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Similar Weight Loss With Low - or High-Carbohydrate Diets. Golay 1996
Similar Weight Loss With Low - or High-Carbohydrate Diets. Golay 1996
weight
Alain
Anne-Fran#{231}oise
Golay,
Gerald
Yves
Morel,
Nicolas
de
Tonnac,
Svetalina
Tankova,
of diets
The goal
that
relative
were
amounts
6-wk
period
persons
low
kcal/d)
was
assigned
composed
body
groups,
and
a function
of diet
fat
15%
neither
plasma
insulin
nor
de-
were
glucose,
that
seen
as
insulin,
decreased
contained
signifi15%
triacylglycerol
1996;63:
loss
not
in response
to
Am J Clin Nutr
174-8.
KEY
Obesity,
high-carbohydrate
weight
loss,
also
received
AND
a body
diet
well
as
attention
is little
is focused
individuals.
When
grams
it is necessary
argument
that
there
are widely
on how
to bring
evaluating
the
to differentiate
obesity
constitutes
different
about
opinions
weight
when
loss
proof
a return
these issues
this instance,
been
appears
to the original
consensus
argued
has
that
when
changes
patients
containing
drate.
The
tions,
and
changes
174
were
moderate,
present
study
weight
reached.
lead
was
high
initiated
several
For
in
example,
obese
of
of
these
30,
>
with
strong
psychiatric
of a history
personal
diagnoses,
was submitted
of the Department
to a low-energy
multidisciplinary
nutritional
motivation,
were
excluded
to and accepted
of Medicine
consisted
and
diet,
subjects
program
that
education,
Exercise
day
by
at Geneva
and
of
standard
was
by
tech-
exercise
physical
provided
in a
physical
behavioral
1 h of aerobic
1 h of underwater
education
participated
included
training
activity
per
a registered
day.
dietitian
admission
signed
to the
to receive
consisted
hospital,
diets
of either
From
and
patients
containing
15%
or 45%
randomly
as-
4.2
Mi/d
were
(1000
kcal/d)
that
of
energy
as
carbohydrate.
diets
Clinical
Address
Unit,
observa-
Geneva
patients
of the
and
Nutr
the
Department
University
of Medicine,
School
Center,
Geneva
of Medicine
Department
University
and Geriatric
of Veterans
Affairs
Hospital,
Research,
Medical
and
Education
Center,
Palo
Alto, CA.
carbohy-
J Clin
on the basis
Hospital.
Stanford
carbohydrate
Am
education.
it
similar
(1200-kcal/d)
per
loss
weight
were
proportions
in 43
of
that both
to extend
facets
first
but even
weight
variables
5.0-MJ/d
and
The
to better
indicate
metabolic
a comparison
and
been
et al (12)
prescribed
low,
(8-10).
straightforward,
diets
in associated
involved
in
not
low-fat
weight
to be the most
were
which
nutritional
decided
The protocol
committee
Nutritional
in obese
efficacy
of weight-loss
between
considerations
it was
(kg/rn2)
those
University
niques.
(1-4),
visit,
index
the study.
activity,
there
patients
during
METHODS
first
mass
the ethical
INTRODUCTION
hazard
and
lowfrom
compliance,
of the study,
behavioral
of
of energy
low-carbohydrate
the
structured,
Although
dietary
duration
initiation
or 45%
In addition
health
the
15%
Forty-three
adult, obese patients
were studied
before
and
after a 6-wk period of hospitalization.
These subjects
had been
referred
to the Obesity
Outpatient
Clinic of the Department
of
Medicine
at Geneva
University
Hospital
for dietary
treatment
of their obesity.
as
WORDS
diet,
weight
period.
they
followed
of either
To increase
for the entire
During
con-
centrations
fell significantly
in response to the higher-carbohydrate
diet. The results of this study showed that it was energy intake,
nutrient
composition,
that determined
low-energy
diets over a short time
carbohydrate.
hospitalized
SUBJECTS
0.6 kg) or
plasma
that
consisting
and 26%
of weight
circumference
Fasting
diets
carbo-
significant
of the changes
composition.
but
(8.9
metabolism
energy
time
4.2
15%
Furthermore,
waist-to-hip
obese
containing
protein,
in the amount
either
the magnitude
during
45% carbohydrate,
difference
and
diets
32%
cholesterol,
and triacylglycerol
concentrations
cantly
in patients
eating
low-energy
diets
carbohydrate,
weight
lipoprotein
in
1996;63:174-8.
reprint
Department
requests
of
to A Golay,
Medicine,
Diabetes
University
of
Treatment
Geneva
and Teaching
Hospital,
1211,
14, Switzerland.
