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.

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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.

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