Twelve-month outcomes of a randomized trial of a moderate-carbohydrate versus very low-carbohydrate diet in overweight adults with type 2 diabetes mellitus or prediabetes

Laura R. Saslow; Jennifer J. Daubenmier; Judith T. Moskowitz; Sarah Kim; Elizabeth J. Murphy; Stephen D. Phinney; Robert Ploutz-Snyder; Veronica Goldman; Rachel M. Cox; Ashley E. Mason; Patricia Moran; Frederick M. Hecht

doi:10.1038/s41387-017-0006-9

Twelve-month outcomes of a randomized trial of a moderate-carbohydrate versus very low-carbohydrate diet in overweight adults with type 2 diabetes mellitus or prediabetes

Laura R. Saslow^*, Jennifer J. Daubenmier, Judith T. Moskowitz, Sarah Kim, Elizabeth J. Murphy, Stephen D. Phinney, Robert Ploutz-Snyder, Veronica Goldman, Rachel M. Cox, Ashley E. Mason, Patricia Moran, Frederick M. Hecht

^*Corresponding author for this work

Medical Social Sciences

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160 Scopus citations

Abstract

Dietary treatment is important in management of type 2 diabetes or prediabetes, but uncertainty exists about the optimal diet. We randomized adults (n = 34) with glycated hemoglobin (HbA1c) > 6.0% and elevated body weight (BMI > 25) to a very low-carbohydrate ketogenic (LCK) diet (n = 16) or a moderate-carbohydrate, calorie-restricted, low-fat (MCCR) diet (n = 18). All participants were encouraged to be physically active, get sufficient sleep, and practice behavioral adherence strategies based on positive affect and mindful eating. At 12 months, participants in the LCK group had greater reductions in HbA1c levels (estimated marginal mean (EMM) at baseline = 6.6%, at 12 mos = 6.1%) than participants in MCCR group (EMM at baseline = 6.9%, at 12 mos = 6.7%), p =.007. Participants in the LCK group lost more weight (EMM at baseline = 99.9 kg, at 12 mos = 92.0 kg) than participants in the MCCR group (EMM at baseline = 97.5 kg, at 12 mos = 95.8 kg), p <.001. The LCK participants experienced larger reductions in diabetes-related medication use; of participants who took sulfonylureas or dipeptidyl peptidase-4 inhibitors at baseline, 6/10 in the LCK group discontinued these medications compared with 0/6 in the MCCR group (p =.005). In a 12-month trial, adults with elevated HbA1c and body weight assigned to an LCK diet had greater reductions in HbA1c, lost more weight, and reduced more medications than those instructed to follow an MCCR diet.

Original language	English (US)
Article number	304
Journal	Nutrition and Diabetes
Volume	7
Issue number	12
DOIs	https://doi.org/10.1038/s41387-017-0006-9
State	Published - Dec 1 2017

Funding

Thanks very much to Michael Hall for his help with running the in-person study, Carley Hauck for teaching the positive affect and mindful eating skills, and to our dedicated participants. The research was supported by a grant from the William K. Bowes, Jr. Foundation and the Mount Zion Health Fund. Laura Saslow and Ashley E. Mason were supported by National Institutes of Health grant T32AT003997 from the National Center for Complementary and Integrative Health. Laura Saslow was also supported by a K01 from the National Institute of Diabetes and Digestive and Kidney Diseases (DK107456). Ashley E. Mason was also supported by a K23 from the National Heart, Lung, and Blood Institute (HL133442). Judith Moskowitz was supported by National Institutes of Health grant K24 MH093225 from the National Institute of Mental Health. Frederick Hecht was supported by National Institutes of Health grant K24 AT007827 from National Center for Complementary and Integrative Health. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Thanks very much to Michael Hall for his help with running the in-person study, Carley Hauck for teaching the positive affect and mindful eating skills, and to our dedicated participants. The research was supported by a grant from the William K. Bowes, Jr. Foundation and the Mount Zion Health Fund. Laura Saslow and Ashley E. Mason were supported by National Institutes of Health grant T32AT003997 from the National Center for Complementary and Integrative Health. Laura Saslow was also supported by a K01 from the National Institute of Diabetes and Digestive and Kidney Diseases (DK107456). Ashley E. Mason was also supported by a K23 from the National Heart, Lung, and Blood Institute (HL133442). Judith Moskowitz was supported by National Institutes of Health grant K24 MH093225 from the National Institute of Mental Health. Frederick Hecht was supported by National Institutes of Health grant K24 AT007827 from National Center for Complementary and Integrative Health. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript

