Obesity / Weight Loss
Christopher D. Gardner, PhD; Alexandre Kiazand, MD; Sofiya Alhassan, PhD; Soowon Kim, PhD; Randall S. Stafford, MD, PhD; Raymond R. Balise, PhD; Helena C. Kraemer, PhD; Abby C. King, PhD
RCT with 311 participants: In this study, premenopausal overweight and obese women assigned to follow the Atkins diet, which had the lowest carbohydrate intake, lost more weight at 12 months than women assigned to follow the Zone diet, and had experienced comparable or more favorable metabolic effects than those assigned to the Zone, Ornish, or LEARN diets.
LM Morgan; BA Griffin; DJ Millward; A DeLooy; KR Fox; S Baic; MP Bonham4; JMW Wallace; I MacDonald; MA Taylor; H Truby
RCT – 4 arm: The Atkins (low-carbohydrate) diet was followed by marked reductions in plasma TAG (–38.2% 6 months). This diet was associated with an increase in LDL particle size, a change that has been linked to reduced CVD risk.
Frank M. Sacks, MD; George A. Bray, MD; Vincent J. Carey, PhD; Steven R. Smith, MD; Donna H. Ryan, MD; Stephen D. Anton, PhD; Katherine McManus, MS, RD; Catherine M. Champagne, PhD; Louise M. Bishop, MS, RD; Nancy Laranjo, BA; Meryl S. Leboff, MD; Jennifer C. Rood, PhD; Lilian de Jonge, PhD; Frank L. Greenway, MD; Catherine M. Loria, PhD; Eva Obarzanek, PhD; Donald A. Williamson, PhD
Randomozed, three arms: 811 overweight adults to one of four diets; the targeted percentages of energy derived from fat, protein, and carbohydrates in the four diets were 20, 15, and 65%; 20, 25, and 55%; 40, 15, and 45%; and 40, 25, and 35%. At end of study, diets higher in protein and fat showed greater weight loss and reduced waist circumference than diet high in carbohdyrates.
M. Siegel, MD; Whitney Rich, RD; Evelyn C. Joseph, MD; Joan Linhardt; Jamie Knight; Jane Khoury, PhD; Stephen R. Daniels, MD, PhD
Single arm prospective: The LCD appears to be an effective and practical office-based intervention in obese teenagers.
Nichola J. Davis, MD, MS; Nora Tomuta, MD; Clyde Schechter, MD; Carmen R. Isasi, MD, PHD; C.J. Segal-Isaacson, EDD, RD; Daniel Stein, MD; Joel Zonszein, MD; Judith Wylie-Rosett, EDD, RD
RCT with 105 participants: Among patients with type 2 diabetes, after 1 year a lowcarbohydrate diet had effects on weight and A1C similar to those seen with a low-fat diet. There was no significant effect on blood pressure, but the low-carbohydrate diet produced a greater increase in HDL cholesterol. Weight loss occurred faster in the low-carbohydrate group than in the low-fat group in the first 3 months.
Grant D Brinkworth; Manny Noakes; Jonathan D Buckley; Jennifer B Keogh; Peter M Clifton
RCT with 69 participants: Low Carb group (over a isocaloric low fat diet) had greater decreases in triglycerides, increases in HDL cholesterol, and LDL cholesterol, and a greater but nonsignificant increase in apolipoprotein B. Both dietary patterns resulted in similar weight loss and changes in body composition. The LC diet may offer clinical benefits to obese persons with insulin resistance.
William S. Yancy Jr, MD, MHS; Eric C. Westman, MD, MHS; Jennifer R. McDuffie, PhD, RD, MPH; Steven C. Grambow, PhD; Amy S. Jeffreys, MStat; Jamiyla Bolton, MS; Allison Chalecki, RD; Eugene Z. Oddone, MD, MHS
RCT with 146 participants: Obese and overweight outpatients were assigned to either a low-carbohydrate ketogenic diet (LCKD) or Orlistat therapy combined with a low fat diet (O + LFD). In a sample of medical outpatients, an LCKD led to similar improvements as O + LFD for weight, serum lipid, and glycemic parameters and was more effective for lowering blood pressure.
