Abstract:
BACKGROUND/OBJECTIVES:Recently, the role of a low-carbohydrate diet in diabetes management has generated interest with claims being made regarding its superiority over the traditional high-carbohydrate, low-fat dietary approach. This systematic review and meta-analysis evaluated the interpretation and effect of a low-carbohydrate diet in the management of type 2 diabetes. SUBJECTS/METHODS:Randomised controlled trials were searched for which included adults with type 2 diabetes aged 18 years or more. The intervention was a low-carbohydrate diet as defined by the author compared to a control group of usual care. MEDLINE, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials, ISRCTN, ProQuest and opengrey.eu were searched. Independent experts were contacted and reference lists of selected papers were checked. Results were analysed descriptively and meta-analyses were completed to include trials that presented data at 1 year. RESULTS:Eighteen studies (n = 2204) were eligible for inclusion within the systematic review. The definition of a low-carbohydrate diet varied. At trial end, the descriptive analysis suggested that the low-carbohydrate intervention arm (LCIA) may promote favourable outcomes in terms of HbA1c, triglycerides and HDL cholesterol. The LCIA demonstrated reduced requirements for diabetes medication, which may have reduced the observed benefit of dietary carbohydrate restriction on HbA1c. Seven studies provided data to be included in the meta-analyses at 1 year. The meta-analyses showed statistical significance in favour of the LCIA for HbA1c (estimated effect = -0.28%, 95% CI -0.53 to -0.02, p = 0.03; χ 2 = 13.15, df = 6, p = 0.03; I 2 = 54%), HDL cholesterol (estimated effect = 0.06 mmol/L, 95% CI 0.04-0.09, p < 0.00001; χ 2 = 6.05, df = 6, p = 0.42; I 2 = 1%), triglycerides (estimated effect = -0.24 mmol/L, 95% CI -0.35 to -0.13, p < 0.0001; χ 2 = 1.88, df = 6, p = 0.93; I 2 = 0%) and systolic blood pressure (estimated effect = -2.74 mmHg, 95% CI -5.27 to -0.20, p = 0.03; χ 2 = 10.54, df = 6, p = 0.10; I 2 = 43%). Meta-analyses for weight, total cholesterol, LDL cholesterol and diastolic blood pressure did not demonstrate a statistically significant difference between interventions. Dietary adherence was an issue in most studies. A very low-carbohydrate diet (<50 g/day) seems unrealistic in this population, however, a low-carbohydrate diet (<130 g/day) appears to be achievable. Improved clinical outcomes were observed in some studies as a result of achieving a low- or moderate-carbohydrate diet. Fifteen out of 18 studies were considered high risk of bias, with performance bias being a common issue. CONCLUSIONS:Reducing dietary carbohydrate may produce clinical improvements in the management of type 2 diabetes. Further research is needed to understand the true effect of dietary carbohydrate restriction on HbA1c independent of medication reduction and to address known issues with adherence to this dietary intervention. Clarity is needed regarding appropriate classification of a low-carbohydrate diet.
journal_name
Eur J Clin Nutrjournal_title
European journal of clinical nutritionauthors
Huntriss R,Campbell M,Bedwell Cdoi
10.1038/s41430-017-0019-4subject
Has Abstractpub_date
2018-03-01 00:00:00pages
311-325issue
3eissn
0954-3007issn
1476-5640pii
10.1038/s41430-017-0019-4journal_volume
72pub_type
杂志文章,meta分析abstract:OBJECTIVE:To assess the effect of cigarette smoking on the relationship between dietary intake and circulating levels of beta-carotene. DESIGN:A secondary analysis of data collected for the Diet and Nutritional Survey of British Adults by The Department of Health and The Ministry of Agriculture, Fisheries and Food; th...
journal_title:European journal of clinical nutrition
pub_type: 杂志文章
doi:
更新日期:1996-04-01 00:00:00
abstract:OBJECTIVE:To evaluate dietary habits and nutritional status of Spanish school children and adolescents, and their relationship with the Mediterranean Diet. DESIGN:Cross-sectional study by face-to-face interview. SETTING:Free living children and adolescents of all Spanish regions. SUBJECTS:A random sample of 3166 peo...
