Abstract
The adequate composition of carbohydrate and fat in low calorie diets for type 2 diabetes
mellitus patients with obesity is not fully established. The aim of this study was
to investigate the effects of low carbohydrate diet on glucose and lipid metabolism,
especially on visceral fat accumulation, and comparing that of a high carbohydrate
diet. Obese subjects with type 2 diabetes mellitus were randomly assigned to take
a low calorie and low carbohydrate diet (n=11, 1000 kcal per day, protein:carbohydrate:fat=25:40:35) or a low calorie and high carbohydrate
diet (n=11, 1000 kcal per day, protein:carbohydrate:fat=25:65:10) for 4 weeks. Similar decreases in
body weight and serum glucose levels were observed in both groups. Fasting serum insulin
levels were reduced in the low carbohydrate diet group compared to the high carbohydrate
diet group (−30% versus −10%, P<0.05). Total serum cholesterol and triglyceride levels decreased in both groups,
but were not significantly different from each other. High-density lipoprotein–cholesterol
(HDL–C) increased in the low carbohydrate diet group but not in the high carbohydrate
diet group (+15% versus 0%, P<0.01). There was a larger decrease in visceral fat area measured by computed tomography
in the low carbohydrate diet group compared to the high carbohydrate diet group (−40 cm2 versus −10 cm2, P<0.05). The ratio of visceral fat area to subcutaneous fat area did not change in
the high carbohydrate diet group (from 0.70 to 0.68), but it decreased significantly
in the low carbohydrate diet group (from 0.69 to 0.47, P<0.05). These results suggest that, when restrict diet was made isocaloric, a low
calorie/low carbohydrate diet might be more effective treatment for a reduction of
visceral fat, improved insulin sensitivity and increased in HDL–C levels than low
calorie/high carbohydrate diet in obese subjects with type 2 diabetes mellitus.
Keywords
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Article info
Publication history
Published online: August 19, 2004
Accepted:
January 29,
2004
Received in revised form:
December 9,
2003
Received:
March 15,
2003
Identification
Copyright
© 2004 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
