The DOI matches its Crossref record; 77 of the 79 references it cites were found in a registry or an index; none of the 29 sources its claims cite is checked for support yet.
Systematic review and meta-analysis of different dietary approaches to the management of type 2 diabetes
Open accessAbstract
Background There is evidence that reducing blood glucose concentrations, inducing weight loss, and improving the lipid profile reduces cardiovascular risk in people with type 2 diabetes.Objective We assessed the effect of various diets on glycemic control, lipids, and weight loss.Design We conducted searches of PubMed, Embase, and Google Scholar to August 2011. We included randomized controlled trials (RCTs) with interventions that lasted ≥6 mo that compared low-carbohydrate, vegetarian, vegan, low-glycemic index (GI), high-fiber, Mediterranean, and high-protein diets with control diets including low-fat, high-GI, American Diabetes Association, European Association for the Study of Diabetes, and low-protein diets.Results A total of 20 RCTs were included (n = 3073 included in final analyses across 3460 randomly assigned individuals). The low-carbohydrate, low-GI, Mediterranean, and high-protein diets all led to a greater improvement in glycemic control [glycated hemoglobin reductions of -0.12% (P = 0.04), -0.14% (P = 0.008), -0.47% (P < 0.00001), and -0.28% (P < 0.00001), respectively] compared with their respective control diets, with the largest effect size seen in the Mediterranean diet. Low-carbohydrate and Mediterranean diets led to greater weight loss [-0.69 kg (P = 0.21) and -1.84 kg (P < 0.00001), respectively], with an increase in HDL seen in all diets except the high-protein diet.Conclusion Low-carbohydrate, low-GI, Mediterranean, and high-protein diets are effective in improving various markers of cardiovascular risk in people with diabetes and should be considered in the overall strategy of diabetes management.
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“with an increase in HDL seen in all diets except the high-protein diet.”
§ Systematic review and meta-analysis of different dietary approaches to the management of type 2 diabetes 1-3 > Abstract
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“Low-GI diets were effective in increasing HDL (WMD: +0.05 mmol/L, 95% CI: 0.02, 0.07 mmol/L; P , 0.0001)”
§ Systematic review and meta-analysis of different dietary approaches to the management of type 2 diabetes 1-3 > Change in lipids
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“but the reductions in LDL and triglycerides were not significant compared with those for control diets (for low-GI diets, WMD: 20.07 mmol/L; 95% CI: 20.16, 0.02 mmol/L; P = 0.15”
§ Systematic review and meta-analysis of different dietary approaches to the management of type 2 diabetes 1-3 > Change in lipids
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“Salas-Salvado ´et al (31) compared 2 variations of the Mediterranean diet with a low-fat diet in 1224 participants with high cardiovascular risk.Approximately two-thirds of participants had diabetes, and the major significant finding was a greater reduction in triglycerides in the group who consumed the Mediterranean diet with nut supplementation.”
§ Systematic review and meta-analysis of different dietary approaches to the management of type 2 diabetes 1-3 > Studies excluded from meta-analyses
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“Data pooled from 2 studies showed no benefit of high-protein diet compared with control diets for achieving weight loss (WMD: +0.44 kg; 95% CI: -0.96, 1.84; P = 0.54).”
§ Systematic review and meta-analysis of different dietary approaches to the management of type 2 diabetes 1-3 > Weight loss
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“Four studies (31, 35-37) compared Mediterranean diets with low fat and the ADA diet”
§ Systematic review and meta-analysis of different dietary approaches to the management of type 2 diabetes 1-3 > Intervention
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“pooled data from the other studies showed no significant reduction in LDL (WMD: 20.08 mmol/L; 95% CI; 20.24, 0.08 mmol/L; P = 0.34).”
§ Systematic review and meta-analysis of different dietary approaches to the management of type 2 diabetes 1-3 > Change in lipids
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“Low-carbohydrate diets appeared to be beneficial in increasing HDL (WMD +0.08 mmol/L; 95% CI: 0.05, 0.11 mmol/L; P , 0.00001)”
§ Systematic review and meta-analysis of different dietary approaches to the management of type 2 diabetes 1-3 > Change in lipids
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“or triglycerides (WMD: 20.04 mmol/L; 95% CI: 20.15, 0.07 mmol/L; P = 0.47).”