Received
November
Accepted
for publication
Printed
in USA.
14, 1994.
October
1996
17,
American
1995.
Society
for Clinical
Nutrition
in total
different
43 adult,
to receive
loss in response
to diets containing
45% (7.5 0.5 kg) carbohydrate.
in both
the effect
widely
on body
of either
no significant
creases
to evaluate
but
Consequently,
fat. There
was
in energy
(1000
hydrate,
of this study
equally
of hospitalization.
were
MJ/d
loss
and
Reaven
ABSTRACT
has
WEIGHT
Baseline
characteristics
listed
in Table
distribution,
mass
started
on
tions
of the
two
of
rotation
for
lunch
diets.
2. Both
and
A 7-d
the
menus
rotational
nutrient
menu
but
meals
and
were
during
compliance
instructed
with
once
a week
took
the quality
meal
The
patients
the
and
software
PRODI3+
The absolute
amount
(1 15 14 compared
less
with
5 g). Both
diets
contained
(
14 g/d) and cholesterol
Urinary
nitrogen
a l-d
These
food
used
to calculate
measured
11514
155
455
Fat
(g/d)
605
305
(%)
Protein
535
265
(gld)
799
735
(%)
325
295
SD.
by the
and
record
age
(skinfold
used
times
diet
of fat was
with 60
Kjeldahl
with
these
six
urine
urinary
collections.
fat
method
were
mated
on
mg/kg
body
the
calculated
basis
wt,
by
umental
of previously
respectively
from
total
dietary
at
TABLE
Physical
characteristics
biceps,
Daily
output
(urine,
subscapula,
Age(y)
3M,
l9F)
419
(kg)
107 23
Height
(cm)
162
(kg/m2)
41
BP (mm Hg)
BP
(mm
Hg)
iE SD.
BP,
blood
stool,
and
10
was
integ-
of adiposity
were
skinfold-thickness
and
suprailiac
138 14
89 9
pressure.
45%
Carbohydrate
6M,
(n
1SF)
4518
Weight
Diastolic
5 and
balance
102
164
18
38 5
136
18
85
14
(r
(23).
two
techniques
0.64,
P <
as a mean
and
of these
bioelectrical
analyzed
as means
analysis
approach
compo-
were
0.0001).
two
SEMs
signifPercent-
measurements
and
procedure
by two-way
Body
impedance).
general-linear-models
were
of SAS
analyzed
(SAS
Insti-
between
the two
weight
loss,
data
of variance,
of Scheff#{233}(24,
with
the mul-
25).
RESULTS
Values
for
cumferences,
in Table
total
body
and
4. These
weight,
body
waist-to-hip
ratio
values
were not
fat,
waist
before
the
significantly
and
hip
diets are
different
cirgiven
be-
either
fat,
15%
waist
and
or 45%
hip
significantly
the changes
percentage
weight
groups,
as a function
vary
loss
and
carbohydrate.
circumference,
in both
did not
the
was
1 .3 0.5
0.6
g (45%-carbohydrate
of both
during
1 .8
during
the last S wk.
Table
5 lists
values
HDL-cholesterol,
tions
and
after
for
cholesterol,
before
the
though
trends
diets,
the
of
The
were
equal:
more
groups.
nitrogen
compared
balance
week F- I .5
the first
0.2 g (45%
fasting
dietary
plasma
intervention,
more
0.2
(15%
than
glucose,
triacylglycerol
were
-0.5
was
carbohydrate)]
significantly
contained
15%
direction
The
balance
with
Nitrogen
and
decreased
which
in a similar
loss
between
was
these indexes
were not significantly
different
groups
before
dieting.
These
data also show
glucose,
insulin,
cholesterol,
HDL-cholesterol,
erol concentrations
the low-energy
magnitude
composition.
were
not significantly
diet) compared
with
diet)
diet).
diet
and
fat
diet)]
diets
(15%-carbohydrate
each
and
ratio
percentage
1 1 .2 0.9 g (45%-carbohydrate
effect
total
waist-to-hip
of diet
carbohydrate
diet)]
and nitrogen
losses
different
[13.9 1.7 g (15%-carbohydrate
protein-sparing
Furthermore,
and
in
negative
with
carbohydrate)
Carbohydrate
(F1
Systolic
esti-
subjects
15%
BMI
were
studies:
nitrogen
percentage
techniques:
triceps,
of the
losses
input.
