Low-fat low-carb mediterranean comparison
in [Diabetes Management]
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From: Alan S on 17 Jul 2008 02:30 Just out today in the NEJM: http://content.nejm.org/cgi/content/full/359/3/229?query=TOC Weight Loss with a Low-Carbohydrate, Mediterranean, or Low-Fat Diet There is a longer version on the link. There is an editorial comment in Journal Watch here: http://cardiology.jwatch.org/cgi/content/full/2008/716/1 A significant point that might be missed by commentators is this (my capitals for emphasis): "one of three diets: low-fat, RESTRICTED-calorie; Mediterranean, RESTRICTED-calorie; or low-carbohydrate, NON–RESTRICTED-calorie. " Additionally, although the focus was weight loss they also looked at glucose and insulin. Figure 4 is interesting, http://content.nejm.org/content/vol359/issue3/images/large/04f4.jpeg with surprising advantages for the Mediterranean over the low-carb. I wonder if anyone looked at the differences in specific menus, especially breakfasts. "ABSTRACT Background Trials comparing the effectiveness and safety of weight-loss diets are frequently limited by short follow-up times and high dropout rates. Methods In this 2-year trial, we randomly assigned 322 moderately obese subjects (mean age, 52 years; mean body-mass index [the weight in kilograms divided by the square of the height in meters], 31; male sex, 86%) to one of three diets: low-fat, restricted-calorie; Mediterranean, restricted-calorie; or low-carbohydrate, non–restricted-calorie. Results The rate of adherence to a study diet was 95.4% at 1 year and 84.6% at 2 years. The Mediterranean-diet group consumed the largest amounts of dietary fiber and had the highest ratio of monounsaturated to saturated fat (P<0.05 for all comparisons among treatment groups). The low-carbohydrate group consumed the smallest amount of carbohydrates and the largest amounts of fat, protein, and cholesterol and had the highest percentage of participants with detectable urinary ketones (P<0.05 for all comparisons among treatment groups). The mean weight loss was 2.9 kg for the low-fat group, 4.4 kg for the Mediterranean-diet group, and 4.7 kg for the low-carbohydrate group (P<0.001 for the interaction between diet group and time); among the 272 participants who completed the intervention, the mean weight losses were 3.3 kg, 4.6 kg, and 5.5 kg, respectively. The relative reduction in the ratio of total cholesterol to high-density lipoprotein cholesterol was 20% in the low-carbohydrate group and 12% in the low-fat group (P=0.01). Among the 36 subjects with diabetes, changes in fasting plasma glucose and insulin levels were more favorable among those assigned to the Mediterranean diet than among those assigned to the low-fat diet (P<0.001 for the interaction among diabetes and Mediterranean diet and time with respect to fasting glucose levels). Conclusions Mediterranean and low-carbohydrate diets may be effective alternatives to low-fat diets. The more favorable effects on lipids (with the low-carbohydrate diet) and on glycemic control (with the Mediterranean diet) suggest that personal preferences and metabolic considerations might inform individualized tailoring of dietary interventions." Cheers, Alan, T2, Australia. -- d&e, metformin 1500mg, ezetrol 10mg Everything in Moderation - Except Laughter. http://loraldiabetes.blogspot.com http://www.flickr.com/photos/alan_s/ http://loraltravel.blogspot.com (The Red Fort, Agra)
