Factors associated with choice of a low-fat or low-carbohydrate diet during a behavioral weight loss intervention

Abstract

Individuals undertaking a weight loss effort have a choice among proven dietary approaches. Factors contributing to choice of either a low-fat/low-calorie diet or a low-carbohydrate diet, two of the most studied and popular dietary approaches, are unknown. The current study used data from participants randomized to the 'choice' arm of a trial examining whether being able to choose a diet regimen yields higher weight loss than being randomly assigned to a diet. At study entry, participants attended a group session during which they were provided tailored feedback indicating which diet was most consistent with their food preferences using the Geiselman Food Preference Questionnaire (FPQ), information about both diets, and example meals for each diet. One week later, they indicated which diet they chose to follow during the 48-week study, with the option of switching diets after 12 weeks. Of 105 choice arm participants, 44 (42%) chose the low-fat/low-calorie diet and 61 (58%) chose the low-carbohydrate diet. In bivariate analyses, diet choice was not associated with age, race, sex, education, BMI, or diabetes (all p > 0.05). Low-carbohydrate diet choice was associated with baseline higher percent fat intake (p = 0.007), lower percent carbohydrate intake (p = 0.02), and food preferences consistent with a low-carbohydrate diet according to FPQ (p < 0.0001). In a multivariable logistic regression model, only FPQ diet preference was associated with diet choice (p = 0.001). Reported reasons for diet choice were generally similar for those choosing either diet; however, concerns about negative health effects of the unselected diet was rated as more influential among participants selecting the low-fat diet. Only three low-carbohydrate and two low-fat diet participants switched diets at 12 weeks. Results suggest that when provided a choice between two popular weight loss dietary approaches, an individual's selection is likely influenced by baseline dietary intake pattern, and especially by his or her dietary preferences. Research is needed to determine if congruency between food preferences and dietary approach is associated with weight loss.

Food preferences and weight change during low-fat and low-carbohydrate diets

“…Then, participants were scheduled in their first group weight loss session for the following week, either for the low-fat diet or low-carbohydrate diet. Factors associated with diet selection have been reported, which included food preferences as well as other factors (e.g., expected health benefits; McVay et al, 2014). …”

“…We conducted Aim 1 analyses exclusively in the ‘no choice’ condition in order to take advantage of randomization, which ensures that there is not confounding due to self-selection of diet that had occurred in the diet choice condition. This is particularly important in this study given that diet selection in the diet choice condition was associated with dietary preferences (McVay et al 2014). …”

Effect of Allowing Choice of Diet on Weight Loss

“…23 (12) 13 (7) 21 (10) 15 (8) 36 weeks 24 (13) 12 (4) 22 (10) 15 (9) 48 weeks 25 (14) 12 (5) 21 (10) 17 (12) Saturated fat, % daily kcal Baseline 66 (30) 63 (26) 88 (60) 12 weeks 62 (33) 43 (22) 67 (34) 61 (34) 24 weeks 59 (34) 46 (23) 53 (27) 51 (27) 36 weeks 62 (36) 44 (15) 55 (25) 54 (28) 48 weeks 61 (34) 43 (20) 53 (27) 55 (31) Protein, % daily kcal Estimated mean weight trajectories in kg over 48 weeks for the Choice and Comparator arms from linear mixed models. Table 1 Baseline participant characteristics (11) 54 (11) 55 (10) 49 (13) 55 (10) 57 (10) 47 ( 109 (21) 109 (22) 108 (16) 108 (19) 107 (19) 112 (22) Body mass index, kg/m 2 36 (6) 36 (6) 36 (7) 35 (4) 36 (5) 36 (5) 37 ( 46 …”

Effect of Low Carbohydrate Diet on Type 2 Diabetic Patients and Usefulness of M-Value

“…LCD was originally developed by Bernstein, Atkins and others, 1,2 and now it becomes a universal topic of discussion. [3][4][5][6][7][8] The Japanese Dietetic Association recommended taking 50-60 % carbohydrate, but our group treated DM patients by LCD with 12% carbohydrate since 1999, and experienced a good response and prognosis. [9][10][11][12][13] LCD often accompanied with increase of ketone bodies as a toxic substance, but recent study found the physiological role of beta-hydroxybutyrate, especially in the normal delivery and very low carbohydrate treatment was effective to treat gestational diabetes.…”