Efficacy and Safety of Low-Carbohydrate Diets

Bravata, Dena M; Sanders, Lisa; Huang, Jane; Krumholz, Harlan M.; Olkin, Ingram; Gardner, Christopher D.; Bravata, Dawn M.

doi:10.1001/jama.289.14.1837

Cited by 484 publications

(277 citation statements)

References 95 publications

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“…Lowcarbohydrate/high protein diets are popular at present, although their long-term efficacy and safety are not established. [19][20][21] In the current study, among people who had not changed their diet during follow-up, the largest weight gain was seen in the meat-eaters, whereas the smallest weight gain was seen in the vegans. As reported previously, at baseline the percent of energy intake from protein was lowest among the vegans and highest among the meat-eaters, whereas the opposite was seen for carbohydrates.…”

Section: Discussionmentioning

confidence: 62%

Weight gain over 5 years in 21 966 meat-eating, fish-eating, vegetarian, and vegan men and women in EPIC-Oxford

et al. 2006

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Background: Cross-sectional studies have shown that vegetarians and vegans are leaner than omnivores. Longitudinal data on weight gain in these groups are sparse. Objective: We investigated changes in weight and body mass index (BMI) over a 5-year period in meat-eating, fish-eating, vegetarian, and vegan men and women in the UK. Design: Self-reported anthropometric, dietary and lifestyle data were collected at baseline in 1994-1999 and at follow-up in 2000-2003; the median duration of follow-up was 5.3 years. Subjects: A total of 21 966 men and women participating in Oxford arm of the European Prospective Investigation into Cancer and Nutrition aged 20-69 years at baseline. Results: The mean annual weight gain was 389 (SD 884) g in men and 398 (SD 892) g in women. The differences between meat-eaters, fish-eaters, vegetarians and vegans in age-adjusted mean BMI at follow-up were similar to those seen at baseline. Multivariable-adjusted mean weight gain was somewhat smaller in vegans (284 g in men and 303 g in women, Po0.05 for both sexes) and fish-eaters (338 g, women only, Po0.001) compared with meat-eaters. Men and women who changed their diet in one or several steps in the direction meat-eater-fish-eater-vegetarian-vegan showed the smallest mean annual weight gain of 242 (95% CI 133-351) and 301 (95% CI 238-365) g, respectively. Conclusion: During 5 years follow-up, the mean annual weight gain in a health-conscious cohort in the UK was approximately 400 g. Small differences in weight gain were observed between meat-eaters, fish-eaters, vegetarians and vegans. Lowest weight gain was seen among those who, during follow-up, had changed to a diet containing fewer animal food.

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Section: Discussionmentioning

confidence: 62%

Weight gain over 5 years in 21 966 meat-eating, fish-eating, vegetarian, and vegan men and women in EPIC-Oxford

et al. 2006

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“…Weight loss independent of the diet, is associated with lipid reduction (38,39). The longer-term effect of the Atkins plan on CVD risk is unknown because long-term studies have not been conducted (40).…”

