Ann Intern Med. 2014 Sep 2;161(5):309-18.
Effects of low-carbohydrate and low-fat diets: a randomized trial.
Bazzano LA, Hu T, Reynolds K, Yao L, Bunol C, Liu Y, Chen CS, Klag MJ, Whelton PK, He J.
Abstract
BACKGROUND:
Low-carbohydrate diets are popular for weight loss, but their cardiovascular effects have not been well-studied, particularly in diverse populations.
OBJECTIVE:
To examine the effects of a low-carbohydrate diet compared with a low-fat diet on body weight and cardiovascular risk factors.
DESIGN:
A randomized, parallel-group trial. (ClinicalTrials.gov: NCT00609271).
SETTING:
A large academic medical center.
PARTICIPANTS:
148 men and women without clinical cardiovascular disease and diabetes.
INTERVENTION:
A low-carbohydrate (<40 g/d) or low-fat (<30% of daily energy intake from total fat [<7% saturated fat]) diet. Both groups received dietary counseling at regular intervals throughout the trial.
MEASUREMENTS:
Data on weight, cardiovascular risk factors, and dietary composition were collected at 0, 3, 6, and 12 months.
RESULTS:
Sixty participants (82%) in the low-fat group and 59 (79%) in the low-carbohydrate group completed the intervention. At 12 months, participants on the low-carbohydrate diet had greater decreases in weight (mean difference in change, -3.5 kg [95% CI, -5.6 to -1.4 kg]; P = 0.002), fat mass (mean difference in change, -1.5% [CI, -2.6% to -0.4%]; P = 0.011), ratio of total-high-density lipoprotein (HDL) cholesterol (mean difference in change, -0.44 [CI, -0.71 to -0.16]; P = 0.002), and triglyceride level (mean difference in change, -0.16 mmol/L [-14.1 mg/dL] [CI, -0.31 to -0.01 mmol/L {-27.4 to -0.8 mg/dL}]; P = 0.038) and greater increases in HDL cholesterol level (mean difference in change, 0.18 mmol/L [7.0 mg/dL] [CI, 0.08 to 0.28 mmol/L {3.0 to 11.0 mg/dL}]; P < 0.001) than those on the low-fat diet.
LIMITATION:
Lack of clinical cardiovascular disease end points.
CONCLUSION:
The low-carbohydrate diet was more effective for weight loss and cardiovascular risk factor reduction than the low-fat diet. Restricting carbohydrate may be an option for persons seeking to lose weight and reduce cardiovascular risk factors.
PMID: 25178568 [PubMed - indexed for MEDLINE]