ASJC Scopus subject areas

Internal Medicine
Endocrinology, Diabetes and Metabolism

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1038/s41387-017-0006-9

Cite this

Saslow, L. R., Daubenmier, J. J., Moskowitz, J. T., Kim, S., Murphy, E. J., Phinney, S. D., Ploutz-Snyder, R., Goldman, V., Cox, R. M., Mason, A. E., Moran, P., & Hecht, F. M. (2017). Twelve-month outcomes of a randomized trial of a moderate-carbohydrate versus very low-carbohydrate diet in overweight adults with type 2 diabetes mellitus or prediabetes. Nutrition and Diabetes, 7(12), Article 304. https://doi.org/10.1038/s41387-017-0006-9

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title = "Twelve-month outcomes of a randomized trial of a moderate-carbohydrate versus very low-carbohydrate diet in overweight adults with type 2 diabetes mellitus or prediabetes",

abstract = "Dietary treatment is important in management of type 2 diabetes or prediabetes, but uncertainty exists about the optimal diet. We randomized adults (n = 34) with glycated hemoglobin (HbA1c) > 6.0% and elevated body weight (BMI > 25) to a very low-carbohydrate ketogenic (LCK) diet (n = 16) or a moderate-carbohydrate, calorie-restricted, low-fat (MCCR) diet (n = 18). All participants were encouraged to be physically active, get sufficient sleep, and practice behavioral adherence strategies based on positive affect and mindful eating. At 12 months, participants in the LCK group had greater reductions in HbA1c levels (estimated marginal mean (EMM) at baseline = 6.6%, at 12 mos = 6.1%) than participants in MCCR group (EMM at baseline = 6.9%, at 12 mos = 6.7%), p =.007. Participants in the LCK group lost more weight (EMM at baseline = 99.9 kg, at 12 mos = 92.0 kg) than participants in the MCCR group (EMM at baseline = 97.5 kg, at 12 mos = 95.8 kg), p <.001. The LCK participants experienced larger reductions in diabetes-related medication use; of participants who took sulfonylureas or dipeptidyl peptidase-4 inhibitors at baseline, 6/10 in the LCK group discontinued these medications compared with 0/6 in the MCCR group (p =.005). In a 12-month trial, adults with elevated HbA1c and body weight assigned to an LCK diet had greater reductions in HbA1c, lost more weight, and reduced more medications than those instructed to follow an MCCR diet.",

author = "Saslow, {Laura R.} and Daubenmier, {Jennifer J.} and Moskowitz, {Judith T.} and Sarah Kim and Murphy, {Elizabeth J.} and Phinney, {Stephen D.} and Robert Ploutz-Snyder and Veronica Goldman and Cox, {Rachel M.} and Mason, {Ashley E.} and Patricia Moran and Hecht, {Frederick M.}",

