Scientific One Year Study of Low Carb vs Low Fat - GOOD NEWS

[JoanOH]

Fascinating. Despite a recent report by CNN that this study shows low-carb and low-fat have about the same results, read the actual study for yourself! Here is scientific proof that low-carb works and is healthy in a study conducted over a one year period! Low carb showed more weight loss and improvement in lipid profile! If my doctor wasn't pro-Atkins, I'd be taking a copy of this study for her to read!
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A Low-Carbohydrate, Ketogenic Diet versus a Low-Fat Diet To Treat
Obesity and Hyperlipidemia

A Randomized, Controlled Trial
William S. Yancy, Jr., MD, MHS; Maren K. Olsen, PhD; John R. Guyton,
MD; Ronna P. Bakst, RD; and Eric C. Westman, MD, MHS

Annals of Internal Medicine
18 May 2004 | Volume 140 Issue 10 | Pages 769-777

Background: Low-carbohydrate diets remain popular despite a paucity of
scientific evidence on their effectiveness.

Objective: To compare the effects of a low-carbohydrate, ketogenic
diet program with those of a low-fat, low-cholesterol, reduced-calorie
diet.

Design: Randomized, controlled trial.

Setting: Outpatient research clinic.

Participants: 120 overweight, hyperlipidemic volunteers from the
community.

Intervention: Low-carbohydrate diet (initially, <20 g of carbohydrate
daily) plus nutritional supplementation, exercise recommendation, and
group meetings, or low-fat diet (<30% energy from fat, <300 mg of
cholesterol daily, and deficit of 500 to 1000 kcal/d) plus exercise
recommendation and group meetings.

Measurements: Body weight, body composition, fasting serum lipid
levels, and tolerability.

Results: A greater proportion of the low-carbohydrate diet group than
the low-fat diet group completed the study (76% vs. 57%; P = 0.02). At
24 weeks, weight loss was greater in the low-carbohydrate diet group
than in the low-fat diet group (mean change, -12.9% vs. -6.7%; P <
0.001). Patients in both groups lost substantially more fat mass
(change, -9.4 kg with the low-carbohydrate diet vs. -4.8 kg with the
low-fat diet) than fat-free mass (change, -3.3 kg vs. -2.4 kg,
respectively). Compared with recipients of the low-fat diet,
recipients of the low-carbohydrate diet had greater decreases in serum
triglyceride levels (change, -0.84 mmol/L vs. -0.31 mmol/L [-74.2
mg/dL vs. -27.9 mg/dL]; P = 0.004) and greater increases in
high-density lipoprotein cholesterol levels (0.14 mmol/L vs. -0.04
mmol/L [5.5 mg/dL vs. -1.6 mg/dL]; P < 0.001). Changes in low-density
lipoprotein cholesterol level did not differ statistically (0.04
mmol/L [1.6 mg/dL] with the low-carbohydrate diet and -0.19 mmol/L
[-7.4 mg/dL] with the low-fat diet; P = 0.2). Minor adverse effects
were more frequent in the low-carbohydrate diet group.

Limitations: We could not definitively distinguish effects of the
low-carbohydrate diet and those of the nutritional supplements
provided only to that group. In addition, participants were healthy
and were followed for only 24 weeks. These factors limit the
generalizability of the study results.

Conclusions: Compared with a low-fat diet, a low-carbohydrate diet
program had better participant retention and greater weight loss.
During active weight loss, serum triglyceride levels decreased more
and high-density lipoprotein cholesterol level increased more with the
low-carbohydrate diet than with the low-fat diet.
**************

The Effects of Low-Carbohydrate versus Conventional Weight Loss Diets
in Severely Obese Adults: One-Year Follow-up of a Randomized Trial
Linda Stern, MD; Nayyar Iqbal, MD; Prakash Seshadri, MD; Kathryn L.
Chicano, CRNP; Denise A. Daily, RD; Joyce McGrory, CRNP; Monica
Williams, BS; Edward J. Gracely, PhD; and Frederick F. Samaha, MD

18 May 2004 | Volume 140 Issue 10 | Pages 778-785


Background: A previous paper reported the 6-month comparison of weight
loss and metabolic changes in obese adults randomly assigned to either
a low-carbohydrate diet or a conventional weight loss diet.

