Background and aim
Very low carbohydrate ad libitum diets have been shown to enhance weight loss without increasing cardiometabolic risk factors but no kilojoule-controlled trials have been conducted relative to no intervention. The aim of this study was to compare the changes in weight and other cardiovascular risk factors in 3 isocaloric energy-restricted diets to no-intervention control after 1 year.
Methods and results
One hundred and thirteen subjects (age 47±10 years, BMI 32±6 kg/m2 with one additional cardiovascular risk factor) were randomly allocated to one of three isocaloric diets (VLC-very low carbohydrate, 60% fat, 4% carbohydrate, n=30; VLF-very low fat, 10% fat, n=30; HUF-high unsaturated fat, 30% fat, n=30) with intensive support for 3 months followed by minimal support for 12 months compared to a control group (no intervention, n=23). The estimated weight change was −3.0±0.2 kg for VLC, −2.0±0.1 kg for VLF, −3.7±0.01 kg for HUF and 0.8±0.5 kg for controls (P=0.065). After correcting for baseline values, decreases in body weight and diastolic blood pressure in the diet groups (−2.9±5.2) were significantly different to the increase in the control group (0.8±5.0) (P<0.05). No differences in cardiovascular risk factors were observed between the diet groups.
Significant cardiometabolic risk factor reduction was observed equally with VLC, VLF and HUF diets after 15 months, compared to an exacerbation of risk factors in the control group. At a modest level of adherence, 3 months of intensive support on these dietary patterns confer an improvement in cardiometabolic profile compared to no dietary intervention after 15 months.
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- Body weight and mortality among women.N Engl J Med. 1995; 333: 677-685
- Obesity as an independent risk factor for cardiovascular disease: a 26-year follow-up of participants in the Framingham Heart Study.Circulation. 1983; 67: 968-977
- Effects of weight reduction on blood lipids and lipoproteins: a meta-analysis.Am J Clin Nutr. 1992; 56: 320-328
- Weight loss and blood pressure control (Pro).Hypertension. 2008; 51 ([discussion: 1425]): 1420-1425
- Effects of low-carbohydrate vs low-fat diets on weight loss and cardiovascular risk factors: a meta-analysis of randomized controlled trials.Arch Intern Med. 2006; 166: 285-293
- Efficacy and safety of low-carbohydrate diets: a systematic review.JAMA. 2003; 289: 1837-1850
- Low carbohydrate-high protein diet and mortality in a cohort of Swedish women.J Intern Med. 2007; 261: 366-374
- Low-carbohydrate-diet score and the risk of coronary heart disease in women.N Engl J Med. 2006; 355: 1991-2002
- A randomized trial comparing a very low carbohydrate diet and a calorie-restricted low fat diet on body weight and cardiovascular risk factors in healthy women.J Clin Endocrinol Metab. 2003; 88: 1617-1623
- A randomized trial of a low-carbohydrate diet for obesity.N Engl J Med. 2003; 348: 2082-2090
- A low-carbohydrate as compared with a low-fat diet in severe obesity.N Engl J Med. 2003; 348: 2074-2081
- Comparison of high-fat and high-protein diets with a high-carbohydrate diet in insulin-resistant obese women.Diabetologia. 2005; 48: 8-16
- Effects of a low-carbohydrate diet on weight loss and cardiovascular risk factor in overweight adolescents.J Pediatr. 2003; 142: 253-258
- A low-carbohydrate, ketogenic diet versus a low-fat diet to treat obesity and hyperlipidemia: a randomized, controlled trial.Ann Intern Med. 2004; 140: 769-777
- Comparison of isocaloric very low carbohydrate/high saturated fat and high carbohydrate/low saturated fat diets on body composition and cardiovascular risk.Nutr Metab (Lond). 2006; 3: 7
- Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge.Clin Chem. 1972; 18: 499-502
- The effect of metformin and rosiglitazone on postprandial lipid metabolism in obese insulin-resistant subjects.Diabetes Obes Metab. 2005; 7: 381-389
- Accounting for dropout bias using mixed-effects models.J Biopharm Stat. 2001; 11: 9-21
- Comparison of the Atkins, Ornish, Weight Watchers, and Zone diets for weight loss and heart disease risk reduction: a randomized trial.JAMA. 2005; 293: 43-53
- Comparison of the Atkins, Zone, Ornish, and LEARN diets for change in weight and related risk factors among overweight premenopausal women: the A TO Z Weight Loss Study: a randomized trial.JAMA. 2007; 297: 969-977
- Long-term effects of popular dietary approaches on weight loss and features of insulin resistance.Int J Obes (Lond). 2006; 30: 342-349
- Metabolic effects of weight loss on a very-low-carbohydrate diet compared with an isocaloric high-carbohydrate diet in abdominally obese subjects.J Am Coll Cardiol. 2008; 51: 59-67
- Thermodynamics of weight loss diets.Nutr Metab (Lond). 2004; 1: 15
- High-protein weight-loss diets: are they safe and do they work? A review of the experimental and epidemiologic data.Nutr Rev. 2002; 60: 189-200
- Executive summary of the third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III).JAMA. 2001; 285: 2486-2497
- Effects of dietary fatty acids and carbohydrates on the ratio of serum total to HDL cholesterol and on serum lipids and apolipoproteins: a meta-analysis of 60 controlled trials.Am J Clin Nutr. 2003; 77: 1146-1155
- Dietary lipids and blood cholesterol: quantitative meta-analysis of metabolic ward studies.BMJ. 1997; 314: 112-117
- 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: 778-785
Published online: August 20, 2009
Accepted: May 6, 2009
Received in revised form: April 21, 2009
Received: January 12, 2009
☆Funding source: This study was supported by a National Heart Foundation, Australia and CSIRO Health Sciences and Nutrition, Adelaide, Australia.
© 2009 Elsevier B.V. Published by Elsevier Inc. All rights reserved.