A six-month low-carbohydrate diet high in fat in patients with type 2 diabetes does not affect the vasodilatory reactivity of the brachial artery

Eva Gram-Kampmann; Thomas Bastholm Olesen; Camilla Dalby Hansen; Mie Balle Hugger; Jane Møller Jensen; Anne Pernille Hermann; Michael Hecht Olsen; Aleksander Krag; Henning Beck-Nielsen; Kurt Højlund

doi:10.1007/s00125-022-05755-w

A six-month low-carbohydrate diet high in fat in patients with type 2 diabetes does not affect the vasodilatory reactivity of the brachial artery

Eva Gram-Kampmann, Thomas Bastholm Olesen, Camilla Dalby Hansen, Mie Balle Hugger, Jane Møller Jensen, Anne Pernille Hermann, Michael Hecht Olsen, Aleksander Krag, Henning Beck-Nielsen, Kurt Højlund

Publikation: Bidrag til tidsskrift › Konferenceabstrakt i tidsskrift › Forskning › peer review

Abstract

Background and aims: One of the major causes of mortality in type 2 diabetes (T2D) is cardiovascular disease (CVD). Endothelial dysfunction (ED) is an early sign of atherosclerosis which is present before overt clinical CVD. In non-diabetic subjects, low-carbohydrate diets (LCDs) have been demonstrated to improve vasodilatory reactivity in the endothelium, but in T2D patients, the effect of a LCD on measures of ED is mixed. The aim of this study was to examine the effect of a non-calorie-restricted LCD high in fat for six months on measures of ED in T2D.

Materials and methods: Patients with T2D were randomized 2:1 to either a LCD with a max. of 20 E% (percentage of total energy intake) from carbohydrates and min. 50 E% from fat (n = 49) or a control diet with 50-60 E% from carbohydrates (n = 22) for 6 months. Both diets were non-calorie restricted. Flow-mediated vasodilation (FMD) and nitroglycerine-induced vasodilation (NID) were assessed at baseline and after six months using B-mode ultrasound scans of the brachial artery and are reported as dilation in percentage (%). Blood samples were collected and dual-energy x-ray absorptiometry (DXA) and anthropometrics were assessed at baseline and after six months. We report baselines differences and the mean difference in change (MDIC) between groups from baseline to six months.

Results: Participants on the LCD reduced their self-reported carbohydrate intake to ~ 14 E% and increased their fat intake to ~63 E% including a 2.7 fold increase in saturated fatty acids (SFA). The LCD caused a clinically relevant decrease in HbA1c (MDIC: -8.9 ± 1.7 mmol/mol; P < 0.001), a reduction in weight (MDIC: -3.9 ± 1.0 kg; P < 0.01) and improved body composition (P
Conclusions: A non-calorie-restricted LCD high in fat for 6 months does not affect either FMD or NID in patients with T2D. While these results could not confirm a beneficial effect of LCD on ED as observed in non-diabetic individuals, the data also suggest that the higher intake of fat, in particular SFA, associated with a LCD, does not adversely affect endothelial function and hence cardiovascular risk in patients with T2D.

Grant acknowledgement: Novo Nordisk Foundation, A. P. Møller Foundation

Originalsprog	Engelsk
Artikelnummer	827
Tidsskrift	Diabetologia
Vol/bind	65
Udgave nummer	Suppl. 1
Antal sider	1
ISSN	0012-186X
DOI	https://doi.org/10.1007/s00125-022-05755-w
Status	Udgivet - 23. sep. 2022
Begivenhed	58th EASD Annual Meeting - Stockholm, Sverige Varighed: 19. sep. 2022 → 23. sep. 2022 Konferencens nummer: 58

Konference

Konference	58th EASD Annual Meeting
Nummer	58
Land/Område	Sverige
By	Stockholm
Periode	19/09/2022 → 23/09/2022

Emneord

lavkulhydratdiæt
type 2 diabetes
endothelial dysfunktion
inflammation

Dokumenter og links

10.1007/s00125-022-05755-w

1 Ph.d.-afhandling

A Low-Carbohydrate Diet in Type 2 Diabetes: Effects over six months on glycemic control, cardiovascular risk factors, vascular endothelial function and pro-inflammatory markers
Bidragets oversatte titel: Lavkulhydratdiæt og Type 2 Diabetes: Effekt over seks måneder på glykæmisk kontrol, kardiovaskulære risikofaktorer, vaskulær endotelfunktion og proinflammatoriske markørerGram-Kampmann, E., 27. apr. 2023, Syddansk Universitet. Det Sundhedsvidenskabelige Fakultet. 139 s.
Publikation: Afhandling › Ph.d.-afhandling

