title: Effects of an ad libitum low-glycemic load diet on cardiovascular disease risk factors in obese young adults.
abstract: BACKGROUND
  The optimal nutritional approach for the prevention of cardiovascular disease among obese persons remains a topic of intense controversy. Available approaches range from conventional low-fat to very-low-carbohydrate diets.
  
  
  OBJECTIVE
  The aim of this pilot study was to evaluate the efficacy of an ad libitum low-glycemic load diet, without strict limitation on carbohydrate intake, as an alternative to a conventional low-fat diet.
  
  
  METHODS
  A randomized controlled trial compared 2 dietary treatments in obese young adults (n = 23) over 12 mo. The experimental treatment emphasized ad libitum consumption of low-glycemic-index foods, with 45-50% of energy from carbohydrates and 30-35% from fat. The conventional treatment was restricted in energy (250-500 kcal/d deficit) and fat (<30% of energy), with 55-60% of energy from carbohydrate. We compared changes in study outcomes by repeated-measures analysis of log-transformed data and expressed the results as mean percentage change.
  
  
  RESULTS
  Body weight decreased significantly over a 6-mo intensive intervention in both the experimental and conventional diet groups (-8.4% and -7.8%, respectively) and remained below baseline at 12 mo (-7.8% and -6.1%, respectively). The experimental diet group showed a significantly greater mean decline in plasma triacylglycerols than did the conventional diet group (-37.2% and -19.1%, respectively; P = 0.005). Mean plasminogen activator inhibitor 1 concentrations decreased (-39.0%) in the experimental diet group but increased (33.1%) in the conventional diet group (P = 0.004). Changes in cholesterol concentrations, blood pressure, and insulin sensitivity did not differ significantly between the groups.
  
  
  CONCLUSIONS
  An ad libitum low-glycemic load diet may be more efficacious than a conventional, energy-restricted, low-fat diet in reducing cardiovascular disease risk.
authors.affiliation: Division of Endocrinology, Department of Medicine, Children's Hospital, Boston, MA 02115, USA.
authors.forename: Cara B
authors.initials: CB
authors.lastname: Ebbeling
authors.forename: Michael M
authors.initials: MM
authors.lastname: Leidig
authors.forename: Kelly B
authors.initials: KB
authors.lastname: Sinclair
authors.forename: Linda G
authors.initials: LG
authors.lastname: Seger-Shippee
authors.forename: Henry A
authors.initials: HA
authors.lastname: Feldman
authors.forename: David S
authors.initials: DS
authors.lastname: Ludwig
mesh_terms: D000328:Adult; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000209:etiology; D002784:Cholesterol / Q000097:blood; D004040:Dietary Carbohydrates / Q000008:administration & dosage*; D004041:Dietary Fats / Q000008:administration & dosage*; D015444:Exercise; D005260:Female; D038321:Glycemic Index; D006801:Humans; D008297:Male; D009765:Obesity / Q000097:blood / Q000150:complications / Q000178:diet therapy*; D012307:Risk Factors
chemical_list: D004040:Dietary Carbohydrates; D004041:Dietary Fats; D002784:Cholesterol