Low-Carbohydrate Mediterranean Diet Better Than Low-Fat Diet at Managing Diabetes
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Reviewed By Elizabeth Klodas, MD, FACC
Aug. 31, 2009 -- Eating a Mediterranean-style diet may help people with type 2 diabetes keep their disease under control without drugs better than following a typical low-fat diet.
A new study from Italy shows that people with type 2 diabetes who ate a Mediterranean diet rich in vegetables and whole grains with at least 30% of daily calories from fat (mostly olive oil) were better able to manage their disease without diabetes medications than those who ate a low-fat diet with no more than 30% of calories from fat (with less than 10% coming from saturated fat choices).
After four years, researchers found that 44% of people on the Mediterranean diet ended up requiring diabetes medications to control their blood sugars compared with 70% of those who followed the low-fat diet.
It's one of the longest-term studies of its kind, and researchers, including Katherine Esposito, MD, of the Second University of Naples, say the results "reinforce the message that benefits of lifestyle interventions should not be overlooked."
Best Diet for Diabetes Control
In the study, researchers randomly assigned 215 overweight people recently diagnosed with type 2 diabetes who had never been treated with diabetes medications to either a Mediterranean-style diet or a low-fat diet.
The Mediterranean diet was rich in vegetables and whole grains and low in red meat, which was replaced with fish or poultry. Overall, the diet consisted of no more than 50% of daily calories from carbohydrates and no less than 30% of calories from fat.
The low-fat diet was based on American Heart Association guidelines and was rich in whole grains and limited in sweets with no more than 30% of calories from fat and 10% from saturated fats, such as animal fats.
After four years of follow-up, the Mediterranean diet group had better glycemic (blood sugar) control and were less likely to require diabetes medications to bring their blood sugar within healthy levels.
In addition, people who followed the Mediterranean diet group also experienced improvement in other heart disease risk factors. Interestingly, weight loss was relatively comparable between the two groups by the end of the trial, suggesting that attributes of the Mediterranean diet beyond weight loss affect blood sugar control.
SOURCES: Esposito, K. Annals of Internal Medicine, Sept. 1, 2009; vol 151: pp 306-315. News release, American College of Physicians.
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