Cited by 25Dietary Effects on HealthDiet and metabolism studiesBariatric Surgery and Outcomes

Efficacy of low- and very-low-energy diets in people with type 2 diabetes mellitus: A systematic review and meta-analysis of interventional studies

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Kloecker, David E., Zaccardi, Francesco, Baldry, Emma, Davies, Melanie J., Khunti, Kamlesh, Webb, David R.·2019·Diabetes, Obesity and Metabolism

Abstract

Aims: To review systematically and quantify the weight loss achieved through low‐ (LEDs) and very‐low‐energy diets (VLEDs) in people with type 2 diabetes mellitus (T2DM). Materials and methods: Studies reporting the effects of diet‐only interventions of up to 1600 kcal/d in people with T2DM were searched in MEDLINE, EMBASE and CINAHL up to July 2018. Changes in the primary (body weight and body mass index [BMI]) and secondary outcomes (glycated haemoglobin, blood lipids) according to energy restriction and duration of diet were modelled using restricted cubic splines. Results: Forty‐four studies (3817 participants) were included. The overall quality of the evidence was moderate and limited to short‐term interventions up to 4 months. Baseline mean weight and BMI were 92.1 kg and 36.6 kg/m 2 . VLEDs of 400 kcal/d led to 5.4% weight loss at 2 weeks, increasing to 17.9% at 3 months. More modest reductions of 7.3% were observed on LEDs of 1200 kcal/d and 2.0% on 1600 kcal/d after 3 months. No clear patterns emerged for secondary outcomes. Publication bias was significant for primary outcomes. Conclusions: Through modelling, we were able to describe effective dietary deficit strategies to achieve weight reduction up to 4 months in people with T2DM. High‐quality studies are required to further support clinical practice with evidence‐based dietary interventions.

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  • Very low calorie diets (VLCD/VLED) and very low calorie ketogenic diets (VLCKD) are primarily used in patients with severe obesity or metabolic complications, especially when rapid and substantial weight loss is required.

    “Very low calorie diets (VLCD/VLED) and very low calorie ketogenic diets (VLCKD) are primarily used in patients with severe obesity or metabolic complications, especially in situations that require rapid and substantial weight loss.”
  • In very low calorie protocols providing about 400 kcal per day, reported losses ranged from approximately 5 kg after two weeks to more than 25 kg after several months, whereas interventions providing about 800 kcal produced smaller but directionally comparable effects.

    “In protocols providing about 400 kcal per day, reported losses ranged from approximately 5 kg after two weeks to more than 25 kg after several months, whereas interventions providing about 800 kcal produced smaller but directionally comparable effects [19].”
  • VLCD/VLED protocols provide fewer than 800 kcal per day, while VLCKD additionally limits carbohydrate intake to 30 to 50 g per day, inducing a state of ketosis.

    “VLCD/VLED protocols provide fewer than 800 kcal per day, while VLCKD additionally limits carbohydrate intake to 30 to 50 g per day, inducing a state of ketosis.”
  • Very low calorie dietary interventions remain one of the few approaches capable of producing rapid and substantial reductions in body weight.

    “Very low calorie dietary interventions remain one of the few approaches capable of producing rapid and substantial reductions in body weight [18,19,21].”

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Research works printed but not linked: 3

  1. Holt RIG, Cockram C, Flyvbjerg A, Goldstein BJ. Textbook of Diabetes. Hoboken: Hoboken: John Wiley & Sons, Incorporated; 2016.
  2. Zaccardi, F;Baldry, E;Davies, MJ;Khunti, K;Webb, DR Title: Efficacy of low-and very-low-energy diets in people with type 2 diabetes mellitus: A systematic review and meta-analysis of interventional studies Date: 2019-07 Citation:
  3. Kloecker, D. E., Zaccardi, F., Baldry, E., Davies, M. J., Khunti, K. & Webb, D. R. (2019). Efficacy of low-and very-low-energy diets in people with type 2 diabetes mellitus: A systematic review and meta-analysis of interventional studies. DIABETES OBESITY & METABOLISM, 21 (7), pp.1695-1705. https://doi.org/10.1111/dom.13727. Persistent Link: http://hdl.handle.net/11343/285712

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Authors
Kloecker, D. E., Zaccardi, F., Baldry, E., Davies, M. J., Khunti, K., & Webb, D. R.
Affiliations
University of Leicester (GB)
Corresponding author
Kloecker, David E.
Venue
Diabetes, Obesity and Metabolism
Publisher
Wiley
Published
2019-04-29
Volume
21
Issue
7
Pages
1695-1705
ISSN
  • 1462-8902 (ISSN-L)
  • 1463-1326
OpenAlex
W2935086721
Cited by
25
References
67
Citations by year
2026: 1 · 2025: 4 · 2024: 3 · 2023: 3 · 2022: 4 · 2021: 7 · 2020: 3
FWCI
0.41
Type
journal article
Language
en
Open access
Locations
  • Diabetes Obesity and Metabolism (publishedVersion)
  • PubMed (publishedVersion)
  • Figshare (submittedVersion, cc-by)
  • Minerva Access (University of Melbourne) (submittedVersion)
  • Leicester Research Archive (University of Leicester) (submittedVersion, other-oa)
Funders
  • University Hospitals of Leicester NHS Trust
  • National Institute for Health and Care Research
  • University of Leicester
  • University of Glasgow
  • Loughborough University
Topics
  • Health Sciences › Medicine › Physiology › Dietary Effects on Health
  • Health Sciences › Medicine › Physiology › Diet and metabolism studies
  • Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
Keywords
type 2 diabetes, very low calorie diet, hypocaloric diet, weight loss, caloric restriction, body mass index, HbA1c, serum lipids, dietary intervention, publication bias
MeSH terms
Adult, Body Weight, Diabetes Mellitus, Type 2, Diet, Reducing, Female, Humans, Male, Middle Aged, Obesity, Weight Loss, Body Mass Index

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