Long-term effects of a very-low-carbohydrate weight loss diet compared with an isocaloric low-fat diet after 12 mo

Grant D. Brinkworth, Manny Noakes, Jonathan D. Buckley, Jennifer B. Keogh, Peter M. Clifton

Research output: Contribution to journalArticle

134 Citations (Scopus)

Abstract

Background: Long-term weight loss and cardiometabolic effects of a very-low-carbohydrate, high-saturated-fat diet (LC) and a high-carbohydrate, low-fat diet (LF) have not been evaluated under isocaloric conditions. Objective: The objective was to compare an energy-controlled LC diet with an LF diet at 1 y. Design: Men and women (n = 118) with abdominal obesity and at least one additional metabolic syndrome risk factor were randomly assigned to either an energy-restricted (≈6-7 MJ) LC diet (4%, 35%, and 61% of energy as carbohydrate, protein, and fat, respectively) or an isocaloric LF diet (46%, 24%, and 30% of energy as carbohydrate, protein, and fat, respectively) for 1 y. Weight, body composition, and cardiometabolic risk markers were assessed. Results: Sixty-nine participants (59%) completed the trial: 33 in the LC group and 36 in the LF group. Both groups lost similar amounts of weight (LC: -14.5 ± 1.7 kg; LF: -11.5 ± 1.2 kg; P = 0.14, time x diet) and body fat (LC: -11.3 ± 1.5 kg; LF: -9.4 ± 1.2 kg; P = 0.30). Blood pressure, fasting glucose, insulin, insulin resistance, and C-reactive protein decreased independently of diet composition. Compared with the LF group, the LC group had greater decreases in triglycerides (-0.36 ± 0.15 mmol/L; 95% CI: -0.67, 20.05 mmol/L; P = 0.011), increases in HDL cholesterol (0.23 ± 0.09 mmol/L; 95% CI: 0.06, 0.40 mmol/L; P = 0.018) and LDL cholesterol (0.6 ± 0.2 mmol/L; 95% CI: 0.2, 1.0 mmol/L; P = 0.001), and a greater but nonsignificant increase in apolipoprotein B (0.08 6 0.04 g/L; 95% CI: -0.004, 0.171 g/L; P = 0.17). Conclusions: Under planned isoenergetic conditions, as expected, both dietary patterns resulted in similar weight loss and changes in body composition. The LC diet may offer clinical benefits to obese persons with insulin resistance. However, the increase in LDL cholesterol with the LC diet suggests that this measure should be monitored. This trial was registered with the Australian New Zealand Clinical Trials Registry at http://www.anzctr.org.au as ACTR 12606000203550.

LanguageEnglish
Pages23-32
Number of pages10
JournalAmerican Journal of Clinical Nutrition
Volume90
Issue number1
DOIs
Publication statusPublished - 1 Jul 2009

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics
  • Medicine(all)

