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Efficacy of low‐ and very‐low‐energy diets in people with type 2 diabetes mellitus: A systematic review and meta‐analysis of interventional studies
Author(s) -
Kloecker David E.,
Zaccardi Francesco,
Baldry Emma,
Davies Melanie J.,
Khunti Kamlesh,
Webb David R.
Publication year - 2019
Publication title -
diabetes, obesity and metabolism
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.445
H-Index - 128
eISSN - 1463-1326
pISSN - 1462-8902
DOI - 10.1111/dom.13727
Subject(s) - medicine , weight loss , cinahl , psychological intervention , type 2 diabetes , body mass index , meta analysis , diabetes mellitus , type 2 diabetes mellitus , gerontology , obesity , endocrinology , psychiatry
Aims To review systematically and quantify the weight loss achieved through low‐ (LEDs) and very‐low‐energy diets (VLEDs) in people with type 2 diabetes mellitus (T2DM). Materials and methods Studies reporting the effects of diet‐only interventions of up to 1600 kcal/d in people with T2DM were searched in MEDLINE, EMBASE and CINAHL up to July 2018. Changes in the primary (body weight and body mass index [BMI]) and secondary outcomes (glycated haemoglobin, blood lipids) according to energy restriction and duration of diet were modelled using restricted cubic splines. Results Forty‐four studies (3817 participants) were included. The overall quality of the evidence was moderate and limited to short‐term interventions up to 4 months. Baseline mean weight and BMI were 92.1 kg and 36.6 kg/m 2 . VLEDs of 400 kcal/d led to 5.4% weight loss at 2 weeks, increasing to 17.9% at 3 months. More modest reductions of 7.3% were observed on LEDs of 1200 kcal/d and 2.0% on 1600 kcal/d after 3 months. No clear patterns emerged for secondary outcomes. Publication bias was significant for primary outcomes. Conclusions Through modelling, we were able to describe effective dietary deficit strategies to achieve weight reduction up to 4 months in people with T2DM. High‐quality studies are required to further support clinical practice with evidence‐based dietary interventions.