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Nutritional basis of type 2 diabetes remission

BMJ 2021; 374 doi: https://doi.org/10.1136/bmj.n1449 (Published 07 July 2021) Cite this as: BMJ 2021;374:n1449

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Acceptability of low energy diet - reference query

Dear Editor

A reference provided in the article (23) claimed that acceptability of low energy diets was up to 6 months. I wonder how that could be possible, as the reference article refers to interviews conducted after 8-week diet? Participants recorded hunger, not surprising for a calorie restricted diet. I think this reference is inappropriate to claim a recorded 6-month acceptance of a starvation diet.

Low carbohydrate diets have reported up to 24 months' follow up with high adherence and, obviously, acceptability. (1) This is not surprising for an ad libitum diet. (2)

Kind regards
Iryna Chapman

References:
1- Athinarayanan SJ, Adams RN, Hallberg SJ, Mckenzie AL, Bhanpuri NH, Campbell WW, et al. . Long-term effects of a novel continuous remote care intervention including nutritional ketosis for the management of type 2 diabetes: a 2-year non-randomized clinical trial. Front Endocrinol. (2018) 10:348.

2- Wheatley SD, Deakin TA, Arjomandkhah NC, Hollinrake PB, Reeves TE. Low Carbohydrate Dietary Approaches for People With Type 2 Diabetes—A Narrative Review. Frontiers in nutrition. 2021:415.
citing - "available evidence does not support the assertion that LCDs are more difficult to follow than other dietary approaches. In the Virta Health trial, for example, where participants were highly motivated and self-selected the diet, adherence was 83% at 1 year (130) and 75% at 2 years (38). "

Competing interests: No competing interests

23 January 2022
Iryna Chapman
Bach of Nutrition student
Deakin University, Melbourne
Melbourne, Australia