat diet."

IIRC we discussed the actual paper, not the ADA selective precis, here
a while ago. But even a cursory glance at the full text shows a few
other little things:

"Of the participants using insulin, the dose was reduced by a mean
SD of 10
14 units in the low-carbohydrate arm and increased
by 4
19 units in the low-fat arm (P
0.12) at 12 months."

This is a little firmer: "There was a significant increase in HDL in
the low-carbohydrate group, which occurred at 6 months and was
sustained at 12 months (Table 2)."

The limitations meant it was not exactly a stringent study:

"Several limitations should be considered in interpreting our
findings. Despite randomization, participants in the low-fat
arm were heavier at baseline than those in the low-carbohydrate arm.
Although we controlled for this imbalance statistically,
it raises the question of whether there were other unmeasured
differences between the arms. We used single-day dietary
recall or a single-day food record to assess dietary intake, either of
which is subject to bias. Participants may not have fully recalled
their dietary intake and, in addition, may have changed their dietary
intake for the day before their scheduled appointment. We did not have
objective measures of physical activity, which could be a confounder;
however, given the similarity of our findings in both groups at 1
year, it is unlikely that there were significant changes in physical
activity in either group."


Cheers, Alan, T2, Australia.
--
d&e, metformin 2000 mg
Everything in Moderation - Except Laughter.
http://loraldiabetes.blogspot.com (Food, Farmers and Factories)
http://loraltravel.blogspot.com (Noumea Revisited)
.

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