Low Carbohydrate and Other Nontraditional Dietary Approaches

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Among the general public, as well as those with type 2 diabetes, there has been a recent increased interest in the use of low-carbohydrate diets for OW/OB intervention. Klein et al. (8) summarizes five randomized trials in adults (34-38), comparing subjects assigned to a low-fat diet (~ 25 percent to 30 percent Kcal from fat and 55 percent to 60 percent Kcal from carbohydrate) to subjects randomly assigned to a low-carbohydrate, high-protein, high-fat diet (~ 25 percent to 40 percent of Kcal from carbohydrate). Subjects on the low-carbohydrate diet lost more weight in the short term (six months) but not the long term (12 months). In addition, glycemic control was found to be better (35, 37) and some serum lipids were improved. While these studies may offer promising dietary alternatives for those who are OW/OB, additional studies of long-term safety and efficacy are needed before low-carbohydrate diets are recommended as a WR strategy for OW/OB individuals with type 2 diabetes.

Other dietary strategies may also offer promise. It has been recently suggested that a high-monounsaturated-fat diet would help avoid the risk of plasma triacyl-glycerol- and glucose-elevating effects of a high-carbohydrate diet, while still providing less saturated fat and cholesterol than a low-carbohydrate/high-fat regimen (27).

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