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Effect of a 6-month low-carbohydrate diet on the circulating fatty acid composition in patients with type 2 diabetes: a secondary analysis of an open-label randomized controlled trial.

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Τίτλος: Effect of a 6-month low-carbohydrate diet on the circulating fatty acid composition in patients with type 2 diabetes: a secondary analysis of an open-label randomized controlled trial.
Συγγραφείς: Rasmussen JLP; Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark; Department of Clinical Research, University of Southern Denmark, Odense, Denmark., Gram-Kampmann EM; Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark., Stidsen JV; Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark; Department of Clinical Research, University of Southern Denmark, Odense, Denmark., Hansen CD; Department of Gastroenterology and Hepatology, Odense University Hospital, Odense, Denmark., Krag A; Department of Gastroenterology and Hepatology, Odense University Hospital, Odense, Denmark., Olsen MH; Department of Internal Medicine 1, Steno Diabetes Center Zealand, Holbæk Hospital, Holbæk, Denmark., Beck-Nielsen H; Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark; Department of Clinical Research, University of Southern Denmark, Odense, Denmark., Handberg A; Department of Clinical Biochemistry, Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark., Højlund K; Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark; Department of Clinical Research, University of Southern Denmark, Odense, Denmark. Electronic address: kurt.hoejlund@rsyd.dk.
Πηγή: The American journal of clinical nutrition [Am J Clin Nutr] 2026 Sep; Vol. 124 (3), pp. 101400. Date of Electronic Publication: 2026 Aug 14.
Τύπος έκδοσης: Journal Article; Randomized Controlled Trial
Γλώσσα: English
Στοιχεία περιοδικού: Publisher: Elsevier Country of Publication: United States NLM ID: 0376027 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1938-3207 (Electronic) Linking ISSN: 00029165 NLM ISO Abbreviation: Am J Clin Nutr Subsets: MEDLINE
Imprint Name(s): Publication: 2023- : [New York, NY] : Elsevier
Original Publication: Bethesda, MD : American Society of Clinical Nutrition
Ιατρικοί όροι (MeSH): Diabetes Mellitus, Type 2*/blood , Diabetes Mellitus, Type 2*/diet therapy , Fatty Acids*/blood , Diet, Carbohydrate-Restricted*, Fatty Acids, Monounsaturated/blood ; Phospholipids/blood ; Humans ; Middle Aged ; Female ; Male ; Aged ; Energy Intake
Περίληψη: Background: Circulating fatty acid profiles are linked to cardiovascular disease risk and mortality. Short-term interventions suggest that low-carbohydrate diets (LCDs) promote cardioprotective shifts in circulating fatty acids in obesity.
Objectives: We examined whether a 6-mo, non-calorie-restricted, LCD high in fat similarly improves circulating fatty acid composition in adults with type 2 diabetes.
Methods: In an open-label, randomized, controlled trial, 71 individuals with type 2 diabetes were randomly assigned 2:1 to an LCD [maximum of 20 E% (energy per cent) carbohydrates] or a control diet (50-60 E% carbohydrates) for 6 mo with no restriction in energy intake. The prespecified secondary outcomes were the mean difference in change between groups in serum phospholipid fatty acids in weight percentage (wt%) measured by gas chromatography and reported as 95% confidence intervals (CIs) and significance adjusted for multiple comparisons (q value).
Results: LCD reduced total saturated [-0.6 (CI: -0.9, -0.2)] and monounsaturated fatty acids [-0.9 (CI: -1.4, -0.3)] and increased total polyunsaturated fatty acids [1.3 (CI: 0.6, 2.0)] compared with the control diet (all q < 0.05). Importantly, LCD reduced palmitoleic acid (16:1n-7) [-0.13 (CI: -0.21, -0.06)], a marker of de novo lipogenesis, by 23% and dihomo-γ-linolenic acid (20:3n-6) [-0.38 (CI: -0.67, -0.09)] by 12%, whereas it increased arachidonic acid (20:4n-6) [1.1 (CI: 0.3, 2.0)] by 9% compared with the control diet (all q < 0.05). Moreover, the LCD improved estimated desaturase activities by lowering stearoyl-coenzyme A desaturase 1 [-0.5 (CI: -0.7, -0.2)] and Δ6 desaturase [-0.6 (CI: -0.9, -0.2)] and increasing Δ5 desaturase [1.05 (CI: 0.3, 1.79)] activities, respectively (all q < 0.01). These changes occurred despite a 2.6-fold higher intake of saturated fatty acids in the LCD group.
