Highlights
- •Vegetarian and Mediterranean dietary patterns may be effective in improving glycemic control in people with diabetes.
- •Evidence on the long-term efficacy of low carbohydrate diets on individuals with type 2 diabetes is not conclusive.
- •Intermittent fasting and macrobiotic regimes in diabetes control although promising, more conclusive research is required.
Abstract
Background and aim
The aim of the present review is to examine evidence from published studies on the
effectiveness of six or more months of low carbohydrate, macrobiotic, vegan, vegetarian,
Mediterranean and intermittent fasting (IF) diets compared to low fat diets on diabetes
control and management.
Methods and results
In accordance with PRISMA guidelines, Cochrane CENTRAL, PubMed and Scopus databases
were systematically searched for relevant studies. Twenty randomised controlled trials
(RCTs) > 6 months that investigated the effectiveness of various dietary patterns
on type 2 diabetes mellitus (T2DM) were included. Risk of bias was assessed using
the Cochrane tool.
There were no significant differences in glycemic control, weight and lipids for the
majority of low carbohydrate diets (LCDs) compared to low fat diets (LFDs). Four out
of fifteen LCD interventions showed better glycemic control while weight loss was
greater in one study. The Mediterranean dietary pattern demonstrated greater reduction
in body weight and HbA1c levels and delayed requirement for diabetes medications.
The vegan and macrobiotic diet demonstrated improved glycemic control, while the vegetarian
diet showed greater body weight reduction and insulin sensitivity.
Conclusions
Although more long-term intervention trials are required, mounting evidence supports
the view that vegan, vegetarian and Mediterranean dietary patterns should be implemented
in public health strategies, in order to better control glycemic markers in individuals
with T2DM.
Keywords
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Article info
Publication history
Published online: February 25, 2019
Accepted:
February 11,
2019
Received in revised form:
February 11,
2019
Received:
July 26,
2018
Handling Editor: A. SianiIdentification
Copyright
© 2019 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.
