Background: Recent therapeutic advancements yield cardiovascular benefit with weight loss (WL) significantly greater than the 5% target, but carbohydrate restriction has been associated with improved cardiometabolic markers independent of WL. We explored differences in cardiometabolic outcomes by percent WL in the context of carbohydrate-restricted nutrition therapy (CRNT) delivered via a continuous remote care model at Virta Health.
Method: Percent WL at 1 year was computed among patients with T2D, and they were categorized into 5 WL groups: <5%, 5-9%, 10-14%, 15-19%, & 20+%. We randomly selected 250 patients within each WL group and conducted 8 linear mixed effects models (intent-to-treat analyses) to assess cardiometabolic changes within and between groups (N=1250; 49% female; enrollment mean age=55, BMI=36, HbA1c=7.6%).
Results: All markers improved across WL groups except total cholesterol (TC) and LDL-C. The change in all markers except TC differed by WL group, such that HbA1c, HDL-C, TG, and liver markers improved more with greater WL and LDL-C increased within normal range in the 2 highest WL groups only. TC was unchanged.
Conclusion: Overall, cardiometabolic benefits increased with WL in T2D, but even patients with <5% WL had some clinically significant improvements (e.g., HbA1c -0.7%) in the context of CRNT.
R.N. Adams: Employee; Virta Health Corp. Stock/Shareholder; Virta Health Corp. S.J. Athinarayanan: Employee; Virta Health Corp. C.G.P. Roberts: Other Relationship; Virta Health Corp. B.M. Volk: Employee; Virta Health Corp. Stock/Shareholder; Virta Health Corp. A.R. Zoller: Employee; Virta Health Corp. Stock/Shareholder; Virta Health Corp. A.L. McKenzie: Employee; Virta Health Corp. Stock/Shareholder; Virta Health Corp. Employee; Abbott.
