Reduced Carbohydrate Diet to Improve Metabolic Outcomes and Decrease Adiposity in Obese Peripubertal African American Girls

Abstract

Objectives Obesity prevalence among African American (AA) girls is higher than that of other groups. As typical calorie-restriction obesity treatment strategies have had limited success, alterations in macronutrient composition might effectively improve metabolic outcomes in this population and impact future body composition trajectories. The objective was to evaluate the efficacy of a moderately restricted carbohydrate (CHO) versus a standard CHO diet on weight/fat loss and metabolic parameters in overweight/obese AA girls aged 9–14 years. Methods A total of 26 AA girls (ranging from 92nd BMI percentile and above) were assigned to either a reduced- (SPEC: 42% calories from CHO, n=12) or a standard- (STAN: 55% of calories from CHO, n=14) CHO diet (protein held constant) for 16-weeks. All meals were provided and clinically tailored to meet the estimated energy requirements (REE × 1.2 in eucaloric phase and REE × 1.2 – 1000kcal in energy deficit phase). The first five-weeks encompassed a eucaloric phase evaluating metabolic changes in the absence of weight change. The subsequent 11-weeks were hypocaloric (1000kcal/d deficit) in effort to promote weight/fat loss. Meal tests were performed during the eucaloric phase for metabolic analyses. Dual-energy x-ray absorptiometry (DXA) was used to evaluate body composition. Results Both groups had reductions in weight/adiposity but the difference did not reach significance. The solid meal test indicated improved glucose/insulin homeostasis on the SPEC diet up to three hours post-ingestion. In addition, significantly lower triglycerides (p<0.001) were observed on the SPEC diet. Conclusions Dietary CHO reduction favorably influences metabolic parameters but did not result in greater weight/fat loss relative to a standard diet in obese AA girls. Future research is needed to determine long-term effectiveness of a reduced CHO diet on glucose and insulin homeostasis and how it may apply to weight maintenance/fat loss during development alone and/or in combination with additional weight loss/metabolic improvement strategies.

The relationships among total body fat, bone mineral content and bone marrow adipose tissue in early-pubertal girls

“…This pilot study represents an ongoing cohort comprised of healthy participants enrolled in clinical studies, including dietary and physical activity interventions, and observational studies aimed at investigating body composition during the pubertal transition4243 conducted at the University of Alabama at Birmingham (UAB). Participants were recruited through newspaper advertisements, flyers posted at various community partnerships and by word-of-mouth.…”

“…Abbreviations: Black, non-Hispanic Black; BMC, bone mineral content; BMAT, bone marrow adipose tissue. a Reproductive maturation status I–V based on criteria of Marshall and Tanner 4243

b Indicates significant difference among Black and White girls ( P <0.05).

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Eating Disorders, Addictions and Substance Use Disorders

“…Furthermore, the success of low carbohydrate diets, such as the Atkins diet, for the treatment of obesity, attests to the feasibility of this approach, at least in some individuals (Casazza et al, 2012;Iqbal et al, 2010;Maeir et al, 2011). Anecdotally, many individuals report that avoidance of white flour and sugar is extremely useful.…”

Improvements in Body Satisfaction Among Obese Preadolescent African American Girls After Participation in a Weight-Loss Intervention

“…15 The current intervention consisted of 2 phases: a 6-week eucaloric phase, which was designed for weight stability, and a 12-week hypocaloric, weight-loss phase. Inclusion of the eucaloric phase of the dietary intervention allows for the examination of the effect of changing dietary habits without caloric deficiency on body dissatisfaction and self-esteem.…”