A study that compared low-carb (30% calories) plant-rich diet versus a healthy Nordic diet (50-55% calories from carbs) vs usual care in patients with pre-diabetes and TD2.
Outcomes of interest: Liver fat, body weight and other cardio-metabolic risk factors.
Ad lib study, and patients bought and prepared their own food so we get good generalisability. Important to underscore it wasn't a calorie restriction weight-loss study.
Diet surveys and blood biomarker data to verify dietary intake.
Length: 12 months
Liver fat reduced comparably on the low-carb and nordic diets (about a fifth of liver fat was lost in both dietS)
Nordic diet did significantly better than the usual care diet for a host of other outcomes and better than the low carb diet for glycemic control.
Authors concluded:
"Thus, the healthy nordic diet was overall the most effective diet for the treatment of T2D and prediabetes, including improving multiple metabolic disorder seen in NAFLD."
"Notably, our descriptive analysis showed that more than half (~ 54%) of the randomized patients to the healthy nordic diet had a remission of NAFLD, compared with only ~17% after the other two diets, and the healthy nordic diet group also had the highest rate of remission of prediabetes"
Note: Not directly comparable to the more recent Sam Klein/Max Peterson trial as that was energy restricted, food provided and a ketogenic diet. The low carb diet in this intervention was higher carb (relatively), focussed on plant fats and ad-lib.