Conclusions: A 6-mo, non-calorie-restricted LCD modified the circulating composition of fatty acids in adults with type 2 diabetes in a manner consistent with a potentially favorable cardioprotective profile. This trial was registered at www.
Clinicaltrials: gov as NCT03068078.
(Copyright © 2026 The Author(s). Published by Elsevier Inc. All rights reserved.)
Competing Interests: Conflict of interest The authors report no conflicts of interest.
Contributed Indexing: Keywords: cardiovascular diseases; fatty acid composition; low-carbohydrate diet; randomized controlled trial; type 2 diabetes
Molecular Sequence: ClinicalTrials.gov NCT03068078
Substance Nomenclature: 0 (Fatty Acids)
0 (Fatty Acids, Monounsaturated)
0 (Phospholipids)
Entry Date(s): Date Created: 20260901 Date Completed: 20260901 Latest Revision: 20260901
Update Code: 20260902
DOI: 10.1016/j.ajcnut.2026.101400
PMID: 42680257
Βάση Δεδομένων: MEDLINE
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  Data: Effect of a 6-month low-carbohydrate diet on the circulating fatty acid composition in patients with type 2 diabetes: a secondary analysis of an open-label randomized controlled trial.
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  Data: &lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Rasmussen+JLP%22&quot;&gt;Rasmussen JLP&lt;/searchLink&gt;; Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark; Department of Clinical Research, University of Southern Denmark, Odense, Denmark.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Gram-Kampmann+EM%22&quot;&gt;Gram-Kampmann EM&lt;/searchLink&gt;; Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Stidsen+JV%22&quot;&gt;Stidsen JV&lt;/searchLink&gt;; Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark; Department of Clinical Research, University of Southern Denmark, Odense, Denmark.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Hansen+CD%22&quot;&gt;Hansen CD&lt;/searchLink&gt;; Department of Gastroenterology and Hepatology, Odense University Hospital, Odense, Denmark.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Krag+A%22&quot;&gt;Krag A&lt;/searchLink&gt;; Department of Gastroenterology and Hepatology, Odense University Hospital, Odense, Denmark.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Olsen+MH%22&quot;&gt;Olsen MH&lt;/searchLink&gt;; Department of Internal Medicine 1, Steno Diabetes Center Zealand, Holb&#230;k Hospital, Holb&#230;k, Denmark.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Beck-Nielsen+H%22&quot;&gt;Beck-Nielsen H&lt;/searchLink&gt;; Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark; Department of Clinical Research, University of Southern Denmark, Odense, Denmark.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Handberg+A%22&quot;&gt;Handberg A&lt;/searchLink&gt;; Department of Clinical Biochemistry, Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22H&#248;jlund+K%22&quot;&gt;H&#248;jlund K&lt;/searchLink&gt;; Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark; Department of Clinical Research, University of Southern Denmark, Odense, Denmark. Electronic address: kurt.hoejlund@rsyd.dk.