Objective: To review the 1-year outcomes between these diets.

Design: Randomized trial.

Setting: Philadelphia Veterans Affairs Medical Center.

Participants: 132 obese adults with a body mass index of 35 kg/m2 or
greater; 83% had diabetes or the metabolic syndrome.

Intervention: Participants received counseling to either restrict
carbohydrate intake to <30 g per day (low-carbohydrate diet) or to
restrict caloric intake by 500 calories per day with <30% of calories
from fat (conventional diet).

Measurements: Changes in weight, lipid levels, glycemic control, and
insulin sensitivity.

Results: By 1 year, mean (±SD) weight change for persons on the
low-carbohydrate diet was -5.1 ± 8.7 kg compared with -3.1 ± 8.4 kg
for persons on the conventional diet. Differences between groups were
not significant (-1.9 kg [95% CI, -4.9 to 1.0 kg]; P = 0.20). For
persons on the low-carbohydrate diet, triglyceride levels decreased
more (P = 0.044) and high-density lipoprotein cholesterol levels
decreased less (P = 0.025). As seen in the small group of persons with
diabetes (n = 54) and after adjustment for covariates, hemoglobin A1c
levels improved more for persons on the low-carbohydrate diet. These
more favorable metabolic responses to a low-carbohydrate diet remained
significant after adjustment for weight loss differences. Changes in
other lipids or insulin sensitivity did not differ between groups.

Limitations: These findings are limited by a high dropout rate (34%)
and by suboptimal dietary adherence of the enrolled persons.

Conclusion: Participants on a low-carbohydrate diet had more favorable
overall outcomes at 1 year than did those on a conventional diet.
Weight loss was similar between groups, but effects on atherogenic
dyslipidemia and glycemic control were still more favorable with a
low-carbohydrate diet after adjustment for differences in weight loss.
===================
Joan J

[Janice]

Thanks, Joan! Good news for all of us!

I'm sure there are more studies going on now on the "long-range" effects of the low-carb diets. Supposedly no one has done any "long-range" studies till now. I think all they would need to do is come to this board and they'd have lots of specimen subjects to read about. LOL

[leesa]

The second study, if you read the whole article, you will also find that in the adverse reactions:

"One person on the low-carbohydrate diet was hospitalized with noncardiac chest pain during the third month of the study. Two persons in the low-carbohydrate group died, including one who died of complications of hyperosmolar coma 5 months into the study and another who had sever ischemic cardiomyopathy and died suddenly 10 months after study enrollment. Laboratory values obtained 14 days before this person's death showed no electrolyte abnomalities"

Although this could be coincidence and shows no conclusive evidence, this worries me as to whether Atkin's diet in the long term could lead to death.

Even though higher HDL levels are more favourable (as the low carbohydrate diets have increased levels), is there any evidence that this increase in HDL levels actually improved the persons health?

NB. i am not against Atkins. I'm just worried about the consequences if i continue as a WOL>

[Elleth Faewen]

The second study, if you read the whole article, you will also find that in the adverse reactions:

"One person on the low-carbohydrate diet was hospitalized with noncardiac chest pain during the third month of the study. Two persons in the low-carbohydrate group died, including one who died of complications of hyperosmolar coma 5 months into the study and another who had sever ischemic cardiomyopathy and died suddenly 10 months after study enrollment. Laboratory values obtained 14 days before this person's death showed no electrolyte abnomalities"

Although this could be coincidence and shows no conclusive evidence, this worries me as to whether Atkin's diet in the long term could lead to death.

Even though higher HDL levels are more favourable (as the low carbohydrate diets have increased levels), is there any evidence that this increase in HDL levels actually improved the persons health?

NB. i am not against Atkins. I'm just worried about the consequences if i continue as a WOL>

The people in this study were overweight and they had a sub-group of diabetics. I am not surprised at either a diabetic coma or heart failure occuring in study participants. Both of these conditions take longer than a year to get that bad. The study group was only 132 participants total, so it is hard to make a statement about overall health. I would like to see a much larger study over a longer period of time. I would also like to see other risk factors for the patient with cardiac myopathy, such as smoking, excessive drinking, lack of exercise, and maintaining a healthy weight. They also did not mention if either of the two people that died followed the diet or not.

A lot of questions, and we need more info to make any conclusions.