A Randomized Trial of a Low-Carbohydrate Diet for Obesity
In a one-year trial, 63 obese men and women were assigned to either a low-carbohydrate, high-protein, high-fat diet or a conventional high-carbohydrate, low-fat diet. Participants who followed the low-carbohydrate diet had lost more weight at three and six months than those on the conventional diet,...
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| Published in | The New England journal of medicine Vol. 348; no. 21; pp. 2082 - 2090 |
|---|---|
| Main Authors | , , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
Boston, MA
Massachusetts Medical Society
22.05.2003
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| Subjects | |
| Online Access | Get full text |
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| Abstract | In a one-year trial, 63 obese men and women were assigned to either a low-carbohydrate, high-protein, high-fat diet or a conventional high-carbohydrate, low-fat diet. Participants who followed the low-carbohydrate diet had lost more weight at three and six months than those on the conventional diet, but the differences had abated by one year. The low-carbohydrate diet was associated with a greater improvement in some risk factors for coronary heart disease. Adherence to either diet was poor, and dropout rates were high.
More weight loss than with a conventional diet, but dropout rates were high.
At any given time, approximately 45 percent of women and 30 percent of men in the United States are trying to lose weight.
1
Despite these efforts, the prevalence of obesity has doubled in the past 20 years
2
and has become a major public health problem.
3
The conventional dietary approach to weight management, recommended by the leading research and medical societies,
4
–
7
is a high-carbohydrate, low-fat, energy-deficit diet. Low-carbohydrate, high-protein, high-fat diets have become increasingly popular, and many best-selling diet books have promoted this approach.
8
,
9
The Atkins diet, originally published in 1973 and again in 1992 and 2002, may be . . . |
|---|---|
| AbstractList | Despite the popularity of the low-carbohydrate, high-protein, high-fat (Atkins) diet, no randomized, controlled trials have evaluated its efficacy.
We conducted a one-year, multicenter, controlled trial involving 63 obese men and women who were randomly assigned to either a low-carbohydrate, high-protein, high-fat diet or a low-calorie, high-carbohydrate, low-fat (conventional) diet. Professional contact was minimal to replicate the approach used by most dieters.
Subjects on the low-carbohydrate diet had lost more weight than subjects on the conventional diet at 3 months (mean [+/-SD], -6.8+/-5.0 vs. -2.7+/-3.7 percent of body weight; P=0.001) and 6 months (-7.0+/-6.5 vs. -3.2+/-5.6 percent of body weight, P=0.02), but the difference at 12 months was not significant (-4.4+/-6.7 vs. -2.5+/-6.3 percent of body weight, P=0.26). After three months, no significant differences were found between the groups in total or low-density lipoprotein cholesterol concentrations. The increase in high-density lipoprotein cholesterol concentrations and the decrease in triglyceride concentrations were greater among subjects on the low-carbohydrate diet than among those on the conventional diet throughout most of the study. Both diets significantly decreased diastolic blood pressure and the insulin response to an oral glucose load.
The low-carbohydrate diet produced a greater weight loss (absolute difference, approximately 4 percent) than did the conventional diet for the first six months, but the differences were not significant at one year. The low-carbohydrate diet was associated with a greater improvement in some risk factors for coronary heart disease. Adherence was poor and attrition was high in both groups. Longer and larger studies are required to determine the long-term safety and efficacy of low-carbohydrate, high-protein, high-fat diets. BACKGROUNDDespite the popularity of the low-carbohydrate, high-protein, high-fat (Atkins) diet, no randomized, controlled trials have evaluated its efficacy.METHODSWe conducted a one-year, multicenter, controlled trial involving 63 obese men and women who were randomly assigned to either a low-carbohydrate, high-protein, high-fat diet or a low-calorie, high-carbohydrate, low-fat (conventional) diet. Professional contact was minimal to replicate the approach used by most dieters.RESULTSSubjects on the low-carbohydrate diet had lost more weight than subjects on the conventional diet at 3 months (mean [+/-SD], -6.8+/-5.0 vs. -2.7+/-3.7 percent of body weight; P=0.001) and 6 months (-7.0+/-6.5 vs. -3.2+/-5.6 percent of body weight, P=0.02), but the difference at 12 months was not significant (-4.4+/-6.7 vs. -2.5+/-6.3 percent of body weight, P=0.26). After three months, no significant differences were found between the groups in total or low-density lipoprotein cholesterol concentrations. The increase in high-density lipoprotein cholesterol concentrations and the decrease in triglyceride concentrations were greater among subjects on the low-carbohydrate diet than among those on the conventional diet throughout most of the study. Both diets significantly decreased diastolic blood pressure and the insulin response to an oral glucose load.CONCLUSIONSThe low-carbohydrate diet produced a greater weight loss (absolute difference, approximately 4 percent) than did the conventional diet for the first six months, but the differences were not significant at one year. The low-carbohydrate diet was associated with a greater improvement in some risk factors for coronary heart disease. Adherence was poor and attrition was high in both groups. Longer and larger studies are required to determine the long-term safety and efficacy of low-carbohydrate, high-protein, high-fat diets. Background Despite the popularity of the low-carbohydrate, high-protein, high-fat (Atkins) diet, no randomized, controlled trials have evaluated its efficacy. Methods We conducted a one-year, multicenter, controlled trial involving 63 obese