Type 2 diabetes patients on a low-carb diet had improvements in physical function, pain reduction, and overall health after 12 months….
Researchers compared the effects on health-related quality of life (HRQoL) of a 2-year intervention with a low-fat diet (LFD) or a low-carbohydrate diet (LCD) based on four group-meetings to achieve compliance.
The prospective, randomized trial recruited 61 men and women with an average age of 62-years and average type 2 diabetes duration of 9.5-years. The generic Short Form-36 (SF-36) questionnaire, designed to measure individuals HRQoL, was administered at baseline, 6-, 12-, & 24-months. Mean body-mass-index was 32.7 ± 5.4 kg/m2 at baseline. Weight-loss did not differ between groups and was maximal at 6 months, LFD: -3.99 ± 4.1 kg, LCD: -4.31 ± 3.6 kg, (p < 0.001 within groups). There was an increase in the physical component score of SF-36 from 44.1 (10.0) to 46.7 (10.5) at 12 months in the LCD group (p < 0.009) while no change occurred in the LFD group (p < 0.03 between groups). At 12 months the physical function, bodily pain and general health scores improved within the LCD group (p values 0.042-0.009) while there was no change within the LFD group.
By 6-months, there were no changes in any of the SF-36 domains from baseline for either group. However, at 12-months the low-carb group showed significant improvements in “physical function,” “bodily pain,” “vitality,” and the combined “Physical Component Score (PCS),” while the low-fat group continued to lack any changes. At 24-months neither group had any significant changes from baseline. Interestingly, the changes in PCS for the low-fat group only was inversely associated with changes in BMI and HbA1c, and there were no associations between regain of body weight from 6 to 12 months and changes of SF-36 variables.
The authors concluded that weight-changes did not differ between the diet groups while improvements in HRQoL only occurred after one year during treatment with LCD. No changes of HRQoL occurred in the LFD group in spite of a similar reduction in body weight.
The authors commented, “Arguably, the best diet is the one that you can stick with. While most studies comparing low-fat to low-carbohydrate diets, including the one at hand, have found similar weight loss outcomes, other factors affecting health may differ between the two. In diabetics, for example, it has been demonstrated that a diet of 50/20/30 FAT/CHO/PRO is superior to an isocaloric 30/55/15 diet for blood glucose regulation in type 2 diabetics despite identical weight-loss.”
Comment from Richard K. Bernstein, M.D., F.A.C.E., F.A.C.N., C.W.S., FCCWS, author of Diabetes Solution: Interesting results. But it was a small study published in a minor journal. While using less carbohydrate than the low fat group, the lower carbohydrate group was not on what we consider a LOW CARBOHYDRATE diet. It certainly suggests that further studies should be pursued.
Received in revised form: July 29, 2014; Accepted: August 30, 2014; Published Online: September 18, 2014 DOI: http://dx.doi.org/10.1016/j.diabres.2014.08.032