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From the eleven studies, nine demonstrated a positive effect of dietary intervention on improving HbA1c values at the end point of intervention.
The main outcome of interest for this review was the mean difference in HbA1c between dietary arms at the end point of intervention.
In fact, the recommendation of an expert panel convened by the American Diabetes Association was that C-peptide response (CPR) is the most appropriate measure of function and clinical end point of intervention in human clinical trials (14).
Differences in prescribed v. reported diets are apparent when comparisons are made with the macronutrient targets set at baseline to those that were reported at the end point of intervention (Table 2).
Similarly, Barnard et al. reported that, at the end point of intervention, dietary adherence was met by only 51%% of those in the low-fat vegan group and by 48%% of those in the ADA group.> -wrap-foot> The results of this systematic review indicate that only four out of the eleven trials demonstrated a benefit of one particular dietary intervention over another.
Inclusion criteria included RCT with minimum 6 months duration, with participants having BMI≥25·0 kg/m, a diagnosis of T2DM using HbA1c, and no statistically significant difference in mean weight loss at the end point of intervention between dietary arms.
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All measurements will be done at baseline, at 12-, and 24-month (the end point of the intervention).
Long term and continued adherence to exercise beyond the end point of the intervention was motivated by the desire to maintain a state of wellbeing (60% of respondents).
Some possible reasons are that, first, the end point of this intervention was during the coldest time of year in Japan, and many people undoubtedly preferred to stay indoors.
Guldbrand et al. compared a low-carbohydrate diet with a low-fat diet, and despite both groups experiencing significant weight loss there were no significant improvements in HbA1c at the end point of either dietary intervention.
As Ogilvie et al. (19) point out, the true end point of TR is not simply institutionalizing effective interventions but improving population health.
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com