note = "Funding Information: Thanks very much to Michael Hall for his help with running the in-person study, Carley Hauck for teaching the positive affect and mindful eating skills, and to our dedicated participants. The research was supported by a grant from the William K. Bowes, Jr. Foundation and the Mount Zion Health Fund. Laura Saslow and Ashley E. Mason were supported by National Institutes of Health grant T32AT003997 from the National Center for Complementary and Integrative Health. Laura Saslow was also supported by a K01 from the National Institute of Diabetes and Digestive and Kidney Diseases (DK107456). Ashley E. Mason was also supported by a K23 from the National Heart, Lung, and Blood Institute (HL133442). Judith Moskowitz was supported by National Institutes of Health grant K24 MH093225 from the National Institute of Mental Health. Frederick Hecht was supported by National Institutes of Health grant K24 AT007827 from National Center for Complementary and Integrative Health. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Funding Information: Thanks very much to Michael Hall for his help with running the in-person study, Carley Hauck for teaching the positive affect and mindful eating skills, and to our dedicated participants. The research was supported by a grant from the William K. Bowes, Jr. Foundation and the Mount Zion Health Fund. Laura Saslow and Ashley E. Mason were supported by National Institutes of Health grant T32AT003997 from the National Center for Complementary and Integrative Health. Laura Saslow was also supported by a K01 from the National Institute of Diabetes and Digestive and Kidney Diseases (DK107456). Ashley E. Mason was also supported by a K23 from the National Heart, Lung, and Blood Institute (HL133442). Judith Moskowitz was supported by National Institutes of Health grant K24 MH093225 from the National Institute of Mental Health. Frederick Hecht was supported by National Institutes of Health grant K24 AT007827 from National Center for Complementary and Integrative Health. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript Publisher Copyright: {\textcopyright} 2017 The Author(s).",

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doi = "10.1038/s41387-017-0006-9",

language = "English (US)",

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Saslow, LR, Daubenmier, JJ, Moskowitz, JT, Kim, S, Murphy, EJ, Phinney, SD, Ploutz-Snyder, R, Goldman, V, Cox, RM, Mason, AE, Moran, P & Hecht, FM 2017, 'Twelve-month outcomes of a randomized trial of a moderate-carbohydrate versus very low-carbohydrate diet in overweight adults with type 2 diabetes mellitus or prediabetes', Nutrition and Diabetes, vol. 7, no. 12, 304. https://doi.org/10.1038/s41387-017-0006-9

Twelve-month outcomes of a randomized trial of a moderate-carbohydrate versus very low-carbohydrate diet in overweight adults with type 2 diabetes mellitus or prediabetes. / Saslow, Laura R.; Daubenmier, Jennifer J.; Moskowitz, Judith T. et al.
In: Nutrition and Diabetes, Vol. 7, No. 12, 304, 01.12.2017.

Research output: Contribution to journal › Article › peer-review

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AU - Daubenmier, Jennifer J.

AU - Moskowitz, Judith T.

AU - Kim, Sarah

AU - Murphy, Elizabeth J.

AU - Phinney, Stephen D.

AU - Ploutz-Snyder, Robert

AU - Goldman, Veronica

AU - Cox, Rachel M.

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AU - Moran, Patricia

AU - Hecht, Frederick M.

N1 - Funding Information: Thanks very much to Michael Hall for his help with running the in-person study, Carley Hauck for teaching the positive affect and mindful eating skills, and to our dedicated participants. The research was supported by a grant from the William K. Bowes, Jr. Foundation and the Mount Zion Health Fund. Laura Saslow and Ashley E. Mason were supported by National Institutes of Health grant T32AT003997 from the National Center for Complementary and Integrative Health. Laura Saslow was also supported by a K01 from the National Institute of Diabetes and Digestive and Kidney Diseases (DK107456). Ashley E. Mason was also supported by a K23 from the National Heart, Lung, and Blood Institute (HL133442). Judith Moskowitz was supported by National Institutes of Health grant K24 MH093225 from the National Institute of Mental Health. Frederick Hecht was supported by National Institutes of Health grant K24 AT007827 from National Center for Complementary and Integrative Health. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Funding Information: Thanks very much to Michael Hall for his help with running the in-person study, Carley Hauck for teaching the positive affect and mindful eating skills, and to our dedicated participants. The research was supported by a grant from the William K. Bowes, Jr. Foundation and the Mount Zion Health Fund. Laura Saslow and Ashley E. Mason were supported by National Institutes of Health grant T32AT003997 from the National Center for Complementary and Integrative Health. Laura Saslow was also supported by a K01 from the National Institute of Diabetes and Digestive and Kidney Diseases (DK107456). Ashley E. Mason was also supported by a K23 from the National Heart, Lung, and Blood Institute (HL133442). Judith Moskowitz was supported by National Institutes of Health grant K24 MH093225 from the National Institute of Mental Health. Frederick Hecht was supported by National Institutes of Health grant K24 AT007827 from National Center for Complementary and Integrative Health. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript Publisher Copyright: © 2017 The Author(s).

