Randomized clinical trial of standard dietary treatment versus a low‐carbohydrate/high‐protein diet or the LighterLife Programme in the management of obesity*

Abstract

Background: With the current obesity epidemic, the search for effective weight loss approaches is required. In the present study, changes in weight, body composition and cardiovascular (CV) risk in response to a low‐fat, reduced‐energy diet (LFRE), a low‐carbohydrate/high‐protein diet (LCHP), or a commercially available very low‐calorie diet (LighterLife; LL) were assessed. Methods: One hundred and twenty obese patients (body mass index ≥35 kg/m2) underwent a screening period of 3 months on the LFRE. Those who lost >5% of their body weight were maintained on this approach for an additional 3 months, whereas those who lost >10% at this time were maintained for 1 year. Patients failing to achieve these targets were randomly allocated to either the LCHP (n = 38) or LL (n = 34) for a period of 9 months. Results: Significantly greater weight loss was seen for patients on the LL than the LCHP at 3 (mean (±SD) −11.6 ± 12.9 vs −2.8 ± 4.5 kg, respectively; P < 0.0001) and 9 months (−15.1 ± 21.1 vs −1.9 ± 5.0 kg, respectively; P < 0.0001) after screening. Significantly greater improvement in total cholesterol, low‐density lipoprotein–cholesterol, fasting glucose, and diastolic blood pressure was seen at 3 months in patients on the LL compared with the LCHP (P < 0.05). These differences were no longer significant at 9 months, with the exception of fasting glucose. The attrition rate was elevated in the LCHP group, but did not differ significantly from the LL group. Conclusion: Greater weight loss and improved CV risk were achieved with the LL, which mostly reflects the patient support provided for each dietary treatment.

The clinical effectiveness and cost-effectiveness of long-term weight management schemes for adults: a systematic review

“…Other guidelines which are relevant to the prevention and management of obesity in adult populations in the UK have been produced by the National Obesity Forum 41 and the Northern Ireland Clinical Resource Efficiency Support Team. 42 They are consistent with the NICE guideline 35 but focus on either primary care 41 or secondary care. 42 Several UK guidelines are also available on the prevention and management of obesity in children and young people [e.g.…”

“…42 They are consistent with the NICE guideline 35 but focus on either primary care 41 or secondary care. 42 Several UK guidelines are also available on the prevention and management of obesity in children and young people [e.g. the Scottish Intercollegiate Guidelines Network guideline 43 (currently being updated; spring 2010)], and on the management of obesity using pharmacological and surgical approaches.…”

“…Three sessions per week (non-consecutive days) for first 28 weeks, two per week during weeks [29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48]. 12 minutes at week 1, additional 2 minutes to routine each week, by week 14 performed 40 minutes of stepping During weeks 29-48 they were assisted in developing at home exercise to replace the third exercise session deleted from their supervised training Delivered: graduate students in exercise physiology who followed structured protocols Level of supervision: all sessions were supervised (no further detail given)…”

“…Participants were given manuals summarising materials for the first 28 weeks, and weeks [29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48] Frequency and length of each session and total number sessions: 28 weekly 90 minute sessions, followed by biweekly maintenance programme sessions (weeks [29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48] Delivered: by clinical psychologists and groups coled by a dietitian (weeks [17][18][19][20][21][22][23][24][25][26] In addition the exercisers took approximately 5-10 minutes each week to discuss adherence...…”

Very Low-Calorie Diets in Type 2 Diabetes Mellitus: Effects on Inflammation, Clinical and Metabolic Parameters

“…At 9 months, there were no significant differences, with the exception of fasting glucose, among the VLCD (average 550 kcal/day) and low-carbohydrate/ high-protein diet (800-1500 kcal/day) regimens. Dropout rates were similar in the VLCD and low-carbohydrate/high-protein diet groups and no adverse effects were reported at 3 and 9 months in both groups [21]. Thus, at least for 9 months, VLCD seems to possess a favorable safety profile compared to less intense restricted calorie diets (>800 kcal/day).…”