§ Systematic review and meta-analysis of different dietary approaches to the management of type 2 diabetes 1-3 > Change in lipids
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“and increased HDL (WMD: +0.04 mmol/L; 95% CI: 0.01, 0.07 mmol/L; P = 0.004).”
§ Systematic review and meta-analysis of different dietary approaches to the management of type 2 diabetes 1-3 > Change in lipids
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“Low-carbohydrate, low-GI ,and Mediterranean diets led to significant improvements in the lipid profile with up to a 4-10% increase in HDL (4% in Mediterranean, 5% in low-GI, and 10% in low-carbohydrate diets), 1-4% reduction in LDL (1% in lowcarbohydrate, 3% in low-GI, and 4% in Mediterranean diets), and 9% reduction in triglycerides.”
§ Systematic review and meta-analysis of different dietary approaches to the management of type 2 diabetes 1-3 > DISCUSSION
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“The Mediterranean diet significantly reduced triglycerides (WMD: 20.21 mmol/L; 95% CI: 20.29, 20.14 mmol/L; P , 0.00001)”
§ Systematic review and meta-analysis of different dietary approaches to the management of type 2 diabetes 1-3 > Change in lipids
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“The Mediterranean diet was more effective in achieving weight loss that control diets were with a WMD in weight loss of 21.84 kg (95% CI: 2.54, 21.15 kg; P , 0.00001).”
§ Systematic review and meta-analysis of different dietary approaches to the management of type 2 diabetes 1-3 > Weight loss
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“The 16 studies included in the quantitative analysis were RCTs with dietary interventions that ranged from 6 mo (30, 32, 34, 35, 42) to 4 y (36).”
§ Systematic review and meta-analysis of different dietary approaches to the management of type 2 diabetes 1-3 > TABLE 1
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“Barnard et al (36) compared a vegan diet with the low-fat ADA diet and showed a significantly greater reduction in total cholesterol, LDL, and Hb A 1c in the vegan group after 74 wk.”
§ Systematic review and meta-analysis of different dietary approaches to the management of type 2 diabetes 1-3 > Studies excluded from meta-analyses
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“A total of 20 RCTs were included (n = 3073 included in final analyses across 3460 randomly assigned individuals).”
- Also stated in: § Participants · plain
“The 20 studies included 3460 patients with final analyses in 3073 patients.”
§ Systematic review and meta-analysis of different dietary approaches to the management of type 2 diabetes 1-3 > Abstract
Strength:plain· not yet calibratedn = 3,073Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
- Also stated in: § Participants · plain
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“A total of 1801 records were identified from the initial electronic search, with an additional 64 records from other sources (references of reviews and other articles).”
§ Systematic review and meta-analysis of different dietary approaches to the management of type 2 diabetes 1-3 > Study selection
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In the paper
“The Mediterranean diet was more effective in achieving weight loss that control diets were with a WMD in weight loss of 21.84 kg (95% CI: 2.54, 21.15 kg; P , 0.00001).”
§ Systematic review and meta-analysis of different dietary approaches to the management of type 2 diabetes 1-3 > Weight loss
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“Yancy et al (32) compared a low-carbohydrate diet with a lowfat diet in 146 patients, 45 of whom had diabetes.There was no significant difference in the amount of weight loss or glycemic control in the whole group (41).”
§ Systematic review and meta-analysis of different dietary approaches to the management of type 2 diabetes 1-3 > Studies excluded from meta-analyses
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“Six studies were excluded from meta-analyses; 4 of these studies had no other studies for comparison within their subgroup (5,(28)(29)(30), and 2 studies included participants with and without diabetes with no separate data provided for subjects with diabetes (31,41).”
§ Systematic review and meta-analysis of different dietary approaches to the management of type 2 diabetes 1-3 > Studies excluded from meta-analyses
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In the paper
“Additional analysis at 18 mo (29) showed an advantage of vegetarian diets in terms of glycemic control and lipid profile but not in weight loss (48).”
§ Systematic review and meta-analysis of different dietary approaches to the management of type 2 diabetes 1-3 > DISCUSSION
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“There was a significant decrease in the percentage of Hb A 1c in subjects who consumed low-carbohydrate compared with other diets (WMD: 20.12%; 95% CI: 20.24%, 20.00%; P = 0.04, I 2 = 75%).”
