Table 3.
Studies investigating the interaction between different diets and the combined effect of pretreatment glycemia and insulinemia status or markersa
| Reference | Study design and country | Participants | Duration and number of participants | Prescribed diets | Groups | Results |
|---|---|---|---|---|---|---|
| Hjorth et al. (34) (SHOPUS) | Secondary analysis of an RCT; Denmark | 11% normal weight; 43% overweight; 46% obese | 26 weeks; n = 176 | Ad libitum New Nordic Diet: C 47% + 44 g fiber/10 MJ: P 18%: F 30% Average Danish Diet: C 46% + 28 g fiber/10 MJ: P 17%: F 34% |
Groups based on combined FPG and FI values: FPG < 5.6 mmol/L and FPG = 5.6–6.9 mmol/L; median FI value among prediabetic individuals used as the split | Participants with high FPG values and low FI values lost 6.3 kg more (p < 0.001) on the New Nordic Diet than on the Average Danish Diet; no difference between diets among those with low FPG and high FI values (Δ0.10 kg; p = 0.89) |
| Hjorth et al. (34) (NUGENOB) | Secondary analysis of an RCT; pan-European | 5% overweight; 95% obese | 10 weeks; n = 743 | −600 kcal/day on either a low-fat–high-carbohydrate diet (C 58%: P 17%: F 25%) or a low-carbohydrate–high-fat diet (C 42%: P 17%: F 41%) | Groups based on combined FPG and FI values: FPG < 5.6 mmol/L, FPG = 5.6–6.9 mmol/L, and FPG ≥ 7.0 mmol/L; median FI among prediabetic individuals used as the split | Participants with high FPG and low FI values lost 3.1 kg more (p = 0.02) on the low-carbohydrate–high-fat diet than on the low-fat–high-carbohydrate diet; participants with low FPG and low FI values lost 0.5 kg more (p = 0.02) on the low-fat–high-carbohydrate diet |
| Hjorth et al. (34) (DiOGenes) | Secondary analysis of an RCT; pan-European | 19% overweight; 81% obese | 26 weeks; n = 266 | Ad libitum High-glycemic-load diet: C 51% (GI = 61):P 17%: F 30% Low-glycemic-load diet: C 46% (GI = 56): P 21%: F 30% |
Groups based on combined FPG and FI values: FPG < 5.6 mmol/L and FPG = 5.6–6.9 mmol/L; median FI among prediabetic individuals used as the split | Participants with high FPG and low FI values regained 7.8 kg more (p < 0.001) on the high-glycemic-load diet than on the low-glycemic-load diet; no difference between diets among participants with low FPG and high FI values (Δ 1.2 kg; p = 0.19) |
| Hjorth et al. (33) (MUFObes) | Secondary analysis of an RCT; Denmark | BMI = 31 (range, 29.3–33.0) kg/m2 | 6 months; n = 104 | Nordic Nutrition Recommended Diet: C 58% (40 g fiber/10 MJ): P 16%: F 24% Average Danish Diet: C 50% (29 g fiber/10 MJ): P 16%: F 32% The MUFA diet was not analyzed when combining FPG and FI as n = 1 in one of the four phenotypes |
Groups based on combined FPG and FI values: FPG < 5.0 mmol/L and FPG = 5.0–5.8 mmol/L; median FI among prediabetic individuals used as the split | Participants with high FPG and high FI values regained 7.0 kg more (p = 0.001) on the Average Danish Diet than on the Nordic Nutrition Recommended Diet; no difference was observed between diets for the other three combinations of FPG and FI (p ≥ 0.15) |
| Hjorth et al. (36) (CHO) | Secondary analysis of an RCT; United States | Obese with BMI = 36.1 ± 3.5 kg/m2 | 24 months; n = 307 | Low-carbohydrate diet (20 g/day for 3 months with low-GI vegetables and unrestricted fat and protein; after 3 months carbohydrates increased by 5 g/day per week until a stable desired weight was achieved) Low-fat diet with limited energy intake (1,200 to 1,800 kcal/day; C 55%: P 15%: F 30%) |
Groups based on combined FPG and FI values: FPG < 5.6 mmol/L and FPG = 5.6–6.9 mmol/L; median FI used as the split | Participants with high FPG and low FI values tended to lose 6.2 kg more (p = 0.088) on the low-carbohydrate ad libitum diet, whereas those with high FPG and high FI values lost 7.2 kg more (p = 0.005) on the low-fat, hypocaloric diet (Δ13.3 kg; p = 0.003); no difference between diets among participants with low FPG values regardless of their FI value (p ≥ 0.16) |
Abbreviations: BMI, body mass index; FPG, fasting plasma glucose; FI, fasting insulin; GI, glycemic index; MUFA, monounsaturated fatty acid; RCT, randomized controlled trial.
a
BMI values are summarized as mean ± standard deviation, median (interquartile range), or as percentage in different weight categories. C:P:F refers to energy percentages of carbohydrate, protein, and fat in the diet.