Isocaloric-restricted Mediterranean diet and Chinese diets high or low in plants in adults with prediabetes

• Published in: The journal of clinical endocrinology and metabolism 2022-08, Vol.107 (8), p.2216-2227
• Main Authors: Luo, Yaogan, Wang, Jiqiu, Sun, Liang, Gu, Weiqiong, Zong, Geng, Song, Boyu, Shen, Chongrong, Zhou, Puchen, Chen, Yufei, Wu, Yanpu, Lin, Huibin, Zheng, He, Ni, Mengshan, Yang, Xiaowei, Chen, Yanru, Xu, Xinming, Zhang, Juan, Shi, Juan, Zhang, Ru, Hu, Jinfen, Hou, Hong, Lu, Ling, Xu, Xiaoqiang, Liang, Liming, Liu, Ruixin, Liu, Xiaoran, Li, Huaixing, Hong, Jie, Wang, Weiqing, Lin, Xu, Ning, Guang
• Format: Article
• Language: English
• Subjects: Adults; Blood sugar; Body mass index; Body weight; Clinical; Compact disc industry; Glucose tolerance tests; Low density lipoproteins; Prediabetic state; Type 2 diabetes
• ISSN: 0021-972X; 1945-7197
• DOI: 10.1210/clinem/dgac303

Calorie restriction plus dietary advice is suggested as a preventive strategy for individuals with obesity and prediabetes, however, optimal diet is still debatable. We aimed to compare the effects of Mediterranean diet (MD) and Chinese diets high or low in plants on body weight and glucose homeostasis among high risk Chinese. In this parallel-arm randomized controlled trial, 253 Chinese adults aged 25-60 years with BMI ≥24.0 kg/m 2 and fasting blood glucose ≥5.6 mmol/L were randomly assigned to three isocaloric-restricted diets: MD (n = 84), a traditional Jiangnan Diet high in plants (TJD, n = 85), or a control diet low in plants (CD, n = 84). During the 6-month trial, a 5-weekday full feeding regimen was followed, along with mobile app-based monitoring. Abdominal fat measurement (magnetic resonance imaging), oral glucose tolerance test (OGTT), and continuous glucose monitoring (CGM) were conducted at baseline, 3- and 6-month. With a 25% calorie-restriction for 6 months, weight deduction was 5.72 kg (95% CI: 5.03, 6.40) for MD, 5.05 kg (4.38, 5.73) for TJD and 5.38 kg (4.70, 6.06) for CD (Ptime < 0.0001). No between-group differences were found for fasting glucose, insulin, and the Matsuda index from OGTT. Notably, CD had significantly longer time below range (glucose < 3.9 mmol/L) than MD [0.81% ( 0.21, 1.40), P = 0.024] and marginally longer time than TJD [0.56% (-0.03,1.15), P = 0.065], as measured by CGM. With the 6-month isocaloric-restricted feeding, TJD and MD achieved comparable weight deduction and improved glucose homeostasis, whereas CD showed a higher risk for hypoglycemia.