§ Systematic review and meta-analysis of different dietary approaches to the management of type 2 diabetes 1-3 > Glycemic control
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“2 studies (40, 44) compared a high-protein diet with low-protein and highcarbohydrate diets, respectively.”
§ Systematic review and meta-analysis of different dietary approaches to the management of type 2 diabetes 1-3 > Intervention
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“Data from the 3 studies that compared low-GI with other diets (34,38,39) showed a 20.14% decrease in Hb A 1c in subjects who consumed low-GI compared with control diets (95% CI: 20.23%, 20.03%; P = 0.008, I 2 = 80%).”
§ Systematic review and meta-analysis of different dietary approaches to the management of type 2 diabetes 1-3 > Glycemic control
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“A similar-sized study (30) that compared a vegetarian diet with the EASD diet showed greater weight loss and reduced requirements for diabetes medication in the vegetarian arm.”
§ Systematic review and meta-analysis of different dietary approaches to the management of type 2 diabetes 1-3 > Studies excluded from meta-analyses
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In the paper
“The lowcarbohydrate, low-GI, Mediterranean, and high-protein diets all led to a greater improvement in glycemic control [glycated hemoglobin reductions of 20.12% (P = 0.04), 20.14% (P = 0.008), 20.47% (P , 0.00001), and 20.28% (P , 0.00001), respectively] compared with their respective control diets”
- Also stated in: § Glycemic control · plain
“There was a significant decrease in the percentage of Hb A 1c in subjects who consumed low-carbohydrate compared with other diets (WMD: 20.12%; 95% CI: 20.24%, 20.00%; P = 0.04, I 2 = 75%).”
§ Systematic review and meta-analysis of different dietary approaches to the management of type 2 diabetes 1-3 > Abstract
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In the paper
“There was no significant difference in weight loss when low-carbohydrate diets were compared with control diets (WMD: 20.69 kg; 95% CI: 21.77, 0.39 kg; P = 0.21).”
§ Systematic review and meta-analysis of different dietary approaches to the management of type 2 diabetes 1-3 > Weight loss
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In the paper
“Data from the 3 studies that compared low-GI with other diets (34,38,39) showed a 20.14% decrease in Hb A 1c in subjects who consumed low-GI compared with control diets (95% CI: 20.23%, 20.03%; P = 0.008, I 2 = 80%).”
§ Systematic review and meta-analysis of different dietary approaches to the management of type 2 diabetes 1-3 > Glycemic control
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“All participants were $18 y old, and all but one study (35) included both sexes.”
§ Systematic review and meta-analysis of different dietary approaches to the management of type 2 diabetes 1-3 > Participants
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In the paper
“with no significant reduction in LDL (WMD: 20.03 mmol/L; 95% CI: 20.12, 0.07 mmol/L; P = 0.57)”
§ Systematic review and meta-analysis of different dietary approaches to the management of type 2 diabetes 1-3 > Change in lipids
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In the paper
“for control diets, WMD: 20.01 mmol/L; 95% CI: 20.04, 0.03 mmol/L; P = 0.69).”
§ Systematic review and meta-analysis of different dietary approaches to the management of type 2 diabetes 1-3 > Change in lipids
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In the paper
“High-protein diets had no effects on markers of the lipid profile (LDL WMD: 20.16 mmol/L; 95% CI: 20.41, 0.09 mmol/L; P = 0.22; triglyceride WMD: 20.11 mmol/L; 95% CI: 20.56, 0.33 mmol/L; P = 0.61; HDL WMD: +0.01 mmol/L; 95% CI: 20.08, 0.10 mmol/L; P = 0.89).”
§ Systematic review and meta-analysis of different dietary approaches to the management of type 2 diabetes 1-3 > DIETS FOR THE MANAGEMENT OF TYPE 2 DIABETES
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In the paper
“Low-carbohydrate and Mediterranean diets led to greater weight loss [20.69 kg (P = 0.21) and 21.84 kg (P , 0.00001), respectively]”
- Also stated in: § Weight loss · plain
“There was no significant difference in weight loss when low-carbohydrate diets were compared with control diets (WMD: 20.69 kg; 95% CI: 21.77, 0.39 kg; P = 0.21).”
