Weight-loss with low or high carbohydrate diet?
OBJECTIVE
With obesity being recognized as an important cardiovascular risk factor, it is important to determine the optimal hypocaloric diet for decreasing that risk. The goal of this study was to compare the effects of two hypocaloric diets of similar caloric value, but differing in carbohydrate content (25% and 45%).


METHODS
Sixty-eight out-patients were followed for 12 w.


METHODS
The patients were assigned to one of two groups that received either a low (25% CHO, n = 31) or a high (45% CHO, n = 37) carbohydrate hypocaloric diet (5.0 MJ/d, 1200 Kcal/d).


RESULTS
After 12 w, the mean weight loss was similar and did not differ significantly between the two groups: 10.2 +/- 0.7 kg (25% CHO) and 8.6 +/- 0.8 kg (45% CHO). Furthermore, loss of adipose tissue was similar, 8.1 +/- 0.5 kg (25% CHO) and 7.1 +/- 0.7 kg (45% CHO). Despite a high protein intake (1.4 g/kg/ideal body weight) there was loss of lean body mass: 2.2 +/- 0.4 kg (25% CHO) and 1.4 +/- 0.3 kg (45% CHO). The waist/hip ratio diminished significantly (P < 0.001) and identically in both groups. The fasting blood glucose (even though normal, along with cholesterol and triglyceride concentrations, were significantly decreased after weight loss. The fasting blood insulin which was mildly elevated before weight loss decreased more markedly with the 25% CHO diet compared to the 45% CHO diet (P < 0.003). The glucose/insulin ratio improved significantly (P < 0.05) after weight loss with both diets (0.17 +/- 0.04 mmol/mU (25% CHO) vs 0.10 +/- 0.03 mmol/mU (45% CHO).


CONCLUSIONS
Neither diet offered a significant advantage when comparing weight loss or other, metabolic parameters over a 12 w period. However, considering the greater improvement of fasting blood insulin, the glucose/insulin ratio and blood triglyceride, the low carbohydrate diet (25%) could be more favourable in the long-term. The improvement of fasting blood insulin could be explained by the differences in monounsaturated fat composition in the low carbohydrate diet.
Golay
A
A
Department of Internal Medicine, University Hospital Geneva.
Eigenheer
C
C
Morel
Y
Y
Kujawski
P
P
Lehmann
T
T
de Tonnac
N
N
D000273:Adipose Tissue / Q000033:anatomy & histology; D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D001824:Body Constitution; D001834:Body Water / Q000378:metabolism; D002784:Cholesterol / Q000097:blood; D004038:Diet, Reducing / Q000145:classification; D004040:Dietary Carbohydrates / Q000008:administration & dosage*; D017097:Electric Impedance; D002149:Energy Intake; D005260:Female; D006801:Humans; D007328:Insulin / Q000097:blood; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000178:diet therapy*; D010349:Patient Compliance; D011506:Proteins / Q000378:metabolism; D011795:Surveys and Questionnaires; D014280:Triglycerides / Q000097:blood; D015431:Weight Loss
D001786:Blood Glucose; D004040:Dietary Carbohydrates; D007328:Insulin; D011506:Proteins; D014280:Triglycerides; D002784:Cholesterol