Abstract

Aim: Evaluate the effects of two low fat hypocaloric diets differing in carbohydrate:protein ratio, with and without resistance training (RT), on weight loss, body composition and cardiovascular disease (CVD) risk outcomes in overweight/obese patients with type 2 diabetes (T2D).

Methods: 83 men/women with T2D (age:56.1±7.5yrs, BMI:35.4±4.6kg/m²) were randomly assigned to an isocaloric, energy restricted diet (females:6 MJ/day, males:7 MJ/day) of either standard carbohydrate (CON; carbohydrate:protein:fat, 53:19:26) or high protein (HP; 43:33:22), with or without supervised RT (3d/wk) for 16-wks. Body weight and composition, waist circumference (WC) and cardiometabolic risk markers were assessed.

Results: 59 participants completed the study. There was a significant group effect (P≤0.04) for body weight, fat mass and WC with greatest reductions in HP+RT; weight (CON:-8.6±4.6kg, HP:-9.0±4.8kg, CON+RT:-10.5±5.1kg, HP+RT:-13.8±6.0kg), fat mass (CON:-6.4±3.4kg, HP:-6.7±4.0kg, CON+RT:-7.9±3.7kg, HP+RT:-11.1±3.7kg), WC (CON:-8.2±4.6cm, HP:-8.9±3.9cm, CON+RT:-11.3±4.6cm, HP+RT:-13.7±4.6cm). There was an overall reduction (P<0.001) in fat-free mass:-2.0±2.3kg, blood pressure:-15/8±10/6mmHg, glucose:-2.1±2.2 mmol/L, insulin:-4.7±5.4mU/L, HbA1c:-1.25±0.94%, triglycerides:-0.47±0.81mmol/L, total cholesterol:-0.67±0.69 mmol/L and LDL-cholesterol:-0.37±0.53 mmol/L, with no difference between groups (P≥0.17).

Conclusion: An energy restricted HP diet combined with RT achieved greater weight loss and more favourable changes in body composition. All treatments had similar improvements in glycemic control and CVD risk markers.