723-P: Effect of Low-Carbohydrate High-Fat vs. High-Carbohydrate Low-Fat Diet on HbA1c Control in Chinese Patients with Type 2 Diabetes

AbstractThis study compared the longer-term effects of a very low-carbohydrate, high-fat diet with a high-carbohydrate, low-fat diet on cognitive performance in individuals with type 2 diabetes (T2D). In total, 115 obese adults with T2D (sixty-six males, BMI: 34·6 (sd 4·3) kg/m2, age: 58 (sd 7) years, HbA1c: 7·3 (sd 1·1) %, diabetes duration: 8 (sd 6) years) were randomised to consume either an energy-restricted, very low-carbohydrate, low-saturated-fat (LC) diet or an energy-matched high unrefined carbohydrate, low-fat (HC) diet with supervised aerobic/resistance exercise (60 min, 3 d/week) for 52 weeks. Body weight, HbA1c and cognitive performance assessing perceptual speed, reasoning speed, reasoning ability, working memory, verbal fluency, processing speed, short-term memory, inhibition and memory scanning speed were assessed before and after intervention. No differences in the changes in cognitive test performance scores between the diet groups were observed for any of the cognitive function outcomes assessed (P≥0·24 time×diet). Percentage reduction in body weight correlated with improvements with perceptual speed performance. In obese adults with T2D, both LC and HC weight-loss diets combined with exercise training had similar effects on cognitive performance. This suggests that an LC diet integrated within a lifestyle modification programme can be used as a strategy for weight and diabetes management without the concern of negatively affecting cognitive function.

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SAT-293 Osteocalcin and Exercise Improve Mood and Cognition in Female Mice with High-Fat Diet Induced Type 2 Diabetes

Journal of the Endocrine Society ◽

10.1210/jendso/bvaa046.500 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

Author(s):

Jesse Rentz ◽

Jordan Winberg ◽

Walter Swardfager ◽

Jane Mitchell

Keyword(s):

Type 2 Diabetes ◽

High Fat Diet ◽

Treadmill Running ◽

Control Group ◽

High Fat ◽

Low Fat ◽

Female Mice ◽

Low Fat Diet ◽

Metabolic Conditions

Abstract The skeleton has been characterized as an endocrine organ, demonstrating a capacity to modulate cognition, mood and energy homeostasis (1,2). These endocrine actions of the skeleton have been attributed to the osteoblast-derived peptide osteocalcin. In mice, uncarboxylated osteocalcin (ucOCN) decreased the acquisition of type 2 diabetes mellitus (T2DM) and ameliorated depressive- and anxiety-like behaviours (1,2). Clinically, T2DM patients present with reduced serum osteocalcin levels and approximately 1 in 4 also suffer from co-morbid depression (3,4). The cognitive and metabolic benefits of ucOCN are similar to the beneficial effects of exercise that is recommended in treatment of both depression and T2DM. Here we compared the effects of ucOCN or exercise in female C57-BL/6J mice under two different metabolic conditions. Mice were fed either a high-fat diet (60% calories from fat) to induce T2DM or a control diet (10% calories from fat). Groups of mice were either sedentary or exercised daily by 30 min treadmill running for two months, with or without daily administration of ucOCN (30 ng/g/day). Mice with T2DM displayed depressive behaviours marked by a higher immobile time in tail suspension tests compared to control mice (97±25 n=11 vs 207±9.0 s n=12; t21=4.21, P=0.0004). Exercise and osteocalcin both improved depressive behaviour (137±8 n=12; t22=5.85, P<0.0001 & 127±15 s n=12; t22=4.46, P=0.0002). Anxiety, measured by the elevated-plus maze revealed the mice with T2DM displayed increased anxiety spending less time in the open arms and had a lower ratio of open to closed arm entries than the control group (0.37±0.03 n=10 vs 0.21±0.032 n=11; t19=3.56, P=0.0021). Neither exercise nor osteocalcin improved anxiety in the T2DM mice. The puzzle box test revealed the negative effects of the high-fat diet in problem solving and memory, where the sedentary mice displayed greater latencies to solve each task compared to control mice. Exercised and mice receiving osteocalcin displayed performances comparable to that of the control group. Under normal metabolic conditions (low fat diet), neither osteocalcin nor exercise altered responses in any of the behavioural tests. Together, these results: 1. The effects of osteocalcin on behaviour and cognition are comparable to that of the effects of exercise in female mice with T2DM; 2. Behaviour and cognition did not improve from exercise or osteocalcin in female mice on a low-fat diet. References: (1) Ferron et al., Bone. 2012 Feb;50(2):568–575. (2) Oury et al., Cell. 2013 Sep 26:155(1):228–241. (3) Liu et al., Horm Metab Res. 2015 Oct;47(11):813–9. (4) Khaledi et al., Acta Diabetol. 2019 June;56(6):631–650.

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Faculty Opinions recommendation of In type 2 diabetes, randomisation to advice to follow a low-carbohydrate diet transiently improves glycaemic control compared with advice to follow a low-fat diet producing a similar weight loss.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.715898104.791502807 ◽

2012 ◽

Author(s):

Kirsi Pietilainen

Keyword(s):

Type 2 Diabetes ◽

Weight Loss ◽

Glycaemic Control ◽

Low Fat ◽

Carbohydrate Diet ◽

Low Carbohydrate Diet ◽

Low Fat Diet ◽

Low Carbohydrate ◽

Similar Weight

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Following a Low Carbohydrate, High Fat Diet Compared to Reduced Calorie, High Carbohydrate Diet as a Nutritional Intervention in Type Two Diabetes Mellitus Patients: A Systematic Review

Journal of Food Studies ◽

10.5296/jfs.v9i1.17045 ◽

2020 ◽

Vol 9 (1) ◽

pp. 1

Author(s):

Joy Lewis ◽

Kevin Haubrick

Keyword(s):

Systematic Review ◽

Type 2 Diabetes ◽

Blood Glucose ◽

High Fat Diet ◽

High Fat ◽

Carbohydrate Diet ◽

Eating Pattern ◽

High Carbohydrate ◽

Low Carbohydrate

There is evidence supporting individuals with type 2 diabetes benefit from lifestyle changes through a nutrition intervention that improves diabetic (blood glucose and HgbA1c) and cardiovascular (total cholesterol, HDL, LDL, and triglycerides) biomarkers. The objective of this systematic review was to evaluate if patients with type 2 diabetes following a low carbohydrate, high fat eating pattern is more effective than following a reduced caloric, high carbohydrate eating pattern in the improvement of diabetic (blood glucose and HgbA1c) and cardiovascular (total cholesterol, HDL, LDL, and triglycerides) biomarkers. A literature search was conducted on peer-reviewed research trials registered in PubMed, from January 2007 to September 2019 using combinations of the search terms: Diabetes Mellitus, Type 2 AND Diet, Ketogenic; OR Diet, Carbohydrate-Restricted. The literature was analyzed in chronological order; grouping in four year increments from 2007 to 2019. The thirty-six articles reviewed provide evidence to support the use of a low carbohydrate diet in patients with type 2 diabetes versus a reduced caloric diet. This systematic review highlighted diabetic (HgbA1c and fasting blood glucose) and cardiovascular biomarkers (HDL) of type 2 diabetic patients improve significantly when following a low-carbohydrate, high fat diet versus a reduced calorie, high carbohydrate intake.

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