The effectiveness of a low-carbohydrate diet in management of type 2 diabetes - A systematic review of the current literature
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Background: Dietary treatment is a key factor in management of type 2 diabetes (T2D), and facilitation of a healthy diet is essential to achieve treatment goals. Traditionally, a low-fat, high-carbohydrate diet has been recommended in management of T2D, but recent research suggests that a low-carbohydrate diet may be an option in the short term. Aim/research question: The aim of this master thesis was to conduct a systematic literature review and meta-analysis about the effectiveness of low-carbohydrate diets on weight management, metabolic control and compliance in adults with T2D. Methods/methodology: A systematic search of the following databases was conducted: MEDLINE, EMBASE, CENTRAL, CINAHL, Food Science Source and SweMed+. Randomised controlled trials that investigated the effect of a low-carbohydrate diet (<40 E%) compared to a diet containing >40 E% from carbohydrates, in individuals with T2D, were included in the review Results: Of the 1180 articles identified through the literature search, 29 studies with a total of 1832 participants, were included in the review. Between dietary interventions, three studies favoured the low-carbohydrate diet in weight management, three on HbA1c, four on HDL-cholesterol, one on LDL-cholesterol, two on triacylglycerol, one on systolic blood pressure, and three on diastolic blood pressure. The majority of these low-carbohydrate diets was high in dietary fat, and were compared against low-fat diets, low-protein diets, a low-glycaemic index diet, a high-glycaemic index diet, a Mediterranean diet and standard diabetes care. Conclusion: This master thesis found that low-carbohydrate diets improved weight, HbA1c and cardiovascular risk factors in T2D patients. Still, when compared to control diets with a higher content from carbohydrates, the low-carbohydrate diets were not superior. Compliance to the low-carbohydrate diets appeared to be difficult to achieve and further investigations are needed to identify dietary approaches that can be followed in the long term management of T2D.
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