Low-calorie ketogenic diet beats dietary restriction for treating type 2 diabetes

A new intervention study, comparing two weight loss approaches in diabetes management, has found that following a ketogenic diet rather than a conventional low-calorie diet was more effective in improving body composition and clinical health markers.
The findings, published this week online in the journal Nutrition and Diabetes, show that weight loss and reduction in waist circumference were significantly greater after a four-month ketogenic diet compared to the very low-calorie diet over the same period of time.
The ketogenic diet protocol also produced the largest effect in lowering blood glucose.
Dietary modifications can help decrease risk for obesity-related diseases, such as type 2 diabetes. A very low-carbohydrate (or ketogenic) diet (VLCKD) as therapy for diabetes has been gaining momentum in recent times. Only daily calorie restriction was considered comparable as an effective dietary intervention until now.
Here, Spanish researchers tested their effectiveness and presented several points of evidence supporting the use of VLCKD over a very-low calorie diet (VLCD) as the first approach to treating type 2 diabetes.
Dr A. Goday, from the Hospital del Mar in Barcelona, and colleagues compared a VLCKD diet with a low-calorie diet over a four-month period in 89 men and women aged between 30 and 65 years old who had type 2 diabetes and a high body mass index (BMI over 30kg/m2).
The participants were divided into two groups. Forty-five of them were assigned to the VLCK diet (50 g of carbohydrate daily) and the rest of the subjects were allocated the very low-calorie diet (600-800 kcal per day with 45 to 60 per cent of them coming from carbohydrates).
Creatinine and blood urea levels did not change significantly relative to baseline between the two groups, suggesting that a good kidney function was maintained with both diets.
At four months, weight loss and reduction in waist circumference in the VLCK diet group were significantly larger than in control subjects, with 85 per cent of participants achieving a 10 per cent weight loss.
Previous research has shown that, comparatively, varying degrees of calorie restriction appears to be effective at reducing body weight between only three and seven per cent.
In terms of the effect of the two diets on HbA1c levels, patients given the VLCK diet had an HbA1c of 42 mmol/mol (vs. 52 mmol/mol at baseline), whereas the average HbA1c in the VLCD group remained at 46 mmol/mol (vs. 51 mmol/mol at baseline).
Overall, this study tends to suggest that VLCKD is most effective in reducing body weight and improving blood sugar control compared to a very low-calorie diet.