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  Data: &lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Diabetes+Mellitus%2C+Type+2%22&quot;&gt;Diabetes Mellitus, Type 2*&lt;/searchLink&gt;/&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Diabetes+Mellitus%2C+Type+2+blood%22&quot;&gt;blood&lt;/searchLink&gt; &lt;br /&gt;&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Diabetes+Mellitus%2C+Type+2%22&quot;&gt;Diabetes Mellitus, Type 2*&lt;/searchLink&gt;/&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Diabetes+Mellitus%2C+Type+2+diet+therapy%22&quot;&gt;diet therapy&lt;/searchLink&gt; &lt;br /&gt;&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Fatty+Acids%22&quot;&gt;Fatty Acids*&lt;/searchLink&gt;/&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Fatty+Acids+blood%22&quot;&gt;blood&lt;/searchLink&gt; &lt;br /&gt;&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Diet%2C+Carbohydrate-Restricted%22&quot;&gt;Diet, Carbohydrate-Restricted*&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Fatty+Acids%2C+Monounsaturated%22&quot;&gt;Fatty Acids, Monounsaturated&lt;/searchLink&gt;/&lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Fatty+Acids%2C+Monounsaturated+blood%22&quot;&gt;blood&lt;/searchLink&gt; ; &lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Phospholipids%22&quot;&gt;Phospholipids&lt;/searchLink&gt;/&lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Phospholipids+blood%22&quot;&gt;blood&lt;/searchLink&gt; ; &lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Humans%22&quot;&gt;Humans&lt;/searchLink&gt; ; &lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Middle+Aged%22&quot;&gt;Middle Aged&lt;/searchLink&gt; ; &lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Female%22&quot;&gt;Female&lt;/searchLink&gt; ; &lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Male%22&quot;&gt;Male&lt;/searchLink&gt; ; &lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Aged%22&quot;&gt;Aged&lt;/searchLink&gt; ; &lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Energy+Intake%22&quot;&gt;Energy Intake&lt;/searchLink&gt;
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  Label: Abstract
  Group: Ab
  Data: Background: Circulating fatty acid profiles are linked to cardiovascular disease risk and mortality. Short-term interventions suggest that low-carbohydrate diets (LCDs) promote cardioprotective shifts in circulating fatty acids in obesity.&lt;br /&gt;Objectives: We examined whether a 6-mo, non-calorie-restricted, LCD high in fat similarly improves circulating fatty acid composition in adults with type 2 diabetes.&lt;br /&gt;Methods: In an open-label, randomized, controlled trial, 71 individuals with type 2 diabetes were randomly assigned 2:1 to an LCD [maximum of 20 E% (energy per cent) carbohydrates] or a control diet (50-60 E% carbohydrates) for 6 mo with no restriction in energy intake. The prespecified secondary outcomes were the mean difference in change between groups in serum phospholipid fatty acids in weight percentage (wt%) measured by gas chromatography and reported as 95% confidence intervals (CIs) and significance adjusted for multiple comparisons (q value).&lt;br /&gt;Results: LCD reduced total saturated [-0.6 (CI: -0.9, -0.2)] and monounsaturated fatty acids [-0.9 (CI: -1.4, -0.3)] and increased total polyunsaturated fatty acids [1.3 (CI: 0.6, 2.0)] compared with the control diet (all q &amp;lt; 0.05). Importantly, LCD reduced palmitoleic acid (16:1n-7) [-0.13 (CI: -0.21, -0.06)], a marker of de novo lipogenesis, by 23% and dihomo-γ-linolenic acid (20:3n-6) [-0.38 (CI: -0.67, -0.09)] by 12%, whereas it increased arachidonic acid (20:4n-6) [1.1 (CI: 0.3, 2.0)] by 9% compared with the control diet (all q &amp;lt; 0.05). Moreover, the LCD improved estimated desaturase activities by lowering stearoyl-coenzyme A desaturase 1 [-0.5 (CI: -0.7, -0.2)] and Δ6 desaturase [-0.6 (CI: -0.9, -0.2)] and increasing Δ5 desaturase [1.05 (CI: 0.3, 1.79)] activities, respectively (all q &amp;lt; 0.01). These changes occurred despite a 2.6-fold higher intake of saturated fatty acids in the LCD group.&lt;br /&gt;Conclusions: A 6-mo, non-calorie-restricted LCD modified the circulating composition of fatty acids in adults with type 2 diabetes in a manner consistent with a potentially favorable cardioprotective profile. This trial was registered at www.&lt;br /&gt;Clinicaltrials: gov as NCT03068078.&lt;br /&gt; (Copyright &#169; 2026 The Author(s). Published by Elsevier Inc. All rights reserved.)
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  Data: Conflict of interest The authors report no conflicts of interest.
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        Text: English
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        StartPage: 101400
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