Obesity / Weight Loss
Shabina Roohi Ahmed, Sridevi Bellamkonda, Mihail Zilbermint, Jiangxia Wang, Rita Rastogi Kalyani
The optimal diet to improve glycemia in patients with type 2 diabetes remains unclear. Low carbohydrate, high fat (LCHF) diets can improve glycemic control, but have not been investigated in real-world settings.
Matthew Carmen, Debra Lynn Safer, Laura R. Saslow, Tro Kalayjian, Ashley E. Mason, Eric C. Westman and Shebani Sethi Dalai
Report on the feasibility of a low-carbohydrate ketogenic diet initiated by three patients
(age 54, 34, and 63) with obesity (average BMI 43.5 kg/m2) with comorbid binge eating and food addiction
symptoms. All patients tolerated following the ketogenic diet (macronutrient proportion 10% carbohydrate, 30%
protein, and 60% fat; at least 5040 kJ) for the prescribed period (e.g., 6–7 months) and none reported any major
Alice Albanese, L. Prevedello, M. Markovich, L. Busetto, R. Vettor, M. Foletto
Pre-operative diet may play an important role as far as patients’ fitness for surgery, post-operative outcomes, and successful weight loss. Our aim was to compare surgical outcome and weight loss in two groups of patients who were offered two different pre-operative kinds of diet: very low calorie diet (VLCD) and very low calorie ketogenic diet (VLCKD).
Robert H. Lustig; Kathleen Mulligan; Susan M. Noworolsk;i Viva W. Tai; Michael J. Wen; Ayca Erkin‐Cakmak; Alejandro Gugliucci; Jean‐Marc Schwarz
Single arm prospective with 27 participants from 2 specific, at risk, ethnic groups: This study argues that the health detriments of sugar, and fructose specifically, are independent of its caloric value or effects on weight. Further studies will be required to determine whether sugar restriction alone can impact metabolic syndrome in adults and whether such effects are short‐lived or long‐term.
Eric C Westman, MD, MHS; William S Yancy, MD; Joel S Edman, DSc; Keith F Tomlin; Christine E Perkins, MSW
Single arm prospective with 51 participants: In these subjects, the mean body weight decreased 10.3% +/- 5.9% from baseline to 6 months. The mean percentage of body weight that was fat decreased 2.9% +/- 3.2% from baseline to 6 months. Serum total cholesterol level decreased 11 +/- 26 mg/dL, low-density lipoprotein cholesterol level decreased 10 +/- 25 mg/dL, triglyceride level decreased 56 +/- 45 mg/dL, high-density lipoprotein (HDL) cholesterol level increased 10 +/- 8 mg/dL, and the cholesterol/HDL cholesterol ratio decreased 0.9 +/- 0.6 units. A very low carbohydrate diet program led to sustained weight loss during a 6-month period.
Jeff S. Volek; Matthew J. Sharman; Dawn M. Love; Neva G. Avery; Ana L. G[oacute]mez; Timothy P. Scheett; William J. Kraemer
Single arm propective with 12 participants: Authors conclude that a carbohydrate-restricted diet resulted in a significant reduction in fat mass and a concomitant increase in lean body mass in normal-weight men, which may be partially mediated by the reduction in circulating insulin concentrations.
James H. Hays; Robert T. Gorman; K. M. M. Shakir
Retrospective chart review: Addition of saturated fat and removal of starch from a highmonounsaturated fat and starch-restricted diet improved glycemic control and were associated with weight loss without detectable adverse effects on serum lipids.
Stephen B. Sondike, MD; Nancy Copperman, MS, RD; Marc S. Jacobson, MD
RCT with 30 participants: To compare the effects of a low-carbohydrate (LC) diet with those of a low-fat (LF) diet on weight loss and serum lipids in overweight adolescents. The LC group lost more weight (mean, 9.9 +/- 9.3 kg vs 4.1 +/- 4.9 kg) and had improvement in non-HDL cholesterol levels. There were no adverse effects on the lipid profiles of participants in either group. The LC diet appears to be an effective method for short-term weight loss in overweight adolescents and does not harm the lipid profile.
Frederick F. Samaha, MD; Nayyar Iqbal, MD; Prakash Seshadri, MD; Kathryn L. Chicano, CRNP; Denise A. Daily, RD; Joyce McGrory, CRNP; Terrence Williams, BS; Monica Williams, BS; Edward J. Gracely, PhD; and Linda Stern, MD
RCT with 132 participants: Severely obese subjects with a high prevalence of diabetes or the metabolic syndrome lost more weight during six months on a carbohydrate-restricted diet than on a calorie- and fatrestricted diet, with a relative improvement in insulin sensitivity and triglyceride levels, even after adjustment for the amount of weight lost.