Body
fat composition
and
determined
by two different
measurements
stool
reported
(21).
subtracting
losses)
and
expressed
tiple-comparison
body
samples
were collected
every week
loss was computed
on the basis of
Integumental
linear
are expressed
the
decreased
Twenty-four-hour
and average
daily
and
thickness
analysis
by these
higher
saturated
of fat was
Data
alimen-
impedance
as assessed
correlated
into
ac-
bioelectrical
values
records
15%-carbohydrate
of
(22),
icantly
(20).
375
sition
tables
(15).
was three
in the
was
food
consumed
similar
amounts
(230
mg/d).
was
320
(%)
verify
4296
315
4214
(g/d)
The
To
45%-carbohydrate
in the
than
(22%),
a dietitian
diet
di-
(12%).
of food
of carbohydrate
in the 45%-carbohydrate
and
study.
was
The
I d of the
compliance.
completed
the quantity
used.
offered
snack
foods
6 wk of the
food
(kI/d)
Carbohydrate
to improve
the diet,
during
all
Energy
Carbohydrate
45%
Carbohydrate
insulin,
concentraand
shows
that
between
the two
that fasting
plasma
and triacylglycin patients
carbohydrate.
seen when
eating
Al-
patients
ate
count.
to eat
each
of diets
Composi-
breakfast
bedtime
Composition
diets
high-carbohydrate
among
total energy
and protein
contents
of the
Energy
intake
was carefully
measured
present
was
from
and
TABLE
15%
con-
I 75
DIETS
patients
various
of
low-carbohydrate
(33%),
of
composition
compositions
dinner
subjects
the
in Table
Recipes
are
of sex
HIGH-CARBOHYDRATE
pressure.
experimental
in Table
3.
intake
was distributed
(33%),
blood
acquired,
two
similar
and
were
OR
groups
shown
Itemized
menu
index,
LOW-
in terms
are
standardized.
foods.
experimental
comparable
data
foods.
provided
verse
WITH
of the
diets
natural
were
menus
one
two
were
metabolic
were
items
body
baseline
sisted
the
groups
age,
After
of
1. The
LOSS
GOLAY
176
TABLE
Itemized
composition
ET AL
DISCUSSION
of diets
Food
In this study
Weight
items
varied
carbohydrate
15% Carbohydrate
points.
Breakfast
Low-fat
fresh
Low-fat
ham
cheese
(20%
fat)
meat
or fish
Vegetable
closely
variations
100
beneficial
sweetened
180
yogurt
Low-fat
meat
or eggs
100
Whole-wheat
bread
15
Snack
fresh
cheese
(20%
fat)
Carbohydrate
and
fasting
plasma
of weight
lipid
glucose,
150
50
150
60
100
sweetened
yogurt
180
Vegetable
pasta,
or cereals
thermic
150
60
(4%)
fresh
cheese
(20%
1g
fat)
Fruit
low-energy
diets
tude
of the differences
insulin
nor triacylglycerol
response
to the
TABLE 4
Body composition
containing
45%
carbohydrate,
was
attenuated
concentrations
higher-carbohydrate
diet.
before
loss
more
the tendency
of this
Body
tion
neither
plasma
significantly
in
ingested,
dependent
effect
issue
circumference
99
on
weight
in
fat intake
differences
et al. First,
and prob-
in
degree
For
the
weight
example,
thermic
a thermic
of
ie, a 100-i
to fat
on
the
of fat
it has
to fat,
other
hand,
the
diets
containing
4.2
of carbohydrate
is
of 50 J associated
difference
in hypoenergetic
loss
the
diets
increasing
weight
that the
that
of low-energy
of 45%
effect
that
On
effect
when
effect
than
considerations,
of carbohydrate
(27).
to the
unlikely
is the evidence
is higher
of these
the ratio
102
42
that
per
the
day.
relative
diets
ensues
with
Thus,
propor-
will
have
in compliant
104
loss:
p <
0.001,
P < 0.01,
1 13
121 2
0.93
0.05.
95
32
7.4 0.6
32
<
41
1.0
11732
0.88 0.0l
0.02
After
b efore
low
Before
38 22
1264
from
diets
variations
(8%)
0.5
17.7
1 15 4
0.91
different
and
that
45% Carbohydrate
8.3
Hipcircumference(cm)
Waist-to-hip
ratio
i SEM.
