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The effects of low-carbohydrate versus conventional weight loss diets in severely obese adults: one-year follow-up of a randomized trial.
Ann Intern Med. 2004 May 18; 140(10):778-85.AIM

Abstract

BACKGROUND

A previous paper reported the 6-month comparison of weight loss and metabolic changes in obese adults randomly assigned to either a low-carbohydrate diet or a conventional weight loss diet.

OBJECTIVE

To review the 1-year outcomes between these diets.

DESIGN

Randomized trial.

SETTING

Philadelphia Veterans Affairs Medical Center.

PARTICIPANTS

132 obese adults with a body mass index of 35 kg/m2 or greater; 83% had diabetes or the metabolic syndrome.

INTERVENTION

Participants received counseling to either restrict carbohydrate intake to <30 g per day (low-carbohydrate diet) or to restrict caloric intake by 500 calories per day with <30% of calories from fat (conventional diet).

MEASUREMENTS

Changes in weight, lipid levels, glycemic control, and insulin sensitivity.

RESULTS

By 1 year, mean (+/-SD) weight change for persons on the low-carbohydrate diet was -5.1 +/- 8.7 kg compared with -3.1 +/- 8.4 kg for persons on the conventional diet. Differences between groups were not significant (-1.9 kg [95% CI, -4.9 to 1.0 kg]; P = 0.20). For persons on the low-carbohydrate diet, triglyceride levels decreased more (P = 0.044) and high-density lipoprotein cholesterol levels decreased less (P = 0.025). As seen in the small group of persons with diabetes (n = 54) and after adjustment for covariates, hemoglobin A1c levels improved more for persons on the low-carbohydrate diet. These more favorable metabolic responses to a low-carbohydrate diet remained significant after adjustment for weight loss differences. Changes in other lipids or insulin sensitivity did not differ between groups.

LIMITATIONS

These findings are limited by a high dropout rate (34%) and by suboptimal dietary adherence of the enrolled persons.

CONCLUSION

Participants on a low-carbohydrate diet had more favorable overall outcomes at 1 year than did those on a conventional diet. Weight loss was similar between groups, but effects on atherogenic dyslipidemia and glycemic control were still more favorable with a low-carbohydrate diet after adjustment for differences in weight loss.

Authors+Show Affiliations

Stern L
Philadelphia Veterans Affairs Medical Center, University of Pennsylvania Medical Center, and Drexel University College of Medicine, Philadelphia, Pennsylvania 19104, USA.
Iqbal N
No affiliation info available
Seshadri P
No affiliation info available
Chicano KL
No affiliation info available
Daily DA
No affiliation info available
McGrory J
No affiliation info available
Williams M
No affiliation info available
Gracely EJ
No affiliation info available
Samaha FF
No affiliation info available

MeSH

AdolescentAdultAgedBlood GlucoseDiabetes ComplicationsDiabetes MellitusDiet, Fat-RestrictedDiet, ReducingDietary CarbohydratesFemaleFollow-Up StudiesHumansInsulinLipidsMaleMetabolic SyndromeMiddle AgedObesity, MorbidPatient CompliancePatient DropoutsWeight Loss

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

15148064

Clinical Trial Links

Prader-Willi Syndrome Macronutrient Study
A Trial of the Ideal Protein System Versus Low Fat Diet for Weight Loss

Citation

Stern, Linda, et al. "The Effects of Low-carbohydrate Versus Conventional Weight Loss Diets in Severely Obese Adults: One-year Follow-up of a Randomized Trial." Annals of Internal Medicine, vol. 140, no. 10, 2004, pp. 778-85.
Stern L, Iqbal N, Seshadri P, et al. The effects of low-carbohydrate versus conventional weight loss diets in severely obese adults: one-year follow-up of a randomized trial. Ann Intern Med. 2004;140(10):778-85.
Stern, L., Iqbal, N., Seshadri, P., Chicano, K. L., Daily, D. A., McGrory, J., Williams, M., Gracely, E. J., & Samaha, F. F. (2004). The effects of low-carbohydrate versus conventional weight loss diets in severely obese adults: one-year follow-up of a randomized trial. Annals of Internal Medicine, 140(10), 778-85.
Stern L, et al. The Effects of Low-carbohydrate Versus Conventional Weight Loss Diets in Severely Obese Adults: One-year Follow-up of a Randomized Trial. Ann Intern Med. 2004 May 18;140(10):778-85. PubMed PMID: 15148064.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The effects of low-carbohydrate versus conventional weight loss diets in severely obese adults: one-year follow-up of a randomized trial. AU - Stern,Linda, AU - Iqbal,Nayyar, AU - Seshadri,Prakash, AU - Chicano,Kathryn L, AU - Daily,Denise A, AU - McGrory,Joyce, AU - Williams,Monica, AU - Gracely,Edward J, AU - Samaha,Frederick F, PY - 2004/5/19/pubmed PY - 2004/5/27/medline PY - 2004/5/19/entrez SP - 778 EP - 85 JF - Annals of internal medicine JO - Ann Intern Med VL - 140 IS - 10 N2 - BACKGROUND: A previous paper reported the 6-month comparison of weight loss and metabolic changes in obese adults randomly assigned to either a low-carbohydrate diet or a conventional weight loss diet. OBJECTIVE: To review the 1-year outcomes between these diets. DESIGN: Randomized trial. SETTING: Philadelphia Veterans Affairs Medical Center. PARTICIPANTS: 132 obese adults with a body mass index of 35 kg/m2 or greater; 83% had diabetes or the metabolic syndrome. INTERVENTION: Participants received counseling to either restrict carbohydrate intake to <30 g per day (low-carbohydrate diet) or to restrict caloric intake by 500 calories per day with <30% of calories from fat (conventional diet). MEASUREMENTS: Changes in weight, lipid levels, glycemic control, and insulin sensitivity. RESULTS: By 1 year, mean (+/-SD) weight change for persons on the low-carbohydrate diet was -5.1 +/- 8.7 kg compared with -3.1 +/- 8.4 kg for persons on the conventional diet. Differences between groups were not significant (-1.9 kg [95% CI, -4.9 to 1.0 kg]; P = 0.20). For persons on the low-carbohydrate diet, triglyceride levels decreased more (P = 0.044) and high-density lipoprotein cholesterol levels decreased less (P = 0.025). As seen in the small group of persons with diabetes (n = 54) and after adjustment for covariates, hemoglobin A1c levels improved more for persons on the low-carbohydrate diet. These more favorable metabolic responses to a low-carbohydrate diet remained significant after adjustment for weight loss differences. Changes in other lipids or insulin sensitivity did not differ between groups. LIMITATIONS: These findings are limited by a high dropout rate (34%) and by suboptimal dietary adherence of the enrolled persons. CONCLUSION: Participants on a low-carbohydrate diet had more favorable overall outcomes at 1 year than did those on a conventional diet. Weight loss was similar between groups, but effects on atherogenic dyslipidemia and glycemic control were still more favorable with a low-carbohydrate diet after adjustment for differences in weight loss. SN - 1539-3704 UR - https://www.unboundmedicine.com/medline/citation/15148064/full_citation DB - PRIME DP - Unbound Medicine ER -
Grapherence [↓235]

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