Joseph T. Hickey; Lisa Hickey ; William S. YancyJr.; Juanita Hepburn; Eric C. Westman
Retrospective Cohort: A carbohydrate-restricted diet recommendation led to improvements in lipid profiles and lipoprotein subclass traits of the metabolic syndrome in a clinical outpatient setting, and should be considered as a treatment for the metabolic syndrome.
James H. Hays, MD; Angela DiSabatino, RN, MS; Robert T. Gorman, PhD; Simi Vincent, PhD, MD; Michael E. Stillabower, MD
Prospective single arm: To determine whether a diet of high saturated fat and avoidance of starch (HSF-SA) results in weight loss without adverse effects on serum lipids in obese nondiabetic patients. HSF-SA diet results in weight loss after 6 weeks without adverse effects on serum lipid levels verified by nuclear magnetic resonance, and further weight loss with a lipidneutral effect may persist for up to 52 weeks.
Gary D. Foster, PhD; Holly R. Wyatt, MD; James O. Hill, PhD; Brian G. McGuckin, EdM; Carrie Brill, BS; B. Selma Mohammed, MD, PhD; Philippe O. Szapary, MD; Daniel J. Rader, MD; Joel S. Edman, DSc; Samuel Klein, MD
RCT with 63 participants: The low-carbohydrate diet produced a greater weight loss (4%) than did the conventional diet for the first six months, but the differences were not significant at one year. The lowcarbohydrate diet was associated with a greater improvement in some risk factors for coronary heart disease.
James R. BailesJr.; Misty T. Strow; Joseph Werthammer; Richard A. McGinnis; Yoram Elitsur
Non-ramdomized Prospective Controlled Study: Obese children following a high protein, low CHO diet (<30g/day) lost an average of 5.21 ± 3.44 kg and decreased their BMI by 2.42 ± 1.3 points, compared to the children in the Low Cal Diet (calorie restricted) who gained an average of 2.36 ± 2.54 kg and 1.00 point on the BMI value. A high protein, low carbohydrate, unlimited calorie diet was superior to a restricted calorie protocol for weight loss in obese school age children; moreover, compliance was better.
William S. Yancy Jr., MD, MHS; Maren K. Olsen, PhD; John R. Guyton, MD; Ronna P. Bakst, RD; Eric C. Westman, MD, MHS
RCT with 120 participants: Compared with a low-fat diet, a low-carbohydrate diet program had better participant retention and greater weight loss. During active weight loss, serum triglyceride levels decreased more and high-density lipoprotein cholesterol level increased more with the low-carbohydrate diet than with the low-fat diet.
JS Volek; MJ Sharman; AL Gómez; DA Judelson; MR Rubin; G Watson; B Sokmen; R Silvestre; DN French; WJ Kraemer
RCT with 28 particpants: This study shows a clear benefit of a VLCK over LF diet for short-term body weight and fat loss, especially in men. A preferential loss of fat in the trunk region with a VLCK diet is novel and potentially clinically significant but requires further validation.
Jeff S. Volek , PhD, RD, FACN; Matthew J. Sharman , MA; Ana L. Gómez , MS; Chris DiPasquale , MS; Melissa Roti , PhD; Amy Pumerantz , BS; William J. Kraemer , PhD
Ramdomized crossover with 13 participants: Compared to a low-fat weight loss diet, a short-term very low-carbohydrate diet did not lower LDL-C but did prevent the decline in HDL-C and resulted in improved insulin sensitivity in overweight and obese, but otherwise healthy women. Small decreases in body mass improved postprandial lipemia, and therefore cardiovascular risk, independent of diet composition.
Kelly A. Meckling; Caitriona O’Sullivan; Dayna Saari
RCT with 31 participants: Both groups of subjects had significant weight loss over the 10 wk of diet intervention and nearly identical improvements in body weight and fat mass. Only the LC group had a significant decrease in circulating insulin concentrations. Group results indicated that the diets were equally effective in reducing systolic blood pressure by about 10 mm Hg and diastolic pressure by 5 mm Hg and decreasing plasminogen activator inhibitor-1 bioactivity. These data suggest that energy restriction achieved by a very LC diet is equally effective as a LF diet strategy for weight loss and decreasing body fat in overweight and obese adults.