§ Systematic review and meta-analysis of different dietary approaches to the management of type 2 diabetes 1-3 > Abstract
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- Also stated in: § Weight loss · plain
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In the paper
“The 20 studies included 3460 patients with final analyses in 3073 patients.”
§ Systematic review and meta-analysis of different dietary approaches to the management of type 2 diabetes 1-3 > Participants
Strength:plain· not yet calibratedn = 3,073Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
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In the paper
“Four of the studies (31)(32)(33)41) included patients with and without diabetes, and one of these studies (32) provided data on the change in glycemic control in the diabetic group, and another study (33) was included in quantitative analysis despite not having separate data for the diabetic group because .80% of the study population had diabetes.”
§ Systematic review and meta-analysis of different dietary approaches to the management of type 2 diabetes 1-3 > Participants
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In the paper
“The 3 studies that compared Mediterranean with other diets (35)(36)(37) showed a WMD in Hb A 1c of 20.47% in favor of the Mediterranean diet (95% CI: 20.64%, 20.30%; P , 0.00001, I 2 = 82%).”
§ Systematic review and meta-analysis of different dietary approaches to the management of type 2 diabetes 1-3 > Glycemic control
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In the paper
“No significant benefit was shown in studies that compared highcarbohydrate with high-MUFA diets (5) and high-fiber with lowfat diets (28).”
§ Systematic review and meta-analysis of different dietary approaches to the management of type 2 diabetes 1-3 > Studies excluded from meta-analyses
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In the paper
“Other studies compared vegan with ADA diets (29), vegetarian with EASD diets (30), highcarbohydrate with high-MUFA diets (5), and high-fiber with low-fat diets (28).”
§ Systematic review and meta-analysis of different dietary approaches to the management of type 2 diabetes 1-3 > Intervention
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In the paper
“Data pooled from 2 studies that compared high-protein with other diets (40,44) showed a significant decrease in the percentage of Hb A 1c in subjects who consumed high-protein diets (WMD: 20.28%; 95% CI: 20.38%, 20.18%; P , 0.00001, I 2 = 60%).”
§ Systematic review and meta-analysis of different dietary approaches to the management of type 2 diabetes 1-3 > Glycemic control
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In the paper
“Data pooled from 2 studies that compared high-protein with other diets (40,44) showed a significant decrease in the percentage of Hb A 1c in subjects who consumed high-protein diets (WMD: 20.28%; 95% CI: 20.38%, 20.18%; P , 0.00001, I 2 = 60%).”
§ Systematic review and meta-analysis of different dietary approaches to the management of type 2 diabetes 1-3 > Glycemic control
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In the paper
“Low-GI diets resulted in a lower Hb A 1c and higher HDL but no significant difference in weight loss (34,38,39).”
§ Systematic review and meta-analysis of different dietary approaches to the management of type 2 diabetes 1-3 > DISCUSSION
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In the paper
“Forest plots that show differences in Hb A 1c between low-carbohydrate and other diets (A), low-GI and other diets (B), Mediterranean and other diets (C), and high-protein and other diets (D).”
§ Systematic review and meta-analysis of different dietary approaches to the management of type 2 diabetes 1-3 > DISCUSSION
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In the paper
“The studies that compared a diet high in carbohydrates to one high in MUFAs and high-fiber with low-fat diets showed no significant differences in weight, glycemic control, and lipid profile (5,28).”
§ Systematic review and meta-analysis of different dietary approaches to the management of type 2 diabetes 1-3 > DISCUSSION
What the sources say
- Not checked yetcites [5] Brehm, 2009, One-year comparison of a high monounsaturated fat diet with a high-carbohydrate diet in type 2 diabetes, Diabetes Care source
- Not checked yetcites [28] Milne, 1994, Long-term comparison of three dietary prescriptions in the treatment of NIDDM, Diabetes Care source
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In the paper
“Neither study showed any significant differences in weight, glycemic control, or lipids, but pooled data showed significantly lower Hb A 1c concentrations in the high-protein-diet group.”
§ Systematic review and meta-analysis of different dietary approaches to the management of type 2 diabetes 1-3 > DISCUSSION
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In the paper
“Kahleova et al (30) randomly assigned a similar number of participants to receive either a vegetarian or EASD diet and showed significant reductions in diabetes medication, greater weight loss, and increased insulin sensitivity in the vegetarian arm but no significant difference in Hb A 1c .”