2--I
Significantly
47 3
(cm)
one,
reported
consuming
to address
to gain
of carbohydrate
significant
After
two
patients.
107
fat (kg)
is a pragmatic
of Rabast
information
be questioned.
are
it is theoretically
Before
(kg)
in
in subjects
decrease
in dietary
are two crucial
15% Carbohydrate
fall
triacylglycerol,
et al (1 1), who
weight
a consequence
that the higher
relevance
MJ
the magni-
and
fell
first
of carbohydrate
the less
must
less
150 J, compared
with
eating 15% carbohydrate,
the
The
and those
important
effect
(26).
As
suggested
been
Snack
Low-fat
the
compliance.
100
Oil
of carbo-
was decreased
of Rabast
lost
are
A second
meat or eggs
cholesterol,
to
and
dietary
Dinner
Low-fat
addressed.
our results
output,
Snack
artificially
measures
ably
most
important,
the current
studies
were
performed
on
inpatients,
not outpatients.
Second,
subjects
in our study
also
participated
in programs
of physical
exercise
and both behavioral and nutritional
education.
Consequently,
we believe
that
the results
of our study
emphasize
issues
of energy
intake
and
Oil
Low-fat,
be
individuals
between
100
Fruit
insulin,
to
the other
hand,
to modify
the
specifically,
concentrations
the publications
carbohydrate,
can lead
or cereals
More
end-
in response
of the amount
of
being
related
most
loss on certain
metabolism.
and
metabolic
similar
independent
test diets,
that
fat
0.02
34 22
16.8
1.2
103
32
11222
0.91
0.02
pasta,
must
obese
Vegetable
Rice,
effects
involves
50
Breakfast
Low-fat skimmed
milk (0% fat)
Whole-wheat
bread
Butter or margarine
Lunch
Low-fat meat or fish
Rice,
apparently
in the two
various
was
to total energy
intake
(Table
3). On
in dietary
composition
did appear
hydrate
issues
Low-fat
and
loss
diets
of
25
Oil
loss
proportions
eating a low-energy
diet relatively
high in carbohydrate,
and
the changes
in plasma
insulin
and triacylglycerol
concentra-
100
Vegetable
45%
was
of low-energy
relative
of weight
and HDL-cholesterol
Dinner
the effects
their
weight
amount
100
Snack
artificially
on both
The
Oil
Low-fat,
in
150
50
Lunch
Low-fat
we evaluated
substantially
WEIGHT
TABLE
LOSS
WITH
LOW-
OR
HIGH-CARBOHYDRATE
indexes
before
and
after
weight
loss
Carbohydrate
15%
45% Carbohydrate
Before
Plasma
Plasma
Plasma
Plasma
glucose (mmolIL)
insulin (pmol/L)
cholesterol
(mmol/L)
HDL cholesterol
(mmoLfL)
Plasma
triacylglycerol
5.3 0.2
106.8 15.6
5.7
(mmolIL)
Significantly
In
different
conclusion,
loss
diets
from
our
can
weight
results
occur
as inpatients,
before
and
subjects
that
this
0.3
the
high-carbohydrate
of
low-fat,
4.4
0.12
57.6
6.62
4.5
0.22
advocated
tion
Program
insulin
and
(28)
seems
triacylglycerol
likely
insulin
related
and
portion
tion,
to previous
triacylglycerol
to dietary
the
by
carbohydrate
servation
that
in
weight
ate low-energy
and carbohydrate
diets
that are
loss
advocacy
similar
0.001,
p <
of this
that
dietary
low-fat
such
information
to suggest
that
composition,
low-energy
that
diets.
We are grateful
by
shown
to
this
loss
it
13.
14.
in
of
seems
energy
not
response
of the dietary
especially
staff
T Lehmann,
P Rigoli,
16.
of
C Bussien,
persons
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D, Wishewski
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reasonable
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diets
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Until
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when
in insulin
and lipid
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it seems
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Medicine
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in carbohydrate
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1.8 0.2
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5.3
0.2
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This
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Given
0.4
2.2
consumption
women
diet
9.6
6. 1
1.4 0.l
Cholesterol
concentration
significantly
high-carbohydrate
0.2
1.7 0.1
that
the
5.0
88.2
1.0 0.l
results
showing
concentrations
HDL-cholesterol
decrease
low-fat,
National
13.2
0.1
diets
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11
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