Cynthia A. Thomson; Alison T. Stopeck; Jennifer W. Bea; Ellen Cussler; Emily Nardi; Georgette Frey; Patricia A. Thompson
RCT with 40 Participants: A group of overweight female breast cancer survivors were assigned either a low-fat diet or Modified Atkins Diet. All subjects demonstrated improvements in total/HDL cholesterol ratio, and significant reductions inHbA1c, insulin, and HOMA. Triglycerides levels were significantly reduced only in the low-carbohydrate diet group. Significant improvements in weight and metabolic indexes can be demonstrated among overweight breast cancer survivors adherent to either the Modified Atkins Diet or fatrestricted diet.
Nancy F. Krebs, MD, MS; Dexiang Gao, PhD; Jane Gralla, PhD; Juliet S. Collins; MD, Susan L. Johnson, PhD
RCT with 46 participants: Significant reduction in BMI-Z-score was achieved in both groups during intervention, and was significantly greater for the HPLC (high protein low carbohydrate) group. Both groups maintained significant BMI-Z reduction at follow-up; changes were not significantly different between groups. The HPLC diet is a safe and effective option for medically supervised weight loss in severely obese adolescents.
Nayyar Iqbal; Marion L. Vetter; Reneé H. Moore; Jesse L. Chittams; Cornelia V. Dalton‐Bakes; Monique Dowd; Catherine Williams‐Smith; Serena Cardillo; Thomas A. Wadden
RCT with 104 Participants: At this time, participants in the low-carbohydrate group lost 1.5 kg, compared to 0.2 kg in the low-fat group (P = 0.147). Lipids, glycemic indexes, and dietary intake did not differ between groups at month 24 (or at months 6 or 12).
Gary D. Foster, PhD; Holly R. Wyatt, MD; James O. Hill, PhD; Angela P. Makris, PhD, RD; Diane L. Rosenbaum, BA; Carrie Brill, BS; Richard I. Stein, PhD; B. Selma Mohammed, MD, PhD; Bernard Miller, MD; Daniel J. Rader, MD; Babette Zemel, PhD; Thomas A. Wadden, PhD; Thomas Tenhave, PhD; Craig W. Newcomb, MS; Samuel Klein, MD
RCT with 307 participants: 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. Weight loss was approximately 11 kg (11%) at 1 year and 7 kg (7%) at 2 years. 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.
Tae Sasakabe, Hajime Haimoto, Hiroyuki Umegaki, Kenji Wakai
Single arm prospective with 52 participants: Six months of a moderate LCD resulted in preferential VAT (visceral adipose tissue) loss only in women, with significant correlations between % change SAT (subcutaneous adipose tissue) and both change HDL and change FBG (fasting blood glucose), as well as between % change VAT and change TG. Authors results suggest that an LCD has the potential to reduce abdominal fat in patients with T2DM and deterioration of serum lipid profiles.
F. L. Santos, S. S. Esteves, A. da Costa Pereira, W. S. Yancy Jr, J. P. L. Nunes
Meta-analysis: LCD was shown to have favourable effects on body weight and major cardiovascular risk factors.
Cara B. Ebbeling, PhD; Janis F. Swain, MS, RD; Henry A. Feldman, PhD; William W. Wong, PhD; David L. Hachey, PhD; Erica Garcia-Lago, BA; David S. Ludwig, MD, PhD
3 way randomized crossover with 21 participants: Individuals on the very low carb diet had the highest resting metabolism.
Carolyn O. Walsh, Cara B. Ebbeling, Janis F. Swain, Robert L. Markowitz, Henry A. Feldman, David S. Ludwig
Randomized Crossover with 8 participants: These findings suggest that a Low Fat diet may adversely affect postprandial Energy Availability and risk for weight regain during weight loss maintenance.
Megan R. Ruth, Ava M. Port, Mitali Shah, Ashley C. Bourland, Nawfal W. Istfan, Kerrie P. Nelson, Noyan Gokce, Caroline M. Apovian
RCT with 55 participants: Relative to the Low Fat/High Carb group, the High Fat/Low Carb group had greater improvements in blood lipids and systemic inflammation with similar changes in body weight and composition. This small-scale study suggests that HFLC diets may be more beneficial to cardiovascular health and inflammation in free-living obese adults compared to LFHC diets.