journal_title:European journal of clinical nutrition
pub_type: 杂志文章
doi:10.1038/sj.ejcn.1601812
更新日期:2003-09-01 00:00:00
abstract::Some studies on energy metabolism of men and women in Third World countries suggested that their basal metabolic rate (BMR) is lower compared to BMRs of people in Northern European and American countries. It is, however, not clear whether this results from ethnic factors, climate or adaptation to, for instance, a low ...
journal_title:European journal of clinical nutrition
pub_type: 杂志文章
doi:
更新日期:1988-12-01 00:00:00
abstract:BACKGROUND/OBJECTIVES:There is a lack of detailed data on fish consumption in European children and adolescents. We therefore investigated fish consumption patterns, portion sizes and estimated intakes of long-chain n-3 polyunsaturated fatty acids (PUFA; eicosapentaenoic acid, docosahexaenoic acid). SUBJECTS/METHODS:F...
journal_title:European journal of clinical nutrition
pub_type: 杂志文章
doi:10.1038/ejcn.2009.40
更新日期:2009-09-01 00:00:00
abstract:OBJECTIVE:To describe the nutritional status of schoolchildren from a rural area of Tanzania, with a particular emphasis on older adolescents to determine the timing of the growth spurt and differences by sex. DESIGN:A cross-sectional survey using a randomly selected sample. SUBJECTS:Six thousand eight hundred and on...
journal_title:European journal of clinical nutrition
pub_type: 杂志文章
doi:10.1038/sj.ejcn.1600890
更新日期:2000-01-01 00:00:00
abstract:BACKGROUND/OBJECTIVES:To facilitate the development of practical public health advice targeted at childhood obesity (OB) prevention and make the intervention programs more effective, one has to promote the most protective habits and limit or modify the risk factors. The objective of the present study was to recognize t...
journal_title:European journal of clinical nutrition
pub_type: 杂志文章
doi:10.1038/ejcn.2014.89
更新日期:2014-10-01 00:00:00
abstract:OBJECTIVE:To explore the association of eating styles with overweight and obesity in young adults, controlling for identical genetic background in monozygotic twins. DESIGN:Prospective twin cohort study. SETTING:Finland, 1991-2002. SUBJECTS:Two-hundred and thirty-three women and 2060 men from the FinnTwin16 study, a...
journal_title:European journal of clinical nutrition
pub_type: 杂志文章
doi:10.1038/sj.ejcn.1602601
更新日期:2007-07-01 00:00:00
abstract:OBJECTIVE:To evaluate the effect of dosage on the metabolic response to vegetables added to a mixed lunch meal, and to relate the amounts to the tripartite plate model. Carrots were chosen as an example, and the carrots were blanched, frozen and boiled to include possible effects of processing and cooking. The effects ...
journal_title:European journal of clinical nutrition
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1994-06-01 00:00:00
abstract:BACKGROUND:The anthropometric measurement of mid-arm muscular area (MAMA) involves overestimation because of various assumptions, this overestimation being progressive with increasing adiposity. However, the effects of muscle atrophy and variation of the subcutaneous fat thickness have remained uncertain. OBJECTIVES:T...
journal_title:European journal of clinical nutrition
pub_type: 杂志文章
doi:10.1038/ejcn.2010.87
更新日期:2010-08-01 00:00:00
abstract:OBJECTIVE:To estimate the intake of ruminant trans fatty acids (TFA) in the Danish population aged 1-80 years. DESIGN:Descriptive study. SUBJECTS:A sex- and age-stratified random sample drawn from the Danish Civil Registration System. A total of 3098 participants (51% female) aged 1-80 years were included. The partic...
journal_title:European journal of clinical nutrition
pub_type: 杂志文章
doi:10.1038/sj.ejcn.1602316
更新日期:2006-03-01 00:00:00
abstract:OBJECTIVE:To study risk factors for and prevalence and validity of clinical-anthropometrical mismatch (CAM) defined as the presence of clinical signs of protein-energy malnutrition despite normal weight-for-age (WFA). DESIGN:A semi-longitudinal study of nutrition and morbidity with a longitudinal assessment of mortali...
journal_title:European journal of clinical nutrition
pub_type: 杂志文章
doi:
更新日期:1994-01-01 00:00:00
abstract:BACKGROUND/OBJECTIVES:Considering the importance of glucose as a brain substrate, the postprandial rate of glucose delivery to the blood could be expected to affect cognitive functions. The purpose was to evaluate to what extent the rate of glucose absorption affected measures of cognitive performance in the postprandi...