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Citationsformater

Gram-Kampmann, E., Olesen, T. B., Dalby Hansen, C., Balle Hugger, M., Møller Jensen, J., Hermann, A. P., Olsen, M. H., Krag, A., Beck-Nielsen, H., & Højlund, K. (2022). A six-month low-carbohydrate diet high in fat in patients with type 2 diabetes does not affect the vasodilatory reactivity of the brachial artery. Diabetologia, 65(Suppl. 1), Artikel 827. https://doi.org/10.1007/s00125-022-05755-w

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title = "A six-month low-carbohydrate diet high in fat in patients with type 2 diabetes does not affect the vasodilatory reactivity of the brachial artery",

abstract = "Background and aims: One of the major causes of mortality in type 2 diabetes (T2D) is cardiovascular disease (CVD). Endothelial dysfunction (ED) is an early sign of atherosclerosis which is present before overt clinical CVD. In non-diabetic subjects, low-carbohydrate diets (LCDs) have been demonstrated to improve vasodilatory reactivity in the endothelium, but in T2D patients, the effect of a LCD on measures of ED is mixed. The aim of this study was to examine the effect of a non-calorie-restricted LCD high in fat for six months on measures of ED in T2D.Materials and methods: Patients with T2D were randomized 2:1 to either a LCD with a max. of 20 E% (percentage of total energy intake) from carbohydrates and min. 50 E% from fat (n = 49) or a control diet with 50-60 E% from carbohydrates (n = 22) for 6 months. Both diets were non-calorie restricted. Flow-mediated vasodilation (FMD) and nitroglycerine-induced vasodilation (NID) were assessed at baseline and after six months using B-mode ultrasound scans of the brachial artery and are reported as dilation in percentage (%). Blood samples were collected and dual-energy x-ray absorptiometry (DXA) and anthropometrics were assessed at baseline and after six months. We report baselines differences and the mean difference in change (MDIC) between groups from baseline to six months. Results: Participants on the LCD reduced their self-reported carbohydrate intake to ~ 14 E% and increased their fat intake to ~63 E% including a 2.7 fold increase in saturated fatty acids (SFA). The LCD caused a clinically relevant decrease in HbA1c (MDIC: -8.9 ± 1.7 mmol/mol; P < 0.001), a reduction in weight (MDIC: -3.9 ± 1.0 kg; P < 0.01) and improved body composition (PConclusions: A non-calorie-restricted LCD high in fat for 6 months does not affect either FMD or NID in patients with T2D. While these results could not confirm a beneficial effect of LCD on ED as observed in non-diabetic individuals, the data also suggest that the higher intake of fat, in particular SFA, associated with a LCD, does not adversely affect endothelial function and hence cardiovascular risk in patients with T2D.Grant acknowledgement: Novo Nordisk Foundation, A. P. M{\o}ller Foundation",

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author = "Eva Gram-Kampmann and Olesen, {Thomas Bastholm} and {Dalby Hansen}, Camilla and {Balle Hugger}, Mie and {M{\o}ller Jensen}, Jane and Hermann, {Anne Pernille} and Olsen, {Michael Hecht} and Aleksander Krag and Henning Beck-Nielsen and Kurt H{\o}jlund",

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doi = "10.1007/s00125-022-05755-w",

language = "English",

volume = "65",

journal = "Diabetologia",

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Gram-Kampmann, E, Olesen, TB , Dalby Hansen, C, Balle Hugger, M, Møller Jensen, J , Hermann, AP , Olsen, MH , Krag, A, Beck-Nielsen, H & Højlund, K 2022, 'A six-month low-carbohydrate diet high in fat in patients with type 2 diabetes does not affect the vasodilatory reactivity of the brachial artery', Diabetologia, bind 65, nr. Suppl. 1, 827. https://doi.org/10.1007/s00125-022-05755-w

A six-month low-carbohydrate diet high in fat in patients with type 2 diabetes does not affect the vasodilatory reactivity of the brachial artery. / Gram-Kampmann, Eva; Olesen, Thomas Bastholm ; Dalby Hansen, Camilla et al.
I: Diabetologia, Bind 65, Nr. Suppl. 1, 827, 23.09.2022.

Publikation: Bidrag til tidsskrift › Konferenceabstrakt i tidsskrift › Forskning › peer review

TY - ABST

T1 - A six-month low-carbohydrate diet high in fat in patients with type 2 diabetes does not affect the vasodilatory reactivity of the brachial artery