Cite this

Brinkworth, Grant D. ; Noakes, Manny ; Buckley, Jonathan D. ; Keogh, Jennifer B. ; Clifton, Peter M. / Long-term effects of a very-low-carbohydrate weight loss diet compared with an isocaloric low-fat diet after 12 mo. In: American Journal of Clinical Nutrition. 2009 ; Vol. 90, No. 1. pp. 23-32.
@article{ae350e0623494cee864c37ab19b731c1,
title = "Long-term effects of a very-low-carbohydrate weight loss diet compared with an isocaloric low-fat diet after 12 mo",
abstract = "Background: Long-term weight loss and cardiometabolic effects of a very-low-carbohydrate, high-saturated-fat diet (LC) and a high-carbohydrate, low-fat diet (LF) have not been evaluated under isocaloric conditions. Objective: The objective was to compare an energy-controlled LC diet with an LF diet at 1 y. Design: Men and women (n = 118) with abdominal obesity and at least one additional metabolic syndrome risk factor were randomly assigned to either an energy-restricted (≈6-7 MJ) LC diet (4{\%}, 35{\%}, and 61{\%} of energy as carbohydrate, protein, and fat, respectively) or an isocaloric LF diet (46{\%}, 24{\%}, and 30{\%} of energy as carbohydrate, protein, and fat, respectively) for 1 y. Weight, body composition, and cardiometabolic risk markers were assessed. Results: Sixty-nine participants (59{\%}) completed the trial: 33 in the LC group and 36 in the LF group. Both groups lost similar amounts of weight (LC: -14.5 ± 1.7 kg; LF: -11.5 ± 1.2 kg; P = 0.14, time x diet) and body fat (LC: -11.3 ± 1.5 kg; LF: -9.4 ± 1.2 kg; P = 0.30). Blood pressure, fasting glucose, insulin, insulin resistance, and C-reactive protein decreased independently of diet composition. Compared with the LF group, the LC group had greater decreases in triglycerides (-0.36 ± 0.15 mmol/L; 95{\%} CI: -0.67, 20.05 mmol/L; P = 0.011), increases in HDL cholesterol (0.23 ± 0.09 mmol/L; 95{\%} CI: 0.06, 0.40 mmol/L; P = 0.018) and LDL cholesterol (0.6 ± 0.2 mmol/L; 95{\%} CI: 0.2, 1.0 mmol/L; P = 0.001), and a greater but nonsignificant increase in apolipoprotein B (0.08 6 0.04 g/L; 95{\%} CI: -0.004, 0.171 g/L; P = 0.17). Conclusions: Under planned isoenergetic conditions, as expected, both dietary patterns resulted in similar weight loss and changes in body composition. The LC diet may offer clinical benefits to obese persons with insulin resistance. However, the increase in LDL cholesterol with the LC diet suggests that this measure should be monitored. This trial was registered with the Australian New Zealand Clinical Trials Registry at http://www.anzctr.org.au as ACTR 12606000203550.",
author = "Brinkworth, {Grant D.} and Manny Noakes and Buckley, {Jonathan D.} and Keogh, {Jennifer B.} and Clifton, {Peter M.}",
year = "2009",
month = "7",
day = "1",
doi = "10.3945/ajcn.2008.27326",
language = "English",
volume = "90",
pages = "23--32",
journal = "American Journal of Clinical Nutrition",
issn = "0002-9165",
publisher = "American Society for Nutrition",
number = "1",

}

Long-term effects of a very-low-carbohydrate weight loss diet compared with an isocaloric low-fat diet after 12 mo. / Brinkworth, Grant D.; Noakes, Manny; Buckley, Jonathan D.; Keogh, Jennifer B.; Clifton, Peter M.

In: American Journal of Clinical Nutrition, Vol. 90, No. 1, 01.07.2009, p. 23-32.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Long-term effects of a very-low-carbohydrate weight loss diet compared with an isocaloric low-fat diet after 12 mo

AU - Brinkworth, Grant D.

AU - Noakes, Manny

AU - Buckley, Jonathan D.

AU - Keogh, Jennifer B.

AU - Clifton, Peter M.

