Metabolic Effects of a Low Carbohydrate Versus a Standard Diet in Morbidly Obese With Prediabetes

Metabolic Effects of a Low Carbohydrate Versus Energy-matched Standard Diet in Morbidly Obese Individuals With Prediabetes

To investigate the metabolic effects of a low carbohydrate versus energy-matched standard diet in morbidly obese individuals with prediabetes awaiting bariatric surgery.

The metabolic benefits of calorie restriction in obese people with or without impaired glycaemia are well-established. The impact of diet composition, however, remains poorly understood. Hepatic lipid content strongly correlates with hepatic insulin resistance, which is a key feature of the pre-diabetic state. The investigators hypothesize that a low carbohydrate diet compared to an energy-matched standard diet in morbidly obese patients with prediabetes scheduled for bariatric surgery results in greater reduction in liver fat.

Inclusion Criteria:

• Female and male subjects aged 18 years or older
• BMI >35 kg/m2 awaiting bariatric surgery
• Pre-diabetes according to American Diabetes Association criteria (HbA1c 5.7%-6.4%)
• Capacity to give informed consent and adhere to study procedures

Exclusion Criteria:

• Excess alcohol consumption (> 3 units/day for men, > 2 units/day for women)
• Moderate to severe kidney disease
• Nephrolithiasis
• Pregnancy/breastfeeding
• Current participation in another clinical trial
• Claustrophobia
• MRI-contraindications (pacemaker/defibrillator, neurostimulator, drug pump, cochlear implant, heart valve/vascular clips, shunt valve)