AU - Gram-Kampmann, Eva

AU - Olesen, Thomas Bastholm

AU - Dalby Hansen, Camilla

AU - Balle Hugger, Mie

AU - Møller Jensen, Jane

AU - Hermann, Anne Pernille

AU - Olsen, Michael Hecht

AU - Krag, Aleksander

AU - Beck-Nielsen, Henning

AU - Højlund, Kurt

N1 - Conference code: 58

PY - 2022/9/23

Y1 - 2022/9/23

N2 - Background and aims: One of the major causes of mortality in type 2 diabetes (T2D) is cardiovascular disease (CVD). Endothelial dysfunction (ED) is an early sign of atherosclerosis which is present before overt clinical CVD. In non-diabetic subjects, low-carbohydrate diets (LCDs) have been demonstrated to improve vasodilatory reactivity in the endothelium, but in T2D patients, the effect of a LCD on measures of ED is mixed. The aim of this study was to examine the effect of a non-calorie-restricted LCD high in fat for six months on measures of ED in T2D.Materials and methods: Patients with T2D were randomized 2:1 to either a LCD with a max. of 20 E% (percentage of total energy intake) from carbohydrates and min. 50 E% from fat (n = 49) or a control diet with 50-60 E% from carbohydrates (n = 22) for 6 months. Both diets were non-calorie restricted. Flow-mediated vasodilation (FMD) and nitroglycerine-induced vasodilation (NID) were assessed at baseline and after six months using B-mode ultrasound scans of the brachial artery and are reported as dilation in percentage (%). Blood samples were collected and dual-energy x-ray absorptiometry (DXA) and anthropometrics were assessed at baseline and after six months. We report baselines differences and the mean difference in change (MDIC) between groups from baseline to six months. Results: Participants on the LCD reduced their self-reported carbohydrate intake to ~ 14 E% and increased their fat intake to ~63 E% including a 2.7 fold increase in saturated fatty acids (SFA). The LCD caused a clinically relevant decrease in HbA1c (MDIC: -8.9 ± 1.7 mmol/mol; P < 0.001), a reduction in weight (MDIC: -3.9 ± 1.0 kg; P < 0.01) and improved body composition (PConclusions: A non-calorie-restricted LCD high in fat for 6 months does not affect either FMD or NID in patients with T2D. While these results could not confirm a beneficial effect of LCD on ED as observed in non-diabetic individuals, the data also suggest that the higher intake of fat, in particular SFA, associated with a LCD, does not adversely affect endothelial function and hence cardiovascular risk in patients with T2D.Grant acknowledgement: Novo Nordisk Foundation, A. P. Møller Foundation

AB - Background and aims: One of the major causes of mortality in type 2 diabetes (T2D) is cardiovascular disease (CVD). Endothelial dysfunction (ED) is an early sign of atherosclerosis which is present before overt clinical CVD. In non-diabetic subjects, low-carbohydrate diets (LCDs) have been demonstrated to improve vasodilatory reactivity in the endothelium, but in T2D patients, the effect of a LCD on measures of ED is mixed. The aim of this study was to examine the effect of a non-calorie-restricted LCD high in fat for six months on measures of ED in T2D.Materials and methods: Patients with T2D were randomized 2:1 to either a LCD with a max. of 20 E% (percentage of total energy intake) from carbohydrates and min. 50 E% from fat (n = 49) or a control diet with 50-60 E% from carbohydrates (n = 22) for 6 months. Both diets were non-calorie restricted. Flow-mediated vasodilation (FMD) and nitroglycerine-induced vasodilation (NID) were assessed at baseline and after six months using B-mode ultrasound scans of the brachial artery and are reported as dilation in percentage (%). Blood samples were collected and dual-energy x-ray absorptiometry (DXA) and anthropometrics were assessed at baseline and after six months. We report baselines differences and the mean difference in change (MDIC) between groups from baseline to six months. Results: Participants on the LCD reduced their self-reported carbohydrate intake to ~ 14 E% and increased their fat intake to ~63 E% including a 2.7 fold increase in saturated fatty acids (SFA). The LCD caused a clinically relevant decrease in HbA1c (MDIC: -8.9 ± 1.7 mmol/mol; P < 0.001), a reduction in weight (MDIC: -3.9 ± 1.0 kg; P < 0.01) and improved body composition (PConclusions: A non-calorie-restricted LCD high in fat for 6 months does not affect either FMD or NID in patients with T2D. While these results could not confirm a beneficial effect of LCD on ED as observed in non-diabetic individuals, the data also suggest that the higher intake of fat, in particular SFA, associated with a LCD, does not adversely affect endothelial function and hence cardiovascular risk in patients with T2D.Grant acknowledgement: Novo Nordisk Foundation, A. P. Møller Foundation

KW - lavkulhydratdiæt

KW - type 2 diabetes

KW - endothelial dysfunktion

KW - inflammation

U2 - 10.1007/s00125-022-05755-w

DO - 10.1007/s00125-022-05755-w

M3 - Conference abstract in journal

C2 - 35920845

SN - 0012-186X

VL - 65

JO - Diabetologia

JF - Diabetologia

IS - Suppl. 1

M1 - 827

T2 - 58th EASD Annual Meeting

Y2 - 19 September 2022 through 23 September 2022

ER -

A six-month low-carbohydrate diet high in fat in patients with type 2 diabetes does not affect the vasodilatory reactivity of the brachial artery

Abstract

Konference

Emneord

Dokumenter og links

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A Low-Carbohydrate Diet in Type 2 Diabetes: Effects over six months on glycemic control, cardiovascular risk factors, vascular endothelial function and pro-inflammatory markers

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