PY - 2009/7/1

Y1 - 2009/7/1

N2 - Background: Long-term weight loss and cardiometabolic effects of a very-low-carbohydrate, high-saturated-fat diet (LC) and a high-carbohydrate, low-fat diet (LF) have not been evaluated under isocaloric conditions. Objective: The objective was to compare an energy-controlled LC diet with an LF diet at 1 y. Design: Men and women (n = 118) with abdominal obesity and at least one additional metabolic syndrome risk factor were randomly assigned to either an energy-restricted (≈6-7 MJ) LC diet (4%, 35%, and 61% of energy as carbohydrate, protein, and fat, respectively) or an isocaloric LF diet (46%, 24%, and 30% of energy as carbohydrate, protein, and fat, respectively) for 1 y. Weight, body composition, and cardiometabolic risk markers were assessed. Results: Sixty-nine participants (59%) completed the trial: 33 in the LC group and 36 in the LF group. Both groups lost similar amounts of weight (LC: -14.5 ± 1.7 kg; LF: -11.5 ± 1.2 kg; P = 0.14, time x diet) and body fat (LC: -11.3 ± 1.5 kg; LF: -9.4 ± 1.2 kg; P = 0.30). Blood pressure, fasting glucose, insulin, insulin resistance, and C-reactive protein decreased independently of diet composition. Compared with the LF group, the LC group had greater decreases in triglycerides (-0.36 ± 0.15 mmol/L; 95% CI: -0.67, 20.05 mmol/L; P = 0.011), increases in HDL cholesterol (0.23 ± 0.09 mmol/L; 95% CI: 0.06, 0.40 mmol/L; P = 0.018) and LDL cholesterol (0.6 ± 0.2 mmol/L; 95% CI: 0.2, 1.0 mmol/L; P = 0.001), and a greater but nonsignificant increase in apolipoprotein B (0.08 6 0.04 g/L; 95% CI: -0.004, 0.171 g/L; P = 0.17). Conclusions: Under planned isoenergetic conditions, as expected, both dietary patterns resulted in similar weight loss and changes in body composition. The LC diet may offer clinical benefits to obese persons with insulin resistance. However, the increase in LDL cholesterol with the LC diet suggests that this measure should be monitored. This trial was registered with the Australian New Zealand Clinical Trials Registry at http://www.anzctr.org.au as ACTR 12606000203550.

AB - Background: Long-term weight loss and cardiometabolic effects of a very-low-carbohydrate, high-saturated-fat diet (LC) and a high-carbohydrate, low-fat diet (LF) have not been evaluated under isocaloric conditions. Objective: The objective was to compare an energy-controlled LC diet with an LF diet at 1 y. Design: Men and women (n = 118) with abdominal obesity and at least one additional metabolic syndrome risk factor were randomly assigned to either an energy-restricted (≈6-7 MJ) LC diet (4%, 35%, and 61% of energy as carbohydrate, protein, and fat, respectively) or an isocaloric LF diet (46%, 24%, and 30% of energy as carbohydrate, protein, and fat, respectively) for 1 y. Weight, body composition, and cardiometabolic risk markers were assessed. Results: Sixty-nine participants (59%) completed the trial: 33 in the LC group and 36 in the LF group. Both groups lost similar amounts of weight (LC: -14.5 ± 1.7 kg; LF: -11.5 ± 1.2 kg; P = 0.14, time x diet) and body fat (LC: -11.3 ± 1.5 kg; LF: -9.4 ± 1.2 kg; P = 0.30). Blood pressure, fasting glucose, insulin, insulin resistance, and C-reactive protein decreased independently of diet composition. Compared with the LF group, the LC group had greater decreases in triglycerides (-0.36 ± 0.15 mmol/L; 95% CI: -0.67, 20.05 mmol/L; P = 0.011), increases in HDL cholesterol (0.23 ± 0.09 mmol/L; 95% CI: 0.06, 0.40 mmol/L; P = 0.018) and LDL cholesterol (0.6 ± 0.2 mmol/L; 95% CI: 0.2, 1.0 mmol/L; P = 0.001), and a greater but nonsignificant increase in apolipoprotein B (0.08 6 0.04 g/L; 95% CI: -0.004, 0.171 g/L; P = 0.17). Conclusions: Under planned isoenergetic conditions, as expected, both dietary patterns resulted in similar weight loss and changes in body composition. The LC diet may offer clinical benefits to obese persons with insulin resistance. However, the increase in LDL cholesterol with the LC diet suggests that this measure should be monitored. This trial was registered with the Australian New Zealand Clinical Trials Registry at http://www.anzctr.org.au as ACTR 12606000203550.

UR - http://www.scopus.com/inward/record.url?scp=67649850543&partnerID=8YFLogxK

U2 - 10.3945/ajcn.2008.27326

DO - 10.3945/ajcn.2008.27326

M3 - Article

VL - 90

SP - 23

EP - 32

JO - American Journal of Clinical Nutrition

T2 - American Journal of Clinical Nutrition

JF - American Journal of Clinical Nutrition

SN - 0002-9165

IS - 1

ER -