High fat diets for weight loss among subjects with elevated fasting glucose levels: The PREDIMED study. (June 2020)

• Record Type: Journal Article
• Authors: Hjorth, Mads F.; Corella, Dolores; Astrup, Arne; Ruiz-Canela, Miguel; Salas-Salvado, Jordi; Fito, Montserrat; Martínez-González, Julio; Romaguera, Dora; Lapetra, José; Estruch, Ramón; Serra-Majem, Luis; Pinto, Xavier; Alonso-Gómez, Ángel; Martínez, J. Alfredo; Martínez-González, Miguel A.
• Is Part Of: Obesity medicine. Volume 18(2020)
• Publication Date: 2020-06
• Subjects: Mediterranean diet -- High-fat diet -- Type 2 diabetes -- Glucose -- Weight loss; Obesity -- Periodicals; Obesity; Obesity; Periodicals; Periodicals; 616.398005
• DOI: 10.1016/j.obmed.2020.100210
• Languages: English
• ISSNs: 2451-8476

Abstract

Abstract: Aim: We studied fasting plasma glucose (FPG) as a determinant of weight change on high-fat diets in the PREDIMED trial. Methods: A total of 3, 622 participants were randomized to receive one of two Mediterranean diets (n = 2, 616) or a control diet (n = 1, 006) for 5 years and had complete data for baseline FPG and body-weight development. Weight change by pre-treatment FPG categories (<100 mg/dL; 100–114.9 mg/dL; 115–125.9 mg/dL; ≥126 mg/dL) were examined. Results: The two Mediterranean diets contained 41.5 E% fat, 16.5 E% protein, and 40 E% carbohydrate whereas the control diet contained 37.8 E% fat, 16.8 E% protein and 43.2 E% carbohydrate. In the Mediterranean diet groups, participants with FPG≥115 lost 1.04 kg (95% CI 0.68; 1.41, n = 1115) whereas participants with FPG<115 mg/dL lost 0.30 kg (95% CI -0.01; 0.60, n = 1501) resulting in a between-group difference of 0.75 kg (95% CI 0.20; 1.30, P = 0.007). Similar, although none-significant, between-group difference was observed in the control group [0.70 kg (95% CI -0.25; 1.65, P = 0.15)]. Conclusions: Participants with elevated pre-treatment FPG lost more weight than participants with lower FPG on these three moderate to high fat diets. Although the effect size is small, results are important as these individuals represent those in most need of weight loss. Highlights: Optimal macronutrient composition for weight loss among patients with type 2 diabetes is controversial. Dietary weight loss effects are mainly observed in short and well controlled studies. Patients with elevated fasting glucose lost more weight than those with low fasting glucose on a Mediterranean diet. Although the effect size was small, an effect was observed during a 5 year ad libitum diet. Results are important as these individuals represent those in most need of weight loss.