The Lifestyle Education About Nutrition for Diabetes (Legend) Study

Exclusion Criteria

• •unable to provide informed consent
• •substance abuse, mental health, cognitive, or medical condition that would, in the opinion of the investigators, make it difficult for the individual to take part in the intervention, may alter key outcomes, or may require important diet modifications and includes conditions such as hypercalcemia or thyroid dysfunction
• •pregnant or planning to become pregnant in the next 12 months, or currently breastfeeding (pregnancy and breastfeeding require modifications to the intervention's dietary approaches)
• •current use of weight loss medications (this is likely to alter weight outcomes and may alter other measures)
• •history of weight loss (bariatric) surgery or plans for bariatric surgery in the next year
• •currently enrolled in a weight loss program or have unalterable plans to enroll in one of these programs in the next year
• •vegan or vegetarian
• •unwilling or unable to participate in study measurements and group classes
• •current use of systemic steroids (self-reported in screening survey; oral or IV systemic steroids excluded. Injected steroids may be permitted depending on frequency and timing of injections with regard to lab assessments (minimum of 2 weeks between injection and blood tests))
• •weight above 400 pounds (weight limit for dual-energy X-ray absorptiometry (DEXA) scans)
• •history of multiple or recent (within the last four years) kidney stones
• •currently following a very low-carbohydrate diet
• •unwilling to stop an SGLT2 inhibitor medication if the participant were to be randomized to the very low-carbohydrate diet