Antonio Paoli, Antonino Bianco, Keith A Grimaldi, Alessandra Lodi, Gerardo Bosco
Single arm perspective with 89 participants: The data from this study demonstrate that the majority of subjects showed significant weight loss (10%) as a result of a two-phase VLCKD and were compliant both during the six month weight loss phase and the six month normocaloric maintenance phase, with no weight regain. We can suggest that the proposed protocol was generally successful because of (a) the protein mass protective effects of a VLCKD and (b) the prescription of a traditional Mediterranean diet in the post weight-loss phase was especially important for achieving “weight loss success”, i.e., continued weight loss for at least one year.
Nassib Bezerra Bueno, Ingrid Sofia Vieira de Melo, Suzana Lima de Oliveira, Terezinha da Rocha Ataide
Metas Analysis: Individuals assigned to a VLCKD achieve a greater weight loss than those assigned to a LFD in the long term; hence, a VLCKD may be an alternative tool against obesity.
Basilio Moreno; Diego Bellido; Ignacio Sajoux; Albert Goday; Dolores Saavedra; Ana B. Crujeiras; Felipe F. Casanueva
RCT with 53 Particpants. In a group of obese patients, the VLCK diet was significantly more effective than a standard LC diet. At one year followup in the group with VLCK diet, most of the patients loss more than 10 % of their initial weight and lean mass was well preserved.
Lydia A. Bazzano, MD, PhD, MPH; Tian Hu, MD, MS; Kristi Reynolds, PhD; Lu Yao, MD, MS; Calynn Bunol, MS, RD, LDN; Yanxi Liu, MS; Chung-Shiuan Chen, MS; Michael J. Klag, MD, MPH; Paul K. Whelton, MD, MSc, MB; Jiang He, MD, PhD
RCT with 148 participants. The low-carbohydrate diet was more effective for weight loss and cardiovascular risk factor reduction than the low-fat diet. Restricting carbohydrate may be an option for persons seeking to lose weight and reduce cardiovascular risk factors.
Christopher D. Gardner, Lisa C. Offringa, Jennifer C. Hartle, Kris Kapphahn, Rise Cherin
RCT with 61 Participants. Both diets demonstrated significant weight loss, as well as improved biomarkers for many disease risk factors.
Jonathan Sackner-Bernstein, David Kanter, Sanjay Kaul
This trial-level meta-analysis of randomized controlled trials comparing LoCHO diets with LoFAT diets in strictly adherent populations demonstrates that each diet was associated with significant weight loss and reduction in predicted risk of ASCVD events. However, LoCHO diet was associated with modest but significantly greater improvements in weight loss and predicted ASCVD risk in studies from 8 weeks to 24 months in duration. These results suggest that future evaluations of dietary guidelines should consider low carbohydrate diets as effective and safe intervention for weight management in the overweight and obese, although long-term effects require further investigation.
Thomas P. Wycherley, Campbell H. Thompson, Jonathan D. Buckley, Natalie D. Luscombe-Marsh, Manny Noakes, Gary A. Wittert, Grant D. Brinkworth
RCT. In patients with obesity and T2DM, HighCHO diet and LowCHO diet have similar effects on endothelial function.
Kevin D Hall, Kong Y Chen, Juen Guo , Yan Y Lam, Rudolph L Leibel, Laurel ES Mayer, Marc L Reitman, Michael Rosenbaum, Steven R Smith, B Timothy Walsh, Eric Ravussin
Metabolic ward crossover with 17 subjects. A logical consequence of the carbohydrate–insulin model is that decreasing the proportion of dietary carbohydrate to fat without altering protein or calories will reduce insulin secretion, increase fat mobilization from adipose tissue, and elevate the oxidation of circulating free fatty acids (FFAs). For those participants following the Ketogenic Diet, insulin response was superior to comparative diet.
Alain J. Nordmann, MD, MSc; Abigail Nordmann, BS; Matthias Briel, MD; Ulrich Keller, MD; William S. Yancy Jr, MD, MSH; Bonnie J. Brehm, PhD; Heiner C. Bucher, MD, MPH
Five trials including a total of 447 individuals. This meta-analysis demonstrates that low-carbohydrate, non–energy-restricted diets appear to be at least as effective as low-fat, energy-restricted diets in inducing weight loss for up to 1 year. However, potential favorable changes in triglyceride and high-density lipoprotein cholesterol values should be weighed against potential unfavorable changes in low-density lipoprotein cholesterol values when low-carbohydrate diets to induce weight loss are considered.