Diabetes, weight loss and remission: Which diet is best?

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A new review examines which diets are best for achieving weight loss with diabetes. Juan Moyano / Stocksy
  • Researchers have been researching the effects of diet on type 2 diabetes for years. Research has shown that weight loss can lead to remission.
  • However, previous studies have yielded conflicting results and it is unclear which diets are most effective.
  • A recent review of previously published data showed that very low-energy diets and meal replacement were the most effective way to control weight in people living with type 2 diabetes.

The International Diabetes Federation (IDF) reports that 1 in 10 adults live with diabetes. Type 2 diabetes accounts for more than 90% of these cases.

The IDF estimates that diabetes will affect 643 million people worldwide by 2030, and the number will increase to 784 million by 2045.

A number of studies have examined the significance of weight loss on type 2 diabetes. However,Weight loss can vary widely between diets and comparisons have yielded conflicting results. There is still uncertainty about what type of diet doctors should recommend.

A global team of researchers led by Prof. Michael Lean from the University of Glasgow in the UK set out to investigate the previous research.

Their goal was to find the most effective diet method to lose weight, maintain weight loss and achieve remission from type 2 diabetes. The research is part of a work program to update the recommendations of the European Association for the Study of Diabetes.

The researchers found that very low-energy diets and meal replacements were the most effective way for people with type 2 diabetes to control their weight. The audit results are displayed in the journal Diabetology.

Dr. Lucy Chambers, head of research communications at Diabetes UK, told Medical news today, “This review, which combines results from many studies, answers important questions about which diets are most effective for weight loss and remission in people with type 2 diabetes.”

Experts broadly accept that weight loss benefits the treatment of type 2 diabetes. The landmark Diabetes remission clinical trial (DiRECT), led by Prof. Lean, showed that it is possible to achieve remission from type 2 diabetes by maintaining over 10 kg (kg) or 22 pounds (lb) weight loss.

Based on this research, Prof. Lean collaborated with Dr. Chaitong Churuangsuk and colleagues from the University of Glasgow and other researchers from the University of Cambridge, UK and the University of Otago in New Zealand.

The team conducted an “umbrella review” of previously published data from studies across the globe. The pooled meta-analyzes examined which type of diet is best for achieving weight loss in adults with type 2 diabetes. They also conducted a new systematic review of published studies of diets for type 2 diabetes remission.

The results of the analysis show that weight management programs that included a lot of low energy diets and formula meal replacements yielded greater weight loss than conventional low energy diets.

Programs that included a total dietary supplement at the start of the diet were the most effective approach to type 2 diabetes remission, reporting for a median 54% of participants at a 1-year mark.

In addition, diets such as high protein, Mediterranean diet, vegetarian and low glycemic diets achieved little – 0.3-2 kg (0.7-4.4 lb) – or no difference in weight loss compared to conventional diets.

“It was a bit of a shock, given all the hype and media attention, to discover how poor the evidence is for low-carb or ketogenic diets,” Prof Lean said. MNT. “This marketing of low-carb diets often uses very compelling but misleading science, suggesting that only one nutrient (carbohydrate) and one hormone (insulin) controls our metabolism and disease risks.”

Celebrities and politicians have been persuaded, but dozens of clinical trials have been conducted, and they simply show no benefit to low-carb diets. What matters is keeping your weight as close to ideal as possible. “

– Prof. Michael Lean

A limitation of the current review is that most of the available documentation relates only to short-term results. The benefits of weight loss on type 2 diabetes mostly depend on long-term control of body weight.

Also, keeping the weight lower may require other behavioral approaches than those that work well for the initial weight loss phase. There are few trials that report data beyond 12 months.

According to the research team, well-conducted research is needed to assess long-term effects on weight, glycemic control, clinical outcomes, and diabetic complications.

Prof. Lean told MNT that “the great need is to find better ways to help people avoid returning to eating patterns [that] made them gain weight and develop [type 2 diabetes]. We know from DiRECT that people who lose weight and get a remission of their diabetes will relapse if they gain weight. ”

“It’s not easy because social marketing from the food industry over the last 40 or 50 years has ‘normalized’ eating habits, which has resulted in people on average being around 1 stone – 7 kg – heavier now, and many of them is much heavier at younger ages. “

Dr. Chambers added: “It is important to remember that there is no uniform ‘diet for diabetes’.” Low calorie diets can be challenging and if you have [type 2 diabetes] and wanting to lose weight, getting the help of a healthcare professional can help you find an approach that is safe and works for you. “

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