§ Systematic review and meta-analysis of different dietary approaches to the management of type 2 diabetes 1-3 > DISCUSSION
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In the paper
“The 3 trials included in the meta-analysis compared a Mediterranean diet with a conventional diet (ie, no change to the current diets of participants) and ADA diet (35)(36)(37) and showed better glycemic control, greater weight loss, and a more-favorable lipid profile in the Mediterranean-diet arm.”
§ Systematic review and meta-analysis of different dietary approaches to the management of type 2 diabetes 1-3 > DISCUSSION
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In the paper
“It is clear that weight loss and reduced total calorie intake are important in the obtainment of good glycemic control (3)(4)(5)(6)(7)”
§ Systematic review and meta-analysis of different dietary approaches to the management of type 2 diabetes 1-3 > INTRODUCTION
What the sources say
- Not checked yetcites (3)(4)(5)(6)(7)
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“Except for 3 studies (8,35,37), all other studies reported the method of random assignment, 10 studies reported the method of allocation concealment, and 6 studies were analyzed on an intention-to-treat basis (7,32,34,36,39,40).”
§ Systematic review and meta-analysis of different dietary approaches to the management of type 2 diabetes 1-3 > Quality of studies
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
In the paper
“A recently published review by Wheeler et al (47) that looked at literature between 2001 and 2010 also showed that lowcarbohydrate diets appeared to improve markers of glycemic control with nonsignificant improvements in lipoproteins.”
§ Systematic review and meta-analysis of different dietary approaches to the management of type 2 diabetes 1-3 > DISCUSSION
What the sources say
- Not checked yetcites [47] Wheeler, 2012, Macronutrients, food groups, and eating patterns in the management of diabetes: a systematic review of the literature, 2010, Diabetes Care source
Strength:hedged· not yet calibratedCausal:conditional· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Several trials (8)(9)(10) have documented the potential benefits of carbohydrate restriction and low-glycemic index (GI) and Mediterranean diets on glycemic control and weight loss that are maintained long term (9,(11)(12)(13)(14).”
§ Systematic review and meta-analysis of different dietary approaches to the management of type 2 diabetes 1-3 > INTRODUCTION
What the sources say
- Not checked yetcites (8)(9)(10)
- Not checked yetcites (9,(11)(12)(13)(14)
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The low-carbohydrate diets appeared to provide superior weight loss, glycemic control, and lipid profile compared with low-fat diets”
§ Systematic review and meta-analysis of different dietary approaches to the management of type 2 diabetes 1-3 > DISCUSSION
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“A meta-analysis was undertaken for each dietary-intervention subgroup when appropriate (16 of 20 trials) with Revman 5 software (Cochrane Information Management System) when data were available for more than one trial and were of sufficient quality.”
§ Systematic review and meta-analysis of different dietary approaches to the management of type 2 diabetes 1-3 > Statistical analysis
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim.
In the paper
“Systematic reviews and meta-analyses have shown that low-GI, high-fiber, and Mediterranean diets improve glucose metabolism (16)(17)(18).”
§ Systematic review and meta-analysis of different dietary approaches to the management of type 2 diabetes 1-3 > INTRODUCTION
What the sources say
- Not checked yetcites (16)(17)(18)
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
In the paper
“Most of these authorities recommend a carbohydrate intake of 50-60% of total energy intake, total fat intake #30% of energy (with moderate polyunsaturated fat and restriction of saturated and trans fat intake).”
§ Systematic review and meta-analysis of different dietary approaches to the management of type 2 diabetes 1-3 > INTRODUCTION
What the sources say
- Not checked yetcites (19)(20)(21)(22)(23)(24)(25)(26)(27)
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“This review provides evidence that modifying the amount of macronutrients can improve glycemic control, weight, and lipids in people with diabetes.”
§ Systematic review and meta-analysis of different dietary approaches to the management of type 2 diabetes 1-3 > DISCUSSION
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“An important difference between the Mediterranean and ADA diets is likely to be the content of MUFAs, which has been shown to have an impact on the lipd profile (54,55), insulin sensitivity (56-58), and postprandial glucose concentrations (59).”
