A low-carbohydrate, ketogenic diet versus a low-fat diet to treat obesity and hyperlipidemia.

A low-carbohydrate, ketogenic diet versus a low-fat diet to treat obesity and hyperlipidemia. WS Yancy, MK Olsen, JR Guyton et al. Annals of Internal Medicine 2004;140(10):769-777.
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To compare the effects of a low-carb, ketogenic (LCK) diet program with those of a low-fat, low-cholesterol, reduced-calorie (LFRC) diet
24 weeks
"Targets Carb: <20g/d. When 50% of weight loss goal reached, increased weekly by 5g/d until level at which body weight was maintained Protein: none; unlimited animal foods (meat, fowl, fish, and shellfish), unlimited eggs, 4 oz hard cheese daily Fat: none Advised to eat salad and limited amounts of more starchy vegetables Intake E: 1461.0kcal Carb : 29.5g/d; 8%E Protein: 97.9g/d, 26%E Fat: 110.6g/d, 68%E"
"LFRC diet E: 500-1000kcal < than individualized E need for weight maintenance Carb: none Protein: none Fat: <30%E; saturated fat <10%E; cholesterol <300 mg Intake E: 1502.0kcal Carb : 197.6g/d; 52%E Protein: 70.5g/d, 19%E Fat: 48.9g/d, 29%E"
"Primary: Body weight, BMI Secondary: lipids; urinary function, adverse effects; CBC; urinary ketones for LC diet group"
"The LC diet group lost more weight, had a greater decrease in TG and a higher HDL-C level. LDL-C remained stable in both groups. Side effects were more common in the LC diet group but were generally mild. "
LC group reported more symptoms (constipation, halitosis, headache, muscle cramps, general weakness, rash). No reports of serious adverse events that could be ascribed to diet,
76% of LC group and 57% of LFRC group completed the study.
"Blood urea N LC diet: increased; SS BG Alkaline phosphate LC diet: decreased. LFRC: increased BG SS p<0.001 All other measures of metabolic effects and eGFR were BG NSS. "
""" ...healthy hyperlipidemic persons who followed a low-carbohydrate diet lost more body weight and body fat than did those who followed a low-fat diet. Serum lipid profiles improved in both groups, but monitoring remains important because a small percentage of persons may experience adverse changes. Further research is needed in other groups and for longer periods to determine the safety of this dietary approach."" "


AHA - American Heart Association;
ALT - alanine aminotransferase;
AMDR - acceptable macronutrient distribution range;
AST - aspartate aminotransferase;
BG - between study groups;
BHOB - beta-hydroxybutyrate;
DBP - diastolic blood pressure;
E- energy, caloric intake;
eGFR - estimated glomerular filtration rate;
FBG - fasting blood glucose;
GGT - gamma-glutamyl transferase;
HDL-C - high-density lipoprotein cholesterol;
iGFR - isotope glomerurar filtration rate;
LDL-C - low-density lipoprotein cholesterol;
NAFLD - non-alcoholic fatty liver disease;
NR - not reported (or data needed for calculation not available);
N - no;
NA - not applicable;
NS - not specified;
NSS - not statistically significant;
SBP - systolic blood pressure;
SS - statistically significant;
TG - triglyceride;
total C - total cholesterol;
V - varied, mixed;
WG - within a study group;
WMD - weighted mean difference;
Y - yes

Number of People in Studies:

3,296 Enrolled in randomized controlled trials on 25% or less carbohydrates
2,626 Completed randomized controlled trials on 25% or less carbohydrates
79.67% 82% completion of studies

Duration of Trial

<6 Months
6-9 Months
1 -2 years
>2 years

# of Trials


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