Adherence to low-carbohydrate and low-fat diets in relation to weight loss and cardiovascular risk factors.
OBJECTIVE
A low-carbohydrate diet can reduce body weight and some cardiovascular disease (CVD) risk factors more than a low-fat diet, but differential adherence may play a role in these effects.


METHODS
Data were used from 148 adults who participated in a 12-month clinical trial examining the effect of a low-carbohydrate diet (<40 g/day) and a low-fat diet (<30% fat, <7% saturated fat) on weight and CVD risk factors. We compared attendance at counseling sessions, deviation from nutrient goals, urinary ketone presence, and composite scores representing the overall adherence based on the distribution of these individual indicators between two interventions.


RESULTS
Composite scores were similar between the two groups. A one-interquartile-range increase in composite score representing better adherence to a low-carbohydrate diet was associated with 2.2 kg or 2.3 % greater weight loss, 1.1 greater reduction in percent fat mass, and 1.3 greater increase in proportion of lean mass. Indicators of adherence to a low-fat diet was not associated with changes in weight, fat mass or lean mass.


CONCLUSIONS
Despite comparable adherence between groups, a low-carbohydrate diet was associated with greater reductions in body weight and improvement in body composition, while a low-fat diet was not associated with weight loss.
Tulane University Health Sciences Center, New Orleans, LA.
Tian
T
Hu
University of Minnesota, Minneapolis, MN.
Lu
L
Yao
Kaiser Permanente Southern California, Department of Research & Evaluation, Pasadena, CA.
Kristi
K
Reynolds
Tulane University Health Sciences Center, New Orleans, LA.
Tianhua
T
Niu
Tulane University Health Sciences Center, New Orleans, LA.
Shengxu
S
Li
Tulane University Health Sciences Center, New Orleans, LA.
Paul K
PK
Whelton
Tulane University Health Sciences Center, New Orleans, LA.
Jiang
J
He
University of Minnesota, Minneapolis, MN.
Lyn M
LM
Steffen
Tulane University Health Sciences Center, New Orleans, LA.
Lydia A
LA
Bazzano
carbohydrates; nutrition; weight loss