§ Systematic review and meta-analysis of different dietary approaches to the management of type 2 diabetes 1-3 > DISCUSSION
What the sources say
- Not checked yetcites [54] Rodríguez-Villar, 2004, Comparison of a high-carbohydrate and a high-monounsaturated fat, olive oil-rich diet on the susceptibility of LDL to oxidative modification in subjects with type 2 diabetes mellitus, Diabet Med source
- Not checked yetcites [55] Garg, 1994, Effects of varying carbohydrate content of diet in patients with non-insulin-dependent diabetes mellitus, JAMA source
- Not checked yetcites [56] Esposito, 2004, Effect of a Mediterranean-style diet on endothelial dysfunction and markers of vascular inflammation in the metabolic syndrome: a randomized trial, JAMA source
- Not checked yetcites [57] Schwenke, 2005, Insulin resistance, low-fat diets, and low-carbohydrate diets: time to test new menus, Curr Opin Lipidol source
- Not checked yetcites [58] Lara-Castro, 2004, Diet, insulin resistance, and obesity: zoning in on data for Atkins dieters living in South Beach, J Clin Endocrinol Metab source
- Not checked yetcites [59] O’Keefe, 2008, Dietary strategies for improving post-prandial glucose, lipids, inflammation, and cardiovascular health, J Am Coll Cardiol source
Strength:hedged· not yet calibratedCausal:conditional· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
In the paper
“Anderson et al (51) performed a meta-analysis that compared low-GI with high-GI diets and showed significant benefits in terms of glycemic control and lipid profile.”
§ Systematic review and meta-analysis of different dietary approaches to the management of type 2 diabetes 1-3 > DISCUSSION
What the sources say
- Not checked yetcites [51] Anderson, 2004, Carbohydrate and fiber recommendations for individuals with diabetes: a quantitative assessment and meta-analysis of the evidence, J Am Coll Nutr source
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Therefore, there is a suggestion that vegan and vegetarian diets might be beneficial in improving glycemic control and inducing weight loss.”
§ Systematic review and meta-analysis of different dietary approaches to the management of type 2 diabetes 1-3 > DISCUSSION
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“This impact on glycemic control might have been due to previous suggestions that protein has effects on appetite suppression (63) and insulin sensitivity (64)(65)(66)(67)(68).”
§ Systematic review and meta-analysis of different dietary approaches to the management of type 2 diabetes 1-3 > DISCUSSION
What the sources say
- Not checked yetcites [63] Weigle, 2005, A high-protein diet induces sustained reductions in appetite, ad libitum caloric intake, and body weight despite compensatory changes in diurnal plasma leptin and ghrelin concentrations, Am J Clin Nutr source
- Not checked yetcites (64)(65)(66)(67)(68)
Strength:hedged· not yet calibratedCausal:conditional· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The Hb A 1c reduction was only 0.14% and might not have been clinically relevant.”
§ Systematic review and meta-analysis of different dietary approaches to the management of type 2 diabetes 1-3 > DISCUSSION
Load-bearingStrength:hedged· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Our conclusion regarding the Mediterranean diet is similar to that in a review by Esposito et al (60), which showed improved glycemic control, and Kastorini et al (61), whose meta-analysis showed an association between the Mediterranean diet and improved lipid profile and lower blood glucose.”
§ Systematic review and meta-analysis of different dietary approaches to the management of type 2 diabetes 1-3 > DISCUSSION
What the sources say
- Not checked yetcites [60] Esposito, 2010, Prevention and control of type 2 diabetes by Mediterranean diet: A systematic review, Diabetes Res Clin Pract source
- Not checked yetcites [61] Kastorini, 2011, The effect of Mediterranean diet on metabolic syndrome and its components: a meta-analysis of 50 studies and 534,906 individuals, J Am Coll Cardiol source
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“However, these studies included subjects those with type 1 diabetes and children and enrolled a mean of just 14 participants for an average of 33 d per trial, which made it difficult to extrapolate the findings to the prevalently older T2D population and made it impossible to predict if these benefits would be sustained over time.”
§ Systematic review and meta-analysis of different dietary approaches to the management of type 2 diabetes 1-3 > DISCUSSION
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
In the paper
“The findings of Wheeler et al (47) were similar to ours with only little differences in glycemic control between low-and high-GI and other diets.”