Section: Discussionmentioning

confidence: 99%

A Dietary Quality Comparison of Popular Weight-Loss Plans

Pagoto²,

Griffith³

et al. 2007

Journal of the American Dietetic Association

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Popular weight-loss plans often have conflicting recommendations, which makes it difficult to determine the most healthful approach to weight loss. Our study compares the dietary quality of popular weight-loss plans. Dietary quality, measured by the Alternate Healthy Eating Index (AHEI), was calculated via sample menus provided in published media for the New Glucose Revolution, Weight Watchers, Atkins, South Beach, Zone, Ornish, and 2005 US Department of Agriculture Food Guide Pyramid (2005 Food Guide Pyramid) plans. The criterion for determining which weight-loss plans were the most popular was their status on the New York Times Bestseller list. Weight Watchers and the 2005 Food Guide Pyramid plan were included because they are the largest commercial weight-loss plan, and the current government recommendation, respectively. Analysis of variance was used to compare nutrient information among the weight-loss plans. The AHEI scores adjusted for energy content were also compared. Of a maximum possible score of 70, the AHEI scores for each weight-loss plan from the highest to the lowest plan were: Ornish (score 64.6), Weight Watchers high-carbohydrate (score 57.4), New Glucose Revolution (score 57.2), South Beach/Phase 2 (score 50.7), Zone (score 49.8), 2005 Food Guide Pyramid (score 48.7), Weight Watchers high-protein (score 47.3), Atkins/100-g carbohydrate (score 46), South Beach/Phase 3 (score 45.61, and Atkind45-g carbohydrate (score 42.3). Dietary quality varied across popular weight-loss plans. Ornish, Weight Watchers high-carbohydrate, and New Glucose Revolution weight-loss plans have an increased capacity for cardiovascular disease prevention when assessed by the AHEI.Obesity is associated with an increased risk for cardiovascular disease (CVD) (1,2). Accompanying the steady rise in obesity during the past 3 decades is the proliferation of popular weight-loss plans. Although most of these weight-loss plans are efficacious for weight reduction in the short term (3-6), how the weight-loss plans compare in terms of dietary quality is unknown. Dietary quality has been defined a s the degree to which a diet reduces risk for chronic diseases, specifically CVD (7).The purpose of this study was to compare popular weight-loss plans' dietary quality as well as other nutrients associated with reduced CVD. Given that obesity is a risk factor for CVD, the optimal weight-loss plan will facilitate weight loss and CVD risk reduction. MATERIALS AND METHODS Diet SelectionEight weight-loss plans were selected for comparison, including New Glucose Revolution, two Weight Watchers plans, Atkins, South Beach, Zone, The New Glucose Revolution (8) endorses a low glycemic index weight-loss plan. The glycemic index ranks carbohydrates according to their effect on blood glucose levels. Glycemic index is the basis for food selection balanced with the selection of lean protein and healthful fats. The glycemic index score reflects how quickly a food raises blood sugar levels. The lowglycemic index plan is purported to facilitate s...

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“…While a wealth of epidemiological data supports a link between high-fat diets and obesity, 6 only limited evidence targets dietary fat as a cause of significant weight gain. 7 One of the more recent trends in dieting encourages a low-carbohydrate, high-fat and/or high-protein approach. While the physiological rationale behind such diets remains questionable, preliminary studies suggest that many people do lose weight while eating very high-fat diets.…”

Section: Introductionmentioning

confidence: 99%

Insulin resistance as a modifier of the relationship between dietary fat intake and weight gain

et al. 2004

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OBJECTIVE: To investigate whether insulin resistance modifies the rate of weight gain associated with a high percent of energy intake from dietary fat. DESIGN: Longitudinal, observational population study. SUBJECTS: A total of 782 nondiabetic Hispanic and non-Hispanic white free-living adult residents of the San Luis Valley in Colorado. MEASUREMENTS: Subjects were seen up to three times over a 14-y period. Weight, height, fasting insulin and glucose, diet by 24 h recall, and self-reported physical activity were collected at each visit. RESULTS: Percentage of energy intake from dietary fat was positively associated with weight gain over time (P ¼ 0.0103). High intake of dietary fat was more strongly related to weight gain in women than in men, and in those with lower total energy intake levels. The relationship between weight change and relative macronutrient intake also varied by baseline insulin sensitivity (P ¼ 0.0025). Weight gain over time in individuals with relative insulin resistance at baseline, as measured by QUICKI, was the greatest among those who consumed a higher percent of energy from fat. CONCLUSION: Percentage of total intake from dietary fat predicts weight change independent of total energy intake. Nondiabetic, insulin-resistant individuals are particularly susceptible to the weight gain associated with high levels of dietary fat intake. Further investigation into the relationship between insulin resistance, diet, and weight gain is warranted.

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Efficacy and Safety of Low-Carbohydrate Diets

Cited by 484 publications

References 95 publications

Weight gain over 5 years in 21 966 meat-eating, fish-eating, vegetarian, and vegan men and women in EPIC-Oxford

Weight gain over 5 years in 21 966 meat-eating, fish-eating, vegetarian, and vegan men and women in EPIC-Oxford

A Dietary Quality Comparison of Popular Weight-Loss Plans

Insulin resistance as a modifier of the relationship between dietary fat intake and weight gain

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