title: The effects of a low-carbohydrate ketogenic diet and a low-fat diet on mood, hunger, and other self-reported symptoms.
abstract: OBJECTIVE
  To investigate the effects of weight loss diets on mood, food cravings, and other self-reported symptoms.
  
  
  METHODS
  Mood and other symptoms were evaluated by participant self-report using the Atkins Health Indicator Test (AHIT) in individuals undergoing weight loss following either a low-carbohydrate, ketogenic diet (LCKD) or a low-fat diet (LFD). Participants were 119 overweight community volunteers randomized to an LCKD or an LFD. An additional 51 participants who had completed an earlier trial contributed data for the psychometric analyses but were not included in the prospective analyses. Self-reported symptom levels on seven scales factor-analytically derived from the AHIT (negative affect, fatigue, somatic symptoms, physical effects of hunger, insomnia, hunger, and stomach problems) were acquired during 12 visits.
  
  
  RESULTS
  After adjusting for the change in BMI over the course of the trial, participants experienced significant improvements in most symptoms regardless of diet. Diet group x visit interactions were observed for negative affect [F(9,803) = 2.30, p = 0.015] and hunger [F(9,803) = 3.62, p < 0.0002]. Examination of means indicated that the LCKD group reported less negative affect and hunger, compared with the LFD group.
  
  
  CONCLUSIONS
  Regardless of diet, participants experienced significant improvement in a broad range of symptoms. Symptoms of negative affect and hunger improved to a greater degree in patients following an LCKD compared with those following an LFD. Whether these symptom changes explain the greater short-term weight loss generally experienced by LCKD followers deserves further research.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Suite 210-B Wing, 2200 West Main Street, Durham, NC 27705, USA.
authors.forename: F Joseph
authors.initials: FJ
authors.lastname: McClernon
authors.forename: William S
authors.initials: WS
authors.lastname: Yancy
authors.forename: Jacqueline A
authors.initials: JA
authors.lastname: Eberstein
authors.forename: Robert C
authors.initials: RC
authors.lastname: Atkins
authors.forename: Eric C
authors.initials: EC
authors.lastname: Westman
mesh_terms: D000328:Adult; D000339:Affect / Q000502:physiology; D000368:Aged; D050528:Diet, Carbohydrate-Restricted; D018752:Diet, Fat-Restricted; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D006815:Hunger / Q000502:physiology; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000178:diet therapy* / Q000523:psychology*; D011446:Prospective Studies; D015431:Weight Loss / Q000502:physiology