Unlimited Energy, Restricted Carbohydrate Diet Improves Lipid Parameters in Obese Children

Dunlap, Brian S.; Bailes, James R.

doi:10.1089/met.2007.0023

Cited by 9 publications

(4 citation statements)

References 26 publications

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“…In addition one small observational study suggested a low CHO diet may be beneficial in younger children. 19 However, no randomized controlled clinical trials had investigated the acceptability, safety and effectiveness of these approaches in younger children. Therefore our objective was to conduct a randomized clinical trial to compare the safety and efficacy of LC and RGL diets to a standard dietary intervention for the management of obesity in younger children.…”

mentioning

confidence: 99%

Role of Carbohydrate Modification in Weight Management among Obese Children: A Randomized Clinical Trial

Kirk

Brehm

Saelens

et al. 2012

The Journal of Pediatrics

103

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Objective To compare the effectiveness and safety of carbohydrate-modified diets with a standard portion-controlled diet among obese children. Study design Obese children (n=102) aged 7-12 years were randomly assigned to a 3-month intervention of low carbohydrate (LC), reduced glycemic load (RGL), or standard portion-controlled (PC) diet, along with weekly dietary counseling and bi-weekly group exercise. Anthropometry, dietary adherence, and clinical measures were evaluated at baseline, 3, 6 and 12 months. Analyses applied intention-to-treat longitudinal mixed models. Results Eighty-five children (83%) completed the 12-month assessment. Daily caloric intake decreased from baseline to all time points for all diet groups (p<0.0001), although LC diet adherence was persistently lower (p<0.0002). At 3 months BMI z-score was lower in all diet groups (LC: -0.27 ± 0.04; RGL: -0.20 ± 0.04; PC: -0.21 ± 0.04; p<0.0001) and maintained at 6 months, with similar results for waist circumference (WC) and percent body fat (%BF). At 12 months, participants in all diet groups had lower BMI z-scores than at baseline (LC: -0.21±0.04; RGL: -0.28±0.04; PC: -0.31±0.04; p<0.0001), and lower %BF, but no reductions in WC were maintained. All diets demonstrated some improved clinical measures. Conclusions Diets with modified carbohydrate intake were as effective as a PC diet for weight management in obese children. However, lower adherence to the LC diet suggests this regimen is more difficult for children to follow, particularly in the long-term.

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mentioning

confidence: 99%

Role of Carbohydrate Modification in Weight Management among Obese Children: A Randomized Clinical Trial

Kirk

Brehm

Saelens

et al. 2012

The Journal of Pediatrics

103

View full text Add to dashboard Cite

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“…Following full‐text review, 128 articles reporting on 125 studies were included in this review (Figure 1). 6,12,17–141 Thirty‐five studies were excluded from meta‐analyses because data was unable to be pooled.…”

Section: Resultsmentioning

confidence: 99%

Targeted dietary approaches for the management of obesity and severe obesity in children and adolescents: A systematic review and meta‐analysis

et al. 2022

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There is a need for a detailed understanding of effective dietary interventions for children with obesity. This systematic review examined the effectiveness of diets of varying energy content as a component of weight treatment in children and adolescents with obesity, severe obesity and obesity-related comorbidity. A systematic search of six databases, from 2000 to 2021, for intervention studies of targeted dietary treatment for obesity in children aged 2-18 years identified 125 studies. Dietary interventions were grouped according to diet type and energy target. Risk of bias was assessed using the Effective Public Healthcare Panacea Project assessment tool. Meta-analysis examined change in body mass index (BMI) at intervention end. A broad array of diet types were effective at reducing BMI in children with obesity. When dietary types were considered by energy target, a gradient effect was observed. Very-low energy diets were most effective with a À 4.40 kg/m 2 (n = 3; 95% CI -7.01 to À1.79). While dietary interventions with no specified energy target were ineffective, resulting in a BMI gain of +0.17 kg/m 2 (n = 22; 95% CI 0.05 to 0.40). Practical definitions of dietary energy target in the management of obesity and severe obesity are urgently required to ensure treatment seeking children have timely access to efficacious interventions.

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“…This finding, along with the significant finding of improved HDLc, compares favourably with that of similar studies. 9,10,11,12,13,21 We were unable to confirm a significant mean change in insulin resistance, using HOMA-IR. However, at baseline, six children exceeded the threshold confirming insulin resistance (HOMA-IR > 3.16) 24 and these participants showed the most meaningful reduction at three months.…”

Section: Themes Supporting Transcripts Of Caregiversmentioning

confidence: 86%

“…8 In children, few studies exist, but on the whole, they are at least as effective as mainstream nutrition for reducing body weight and waist circumference, and appear to be more effective for improving metabolic risk factors such as triglycerides, HDL cholesterol (HDLc) and glycaemic control. 9,10,11,12,13 Low carbohydrate, high-fat (LCHF) approaches have been criticised because of a lack of knowledge around adherence and affordability for families. 14 We agree that the issues around adherence to this way of eating, along with other real-life aspects associated with sustainable behaviour change, are critical, especially for overweight or obese youth in a family setting.…”

Section: Introductionmentioning

confidence: 99%

A 12-week, whole-food carbohydrate-restricted feasibility study in overweight children

Zinn

Schmiedel

McPhee

et al. 2018

JMH

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Background: Childhood obesity is a global health concern. Conventional nutrition guidelines have come under scrutiny in helping to achieve long-term healthy weight. An alternative carbohydrate-restricted, higher fat approach has shown to be effective in adults, but research is limited in youth. Aim: To assess the feasibility of a 12-week whole-food, carbohydrate-restricted diet on weight loss and metabolic health. Setting: Overweight children aged 8–13 years. Methods: In this single-arm study, 25 overweight children were provided with whole-food, carbohydrate-restricted dietary guidelines. Primary outcomes – dietary acceptability, adherence and affordability – were assessed qualitatively weekly (telephone) and post-intervention (focus groups). Secondary outcomes – Body mass index (BMI), waist circumference, lipids and glycaemic control measures – were assessed at 0 and 12 weeks. Change scores were analysed using the t-statistic and interpreted using the statistical significance threshold, p < 0.05. Results: Overall, dietary acceptability was mostly positive, and reports of affordability by parents were mixed. Attrition rates were high (48%); adherence was influenced, positively and negatively, by levels of support from friends and family. Completing children reduced BMI by 2.1 ± 1.5 kg.m2 (p < 0.05). Key blood parameter changes included a reduction in triglycerides (−0.17 ± 0.48 mmol/L; p = 0.242) and an increase in high-density lipoprotein (HDL) cholesterol (0.24 ± 0.19 mmol/L; p < 0.05). Conclusion: Children achieved some weight loss and health outcome success using this dietary approach. For sustainable weight loss maintenance, full family and health professional support, particularly on a more intensive level at the start, may be required.

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Unlimited Energy, Restricted Carbohydrate Diet Improves Lipid Parameters in Obese Children

Cited by 9 publications

References 26 publications

Role of Carbohydrate Modification in Weight Management among Obese Children: A Randomized Clinical Trial

Role of Carbohydrate Modification in Weight Management among Obese Children: A Randomized Clinical Trial

Targeted dietary approaches for the management of obesity and severe obesity in children and adolescents: A systematic review and meta‐analysis

A 12-week, whole-food carbohydrate-restricted feasibility study in overweight children

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