§ Systematic review and meta-analysis of different dietary approaches to the management of type 2 diabetes 1-3 > DISCUSSION
What the sources say
- Not checked yetcites [47] Wheeler, 2012, Macronutrients, food groups, and eating patterns in the management of diabetes: a systematic review of the literature, 2010, Diabetes Care source
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The review of judgments of authors about each risk-of-bias item is presented as percentages across all included studies.”
§ Systematic review and meta-analysis of different dietary approaches to the management of type 2 diabetes 1-3 > DISCUSSION
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“This possibility might be of particular relevance when the effect of low-carbohydrate diets is interpreted.”
§ Systematic review and meta-analysis of different dietary approaches to the management of type 2 diabetes 1-3 > DISCUSSION
Load-bearingStrength:hedged· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim.
- Rests on an assumption: Weight change independently affects glycemic control and lipid profile.
The paper relies on this without support.
There is limited evidence on the optimal dietary approach to control hyperglycemia in type 2 diabetes.
“However, there is limited evidence on the optimal dietary approach to control hyperglycemia in type 2 diabetes (T2D) 4 .”
The paper relies on this without support.
The ideal proportion of carbohydrate, fat, and protein that should be recommended remains unclear.
“but the ideal proportion of the 3 main food components (carbohydrate, fat, and protein) that should be recommended remains unclear.”
The paper relies on this without support.
There is insufficient evidence to justify current recommendations for macronutrient intake in type 2 diabetes.
“However, there is insufficient evidence to justify these recommendations.”
The paper relies on this without support.
No systematic review or meta-analysis has compared the effects of different categories of dietary intervention on glycemic control, weight loss, and lipids in type 2 diabetes.
“To our knowledge, there is no systematic review or meta-analysis that has compared the effects of different categories of dietary intervention on glycemic control, weight loss, and lipids in T2D.”
The paper relies on this without support.
Weight change independently affects glycemic control and lipid profile.
“Another major confounder was the independent effect of weight change on the other measured variables (glycemic control and lipid profile).”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“VLCK diets have been shown to have beneficial effects on weight loss, insulin sensitivity and HbA1c in most studies.13, 30”
From Short-term safety, tolerability and efficacy of a very low-calorie-ketogenic diet interventional weight loss program versus hypocaloric diet in patients with type 2 diabetes mellitus (2016) · cites this paper as [30]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“In fact, the VLCK diet induced a decrease in triglycerides, in line with the improvement in glycemic control as plasma levels of triglycerides is a biomarker of dysfunctional insulin sensitivity.30, 34”
From Short-term safety, tolerability and efficacy of a very low-calorie-ketogenic diet interventional weight loss program versus hypocaloric diet in patients with type 2 diabetes mellitus (2016) · cites this paper as [30]
Experimental — accuracy not yet measuredThe cited source says what the claim attributes to it.
In the citing paper
“Systematic reviews and meta-analyses to date have attempted to pool carbohydrate restricted diets for diabetic populations, reporting mixed results.”
In the citing paper
“Most meta-analyses were of critically low (n = 7; [25–31]) to low quality (n = 5; [32–36]).”
In the citing paper
“Low-glycaemic-index diets [26, 36] were not associated with greater weight loss than control diets.”
In the citing paper
“Pooled results indicated significantly greater weight loss with Mediterranean diets than in control groups, by 0.3 kg (low quality; [32]) to 1.8 kg (critically low quality; [26]), over durations of 4–24 weeks.”
In the citing paper
“All meta-analyses (n = 3) of high-protein diets were of critically low quality [26, 28, 30].”
In the citing paper
“The remaining critically low- to low-quality meta-analyses showed differences of <1 kg between the two diets [26, 27, 31, 33, 34].”
In the citing paper
“Two meta-analyses, of low and critically low quality, considered weight loss from Mediterranean diets [26, 32].”
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
A low-GI trial is cited as a low-carbohydrate trial
MinorStudy 39 is counted among the pooled low-carbohydrate studies, but the paper describes its intervention as low GI with an ADA-diet control.
“Data from 8 studies (7, 8, 32, 33, 38, 39, 43, 44) were pooled and compared low-carbohydrate with a variety of control diets.”