men and women who were randomly assigned to either a low-carbohydrate, high-protein, high-fat diet or a low-calorie, high-carbohydrate, low-fat (conventional) diet. Professional contact was minimal to replicate the approach used by most dieters. Results Subjects on the low-carbohydrate diet had lost more weight than subjects on the conventional diet at 3 months (mean [±SD], -6.8±5.0 vs. -2.7±3.7 percent of body weight; P=0.001) and 6 months (-7.0±6.5 vs. -3.2±5.6 percent of body weight, P=0.02), but the difference at 12 months was not significant (-4.4±6.7 vs. -2.5±6.3 percent of body weight, P=0.26). After three months, no significant differences were found between the groups in total or low-density lipoprotein cholesterol concentrations. The increase in high-density lipoprotein cholesterol concentrations and the decrease in triglyceride concentrations were greater among subjects on the low-carbohydrate diet than among those on the conventional diet throughout most of the study. Both diets significantly decreased diastolic blood pressure and the insulin response to an oral glucose load. Conclusions The low-carbohydrate diet produced a greater weight loss (absolute difference, approximately 4 percent) than did the conventional diet for the first six months, but the differences were not significant at one year. The low-carbohydrate diet was associated with a greater improvement in some risk factors for coronary heart disease. Adherence was poor and attrition was high in both groups. Longer and larger studies are required to determine the long-term safety and efficacy of low-carbohydrate, high-protein, high-fat diets. In a one-year trial, 63 obese men and women were assigned to either a low-carbohydrate, high-protein, high-fat diet or a conventional high-carbohydrate, low-fat diet. Participants who followed the low-carbohydrate diet had lost more weight at three and six months than those on the conventional diet, but the differences had abated by one year. The low-carbohydrate diet was associated with a greater improvement in some risk factors for coronary heart disease. Adherence to either diet was poor, and dropout rates were high. More weight loss than with a conventional diet, but dropout rates were high. At any given time, approximately 45 percent of women and 30 percent of men in the United States are trying to lose weight. 1 Despite these efforts, the prevalence of obesity has doubled in the past 20 years 2 and has become a major public health problem. 3 The conventional dietary approach to weight management, recommended by the leading research and medical societies, 4 – 7 is a high-carbohydrate, low-fat, energy-deficit diet. Low-carbohydrate, high-protein, high-fat diets have become increasingly popular, and many best-selling diet books have promoted this approach. 8 , 9 The Atkins diet, originally published in 1973 and again in 1992 and 2002, may be . . . |
| Author | Brill, Carrie Mohammed, B. Selma Edman, Joel S Szapary, Philippe O Foster, Gary D Hill, James O Klein, Samuel McGuckin, Brian G Wyatt, Holly R Rader, Daniel J |
| Author_xml | – sequence: 1 givenname: Gary D surname: Foster fullname: Foster, Gary D – sequence: 2 givenname: Holly R surname: Wyatt fullname: Wyatt, Holly R – sequence: 3 givenname: James O surname: Hill fullname: Hill, James O – sequence: 4 givenname: Brian G surname: McGuckin fullname: McGuckin, Brian G – sequence: 5 givenname: Carrie surname: Brill fullname: Brill, Carrie – sequence: 6 givenname: B. Selma surname: Mohammed fullname: Mohammed, B. Selma – sequence: 7 givenname: Philippe O surname: Szapary fullname: Szapary, Philippe O – sequence: 8 givenname: Daniel J surname: Rader fullname: Rader, Daniel J – sequence: 9 givenname: Joel S surname: Edman fullname: Edman, Joel S – sequence: 10 givenname: Samuel surname: Klein fullname: Klein, Samuel |
| BackLink | http://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=14817621$$DView record in Pascal Francis https://www.ncbi.nlm.nih.gov/pubmed/12761365$$D View this record in MEDLINE/PubMed |
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| CODEN | NEJMAG |
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| References | 12959095 - N Engl J Med. 2003 Sep 4;349(10):1000-2; author reply 1000-2 12954752 - N Engl J Med. 2003 Sep 4;349(10):1000-2; author reply 1000-2 12761363 - N Engl J Med. 2003 May 22;348(21):2057-8 12761370 - N Engl J Med. 2003 May 22;348(21):2136-7 Dattilo AM (r030) 1992; 56 Allain CC (r019) 1974; 20 r021 r001 r023 r039 r018 Friedewald WT (r020) 1972; 18 r013 r035 r036 r015 r016 Golay A (r027) 1996; 63 r038 r031 r010 r032 r033 r012 r034 r006 r007 r029 r009 r002 r024 r003 r025 r004 r026 r005 Schaefer EJ (r040) 2002; 75 Lewis SB (r037) 1977; 30 Larosa JC (r014) 1980; 77 Golay A (r028) 1996; 20 |
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| Snippet | In a one-year trial, 63 obese men and women were assigned to either a low-carbohydrate, high-protein, high-fat diet or a conventional high-carbohydrate,... Despite the popularity of the low-carbohydrate, high-protein, high-fat (Atkins) diet, no randomized, controlled trials have evaluated its efficacy. We... Background Despite the popularity of the low-carbohydrate, high-protein, high-fat (Atkins) diet, no randomized, controlled trials have evaluated its efficacy.... BACKGROUNDDespite the popularity of the low-carbohydrate, high-protein, high-fat (Atkins) diet, no randomized, controlled trials have evaluated its... |
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| SubjectTerms | Adult Analysis of Variance Biological and medical sciences Body Mass Index Carbohydrates Clinical trials Coronary Disease Diet Diet, Fat-Restricted Diet, Reducing - methods Dietary Carbohydrates - administration & dosage Female Glucose - metabolism Humans Lipoproteins - blood Male Medical sciences Metabolic diseases Middle Aged Obesity Obesity - blood Obesity - diet therapy Risk Factors Triglycerides - blood Weight Loss |
| Title | A Randomized Trial of a Low-Carbohydrate Diet for Obesity |
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