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- May 17, 2008 |
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"Novel Dietary Therapies in the Treatment of Diabetes and Cardiovascular Disease" Dana Whitham (biography)
English - 2003-10-31 - 22 minutes
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Summary :
Nutritional therapy for the type 2 diabetic patient is important, and should be chosen with the aim of reducing not only obesity but CVD risk. Many popular diets have emerged in recent years, including the low carbohydrate Atkin's diet, but how good are they for the diabetic patient?
A review of low carb diets by Bravata et al found that weight lost while on these diets was associated with reduced caloric intake and duration of the diet, but not with reduced carbohydrate consumption (1), and the weight loss caused no significant changes in BP, cholesterol, insulin or blood glucose levels. Two small, short-term studies however claim that more weight was lost on a low carb diet compared to low fat (2) and conventional (3) diets, although in the latter study this effect was no longer observed at 12 months. Long-term, larger studies are however needed to establish the safety and CVD outcomes of the low carb diet. This kind of diet is not only hard to maintain but causes ketosis, which in turn can lead to other health problems.
Low fat, high carb diets on the other hand were used in diabetes prevention trials, and are seen in countries with lower rates of obesity and heart disease. The benefits of this type of diet are discussed, as well as how modalities such as fiber content and fat type used in the diet may impact diabetes and CVD outcomes.
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Learning objectives :
The participant will review evidence on various diets, to determine which kind is appropriate for type 2 diabetics:
- Calories in versus calories out is the biggest determinant of weight
- Low fat diet results in the best metabolic parameters
- All dieters need support
Bibliographic references :
1. Bravata DM, Sanders L, Huang J, Krumholz HM, Olkin I, Gardner CD, Bravata DM. “Efficacy and safety of low-carbohydrate diets: a systematic review.”JAMA. 2003 Apr 9;289(14):1837-50.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12684364&dopt=Abstract
2. Samaha FF, Iqbal N, Seshadri P, Chicano KL, Daily DA, McGrory J, Williams T, Williams M, Gracely EJ, Stern L. “A low-carbohydrate as compared with a low-fat diet in severe obesity.” N Engl J Med. 2003 May 22;348(21):2074-81.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12761364&dopt=Abstract
3. Foster GD, Wyatt HR, Hill JO, McGuckin BG, Brill C, Mohammed BS, Szapary PO, Rader DJ, Edman JS, Klein S. "A randomized trial of a low-carbohydrate diet for obesity."
N Engl J Med. 2003 May 22;348(21):2082-90.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12761365&dopt=Abstract
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