Long-term effects of a very-low-carbohydrate weight loss diet compared with an isocaloric low-fat diet after 12 mo.

13
2009
Long-term effects of a very-low-carbohydrate weight loss diet compared with an isocaloric low-fat diet after 12 mo. GD Brinkworth, M Noakes, JD Buckley et al. American Journal of Clinical Nutrition 2009;90:23-32.
View Study
New Zealand
1
To compare two E-controlled diets - low-carb diet and a lowfat diet at 1 year.
118
80
9%
37
1 year
Y
"Enrolled: 118 men and women who had abdominal obesity and at least one other metabolic syndrome risk factor. Completed: 80. Mean age: ~51; mean BMI ~33.5"
80
Both arms implemented the same E-restricted diet (~6000 kJ/d for women, ~7000 kJ/d for men). Both provided consultations with dietician biweekly for first eight weeks, monthly thereafter. Also had phone help line, food vouchers, prepared foods; completed daily food record.
Y
"Targets E: ~6000 kJ/d (1434.0kcal/d) for women, ~7000 kJ/d (1673.0kcal/d) for men Carb: 4%E; <20g/d 1st 8 weeks; <40g/d thereafter Protein: 35%E Fat: 61%E total fat (20% saturated fat) Intake E: 6882.2 kJ (1644.8kcal/d) Carb: 36.5g/d; 8.9%E Protein: 129.8g/d; 32.3%E Fat: 102.3g/d; 54.9%E (sat fat 37.9%E)"
"Target: 4%-8% Intake: 8.9%"
"Target: 61% Intake: 54.9%"
"Targets E: ~6000 kJ/d for women, ~7000 kJ/d for men Carb: 46%E; <20g/d 1st 8 weeks; <40g/d thereafter Protein: 24%E Fat: 30%E total fat ( 8%/<10g/d saturated fat) Intake at weeks 37-52 E: 6880.4 kJ Carb: 186.5g/d; 46.4%E Protein: 85.6.8g/d; 21.8%E Fat: 48.3g/d; 26.4%E (sat fat 11.5%E)"
"Primary: chronic metabolic effects of dietary patterns Abdominal fat mass, weight, blood pressure, glucose, C-reactive protein, lipids, apolipoprotein B (apo B), insulin resistance (HOMA2-IR), B cell function (HOMA2%B), insulin sensitivity (HOMA2%S), Framington 10-year coronary heart disease risk score (FRS), urinary urea, ketones."
"Results reported are for completers. Isocaloric LC and LF diets resulted in similar weight loss and reductions in blood pressure, glucose, insulin, insulin resistance, and CRP after 12 mo. Effects on blood lipids differed with diet: LC diet resulted in greater increases in total C, LDL-C, and HDL-C and greater reductions in TG. Framington risk score was reduced with both diets, but was NSS BG."
"WG: NR BG: N BG NSS "
*
0
NR
*
*
"WG: NR BG: N SS better with LF diet LC: +0.7mmol/L LF: +0.1 BG SS p=0.004"
*
0
"WG: NR BG: Y LC: +0.30mmol/L LF: +0.07 BG SS p=0.018"
*
1
"WG: NR BG: N SS better with LF diet LC: +0.6mmol/L LF: +0.1 BG SS p=0.001"
*
0
"TG and TG:HDL-C ratio WG: NR BG: Y TG LC: -0.58mmol/L LF: -0.22 BG SS p=0.011 TG:HDL LC: -0.55 LF: -0.23 BG SS p=0.009"
*
1
*
1
"Weight & abdominal fat WG: NR BG: N BG NSS "
*
0
"WG: NR BG: N BG NSS."
*
0
"WG: NR BG: N BG NSS"
*
0
"WG: NR BG: N BG NSS"
*
0
"HOMA2-IR, HOMA2%B, HOMA2%S WG: NR BG: N BG NSS."
*
0
"C-reactive protein WG: NR BG: N BG NSS "
*
0
NR
NR
"Apo B & Framington CVD risk score WG: NR BG: N BG NSS "
"The LC diet may offer clinical benefits to obese persons with insulin resistance. However, the increase in LDL with the LC diet suggests that this measure should be monitored."

Abbreviations:

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

36
6
9s
1

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