From: Alan S on 17 Jul 2008 02:43 On Thu, 17 Jul 2008 16:30:27 +1000, Alan S <loralgtweightandcarbs(a)gmail.com> wrote: >"one of three diets: low-fat, RESTRICTED-calorie; >Mediterranean, RESTRICTED-calorie; or low-carbohydrate, >NON–RESTRICTED-calorie. " A PS The broad details of the three diets are in a Supplementary Annex: http://content.nejm.org/cgi/data/359/3/229/DC1/1 Low Fat Energy restricted Total fat <= 30% Saturated fat <= 10% Dietary cholesterol < 300 mg Carbohydrates Not restricted, whole grains recommended Mediterranean Energy restricted Total fat <= 35% Saturated fat <= 10% Dietary cholesterol < 300 mg Carbohydrates Not restricted, whole grains recommended Specific food items added to Mediterranean only: a. 30-45gr extra virgin olive oil/day b. a handful (5-7) of nuts /day c. 2 fish meals/wk Low Carb Energy Non-restricted Total fat Non-restricted Saturated fat: "not specifically restricted, but moderation recommended, as well as reduced trans fat" Dietary cholesterol not specifically restricted Carbohydrates Restricted "< 20gr in induction phases. Gradually added to maximum of 120gr/day to maintain achieved weight loss". Cheers, Alan, T2, Australia. -- d&e, metformin 1500mg, ezetrol 10mg Everything in Moderation - Except Laughter. http://loraldiabetes.blogspot.com http://www.flickr.com/photos/alan_s/ http://loraltravel.blogspot.com (The Red Fort, Agra)
From: Alan S on 17 Jul 2008 02:53 On Thu, 17 Jul 2008 16:30:27 +1000, Alan S <loralgtweightandcarbs(a)gmail.com> wrote: >Additionally, although the focus was weight loss they also >looked at glucose and insulin. Figure 4 is interesting, >http://content.nejm.org/content/vol359/issue3/images/large/04f4.jpeg >with surprising advantages for the Mediterranean over the >low-carb. I wonder if anyone looked at the differences in >specific menus, especially breakfasts. A PPS (I'm adding notes as I see points:-) Despite the above - the A1c effect was interesting, although not unexpected for us: "Among the participants with diabetes, the proportion of glycated hemoglobin at 24 months decreased by 0.4�1.3% in the low-fat group, 0.5�1.1% in the Mediterranean-diet group, and 0.9�0.8% in the low-carbohydrate group. The changes were significant (P<0.05) only in the low-carbohydrate group (P=0.45 for the comparison among groups)." The disparity between the Fig 4 insulin and FBG tables and that comment does not appear to have been commented on. Cheers, Alan, T2, Australia. -- d&e, metformin 1500mg, ezetrol 10mg Everything in Moderation - Except Laughter. http://loraldiabetes.blogspot.com http://www.flickr.com/photos/alan_s/ http://loraltravel.blogspot.com (The Red Fort, Agra)
From: Nick Cramer on 17 Jul 2008 05:33 Alan S <loralgtweightandcarbs(a)gmail.com> wrote: > On Thu, 17 Jul 2008 16:30:27 +1000, Alan S > [ . . . ] Thanks, Alan. I've suggested to my daughter that she look at the Mediterranian diet (not diabetes friendly) for her kids. Comments? http://www.oldwayspt.org/med_pyramid.html Take care. -- Nick. Support severely wounded and disabled Veterans and their families! I've known US vets who served as far back as the Spanish American War. They are all my heroes! Thank a Veteran and Support Our Troops. You are not forgotten. Thanks ! ! ~Semper Fi~
From: Alan S on 17 Jul 2008 09:28
On 17 Jul 2008 09:33:13 GMT, Nick Cramer <n_cramerSPAM(a)pacbell.net> wrote: >Alan S <loralgtweightandcarbs(a)gmail.com> wrote: >> On Thu, 17 Jul 2008 16:30:27 +1000, Alan S >> [ . . . ] > >Thanks, Alan. I've suggested to my daughter that she look at the >Mediterranian diet (not diabetes friendly) for her kids. Comments? > >http://www.oldwayspt.org/med_pyramid.html > >Take care. I'm a bit biased; that version has pasta and bread on the base. To me that's not just "not diabetes friendly", it's not human friendly with what I know now. For non-diabetics a modicum of pasta and bread isn't a major problem but to make it the base of the pyramid is going too far for me. Additionally, as someone else mentioned recently, keep in mind that European breads may be quite different in GL when compared with your local bread. Cheers, Alan, T2, Australia. -- d&e, metformin 1500mg, ezetrol 10mg Everything in Moderation - Except Laughter. http://loraldiabetes.blogspot.com http://www.flickr.com/photos/alan_s/ http://loraltravel.blogspot.com (The Red Fort, Agra) |