A low carbohydrate Mediterranean diet improves cardiovascular risk factors and diabetes control among overweight patients with type 2 diabetes mellitus: a 1-year prospective randomized intervention study
Article first published online: 22 SEP 2009
© 2010 Blackwell Publishing Ltd
Diabetes, Obesity and Metabolism
Volume 12, Issue 3, pages 204–209, March 2010
How to Cite
Elhayany, A., Lustman, A., Abel, R., Attal-Singer, J. and Vinker, S. (2010), A low carbohydrate Mediterranean diet improves cardiovascular risk factors and diabetes control among overweight patients with type 2 diabetes mellitus: a 1-year prospective randomized intervention study. Diabetes, Obesity and Metabolism, 12: 204–209. doi: 10.1111/j.1463-1326.2009.01151.x
- Issue published online: 31 JAN 2010
- Article first published online: 22 SEP 2009
- Date submitted 16 April 2009; date of first decision 29 July 2009; date of final acceptance 07 August 2009
- cardiovascular risk;
- diabetes mellitus;
- dietary intervention;
- Mediterranean diet
Background: The appropriate dietary intervention for overweight persons with type 2 diabetes mellitus (DM2) is unclear. Trials comparing the effectiveness of diets are frequently limited by short follow-up times and high dropout rates.
Aim: The effects of a low carbohydrate Mediterranean (LCM), a traditional Mediterranean (TM), and the 2003 American Diabetic Association (ADA) diet were compared, on health parameters during a 12-month period.
Methods: In this 12-month trial, 259 overweight diabetic patients (mean age 55 years, mean body mass index 31.4 kg/m2) were randomly assigned to one of the three diets. The primary end-points were reduction of fasting plasma glucose, HbA1c and triglyceride (TG) levels.
Results: 194 patients out of 259 (74.9%) completed follow-up. After 12 months, the mean weight loss for all patients was 8.3 kg: 7.7 kg for ADA, 7.4 kg for TM and 10.1 kg for LCM diets. The reduction in HbA1c was significantly greater in the LCM diet than in the ADA diet (−2.0 and −1.6%, respectively, p < 0.022). HDL cholesterol increased (0.1 mmol/l ± 0.02) only on the LCM (p < 0.002). The reduction in serum TG was greater in the LCM (−1.3 mmol/l) and TM (−1.5 mmol/l) than in the ADA (−0.7 mmol/l), p = 0.001.
Conclusions: An intensive 12-month dietary intervention in a community-based setting was effective in improving most modifiable cardiovascular risk factors in all the dietary groups. Only the LCM improved HDL levels and was superior to both the ADA and TM in improving glycaemic control.