Document Detail


Weight and metabolic outcomes after 2 years on a low-carbohydrate versus low-fat diet: a randomized trial.
MedLine Citation:
PMID:  20679559     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Previous studies comparing low-carbohydrate and low-fat diets have not included a comprehensive behavioral treatment, resulting in suboptimal weight loss.
OBJECTIVE: To evaluate the effects of 2-year treatment with a low-carbohydrate or low-fat diet, each of which was combined with a comprehensive lifestyle modification program.
DESIGN: Randomized parallel-group trial. (ClinicalTrials.gov registration number: NCT00143936)
SETTING: 3 academic medical centers.
PATIENTS: 307 participants with a mean age of 45.5 years (SD, 9.7 years) and mean body mass index of 36.1 kg/m(2) (SD, 3.5 kg/m(2)).
INTERVENTION: A low-carbohydrate diet, which consisted of limited carbohydrate intake (20 g/d for 3 months) in the form of low-glycemic index vegetables with unrestricted consumption of fat and protein. After 3 months, participants in the low-carbohydrate diet group increased their carbohydrate intake (5 g/d per wk) until a stable and desired weight was achieved. A low-fat diet consisted of limited energy intake (1200 to 1800 kcal/d; <or=30% calories from fat). Both diets were combined with comprehensive behavioral treatment.
MEASUREMENTS: Weight at 2 years was the primary outcome. Secondary measures included weight at 3, 6, and 12 months and serum lipid concentrations, blood pressure, urinary ketones, symptoms, bone mineral density, and body composition throughout the study.
RESULTS: Weight loss was approximately 11 kg (11%) at 1 year and 7 kg (7%) at 2 years. There were no differences in weight, body composition, or bone mineral density between the groups at any time point. During the first 6 months, the low-carbohydrate diet group had greater reductions in diastolic blood pressure, triglyceride levels, and very-low-density lipoprotein cholesterol levels, lesser reductions in low-density lipoprotein cholesterol levels, and more adverse symptoms than did the low-fat diet group. The low-carbohydrate diet group had greater increases in high-density lipoprotein cholesterol levels at all time points, approximating a 23% increase at 2 years.
LIMITATION: Intensive behavioral treatment was provided, patients with dyslipidemia and diabetes were excluded, and attrition at 2 years was high.
CONCLUSION: Successful weight loss can be achieved with either a low-fat or low-carbohydrate diet when coupled with behavioral treatment. A low-carbohydrate diet is associated with favorable changes in cardiovascular disease risk factors at 2 years.
PRIMARY FUNDING SOURCE: National Institutes of Health.
Authors:
Gary D Foster; Holly R Wyatt; James O Hill; Angela P Makris; Diane L Rosenbaum; Carrie Brill; Richard I Stein; B Selma Mohammed; Bernard Miller; Daniel J Rader; Babette Zemel; Thomas A Wadden; Thomas Tenhave; Craig W Newcomb; Samuel Klein
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Publication Detail:
Type:  Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Annals of internal medicine     Volume:  153     ISSN:  1539-3704     ISO Abbreviation:  Ann. Intern. Med.     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-08-03     Completed Date:  2010-08-13     Revised Date:  2010-12-03    
Medline Journal Info:
Nlm Unique ID:  0372351     Medline TA:  Ann Intern Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  147-57     Citation Subset:  AIM; IM    
Affiliation:
Center for Obesity Research and Education, Temple University, Philadelphia, Pennsylvania 19140, USA. gfoster@temple.edu
Data Bank Information
Bank Name/Acc. No.:
ClinicalTrials.gov/NCT00143936
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Behavior Therapy*
Blood Pressure
Body Composition
Bone Density
Diet, Carbohydrate-Restricted*
Diet, Fat-Restricted*
Exercise Therapy
Female
Humans
Ketone Bodies / urine
Lipoproteins / blood
Male
Middle Aged
Overweight / diet therapy,  metabolism,  therapy*
Treatment Outcome
Weight Loss
Young Adult
Grant Support
ID/Acronym/Agency:
DK 56341/DK/NIDDK NIH HHS; R01 AT001103-01/AT/NCCAM NIH HHS; R01 AT1103/AT/NCCAM NIH HHS; UL1 RR000051/RR/NCRR NIH HHS; UL1 RR024992/RR/NCRR NIH HHS; UL1RR024134/RR/NCRR NIH HHS
Chemical
Reg. No./Substance:
0/Ketone Bodies; 0/Lipoproteins
Comments/Corrections
Comment In:
Ann Intern Med. 2010 Aug 3;153(3):I35   [PMID:  20679555 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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