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University of Cincinnati and Children’s Hospital Medical Center, Cincinnati, Ohio 45221
Address all correspondence and requests for reprints to: Bonnie Brehm, Ph.D., University of Cincinnati, P.O. Box 210038, Cincinnati, Ohio 45221-0038. E-mail: bonnie.brehm{at}uc.edu.
Untested alternative weight loss diets, such as very low carbohydrate diets, have unsubstantiated efficacy and the potential to adversely affect cardiovascular risk factors. Therefore, we designed a randomized, controlled trial to determine the effects of a very low carbohydrate diet on body composition and cardiovascular risk factors. Subjects were randomized to 6 months of either an ad libitum very low carbohydrate diet or a calorie-restricted diet with 30% of the calories as fat. Anthropometric and metabolic measures were assessed at baseline, 3 months, and 6 months. Fifty-three healthy, obese female volunteers (mean body mass index, 33.6 ± 0.3 kg/m2) were randomized; 42 (79%) completed the trial. Women on both diets reduced calorie consumption by comparable amounts at 3 and 6 months. The very low carbohydrate diet group lost more weight (8.5 ± 1.0 vs. 3.9 ± 1.0 kg; P < 0.001) and more body fat (4.8 ± 0.67 vs. 2.0 ± 0.75 kg; P < 0.01) than the low fat diet group. Mean levels of blood pressure, lipids, fasting glucose, and insulin were within normal ranges in both groups at baseline. Although all of these parameters improved over the course of the study, there were no differences observed between the two diet groups at 3 or 6 months. ß- Hydroxybutyrate increased significantly in the very low carbohydrate group at 3 months (P = 0.001). Based on these data, a very low carbohydrate diet is more effective than a low fat diet for short-term weight loss and, over 6 months, is not associated with deleterious effects on important cardiovascular risk factors in healthy women.
This work was supported by the American Heart Association, University of Cincinnati Obesity Research Center, University of Cincinnati Research Council, Children’s Hospital Medical Center Clinical Research Center (supported in part by USPHS Grant M01-RR-08084 from the General Clinical Research Center Program, National Center for Research Resources, NIH), and NIH Grants DK-54263 and DK-56863.
Abbreviations: DEXA, Dual energy x-ray absorptiometry; HDL, high density lipoprotein; LDL, low density lipoprotein.
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