Jessica Turton is undertaking a PhD at the University of Sydney under the supervision of A/Prof Kieron Rooney, Prof Grant Brinkworth (CSIRO) and Dr Helen Parker. Her thesis is focused on the use of low-carbohydrate diets for type 1 diabetes management.
Type 1 diabetes is an autoimmune condition characterised by the destruction of pancreatic beta cells, absolute insulin deficiency and impaired carbohydrate metabolism. Whilst completing her Masters Research Project in 2017, Jessica identified a sheer lack of high-quality research investigating the appropriate level of carbohydrate intake for this clinical population and she published the first systematic review in this area which is available at PLoSONE (link: https://journals.plos.org/plosone/article/authors?id=10.1371/journal.pone.0194987).
For the first project of her PhD, Jessica acknowledged that she would need to draw upon the vast literature base in type 2 diabetes to help develop an evidence-based low-carbohydrate diet protocol that can be used in a primary clinical trial involving adults with type 1 diabetes. A secondary goal of this research was to improve the translational capacity of existing low-carbohydrate diet literature into clinical practice management for type 2 diabetes. Clinicians can use this paper to obtain the core diet and delivery components of all effective low-carbohydrate dietary interventions used in type 2 diabetes management to formulate evidence-based low-carbohydrate diets for their own patients.
Abstract
Aim
To identify core diet and delivery components of low‐carbohydrate (CHO) diets that have demonstrated efficacy for type 2 diabetes (T2D) management.
Materials and methods
MEDLINE, Pre‐MEDLINE, EMBASE, CINAHL and the Cochrane Library of Controlled Trials databases were systematically searched from inception until August 18, 2018. Primary intervention studies of low‐CHO diets (≤130 g/d or 26% total energy intake [TEI]) were included. Content analysis was performed on the low‐CHO diet protocols classified as safe and effective for T2D management.
Results
A total of 41 studies published between 1963 and 2018 were included, of which 40 were classified as safe and effective for inclusion in the primary analysis. Thirteen studies (13/40) were on very‐low‐CHO diets (<50 g/d), 14/40 included low‐CHO diets (≤130 g/d or 26% TEI), and 13/40 were adapted according to participant progress. Thirty‐one studies reported a total energy prescription, of which 18/31 encouraged ad libitum intakes. Twenty studies reported a prescribed dietary fat amount, of which 18/20 were unrestricted or high‐fat (>35% TEI). Twenty‐six studies reported a prescribed dietary protein amount, of which 22 were unrestricted or were high‐protein (>25% TEI). The types of dietary CHO, fat and protein recommended were predominantly whole foods. Common delivery methods reported were dietician and/or physician involvement, moderate to high frequency of contact (≥1 session/month) and use of participant self‐monitoring.
Conclusions
Multiple approaches for developing and delivering a low‐CHO diet intervention for T2D management are safe and effective. A comprehensive set of core dietary components to consider in the formulation of low‐CHO diet protocols were identified for use in clinical practice and to inform evidence‐based guidelines for T2D management.
Link to Full Text
https://onlinelibrary.wiley.com/doi/abs/10.1111/dom.13837
Jessica Turton – ‘An evidence-based approach to developing low carb diets for type 2 diabetes’ https://www.youtube.com/watch?v=gTpMHiUAAuE&t=1619s