journal_title:European journal of clinical nutrition
pub_type: 杂志文章,随机对照试验
doi:10.1038/ejcn.2012.80
更新日期:2012-09-01 00:00:00
abstract:OBJECTIVE:To determine the effect of iron supplementation on iron status and endurance capacity. DESIGN:Randomized, double-blind iron supplementation. SETTING:University of Missouri-Columbia and surrounding community. SUBJECTS:Twenty iron-deficient (serum ferritin, sFer<16 microg/l; serum transferrin receptor, sTfR>...
journal_title:European journal of clinical nutrition
pub_type: 杂志文章,随机对照试验
doi:10.1038/sj.ejcn.1602479
更新日期:2007-01-01 00:00:00
abstract::Changes in plasma insulin and glucose concentrations before and after feeding were measured in six female subjects (post-obese) who had regained a normal body mass after a history of severe obesity (mean weight loss, 37.1 +/- 2.6 kg). The responses of the post-obese group were compared with a group of weight- and age-...
journal_title:European journal of clinical nutrition
pub_type: 杂志文章
doi:
更新日期:1989-08-01 00:00:00
abstract::Aging is the major risk factor for the development of human neurodegenerative maladies such as Alzheimer's, Huntington's and Parkinson's diseases (PDs) and prion disorders, all of which stem from toxic protein aggregation. All of these diseases are correlated with cognitive decline. Cognitive Decline is a dynamic stat...
journal_title:European journal of clinical nutrition
pub_type: 杂志文章,评审
doi:10.1038/ejcn.2014.189
更新日期:2014-11-01 00:00:00
abstract:OBJECTIVE:To determine the effect on blood pressure of dietary advice to consume a combination of plant-based cholesterol-lowering foods (dietary portfolio). METHODS:For 1 year, 66 hyperlipidemic subjects were prescribed diets high in plant sterols (1.0 g/1000 kcal), soy protein (22.5 g/1000 kcal), viscous fibers (10 ...
journal_title:European journal of clinical nutrition
pub_type: 杂志文章,随机对照试验
doi:10.1038/sj.ejcn.1602768
更新日期:2008-06-01 00:00:00
abstract:OBJECTIVE:To examine the coherence of estimated intakes of acrylamide (AA) from foods, with hemoglobin (Hb) AA adduct levels, an objective marker of environmental AA exposure. DESIGN:A cross-sectional study. SETTING:The Malmö Diet and Cancer study, a large population-based prospective cohort (n=28 098) in the south o...
journal_title:European journal of clinical nutrition
pub_type: 杂志文章
doi:10.1038/sj.ejcn.1602704
更新日期:2008-03-01 00:00:00
abstract:OBJECTIVE:To evaluate the effect of moderate alcohol consumption on the acute phase proteins C-reactive protein and fibrinogen. DESIGN:Randomized, diet-controlled, cross-over study. SETTING:The study was performed at TNO Nutrition and Food Research, Zeist, The Netherlands. SUBJECTS:Ten middle-aged men and 10 postmen...
journal_title:European journal of clinical nutrition
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1038/sj.ejcn.1601459
更新日期:2002-11-01 00:00:00
abstract:OBJECTIVE:It was determined whether a combination of Lactobacillus acidophilus (L. acidophilus) 74-2 and Bifidobacterium animalis subsp lactis DGCC 420 (B. lactis 420) affect the faecal microbiota as well as immunological parameters and blood lipids in healthy adults. DESIGN:A placebo-controlled, double-blinded, rando...
journal_title:European journal of clinical nutrition
pub_type: 杂志文章,随机对照试验
doi:10.1038/sj.ejcn.1602761
更新日期:2008-05-01 00:00:00
abstract:OBJECTIVE:To assess the potential impact of a national iron supplementation programme in rural Vietnam. METHODS:The study included questionnaires, focus group discussions of pregnant women and key informant interviews, together with measurements of haemoglobin (Hb) and a stool examination for soil-transmitted helminth...
journal_title:European journal of clinical nutrition
pub_type: 杂志文章
doi:10.1038/sj.ejcn.1602812
更新日期:2008-08-01 00:00:00
abstract:OBJECTIVE:To test the effect of supplementation of diet with ascorbic acid, selenium, alpha-tocopherol and beta-carotene on the oxidation resistance of very low (VLDL) + low density lipoprotein (LDL). DESIGN:A randomized placebo-controlled double-masked clinical trial. SETTING:In healthy men aged 30-58 years smoking ...
