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Assessing the evidence for weight loss strategies in people with and without type 2 diabetes.

Authors
  • Clifton, Peter1
  • 1 Division of Health Sciences, School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, SA 5001, Australia. [email protected] , (Australia)
Type
Published Article
Journal
World Journal of Diabetes
Publisher
Baishideng Publishing Group Co (World Journal of Diabetes)
Publication Date
Oct 15, 2017
Volume
8
Issue
10
Pages
440–454
Identifiers
DOI: 10.4239/wjd.v8.i10.440
PMID: 29085571
Source
Medline
Keywords
License
Unknown

Abstract

This review will examine topical issues in weight loss and weight maintenance in people with and without diabetes. A high protein, low glycemic index diet would appear to be best for 12-mo weight maintenance in people without type 2 diabetes. This dietary pattern is currently being explored in a large prevention of diabetes intervention. Intermittent energy restriction is useful but no better than daily energy restriction but there needs to be larger and longer term trials performed. There appears to be no evidence that intermittent fasting or intermittent severe energy restriction has a metabolic benefit beyond the weight loss produced and does not spare lean mass compared with daily energy restriction. Meal replacements are useful and can produce weight loss similar to or better than food restriction alone. Very low calorie diets can produce weight loss of 11-16 kg at 12 mo with persistent weight loss of 1-2 kg at 4-6 years with a very wide variation in long term results. Long term medication or meal replacement support can produce more sustained weight loss. In type 2 diabetes very low carbohydrate diets are strongly recommended by some groups but the long term evidence is very limited and no published trial is longer than 12 mo. Although obesity is strongly genetically based the microbiome may play a small role but human evidence is currently very limited.

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