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. Issue 7 (July 2022)

• Record Type: Journal Article
• Authors: Jensen, Nicole Jacqueline; Wodschow, Helena Zander; Skytte, Mads Juul; Samkani, Amirsalar; Astrup, Arne; Frystyk, Jan; Hartmann, Bolette; Holst, Jens Juul; Larsen, Thomas Meinert; Madsbad, Sten; Magkos, Faidon; Miskowiak, Kamilla Woznica; Haugaard, Steen Bendix; Krarup, Thure; Rungby, Jørgen; Thomsen, Mads Norvin
• Is Part Of: Clinical nutrition. Volume 41:Issue 7(2022)
• Page Start: 1605
• Page End: 1612
• Publication Date: 2022-07
• Subjects: Carbohydrate restriction -- Cognition -- Dietary intervention -- Health-related quality of life -- Type 2 diabetes -- Weight loss; CD Conventional diabetes -- CGM Continuous glucose monitoring -- CRHP Carbohydrate-reduced high-protein -- CV Coefficient of variation -- E% Percentage of energy intake -- HOMA2-IR Homeostatic Model Assessment 2 for insulin resistance -- HRQoL Health-related quality of life -- IPAQ International Physical Activity Questionnaire -- MCS Mental component summary -- PCS Physical component summary -- RAVLT Rey Auditory Verbal Learning Test -- SDMT Symbol Digit Modalities Test -- SF-36 Short form 36 -- T2D Type 2 diabetes -- TBR Time below range -- TMT Trail Making Test; Critically ill -- Nutrition -- Periodicals; Diet therapy -- Periodicals; Parenteral feeding -- Periodicals; Enteral feeding -- Periodicals; Enteral Nutrition -- Periodicals; Parenteral Nutrition -- Periodicals; Metabolism -- Periodicals; Diétothérapie -- Périodiques; Alimentation parentérale -- Périodiques; Alimentation entérale -- Périodiques; Nutrition -- Périodiques; Diet therapy; Enteral feeding; Nutrition; Parenteral feeding; Electronic journals; Periodicals; Electronic journals; 615.854
• DOI: 10.1016/j.clnu.2022.05.005
• Languages: English
• ISSNs: 0261-5614

Abstract

Summary: 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, HbA1c : 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.