Low-carbohydrate (low & high-fat) versus high-carbohydrate low-fat diets in the treatment of obesity in adolescents. S Demol, M Yackobovitch-Gavan, S Shalitin et al. Acta Paediatr. 2009 Feb;98(2):346-51. Epub 2008 Sep 29.
45
2008
"Low-carbohydrate (low & high-fat) versus high-carbohydrate low-fat diets in the treatment of obesity in adolescents. S Demol, M Yackobovitch-Gavan, S Shalitin et al. Acta Paediatr. 2009 Feb;98(2):346-51. Epub 2008 Sep 29. "
Israel
1
To compare the impact of low-carbohydrate diets of different fat content to high-carbohydrate low-fat diet on weight and metabolic parameters in obese adolescents.
55
55
20%
60
12 weeks
Y
"Enrolled n=55 obese adolescents 21 males; 34 females Mean age: ~ 14.5y Mean BMI: ~34 (all > 95th%ile) Completed 100%"
55
"12-week intervention: Subjects randomly assigned to one of 3 reduced-E diets of the same caloric content: - low-carb, high-protein, low-fat - low-carb, normal-protein, high-fat - high-carb, normal protein, low-fat For the intervention, subjects received detailed instructions and menus (new menus each month), and met weekly with a dietician and psychologist. They were instructed to exercise regularly. At the end of the intervention, all subjects were given new instructions and menus for a high-carb, low-fat maintenance diet and scheduled for follow-up visits every 3 months for the following 9 months. "
Y
"Low-carb, high-protein, low-fat (LCLF diet) Targets E: 1200-1500kcal/d Carb: 20%E, 60g/d Protein: 50%E Fat: 30%E Intake: NR Low-carb, normal-protein, high-fat (LCHF diet) Targets E: 1200-1500kcal/d Carb: 20%E, 60g/d Protein: 20%E Fat: 60%E Intake: NR"
"Target: 20% Intake: NR"
"Target: 30%, 60% Intake: NR"
"High-carb, normal-protein, low-fat (HCLF diet) Targets E: 1200-1500kcal/d Carb: 50-60%E Protein: 20%E Fat: 30%E Intake: NR"
"Primary: weight, BMI, and metabolic parameters Lipids, FBG, fasting insulin, body fat, HOMA, kidney and liver function. "
"Because the low-carb arms were discontinued at the end of the 12-wk intervention (with a high-carb diet then assigned to all subjects until 9-mo follow-up), the results reported here are for 9 months. BMI and body fat reductions were SS across all diet groups. BG NSS. Lipid levels improved across all groups, but differences were NSS BG. Fasting insulin and HOMA improved SS only in the low-carb diet groups. CRP and measures of liver and kidney function were not changed."
"WG: Y BG: N SS reduction was found across all groups. BG NSS Values in supplemental tables."
1
0
NR
*
*
"WG: Y BG: N SS reduction was found across all groups. BG NSS Values in supplemental tables."
1
0
"WG: Y BG: N SS reduction was found across all groups. BG NSS Values in supplemental tables."
1
0
"WG: Y BG: N SS reduction was across all groups. BG NSS Values in supplemental tables."
1
0
"WG: Y BG: N SS reduction was found across all groups. BG NSS Values in supplemental tables."
1
0
*
*
"BMI & body fat WG: NR BG: N SS reduction was found within all groups combined. BG NSS at 12 weeks BMI LCLF: -2.7, -7.7% LCHF: -2.0, -5.9% HCLF: -1.8, -5.3% time effect all groups p<0.001 BG NSS"
*
0
NR
*
*
NR
*
*
"WG: Y BG: NR SS reduction was only in the LC diet groups. BG NSS Values in supplemental tables."
1
*
"WG: Y BG: NR SS reduction was only in the LC diet groups. BG NSS Values in supplemental tables."
1
*
"CRP WG: N BG: N No SS change in any diet group."
0
0
NA
"Kidney function: ""There were no significant changes in renal function (urea, creatinine, uric acid, protein level urine) in any of the groups."" Liver function: Mild liver dysfunction was present in 11% of at baseline (alanineaminotransferase), which disappeared at 12 weeks. Liver enzyme readings were within normal range. Adverse events: NSS BG differences in # or distribution of complaints. Most common: headache, diarrhea, constipation, nausea, and bad mood."
NSS BG difference in attrition.
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