Low carb diet and long term weight loss

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This presents sums up the long term clinical trials on low carbohydrate diet

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Low carb diet and long term weight loss

  1. 1. Effect of a low carbohydrate diet on weight loss. Results from randomized trials lasting at least two years [Updated January 2015] Page 1
  2. 2. Introduction • Meta-analyses of short term studies suggest that low carb diets may equally or more effective than usual recommended diet (ie. Low fat diet) in the treatment of obesity (Hession et al. 2008, Nordmann et al. 2006 and Kirk et al. 2008) • In years 2006-2012 the following low carb diet trials have been published: – Cardillo et al. European Review for Medical and Pharmacological Sciences 2006 – Shai et al. N Engl J Med 2008 – Sacks et al. N Engl J Med 2009 – Foster et al. Ann Intern Med. 2010 – Guldbrand et al Diabetologia. 2012 www.pronutritionist.net2
  3. 3. The effects of a low-carbohydrate versus low-fat diet on adipocytokines in severely obese adults: three-year follow-up of a randomized trial Cardillo et al. European Review for Medical and Pharmacological Sciences 2006; 10: 99-106 [Open access] Page 3 11
  4. 4. Page 4 The only 3 year trial: a tie Page 4 Cardillo et al. European Review for Medical and Pharmacological Results at 36 months
  5. 5. Weight Loss with a Low-Carbohydrate, Mediterranean, or Low-Fat Diet Shai et al. N Engl J Med 2008; 359:229-241 [Open access] Page 5 22
  6. 6. Page 6 The first 2 year trial: low carb diet more effective Page 6 Shai et al. N Engl J Med 2008; 359:229-241
  7. 7. 7 *) statistically significant from baseline Schwarzfuchs & Golan Four-Year Follow-up after Two-Year Dietary Interventions NEJM 2012; 367:1373-1374 Four years´ extension of previous Shai study.
  8. 8. Comparison of Weight-Loss Diets with Different Compositions of Fat, Protein, and Carbohydrates Sacks et al. N Engl J Med 2009; 360:859-873 [Open access] Page 8 33
  9. 9. Page 9 The 2nd 2 year trial: a tie Page 9 Sacks et al. N Engl J Med 2009; 360:859-873 ”There was no effect on weight loss of carbohydrate level through the target range of 35 to 65 %.”
  10. 10. Weight and Metabolic Outcomes After 2 Years on a Low-Carbohydrate Versus Low-Fat DietA Randomized Trial Foster et al. Ann Intern Med. 2010;153:147-157. [Open access] Page 10 44
  11. 11. Page 11 The 3rd 2 year trial: a tie Page 11 Foster et al. Ann Intern Med. 2010;153:147-157 * P values are for the differences between the 2 groups at each time point.
  12. 12. In type 2 diabetes, randomisation to advice to follow a low-carbohydrate diet transiently improves glycaemic control compared with advice to follow a low-fat diet producing a similar weight loss. Guldbrand H et al Diabetologia. 2012 May 6. [Open access] Page 12 55
  13. 13. The 4th 2 year trial: a tie 13 Guldbrand H et al Diabetologia. 2012 May 6 The weight reduction did not differ between the groups (p=0.33    for all time points) Low carb diet Low fat diet
  14. 14. Summary Outcome (weight loss vs low fat diet) Length Note Cardillo et al. 2006 Equal 3 years No data available for 12 and 24 months Shai et al. 2008 Low carb better 2 years Mediterranean diet as effective as low carb diet Sacks et al. 2009 Equal 2 years Protein & Fat modification Foster et al. 2010 Equal 2 years No data on actual intake of food Guldbrand et al. 2012 Equal 2 years Primary care intervention in T2D www.pronutritionist.net14
  15. 15. Pronutritionist’s discussion • Short term weight loss advantage of low carb diets does not seem to hold in long term • No metabolic adverse effects were noted in low carb group. In fact, HDL cholesterol tended to be higer, blood glucose and trglycerides lower in low carb group • These trials are not included in the meta-analyses of Nordmann (2006), Hession (2008) and Kirk (2008) • As these randomized trials are longest in their category, they add substantial value to the understanding of the effect of low carb diet • Results are in line with a recent systematic review which suggested that carbohydrate content of a diet is not directly linked to obesity (Hauner H et al. 2012). Only sugary drinks were shown to be linked to obesity in this review, where as whole grains seemed to be protective • It will be interesting to see if these trials have any effect on the opinions of low carb advocates like Richard David Feinman, Dr. Michael R Eades, Gary Taubes and like. I doubt. Page 15
  16. 16. Please read the whole papers Just follow the yellow links on the respective pages Page 16
  17. 17. Follow me http://twitter.com/pronutritionist http://www.facebook.com/pronutritionist http://www.pronutritionist.net Reijo Laatikainen, Authorized Nutritionist, MBA Dietitian Page 17

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