Advice to follow a low-carbohydrate diet has a favourable impact on low-grade inflammation in type 2 diabetes compared with advice to follow a low-fat diet

Figures & data

Figure 1. Flow diagram of the study.

Table I. Clinical and laboratory characteristics of the two intervention groups at baseline.

	LFD n = 31	LCD n = 30	P
Age, years	63 (11)	61 (9.5)	NS
Male/female, n	13/18	14/16	NS
Duration of diabetes, years	8.8 (6.2)	9.8 (5.5)	NS
Dietary treatment only, n (%)	2 (6.5)	2 (6.7)	NS
Oral glucose-lowering treatment only, n (%)	13 (42)	15 (50)	NS
Oral medication + insulin, n (%)	11 (35)	10 (33)	NS
Insulin only, n (%)	5 (16)	3 (10)	NS
Total insulin dose, E	39 (51)	42 (65)	NS
Metformin dose, mg	1435 (946)	1375 (950)	NS
Glibenclamide dose, mg	0.4 (1.9)	1.1 (2.6)	NS

If not stated otherwise, data are given as mean (SD).

LCD = low-carbohydrate diet; LFD = low-fat diet.

Table II. Dietary outcomes at baseline and 6 months in the two intervention groups (P values ≥ 0.10 are listed as non-significant, NS).

	LFD n = 31	LCD n = 30	P between groups
Energy intake, kJ
Baseline	1809 (493)	1690 (426)	NS
6 months	1553 (427)	1384 (366)	NS
P within group	< 0.01	< 0.001
Fat, E%
Baseline	32 (5.2)	39 (6.8)	< 0.001
6 months	29 (5.4)	49 (7.5)	< 0.001
P within group	NS	< 0.001
Carbohydrate, E%
Baseline	49 (5.6)	41 (11)	< 0.01
6 months	49 (5.9)	25 (8.4)	< 0.001
P within group	NS	< 0.001
Protein, E%
Baseline	19 (3.4)	19 (2.8)	NS
6 months	20 (3.5)	23 (3.7)	< 0.01
P within group	< 0.05	< 0.001
Total fat, g
Baseline	66 (23)	74 (23)	NS
6 months	53 (24)	79 (25)	< 0.001
P within group	< 0.05	NS
Saturated fat, E%
Baseline	13 (2.7)	16 (4.1)	NS
6 months	11 (2.1)	20 (3.7)	< 0.001
P within group	NS	< 0.001
Unsaturated fat, E%
Baseline	12 (2.2)	14 (2.8)	NS
6 months	11 (2.5)	18 (3.2)	< 0.001
P within group	NS	< 0.001
Polyunsaturated fat, E%
Baseline	5.2 (1.5)	5.9 (2.6)	NS
6 months	5.1 (1.9)	7.7 (2.4)	< 0.05
P within group	NS	< 0.001
Total carbohydrates, g
Baseline	213 (64)	167 (56)	< 0.05
6 months	182 (51)	82 (28)	< 0.001
P within group	< 0.05	< 0.001
Fibres, E%
Baseline	2.6 (0.6)	2.4 (0.7)	NS
6 months	2.8 (0.7)	2.2 (0.7)	< 0.01
P within group	NS	< 0.05
Monosaccharides, E%
Baseline	7.2 (3.1)	6.2 (3.0)	NS
6 months	8.1 (2.9)	4.0 (2.1)	< 0.001
P within group	NS	< 0.001
Disaccharides, E%
Baseline	8.7 (1.9)	8.3 (2.6)	NS
6 months	9.1 (2.8)	5.4 (2.8)	< 0.001
P within group	NS	< 0.001
Saccharose, E%
Baseline	5.5 (1.5)	4.9 (2.5)	NS
6 months	5.2 (1.9)	2.5 (1.6)	< 0.001
P within group	NS	< 0.001

Data are given as mean (SD).

E% = energy %; LCD = low-carbohydrate diet; LFD = low-fat diet.

Table III. Values of body mass index (BMI), HbA1c, and lipids at baseline and 6 months in the two intervention groups.

	LFD n = 30	LCD n = 29	P between groups
BMI, kg/m^2
Baseline	34 (5.7)	32 (5.1)	NS
6 months	32 (5.5)	30 (5.1)	NS
P within group	< 0.001	< 0.001
HbA1c, mmol/mol
Baseline	56 (8.0)	57 (8.6)	NS
6 months	55 (9.7)	53 (9.8)	NS
P within group	NS	< 0.01
Total cholesterol, mmol/L
Baseline	4.3 (1.0)	4.5 (1.0)	NS
6 months	4.2 (1.1)	4.4 (1.1)	NS
P within group	NS	NS
LDL cholesterol, mmol/L
Baseline	2.4 (0.7)	2.7 (0.9)	NS
6 months	2.3 (0.8)	2.5 (0.8)	NS
P within group	NS	NS
HDL cholesterol, mmol/L
Baseline	1.1 (0.3)	1.1 (0.3)	NS
6 months	1.1 (0.3)	1.2 (0.5)	NS
P within group	NS	< 0.05
Triglycerides mmol/L
Baseline	1.8 (0.8)	1.7 (1.4)	NS
6 months	1.8 (1.3)	1.5 (1.2)	NS
P within group	NS	NS

Data are given as mean (SD).

LCD = low-carbohydrate diet; LFD = low-fat diet.

Table IV. Levels of inflammatory markers at baseline and 6 months in the two intervention groups.

	LFD n = 30	LCD n = 29	P between groups
CRP, mg/L
Baseline	1.41 (0.45–4.01)	1.12 (0.37–3.32)	NS
6 months	1.67 (0.80–3.24)	0.87 (0.29–2.74)	NS
P within group	NS	NS
IL-1Ra, pg/mL
Baseline	1333 (784–2153)	1298 (818–1873)	NS
6 months	1216 (974–1822)	978 (664–1385)	< 0.05
P within group	NS	< 0.01
IL-6, pg/mL
Baseline	2.16 (1.77–3.59)	2.45 (1.39–4.10)	NS
6 months	3.39 (2.25–4.79)	2.15 (1.65–4.270)	< 0.05
P within group	< 0.05	NS
TNFR1, ng/mL
Baseline	1371 (1227–1760)	1340 (1149–1637)	NS
6 months	1423 (1200–1687)	1320 (1145–1610)	NS
P within group	NS	NS
TNFR2, ng/mL
Baseline	2627 (2162–3150)	2530 (2094–2973)	NS
6 months	2680 (2322–2968)	2480 (2266–2927)	NS
P within group	0.064	NS

Data are given as median (interquartile range). P values ≥ 0.10 are listed as non-significant (NS).

LCD = low-carbohydrate diet; LFD = low-fat diet.