Endocrine Abstracts

Background: India ranks among the countries with a relatively high proportion of calories (71%) from carbohydrates (1). Various types of ‘low’ carbohydrate diets have had intermittent popularity over the past century, most of which also recommend high intake of animal protein. This would not be suitable for a predominantly vegetarian population (32% of Indians are vegetarian compared with <5% in Western societies) (2).

Aim: We wanted to test the feasibility and effectiveness of lowering carbohydrate intake in a traditionally high carbohydrate intake population.

Methods: 142 overweight or obese people (9 with diabetes) were advised on a 50–70 gms/day carbohydrate, high fiber, moderate fat and protein diet with options to suit both vegetarians and non-vegetarians in our clinic.

Results: We present the data for 41 people who followed up with us for at least 1 return visit, with average follow up ranging from 1–6 months. Reducing the carbohydrate intake lead to significant reduction in weight, BMI and waist circumference. The average reduction in BMI was −1.38 (range −7.5 to +0.6). The average reduction in waist circumference was −4.8 cms (range −23 cms to +8 cms). Of the 9 people who had diabetes, 2 were on SGLT-2 inhibitors and 6 on metformin. The remainder had either prediabetes or normal glucose tolerance and were on no other medications. In 16 people in whom repeat HbA1C measurements were available, HbA1C dropped by 0.59% in 12/16 (range 0.1 to 1.7), did not change in 3 and increased by 1.6% in 1. In 26 people who had a BP reading on at least 2 occasions, the systolic BP dropped by 0–10 mm Hg. There was no difference in diastolic BP. In 6 people who had repeat lipid profile, Cholesterol (total and LDL-c) dropped along with triglycerides and HDL-c increased.

Conclusions: We have shown the feasibility and effectiveness of initiating and maintaining a low carbohydrate diet in a traditional high carbohydrate vegetarian society. Various parameters of visceral obesity and metabolic syndrome improved significantly. We plan to continue to collect data for a longer period of time to demonstrate long term ability to maintain the diet and weight reduction.

1. http://chartsbin.com/view/1160 (accessed on 03/02/2019)

2. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0110586 (accessed on 03/02/2019)