Weight-loss induced by carbohydrate restriction does not negatively affect health-related quality of life and cognition in people with type 2 diabetes: A randomised controlled trial

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  • Nicole Jacqueline Jensen, Københavns Universitet
  • ,
  • Helena Zander Wodschow, Københavns Universitet
  • ,
  • Mads Juul Skytte, Københavns Universitet
  • ,
  • Amirsalar Samkani, Københavns Universitet
  • ,
  • Arne Astrup, Novo Nordisk Foundation
  • ,
  • Jan Frystyk
  • Bolette Hartmann, Københavns Universitet
  • ,
  • Jens Juul Holst, Københavns Universitet
  • ,
  • Thomas Meinert Larsen, Københavns Universitet
  • ,
  • Sten Madsbad, Københavns Universitet
  • ,
  • Faidon Magkos, Københavns Universitet
  • ,
  • Kamilla Woznica Miskowiak, Københavns Universitet
  • ,
  • Steen Bendix Haugaard, Københavns Universitet
  • ,
  • Thure Krarup, Københavns Universitet
  • ,
  • Jørgen Rungby
  • Mads Norvin Thomsen, Københavns Universitet

Background & aims: We evaluated the effect of weight loss induced by dietary carbohydrate restriction on health-related quality of life (HRQoL) and cognition in type 2 diabetes (T2D). Methods: In this randomised parallel trial, 72 adults with T2D and overweight/obesity (mean ± SD, HbA1c: 57 ± 8 mmol/mol and BMI: 33 ± 5 kg/m2) were randomly assigned to a carbohydrate-reduced high-protein diet (CRHP: C30E%-P30E%-F40E%) or conventional diabetes diet (CD: C50E%-P17E%-F33E%) for 6 weeks, targeting a 6% weight loss. HRQoL was assessed from the short form 36 (SF-36) questionnaire, including physical and mental component summary (PCS and MCS) scores; global cognition, verbal memory, attention and psychomotor speed, and executive function were assessed from a neuropsychological test battery. Results: Both diet groups achieved a 5.8 kg weight loss and improved PCS (median [25th;75th percentiles], CD: 2.7 [1.1; 4.2] vs. CRHP: 2.1 [0.7; 3.7]), with no difference between diets. The CRHP diet resulted in a clinically relevant improvement of MCS, albeit non-significantly different compared with the change after the CD diet (2.0 [-0.7; 4.8], p = 0.15). Global cognition, attention, and verbal memory were unaffected by the CRHP diet, which selectively worsened the Symbol Digit Modality Test assessing psychomotor speed when compared with the CD diet (−4.1 [-7.2;-1.1], p < 0.01). Conclusion: Physical health improved by weight loss independently of macronutrient distribution, while mental health and cognition may be affected by the amount of carbohydrate, protein and fat in the diet. Collectively, our data suggest that weight loss through moderate carbohydrate restriction has no clinically important impact on HRQoL and global cognition in patients with T2D. Registered under ClinicalTrials.gov Identifier no. NCT03814694.

OriginalsprogEngelsk
TidsskriftClinical Nutrition
Vol/bind41
Nummer7
Sider (fra-til)1605-1612
Antal sider8
ISSN0261-5614
DOI
StatusUdgivet - jul. 2022

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