TY - JOUR
T1 - A modified Mediterranean diet is associated with the greatest reduction in alanine aminotransferase levels in obese type 2 diabetes patients
T2 - Results of a quasi-randomised controlled trial
AU - Fraser, A.
AU - Abel, R.
AU - Lawlor, D. A.
AU - Fraser, D.
AU - Elhayany, A.
N1 - Funding Information:
Acknowledgements This study was supported by a grant from Tnuva Research Institute, Rehovot, Israel. A. Fraser receives support from the University of Bristol Overseas Research Scholarship Award Scheme and D. Lawlor is funded by a (UK) Department of Health Career Scientist award. We thank all trial participants and dietitians.
PY - 2008/9
Y1 - 2008/9
N2 - Aim: The aim of the study was to compare the effect of different dietary interventions on alanine aminotransferase (ALT) in obese patients with diabetes. Methods: A post hoc analysis of an open label, parallel design, quasi-randomised (allocation by alternation), controlled trial, conducted in Israel. Obese patients with diabetes (n=259), treated in the community, were centrally allocated to one of three diets: (1) the 2003 recommended American Diabetes Association diet (ADA): 50-55% carbohydrate, 30% fat and 20% protein, n=85; (2) a low glycaemic index (LGI) diet: 50-55% LGI carbohydrate, 30% fat, 15-20% protein, n=89; or (3) a modified Mediterranean diet (MMD): 35% LGI carbohydrate, 45% fat that was high in monounsaturated fat, 15-20% protein, n=85. ALT was measured at 6 and 12 months. Results: ALT levels decreased in all arms; however, the MMD was associated with the lowest ALT levels at month 6 (n=201: ADA n=64, LGI n=73, MMD n=64) and month 12 of follow-up (n=179). At 12 months mean ALT levels were 19.8±1.4 U/l in the ADA diet arm (n=54), 18.0±1.5 U/l in the LGI diet arm (n=64) and 14.4±1.7 in the MMD arm (n=61, p<0.001). Evidence for an effect of diet on ALT levels persisted when controlling for post-randomisation changes in waist to hip ratio, BMI, homeostasis model assessment (HOMA) or triacylglycerol. Conclusions: A Mediterranean diet may have a beneficial effect on liver steatosis in obese patients with diabetes. Results of trials assessing the effect of dietary composition on clinical outcomes should be awaited before a decisive conclusion can be reached. In addition to clinical outcomes, such studies should address the issue of primary prevention of steatosis in high-risk and healthy individuals. Trial registration: ClinicalTrials.gov NCT00520182 Funding: This study was supported by a grant from Tnuva Research Institute, Rehovot, Israel.
AB - Aim: The aim of the study was to compare the effect of different dietary interventions on alanine aminotransferase (ALT) in obese patients with diabetes. Methods: A post hoc analysis of an open label, parallel design, quasi-randomised (allocation by alternation), controlled trial, conducted in Israel. Obese patients with diabetes (n=259), treated in the community, were centrally allocated to one of three diets: (1) the 2003 recommended American Diabetes Association diet (ADA): 50-55% carbohydrate, 30% fat and 20% protein, n=85; (2) a low glycaemic index (LGI) diet: 50-55% LGI carbohydrate, 30% fat, 15-20% protein, n=89; or (3) a modified Mediterranean diet (MMD): 35% LGI carbohydrate, 45% fat that was high in monounsaturated fat, 15-20% protein, n=85. ALT was measured at 6 and 12 months. Results: ALT levels decreased in all arms; however, the MMD was associated with the lowest ALT levels at month 6 (n=201: ADA n=64, LGI n=73, MMD n=64) and month 12 of follow-up (n=179). At 12 months mean ALT levels were 19.8±1.4 U/l in the ADA diet arm (n=54), 18.0±1.5 U/l in the LGI diet arm (n=64) and 14.4±1.7 in the MMD arm (n=61, p<0.001). Evidence for an effect of diet on ALT levels persisted when controlling for post-randomisation changes in waist to hip ratio, BMI, homeostasis model assessment (HOMA) or triacylglycerol. Conclusions: A Mediterranean diet may have a beneficial effect on liver steatosis in obese patients with diabetes. Results of trials assessing the effect of dietary composition on clinical outcomes should be awaited before a decisive conclusion can be reached. In addition to clinical outcomes, such studies should address the issue of primary prevention of steatosis in high-risk and healthy individuals. Trial registration: ClinicalTrials.gov NCT00520182 Funding: This study was supported by a grant from Tnuva Research Institute, Rehovot, Israel.
KW - Alanine aminotransferase
KW - Mediterranean diet
KW - Non-alcoholic fatty liver disease
KW - Randomised controlled trial
KW - Type 2 diabetes
UR - http://www.scopus.com/inward/record.url?scp=49249132482&partnerID=8YFLogxK
U2 - 10.1007/s00125-008-1049-1
DO - 10.1007/s00125-008-1049-1
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C2 - 18597068
AN - SCOPUS:49249132482
SN - 0012-186X
VL - 51
SP - 1616
EP - 1622
JO - Diabetologia
JF - Diabetologia
IS - 9
ER -