journal_title:European journal of clinical nutrition
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1994-09-01 00:00:00
abstract::The possible relationship between consumption of trans fatty acids (TFAs) and risk of insulin resistance or development of diabetes mellitus type II has been considered by a number of human and animal studies over the past decade. This review evaluates the evidence, and concludes that there is limited evidence for a w...
journal_title:European journal of clinical nutrition
pub_type: 杂志文章,评审
doi:10.1038/ejcn.2010.240
更新日期:2011-05-01 00:00:00
abstract:OBJECTIVE:To determine if changes in serum homocysteine values during folic acid supplementation can identify objectively healthy subjects with subclinical folate deficiency. DESIGN:Blood drawn and processed in a regimented fashion from fasting subjects. Serum homocysteine values determined by gas chromatography-mass ...
journal_title:European journal of clinical nutrition
pub_type: 临床试验,杂志文章
doi:10.1038/sj.ejcn.1600385
更新日期:1997-03-01 00:00:00
abstract:INTRODUCTION:In the UK, colorectal cancer is the fourth most common cancer and the second most common cause of cancer death. Surgery is the primary modality of treatment, but it is not without complications. Post-operative complications have been linked to preoperative of weight loss and loss of lean tissue, and also t...
journal_title:European journal of clinical nutrition
pub_type: 杂志文章
doi:10.1038/s41430-019-0414-0
更新日期:2019-11-01 00:00:00
abstract:OBJECTIVE:This study describes the prevalence and characteristics of an elevated resting energy expenditure (REE) in patients with chronic obstructive pulmonary disease (COPD). DESIGN AND SETTING:Patients were consecutively admitted to an in-patient pulmonary rehabilitation centre. SUBJECTS:The study group consisted ...
journal_title:European journal of clinical nutrition
pub_type: 杂志文章
doi:10.1038/sj.ejcn.1600571
更新日期:1998-06-01 00:00:00
abstract:BACKGROUND/OBJECTIVES:Adult skeletal muscle mass (SMM) protects against type 2 diabetes, but little is known about its developmental antecedents. We examined whether pace of early weight gain predicted adult SMM in a birth cohort from Cebu City, Philippines. In addition, we examined whether increases in SMM associated ...
journal_title:European journal of clinical nutrition
pub_type: 杂志文章
doi:10.1038/ejcn.2015.18
更新日期:2015-12-01 00:00:00
abstract:OBJECTIVE:To compare the relations of adiposity and body fat distribution to body mass index (BMI) in Australians of Aboriginal and European ancestry. DESIGN:Cross-sectional volunteer samples. SETTING:Australian Aboriginal communities in remote central and northern Australia, urban European Australians resident in Me...
journal_title:European journal of clinical nutrition
pub_type: 杂志文章
doi:10.1038/sj.ejcn.1601630
更新日期:2003-08-01 00:00:00
abstract::Alcohol-induced hypoglycaemia is a well-known phenomenon in insulin-treated diabetic subjects. Less attention has been paid to the impact of alcohol on blood glucose and insulin responses in non-insulin dependent diabetic subjects. The aim of this study was to investigate the acute metabolic effects of different alcoh...
journal_title:European journal of clinical nutrition
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1993-09-01 00:00:00
abstract::The relationship between diet and attained height was studied in children and adolescents in Southern California. Diet pattern was determined from an extensive food frequency questionnaire in 1765 Caucasian children of 7-18 years, attending state schools (452 m and 443 f) and Seventh-day Adventist schools (427 m and 4...
journal_title:European journal of clinical nutrition
pub_type: 杂志文章
doi:
更新日期:1991-01-01 00:00:00
abstract:BACKGROUND/OBJECTIVES:Optimal obesity indices in predicting cardio-metabolic risk are less studied in Asian. We evaluated optimal waist-to-height ratio (WHtR) for predicting hypertension, dyslipidemia and diabetes in Han and Uygur populations in Xinjiang, a northwest part of China. SUBJECTS/METHODS:This study involved...
journal_title:European journal of clinical nutrition
pub_type: 杂志文章
doi:10.1038/ejcn.2015.25
更新日期:2015-08-01 00:00:00