Background and Objectives:Very-low calorie diets(VLCD)achieve weight loss and remission of Type 2 diabetes(T2DM),but efficacy and acceptability in non-European populations is less clear.This feasibility study examines...Background and Objectives:Very-low calorie diets(VLCD)achieve weight loss and remission of Type 2 diabetes(T2DM),but efficacy and acceptability in non-European populations is less clear.This feasibility study examines the impact of 10%weight loss through VLCD on metabolic and body composition outcomes in a multiethnic cohort of Aotearoa New Zealand(AoNZ)men with prediabetes/early T2DM,and VLCD tolerability/cultural acceptability.Methods and Study Design:Participants followed a VLCD intervention(mean energy 3033kJ/day)until achievement of 10%weight loss.An oral glucose tolerance test(OGTT),hyperinsulinaemic isoglycaemic clamp with stable isotopes,hood calorimetry and dual-energy Xray absorptiometry(DXA)were undertaken before and after intervention.Qualitative data on VLCD tolerability/cultural acceptability were collected.Results:Fifteen participants were enrolled;nine achieved 10%weight loss.In this group,mean HbA1c reduced by 4.8mmol/mol(2.4-7.1)and reverted to normoglycaemia in n=5/9;mean body weight reduced by 12.0 kg(11.0-13.1)and whole-body glucose disposal improved by 1.5 mg kgFFM^(-1)min^(-1)(0.7-2.2).Blood pressure and fasting triglycerides improved significantly.No changes in hepatic glucose metabolism were found.In all participants who attended completion testing,HbA1c reduced by 3.4mmol/mol(SD 3.5)and total weight by 9.0kg(SD 5.7).The intervention was highly tolerable/culturally acceptable however challenges with fulfilment of cultural obligations were described.Conclusions:Results support VLCD use in AoNZ however further work to investigate ethnic differences in physiological response to VLCDs and to optimise protocols for multi-ethnic populations are required.展开更多
基金Health Research Council of New Zealand(HRC 17/542)the New Zealand Society for the Study of Diabetes(2016 NZSSD NZMS Medical Technology Grant)+1 种基金the University of Otago(University of Otago Research Grant 2017)for their study fundingthe Health Research Council of New Zealand for Clinical Research Training Fellowship funding(HRC 16/058)for PW.
文摘Background and Objectives:Very-low calorie diets(VLCD)achieve weight loss and remission of Type 2 diabetes(T2DM),but efficacy and acceptability in non-European populations is less clear.This feasibility study examines the impact of 10%weight loss through VLCD on metabolic and body composition outcomes in a multiethnic cohort of Aotearoa New Zealand(AoNZ)men with prediabetes/early T2DM,and VLCD tolerability/cultural acceptability.Methods and Study Design:Participants followed a VLCD intervention(mean energy 3033kJ/day)until achievement of 10%weight loss.An oral glucose tolerance test(OGTT),hyperinsulinaemic isoglycaemic clamp with stable isotopes,hood calorimetry and dual-energy Xray absorptiometry(DXA)were undertaken before and after intervention.Qualitative data on VLCD tolerability/cultural acceptability were collected.Results:Fifteen participants were enrolled;nine achieved 10%weight loss.In this group,mean HbA1c reduced by 4.8mmol/mol(2.4-7.1)and reverted to normoglycaemia in n=5/9;mean body weight reduced by 12.0 kg(11.0-13.1)and whole-body glucose disposal improved by 1.5 mg kgFFM^(-1)min^(-1)(0.7-2.2).Blood pressure and fasting triglycerides improved significantly.No changes in hepatic glucose metabolism were found.In all participants who attended completion testing,HbA1c reduced by 3.4mmol/mol(SD 3.5)and total weight by 9.0kg(SD 5.7).The intervention was highly tolerable/culturally acceptable however challenges with fulfilment of cultural obligations were described.Conclusions:Results support VLCD use in AoNZ however further work to investigate ethnic differences in physiological response to VLCDs and to optimise protocols for multi-ethnic populations are required.
