title: Targeting dietary fat or glycemic load in the treatment of obesity and type 2 diabetes: a randomized controlled trial.
abstract: OBJECTIVE
  To compare the effects of lifestyle modification programs that prescribe low-glycemic load (GL) vs. low-fat diets in a randomized trial.
  
  
  METHODS
  Seventy-nine obese adults with type 2 diabetes received low-fat or low-GL dietary instruction, delivered in 40-week lifestyle modification programs with identical goals for calorie intake and physical activity. Changes in weight, HbA(1c), and other metabolic parameters were compared at weeks 20 and 40.
  
  
  RESULTS
  Weight loss did not differ between groups at week 20 (low-fat: -5.7±3.7%; low-GL: -6.7±4.4%, p=.26) or week 40 (low-fat: -4.5±7.5%; low-GL: -6.4±8.2%, p=.28). Adjusting for changes in antidiabetic medications, subjects on the low-GL diet had larger reductions in HbA(1c) than those on the low-fat diet at week 20 (low-fat: -0.3±0.6%; low-GL: -0.7±0.6%, p=.01), and week 40 (low-fat: -0.1±1.2%; low-GL: -0.8±1.3%; p=.01). Groups did not differ significantly on any other metabolic outcomes (p≥.06).
  
  
  CONCLUSIONS
  Results suggest that targeting GL, rather than dietary fat, in a low-calorie diet can significantly enhance the effect of weight loss on HbA(1c) in patients with type 2 diabetes.
authors.affiliation: Department of Psychiatry, University of Pennsylvania School of Medicine, United States. fabricat@mail.med.upenn.edu
authors.forename: A N
authors.initials: AN
authors.lastname: Fabricatore
authors.forename: T A
authors.initials: TA
authors.lastname: Wadden
authors.forename: C B
authors.initials: CB
authors.lastname: Ebbeling
authors.forename: J G
authors.initials: JG
authors.lastname: Thomas
authors.forename: V A
authors.initials: VA
authors.lastname: Stallings
authors.forename: S
authors.initials: S
authors.lastname: Schwartz
authors.forename: D S
authors.initials: DS
authors.lastname: Ludwig
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000178:diet therapy*; D018752:Diet, Fat-Restricted; D004041:Dietary Fats; D038321:Glycemic Index; D006801:Humans; D008875:Middle Aged; D009765:Obesity / Q000178:diet therapy*; D055815:Young Adult
chemical_list: D004041:Dietary Fats