According to a study, adults who are overweight or obese and have type 2 diabetes or prediabetes are at a higher risk of developing severe health issues.

Experts disagree on the best dietary regimens and supportive measures to suggest, though.

The study was published in the journal The Annals of Family Medicine. In these findings, researchers used a 2 x 2 diet-by-support factorial design to randomise 94 adults with the aforementioned conditions, contrasting a very low-carbohydrate (VLC) or ketogenic diet with a Dietary Approaches to Stop Hypertension (DASH) diet.

They also determined the outcomes of interventions that included and excluded additional support practices like mindful eating, effective emotion regulation, social support, and cooking instruction.

Using intent-to-treat analyses, the VLC diet led to greater improvement in estimated mean systolic blood pressure (SBP; -9.8 mmHg vs. -5.2 mmHg, P =.046), greater improvement in glycosylated haemoglobin (HbA1c; -.4 per cent vs. -.1 per cent, P = 0.034), and greater improvement in weight (-19.14 lbs vs. -10.33 lbs, P = 0.0003), compared to the DASH diet.

The addition of extra support did not have a statistically significant effect on outcomes.

For adults with hypertension, prediabetes or type 2 diabetes, and who are overweight or obese, a VLC diet demonstrated greater improvements in systolic blood pressure, glycemic control, and weight over a four-month period compared to a DASH diet.

What We Know: Nearly half (47 per cent) of adults in the United States have hypertension and about half have prediabetes or type 2 diabetes. Approximately 42 per cent of adults in the United States are also obese.

These conditions can trigger stroke, end-stage renal disease, myocardial infarction and premature death. While first-line treatment for these individuals should be a diet and lifestyle intervention, experts disagree about which diet should be recommended.

What This Study Adds: For adults who are overweight or obese, have hypertension, as well as prediabetes or type 2 diabetes, a very low carbohydrate diet demonstrated greater improvements in systolic blood pressure, glycemic control, and weight over a four-month period compared to a DASH diet.