Low-Fat Versus Low-Carbohydrate Weight Reduction Diets
Open Access
- 31 August 2009
- journal article
- research article
- Published by American Diabetes Association in Diabetes
- Vol. 58 (12), 2741-2748
- https://doi.org/10.2337/db09-0098
Abstract
OBJECTIVE: Low-fat hypocaloric diets reduce insulin resistance and prevent type 2 diabetes in those at risk. Low-carbohydrate, high-fat diets are advocated as an alternative, but reciprocal increases in dietary fat may have detrimental effects on insulin resistance and offset the benefits of weight reduction. RESEARCH DESIGN AND METHODS: We investigated a low-fat (20% fat, 60% carbohydrate) versus a low-carbohydrate (60% fat, 20% carbohydrate) weight reduction diet in 24 overweight/obese subjects ([mean ± SD] BMI 33.6 ± 3.7 kg/m2, aged 39 ± 10 years) in an 8-week randomized controlled trial. All food was weighed and distributed, and intake was calculated to produce a 500 kcal/day energy deficit. Insulin action was assessed by the euglycemic clamp and insulin secretion by meal tolerance test. Body composition, adipokine levels, and vascular compliance by pulse-wave analysis were also measured. RESULTS: Significant weight loss occurred in both groups (P < 0.01), with no difference between groups (P = 0.40). Peripheral glucose uptake increased, but there was no difference between groups (P = 0.28), and suppression of endogenous glucose production was also similar between groups. Meal tolerance–related insulin secretion decreased with weight loss with no difference between groups (P = 0.71). The change in overall systemic arterial stiffness was, however, significantly different between diets (P = 0.04); this reflected a significant decrease in augmentation index following the low-fat diet, compared with a nonsignificant increase within the low-carbohydrate group. CONCLUSIONS: This study demonstrates comparable effects on insulin resistance of low-fat and low-carbohydrate diets independent of macronutrient content. The difference in augmentation index may imply a negative effect of low-carbohydrate diets on vascular risk.Keywords
This publication has 41 references indexed in Scilit:
- Dietary carbohydrate restriction induces a unique metabolic state positively affecting atherogenic dyslipidemia, fatty acid partitioning, and metabolic syndromeProgress in Lipid Research, 2008
- Weight Loss with a Low-Carbohydrate, Mediterranean, or Low-Fat DietThe New England Journal of Medicine, 2008
- Benefit of Low-Fat Over Low-Carbohydrate Diet on Endothelial Health in ObesityHypertension, 2008
- Effect of Eucaloric High- and Low-Sucrose Diets With Identical Macronutrient Profile on Insulin Resistance and Vascular RiskDiabetes, 2006
- Obesity and Cardiovascular Disease: Pathophysiology, Evaluation, and Effect of Weight LossCirculation, 2006
- Protective effects of ascorbic acid on arterial hemodynamics during acute hyperglycemiaAmerican Journal of Physiology-Heart and Circulatory Physiology, 2004
- Diet composition and the risk of type 2 diabetes: epidemiological and clinical evidenceBritish Journal of Nutrition, 2004
- Perceived barriers in trying to eat healthier – results of a pan-EU consumer attitudinal surveyBritish Journal of Nutrition, 1999
- Insulin Resistance versus Insulin Deficiency in Non-Insulin-Dependent Diabetes Mellitus: Problems and ProspectsEndocrine Reviews, 1998
- Comparison of Factors Associated With 30-Day Mortality After Coronary Artery Bypass Grafting in Patients With Versus Without Diabetes MellitusThe American Journal of Cardiology, 1998