Weight-loss induced by carbohydrate restriction does not negatively affect health-related quality of life and cognition in people with type 2 diabetes: A randomised controlled trial.

Autor: Jensen NJ; Department of Endocrinology, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark., Wodschow HZ; Department of Endocrinology, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark., Skytte MJ; Department of Endocrinology, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark., Samkani A; Department of Endocrinology, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark., Astrup A; Healthy Weight Center, Novo Nordisk Foundation, Hellerup, Denmark., Frystyk J; Department of Endocrinology, Odense University Hospital, Odense, Denmark; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark., Hartmann B; Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark; Novo Nordisk Foundation Centre for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark., Holst JJ; Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark; Novo Nordisk Foundation Centre for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark., Larsen TM; Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark., Madsbad S; Department of Endocrinology, Copenhagen University Hospital Hvidovre, Copenhagen, Denmark., Magkos F; Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark., Miskowiak KW; Department of Psychology, University of Copenhagen, Copenhagen, Denmark; Psychiatric Centre Copenhagen, Rigshospitalet, Mental Health Services, Capital Region of Denmark, Denmark., Haugaard SB; Department of Endocrinology, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark., Krarup T; Department of Endocrinology, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark; Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark., Rungby J; Department of Endocrinology, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark; Copenhagen Center for Translational Research, Copenhagen University Hospital Bispebjerg Frederiksberg, Copenhagen, Denmark; Steno Diabetes Center Copenhagen, Copenhagen, Denmark., Thomsen MN; Department of Endocrinology, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark. Electronic address: mads.norvin.thomsen@regionh.dk.
Jazyk: angličtina
Zdroj: Clinical nutrition (Edinburgh, Scotland) [Clin Nutr] 2022 Jul; Vol. 41 (7), pp. 1605-1612. Date of Electronic Publication: 2022 May 18.
DOI: 10.1016/j.clnu.2022.05.005
Abstrakt: Background & Aims: We evaluated the effect of weight loss induced by dietary carbohydrate restriction on health-related quality of life (HRQoL) and cognition in type 2 diabetes (T2D).
Methods: In this randomised parallel trial, 72 adults with T2D and overweight/obesity (mean ± SD, HbA 1c : 57 ± 8 mmol/mol and BMI: 33 ± 5 kg/m 2 ) were randomly assigned to a carbohydrate-reduced high-protein diet (CRHP: C30E%-P30E%-F40E%) or conventional diabetes diet (CD: C50E%-P17E%-F33E%) for 6 weeks, targeting a 6% weight loss. HRQoL was assessed from the short form 36 (SF-36) questionnaire, including physical and mental component summary (PCS and MCS) scores; global cognition, verbal memory, attention and psychomotor speed, and executive function were assessed from a neuropsychological test battery.
Results: Both diet groups achieved a 5.8 kg weight loss and improved PCS (median [25th;75th percentiles], CD: 2.7 [1.1; 4.2] vs. CRHP: 2.1 [0.7; 3.7]), with no difference between diets. The CRHP diet resulted in a clinically relevant improvement of MCS, albeit non-significantly different compared with the change after the CD diet (2.0 [-0.7; 4.8], p = 0.15). Global cognition, attention, and verbal memory were unaffected by the CRHP diet, which selectively worsened the Symbol Digit Modality Test assessing psychomotor speed when compared with the CD diet (-4.1 [-7.2;-1.1], p < 0.01).
Conclusion: Physical health improved by weight loss independently of macronutrient distribution, while mental health and cognition may be affected by the amount of carbohydrate, protein and fat in the diet. Collectively, our data suggest that weight loss through moderate carbohydrate restriction has no clinically important impact on HRQoL and global cognition in patients with T2D. Registered under ClinicalTrials.gov Identifier no. NCT03814694.
Competing Interests: Conflict of interest A.A. is currently employed by The Novo Nordisk Foundation to establish a National Centre for Healthy Weight and is a member of advisory board/consultant for: Gelesis, USA; Groupe Éthique et Santé, France; Weight Watchers, USA. A.A. is co-owner of the University of Copenhagen spin-off Flax-Slim ApS andco-inventor on a pending provisional patent application for the use of biomarkers to predict responses to weight-loss diets and other related patents and patent applications that are all owned by the University of Copenhagen in accordance with Danish law. A.A. is co-author of a number of diet and cookery books, including books on personalised diet but is not an advocate or activist for specific diets, and is not strongly committed to any specific diet. T.M.L. is advisor for the “Sense” diet program. The remaining authors have no conflicts of interest to declare.
(Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.)
Databáze: MEDLINE
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