A Randomized Trial Comparing a Very Low Carbohydrate Diet and a Calorie-Restricted Low Fat Diet on Body Weight and Cardiovascular Risk Factors in Healthy Women

• Published in: The journal of clinical endocrinology and metabolism Vol. 88; no. 4; pp. 1617 - 1623
• Main Authors: Brehm, Bonnie J, Seeley, Randy J, Daniels, Stephen R, D’Alessio, David A
• Format: Journal Article
• Language: English
• Published: Bethesda, MD Endocrine Society 01.04.2003; Copyright by The Endocrine Society
• Subjects: Adipose Tissue; Adult; Biological and medical sciences; Blood Glucose - analysis; Blood Pressure; Body Composition; Cardiovascular Diseases - etiology; Diet, Fat-Restricted; Diet, Reducing; Dietary Carbohydrates - administration & dosage; Energy Intake; Fasting; Female; Humans; Insulin - blood; Lipids - blood; Medical sciences; Metabolic diseases; Middle Aged; Miscellaneous; Obesity; Obesity - diet therapy; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Risk Factors; Time Factors; Weight Loss; Human; Obesity; Treatment efficiency; Nutrition disorder; Weight loss; Cardiovascular disease; Body composition; Diet therapy; Atherosclerosis; Risk factor; Fat; Adult; Female; Carbohydrate; Restricted diet; Nutritional status; Comparative study; Low calorie diet
• ISSN: 0021-972X; 1945-7197
• DOI: 10.1210/jc.2002-021480

Untested alternative weight loss diets, such as very low carbohydrate diets, have unsubstantiated efficacy and the potential to adversely affect cardiovascular risk factors. Therefore, we designed a randomized, controlled trial to determine the effects of a very low carbohydrate diet on body composition and cardiovascular risk factors. Subjects were randomized to 6 months of either an ad libitum very low carbohydrate diet or a calorie-restricted diet with 30% of the calories as fat. Anthropometric and metabolic measures were assessed at baseline, 3 months, and 6 months. Fifty-three healthy, obese female volunteers (mean body mass index, 33.6 ± 0.3 kg/m2) were randomized; 42 (79%) completed the trial. Women on both diets reduced calorie consumption by comparable amounts at 3 and 6 months. The very low carbohydrate diet group lost more weight (8.5 ± 1.0 vs. 3.9 ± 1.0 kg; P < 0.001) and more body fat (4.8 ± 0.67 vs. 2.0 ± 0.75 kg; P < 0.01) than the low fat diet group. Mean levels of blood pressure, lipids, fasting glucose, and insulin were within normal ranges in both groups at baseline. Although all of these parameters improved over the course of the study, there were no differences observed between the two diet groups at 3 or 6 months. β- Hydroxybutyrate increased significantly in the very low carbohydrate group at 3 months (P = 0.001). Based on these data, a very low carbohydrate diet is more effective than a low fat diet for short-term weight loss and, over 6 months, is not associated with deleterious effects on important cardiovascular risk factors in healthy women.