Untitled

European Journal of Clinical Nutrition
Table 2 Randomized intervention studies comparing very low carbohydrate diet and low-fat energy-restricted diets: results after 6 and 12 months
Reference/
country
(Samaha
et al., 2003;
Stern et al.,
2004) US
(Foster
et al.,
2003) US
(Dansinger
et al., 2005)
US
(McAuley
et al., 2005,
2006)
New
Zealand
Participants Intervention ‘Low-carb’ diet ‘Low-fat’ diet Follow-up Compliance Weight loss (kg)
M/F. BMI X35,
83% diabetes or
metabolic
syndrome. Low
carb: n ¼ 64. Lowfat:
n ¼ 68; lost to
follow-up: n ¼ 14 at
6 months, n ¼ 6at
12 months
M/F. Obese (mean
BMI 34). Low carb:
n ¼ 33. Low-fat:
n ¼ 30; lost to
follow-up: n ¼ 21 at
6 months, n ¼ 26 at
12 months
M/F. BMI 27–42
(mean 35) with
metabolic risk
factors. Low carb:
n ¼ 40. Low-fat:
n ¼ 40; lost to
follow-up: n ¼ 19
for low carb and
n ¼ 20 for low-fat
F. Insulin resistant,
BMI427. Low carb:
n ¼ 31. Low-fat:
n ¼ 32; lost to
follow-up: n ¼ 6at
6 months, n ¼ 7at
12 months
Group counseling:
weekly sessions for
4 weeks and 11
monthly session;
written materials
One consultation
with dietitian; a
book/manual
Advice during four
group sessions in
first 2 months;
written materials
and diet book
Weekly counseling
for 16 weeks;
written materials
Carbohydrate
intake o30 g per
day
Carbohydrate
o20 g per day
for 2 weeks,
followed by a
gradual increase
Carbohydrate
o20 g per day with
gradual increase to
50 g per day
Carbohydrate
o20 g per day
for 2 weeks with
gradual increase
Fat o30 energy%
and 500 kcal per
day energy deficit
Fat B25%,
protein B15%,
carbohydrate
B60% of energy.
Energy restricted
Vegetarian ‘Ornish’
diet with 10
energy% fat
Conventional
high-fiber, low-fat,
reduced sugar
diet. No explicit
energy-restriction
6 months 24-h recall (energy
%). Low carb: C 37,
F 41, P 22 w .
Low-fat: C 51,
F 33, P 16
12 months 24-h recall
(g per day).
Carbohydrate: low
carb 120; low-fat
230
Low carb a
Low fat a
Difference
5.8 (8.6) 1.9 (4.2) P ¼ 0.002 b
5.1 (8.7) 3.1 (8.4) P ¼ 0.20 c
6 months Testing of urinary
ketone
concentrations.
Significant
difference between
groups up to 12
weeks
6.9 (6.4) 3.1 (5.5) P ¼ 0.02 d
12 months 4.3 (6.6) 2.5 (6.2) P ¼ 0.26 d
6 months Diet records
(g per day):
low carb: C 190 g,
F 81 g; low-fat: C
237 g, F 55 g
3.2 (4.9) 3.6 (6.7) P ¼ 0.76 d
12 months Diet records (g/d):
low carb: C 190 g,
F 81 g; low-fat: C
218 g, F 64 g
6 months Diet records
(energy %): low
carb: C 26, F 47,
P 24; low fat: C 45,
F 28, P 21
12 months Diet records
(energy %): low
carb: C 33, F 41,
P 21; Low fat: C 45,
F 29, P 22
2.1 (4.8) 3.3 (7.3) P ¼ 0.40 d
7.1 4.7 Po0.05 c
5.4 4.4 P40.05 c
S81
Carbohydrate intake and obesity
RM van Dam and JC Seidell