title: A Randomized Controlled Trial of Two Different Macronutrient Profiles on Weight, Body Composition and Metabolic Parameters in Obese Adolescents Seeking Weight Loss.
abstract: OBJECTIVE
  Adolescent obesity is difficult to treat and the optimal dietary pattern, particularly in relation to macronutrient composition, remains controversial. This study tested the effect of two structured diets with differing macronutrient composition versus control, on weight, body composition and metabolic parameters in obese adolescents.
  
  
  METHODS
  A randomized controlled trial conducted in a children's hospital.
  
  
  METHODS
  Eighty seven obese youth (means: age 13.6 years, BMI z-score 2.2, waist: height ratio 0.65, 69% female) completed a psychological preparedness program and were then randomized to a short term 'structured modified carbohydrate' (SMC, 35% carbohydrate; 30% protein; 35% fat, n = 37) or a 'structured low fat' (SLF, 55% carbohydrate; 20% protein; 25% fat, n = 36) or a wait listed control group (n = 14). Anthropometric, body composition and biochemical parameters were measured at randomization and after 12 weeks, and analyzed under the intention to treat principle using analysis of variance models.
  
  
  RESULTS
  After 12 weeks, data was collected from 79 (91%) participants. BMI z-scores were significantly lower in both intervention groups compared to control after adjusting for baseline values, SLF vs. control, mean difference = -0.13 (95%CI = -0.18, -0.07), P<0.001; SMC vs. control, -0.14 (-0.19, -0.09), P<0.001, but there was no difference between the two intervention diet groups: SLF vs. SMC, 0.00 (-0.05, 0.04), P = 0.83.
  
  
  CONCLUSIONS
  Both dietary patterns resulted in similar changes in weight, body composition and metabolic improvements compared to control. The use of a structured eating system which allows flexibility but limited choices can assist in weight change and the rigid application of a low fat eating pattern is not exclusive in its efficacy.
  
  
  BACKGROUND
  International Clinical Trials Registry ISRCTN49438757.
authors.affiliation: Department of Nutrition and Dietetics, Monash University, Clayton, Victoria, Australia.|Children's Nutrition Research Centre, The University of Queensland, Herston, Queensland, Australia.
authors.forename: Helen
authors.initials: H
authors.lastname: Truby
authors.affiliation: Children's Nutrition Research Centre, The University of Queensland, Herston, Queensland, Australia.
authors.forename: Kimberley
authors.initials: K
authors.lastname: Baxter
authors.affiliation: UQ Child Health Research Centre, School of Medicine, The University of Queensland, South Brisbane, Queensland, Australia.|School of Public Health, The University of Queensland, Herston, Queensland, Australia.
authors.forename: Robert S
authors.initials: RS
authors.lastname: Ware
authors.affiliation: UQ Child Health Research Centre, School of Medicine, The University of Queensland, South Brisbane, Queensland, Australia.|Children's Health Queensland Hospital and Health Service, Department of Endocrinology and Diabetes, Lady Cilentro Children's Hospital, South Brisbane, Queensland, Australia.
authors.forename: Diane E
authors.initials: DE
authors.lastname: Jensen
authors.affiliation: Chemical Pathology, Pathology Queensland, Herston, Queensland, Australia.
authors.forename: John W
authors.initials: JW
authors.lastname: Cardinal
authors.affiliation: Children's Nutrition Research Centre, The University of Queensland, Herston, Queensland, Australia.
authors.forename: Janet M
authors.initials: JM
authors.lastname: Warren
authors.affiliation: School of Exercise and Nutrition Sciences, Queensland University of Technology, Kelvin Grove, Queensland, Australia.
authors.forename: Lynne
authors.initials: L
authors.lastname: Daniels
authors.affiliation: Children's Nutrition Research Centre, The University of Queensland, Herston, Queensland, Australia.|UQ Child Health Research Centre, School of Medicine, The University of Queensland, South Brisbane, Queensland, Australia.
authors.forename: Peter S W
authors.initials: PS
authors.lastname: Davies
authors.affiliation: Pathways Health and Research Centre, West End, Brisbane, Queensland, Australia.
authors.forename: Paula
authors.initials: P
authors.lastname: Barrett
authors.affiliation: Department of Nutrition and Dietetics, Monash University, Clayton, Victoria, Australia.
authors.forename: Michelle L
authors.initials: ML
authors.lastname: Blumfield
authors.affiliation: Children's Health Queensland Hospital and Health Service, Department of Endocrinology and Diabetes, Lady Cilentro Children's Hospital, South Brisbane, Queensland, Australia.
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Batch
mesh_terms: D000293:Adolescent; D000886:Anthropometry; D001823:Body Composition; D003710:Demography; D004032:Diet; D004734:Energy Metabolism; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009747:Nutritional Physiological Phenomena; D018579:Patient Selection; D063766:Pediatric Obesity / Q000378:metabolism*; D015431:Weight Loss