Hussein M Dashti, MD PhD FICS FACS; Thazhumpal C Mathew, MSc PhD FRCPath; Talib Hussein, MB ChB; Sami K Asfar, MB ChB MD FRCSEd FACS; Abdulla Behbahani, MB ChB FRCS FACSI PhD FICS FACS; Mousa A Khoursheed, MB ChB FRCS FICS; Hilal M Al-Sayer, MD PhD FICS FACS; Yousef Y Bo-Abbas, MD FRCPC; Naji S Al-Zaid, BSc PhD
Single arm prospective with 83 participants: The present study shows the beneficial effects of a long-term ketogenic diet. It significantly reduced the body weight and body mass index of the patients. Furthermore, it decreased the level of triglycerides, LDL cholesterol and blood glucose, and increased the level of HDL cholesterol. Administering a ketogenic diet for a relatively longer period of time did not produce any significant side effects in the patients. Therefore, the present study confirms that it is safe to use a ketogenic diet for a longer period of time than previously demonstrated.
Y. Wady Aude, MD; Arthur S. Agatston, MD; Francisco Lopez-Jimenez, MD, MSc; Eric H. Lieberman, MD; Marie Almon, MS, RD; Melinda Hansen, ARNP; Gerardo Rojas, MD; Gervasio A. Lamas, MD; Charles H. Hennekens, MD, DrPH
RCT with 60 participants: Compared with the NCEP diet, the MLC diet, which is lower in total carbohydrates but higher in complex carbohydrates, protein, and monounsaturated fat, caused significantly greater weight loss over 12 weeks. Weight loss was significantly greater in the Modified Low Carbohydrate (13.6 lb) than in the National Cholesterol Education Program group (7.5 lb), a difference of 6.1 lb. There were significantly favorable changes in all lipid levels within the MLC but not within the NCEP group. Waist-to-hip ratio was significantly decreased within the MLC group.
Kevin D. O’Brien; Bonnie J. Brehm; Randy J. Seeley; Judy Bean; Mark H. Wener; Stephen Daniels; David A. D’Alessio
RCT with 41 participants: The very low-carbohydrate dieters had a significantly greater decrease in LogSAA, but their weight loss also was significantly greater. In this study, the decreases in inflammatory markers correlated significantly with weight loss. Also, change in LogSAA correlated with change in insulin resistance. Thus, in otherwise healthy, obese women, weight loss was associated with significant decreases in both SAA and CRP. These effects were proportional to the amount of weight lost but independent of dietary macronutrient composition.
Michael L. Dansinger, MD; Joi Augustin Gleason, MS, RD; John L. Griffith, PhD; Harry P. Selker, MD, MSPH; Ernst J. Schaefer, MD
RCT with 160 participants: Each popular diet modestly reduced body weight and several cardiac risk factors at 1 year. Overall dietary adherence rates were low, although increased adherence was associated with greater weight loss and cardiac risk factor reductions for each diet group.
Mary Dean Coleman, PhD, RD; Sharon M. Nickols-Richardson, PhD, RD
Singel Arm: Thirteen overweight premenopausal women aged 32 to 45 years consumed <20 g carbohydrate/day with liberal intakes of protein and fat for 2 weeks; thereafter, carbohydrate intake increased 5 g/week for 10 weeks. Serumhydroxybutyrate was correlated with presence of urinary ketones, but no relationship was found between weekly weight change and serum ketone production. Urinary ketones are detected in premenopausal women complying with a low-carbohydrate/high-protein diet and are associated with serum ketone concentration.
Bonnie J. Brehm; Suzanne E. Spang; Barbara L. Lattin; Randy J. Seeley; Stephen R. Daniels; David A. D’Alessio
RCT with 50 participants: These results confirm that short-term weight loss is greater in obese women on a low-carbohydrate diet than in those on a low-fat diet even when reported food intake is similar.
Guenther Boden, MD; Karin Sargrad, MS, RD, CDE; Carol Homko, PhD, RN, CDE; Maria Mozzoli, BS; T. Peter Stein, PhD
Single arm – meabolic ward with 10 participants: In a small group of obese patients with type 2 diabetes, a low-carbohydrate diet followed for 2 weeks resulted in spontaneous reduction in energy intake to a level appropriate to their height; weight loss that was completely accounted for by reduced caloric intake; much improved 24-hour blood glucose profiles, insulin sensitivity, and hemoglobin A1c; and decreased plasma triglyceride and cholesterol levels.
M. E. Daly; R. Paisey; B. A. Millward; C. Eccles; K. Williams; S. Hammersley; K. M. MacLeod; T. J. Gale
RCT with 102 participants: Weight loss and high-density lipoprotein (HDL) ratio improved was greater in the low-carbohydrate (LC) group over low fat group. Carbohydrate restriction was an effective method of achieving short-term weight loss compared with standard advice.