“Ma et al (39) defined low GI as "choosing predominantly low-GI foods," which translated to foods that had, on average, a 3-point lower GI than those in the control arm (the ADA diet)”
Vegan trial is assigned the Mediterranean trial's citation
MinorThe text calls the vegan-diet study Barnard et al (36), but elsewhere assigns the vegan comparison to reference 29; reference 36 is identified as a Mediterranean-diet trial.
“Barnard et al (36) compared a vegan diet with the low-fat ADA diet”
“The study that compared a vegan diet to the low-fat ADA diet showed significantly lower total cholesterol, LDL, and Hb A 1c in the vegan arm (29).”
Yancy study is given Samaha's reference number
MinorThe text identifies Yancy et al as study 32, whereas the trial summary identifies study 32 as Samaha.
“Yancy et al (32) compared a low-carbohydrate diet with a lowfat diet in 146 patients, 45 of whom had diabetes.”
“Samaha, 2003 (32)”
Study 30 is listed as both included and excluded from meta-analysis
MinorThe duration summary identifies study 30 among the studies in the quantitative analysis, while the exclusions section lists it among studies excluded from meta-analyses.
“The 16 studies included in the quantitative analysis were RCTs with dietary interventions that ranged from 6 mo (30, 32, 34, 35, 42) to 4 y (36).”
“Six studies were excluded from meta-analyses; 4 of these studies had no other studies for comparison within their subgroup (5,(28)(29)(30), and 2 studies included participants with and without diabetes with no separate data provided for subjects with diabetes (31,41).”
Citations
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“INTRODUCTION There is good evidence that complex interventions, including dietary changes, can prevent the progression of impaired glucose tolerance to diabetes (1, 2).”
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“Except for 3 studies (8, 35, 37), all other studies reported the method of random assignment, 10 studies reported the method of allocation concealment, and 6 studies were analyzed on an intention-to-treat basis (7, 32, 34, 36, 39, 40).”
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BackgroundMethodAn increase in dietary protein improves the blood glucose response in persons with type 2 diabetes
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Flagged first, then by citations
2 of the 79 references couldn’t be matched to a known paper.
Research works printed but not linked: 1
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“Findings from recently completed clinical trials provide further support for the utility of the GI and GL [40,77].”
Metadata
- Authors
- Ajala, O., English, P., & Pinkney, J.
- Affiliations
- Peninsula College of Medicine and Dentistry (GB)
- Derriford Hospital (GB)
- Venue
- The American Journal of Clinical Nutrition
- Publisher
- Elsevier BV
- Published
- 2013-03
- Volume
- 97
- Issue
- 3
- Pages
- 505-516
- ISSN
- 0002-9165 (ISSN-L)
- OpenAlex
- W2099244083
- Semantic Scholar
- e4d5824fa11cd712a63bb7bf472781a82f8d88f3
- Cited by
- 821
- References
- 79
- Citations by year
- 2026: 23 · 2025: 28 · 2024: 43 · 2023: 46 · 2022: 64 · 2021: 60 · 2020: 120 · 2019: 58 · 2018: 78 · 2017: 71 · 2016: 70 · 2015: 60 · 2014: 66 · 2013: 34
- FWCI
- 8.44
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- American Journal of Clinical Nutrition (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology (medical) › Diet and metabolism studies
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Keywords
- type 2 diabetes, dietary intervention, glycemic control, HbA1c, low-carbohydrate diet, Mediterranean diet, low glycemic index diet, high-protein diet, weight loss, lipid profile, HDL cholesterol, cardiovascular risk, vegetarian diet, vegan diet, high-fiber diet
- MeSH terms
- Blood Glucose, Energy Intake, Cardiovascular Diseases, Diabetes Mellitus, Type 2, Dietary Carbohydrates, Dietary Fats, Dietary Fiber, Dietary Proteins, Humans, Lipids, Risk Factors, Diet, Vegetarian, Weight Loss, Randomized Controlled Trials as Topic, Diet, Fat-Restricted, Diet, Protein-Restricted, Glycemic Index, Diet, Mediterranean, Diet, Carbohydrate-Restricted
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
A language model drew the claims from the paper on 2026-10-06, under version 3 of the claim definition (model deepseek-v4.1-flash, prompt extract-v3).
A second model labelled each claim on 2026-10-06 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).
Statistics and arithmetic are recomputed, not judged.
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