PY - 2017/12/1

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N2 - Dietary treatment is important in management of type 2 diabetes or prediabetes, but uncertainty exists about the optimal diet. We randomized adults (n = 34) with glycated hemoglobin (HbA1c) > 6.0% and elevated body weight (BMI > 25) to a very low-carbohydrate ketogenic (LCK) diet (n = 16) or a moderate-carbohydrate, calorie-restricted, low-fat (MCCR) diet (n = 18). All participants were encouraged to be physically active, get sufficient sleep, and practice behavioral adherence strategies based on positive affect and mindful eating. At 12 months, participants in the LCK group had greater reductions in HbA1c levels (estimated marginal mean (EMM) at baseline = 6.6%, at 12 mos = 6.1%) than participants in MCCR group (EMM at baseline = 6.9%, at 12 mos = 6.7%), p =.007. Participants in the LCK group lost more weight (EMM at baseline = 99.9 kg, at 12 mos = 92.0 kg) than participants in the MCCR group (EMM at baseline = 97.5 kg, at 12 mos = 95.8 kg), p <.001. The LCK participants experienced larger reductions in diabetes-related medication use; of participants who took sulfonylureas or dipeptidyl peptidase-4 inhibitors at baseline, 6/10 in the LCK group discontinued these medications compared with 0/6 in the MCCR group (p =.005). In a 12-month trial, adults with elevated HbA1c and body weight assigned to an LCK diet had greater reductions in HbA1c, lost more weight, and reduced more medications than those instructed to follow an MCCR diet.

AB - Dietary treatment is important in management of type 2 diabetes or prediabetes, but uncertainty exists about the optimal diet. We randomized adults (n = 34) with glycated hemoglobin (HbA1c) > 6.0% and elevated body weight (BMI > 25) to a very low-carbohydrate ketogenic (LCK) diet (n = 16) or a moderate-carbohydrate, calorie-restricted, low-fat (MCCR) diet (n = 18). All participants were encouraged to be physically active, get sufficient sleep, and practice behavioral adherence strategies based on positive affect and mindful eating. At 12 months, participants in the LCK group had greater reductions in HbA1c levels (estimated marginal mean (EMM) at baseline = 6.6%, at 12 mos = 6.1%) than participants in MCCR group (EMM at baseline = 6.9%, at 12 mos = 6.7%), p =.007. Participants in the LCK group lost more weight (EMM at baseline = 99.9 kg, at 12 mos = 92.0 kg) than participants in the MCCR group (EMM at baseline = 97.5 kg, at 12 mos = 95.8 kg), p <.001. The LCK participants experienced larger reductions in diabetes-related medication use; of participants who took sulfonylureas or dipeptidyl peptidase-4 inhibitors at baseline, 6/10 in the LCK group discontinued these medications compared with 0/6 in the MCCR group (p =.005). In a 12-month trial, adults with elevated HbA1c and body weight assigned to an LCK diet had greater reductions in HbA1c, lost more weight, and reduced more medications than those instructed to follow an MCCR diet.

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Twelve-month outcomes of a randomized trial of a moderate-carbohydrate versus very low-carbohydrate diet in overweight adults with type 2 diabetes mellitus or prediabetes

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UN SDGs

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