Short-Term Carbohydrate-Restricted Diet for Weight Loss in Severely Obese Women
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
Weight loss in bariatric pre-surgery period reduces surgical complications, surgery time, blood loss, and length of hospital stay. Carbohydrate-restricted diets have been used as an alternative for weight loss. We tested the efficacy of a low-calorie carbohydrate-restricted diet (RD) for short-term weight loss in women with severe obesity and evaluate its metabolic effects in relation to a conventional low-calorie diet (CD).
The subjects received a 1,200-kcal diet with or without carbohydrate restriction for a period of 1 week in the hospital. Nineteen obesity class III women were distributed into two groups: experimental (n = 10) and control (n = 9). The following variables were assessed at the beginning and end of the study: anthropometric measurements, body composition, resting energy expenditure, substrate oxidation, and biochemical tests.
Compared with CD, RD led to larger weight loss (2.6 and 4.4 kg, respectively; p = 0.01) and waist circumference reduction (p < 0.01). Among the assessed biochemical indicators, only plasma and urine acetone levels were different (p < 0.01); higher values were found in the experimental group with no symptoms and other diet-related complaints. There was also a significant decrease in triglycerides and carbohydrate oxidation, as well as a significant enhancement in lipid oxidation in the RD group.
Short-term RD was more efficient than CD regarding quick weight loss and waist circumference reduction, which may favor gastroplasty. Also, RD did not lead adverse metabolic effects.
- Obesity: preventing and managing the global epidemic. Report of a WHO Consultation. World Health Organ Tech Rep Ser 2000; 894: i-xii, 1-253
- World Health Organization. Obesity and overweight. What are overweight and obesity? Fact sheet no. 311; September 2006. http://www.who.int/mediacenter/factsheets/fs311/en/print.html. Accessed 08 Aug 2009.
- IBGE Fundação Instituto Brasileiro de Geografia e Estatística / Ministério do Planejamento, Orçamento e Gestão, Ministério da Saúde. Pesquisa de Orçamentos Familiares 2002-2003. Análise da disponibilidade domiciliar de alimentos e do estado nutricional no Brasil. Rio de Janeiro, Brasil: IBGE; 2004.
- Santos LMP, Oliveira IV, Peters LR, et al. Trends in morbid obesity and in bariatric surgeries covered by the Brazilian public health system. Obes Surg; 2008.
- Pardela M, Wiewióra M, Sitkiewicz T, et al. The progress in bariatric surgery. J Physiol Pharm. 2005;56 Suppl 6:35–44.
- World Health Organization. Obesity: preventing and managing the global epidemic. Report of a WHO consultation on obesity. Geneva: WHO; 1998.
- Fandiño J, Benchimol AK, Coutinho WF, et al. Cirurgia bariátrica: aspectos clinico-cirúrgicos e psiquiátricos. Rev Psiquiatr Rio Gd Sul. 2004;26:47–51. CrossRef
- Segal A, Fandiño J. Indicações e contra-indicações para realização das operações bariátricas. Rev Bras Psiquiatr. 2002;24(Supl 3):68–72. CrossRef
- Cartagena R. Preoperative evaluation of patients with obesity and obstructive sleep apnea. Anesthesiol Clin North America. 2005;23:463–78. CrossRef
- Alami RS, Morton JM, Schuster R, et al. Is there a benefit to preoperative weight loss in gastric bypass patients? A prospective randomized trial. Surg Obes Relat Dis. 2007;3:141–5. discussion 145-6. CrossRef
- Ali MR, Baucom-Pro S, Broderick-Villa GA, et al. Weight loss before gastric bypass: feasibility and effect on postoperative weight loss and weight loss maintenance. Surg Obes Relat Dis. 2007;3:515–20. CrossRef
- Tarnoff M, Kaplan LM, Shikora S. An evidenced-based assessment of preoperative weight loss in bariatric surgery. Obes Surg. 2008;18:1059–61. CrossRef
- Volek JS, Sharman MJ, Gómez AL, et al. Comparison of a very low-carbohydrate and low-fat diet on fasting lipids, LDL subclasses, insulin resistance, and postprandial lipemic responses in overweight women. J Am Coll Nutr. 2004;23:177–84.
- Astrup A, Larsen TM, Harper A. Atkins and other low-carbohydrate diets: hoax or an effective tool for weight loss? Lancet. 2004;364:897–9. CrossRef
- Clifton PM. Dietary treatment for obesity. Nat Clin Pract Gastroenterol Hepatol. 2008;5:672–81. CrossRef
- Yancy Jr WS, Foy M, Chalecki AM, et al. A low-carbohydrate, ketogenic diet to treat type 2 diabetes. Nutr Metab (Lond). 2005;2:34. CrossRef
- Shai I, Schwarzfuchs D, Henkin Y, et al. Weight loss with a low-carbohydrate, Mediterranean, or low-fat diet. N Engl J Med. 2008;359:229–41. CrossRef
- Weir JB. New methods for calculating metabolic rate with special reference to protein metabolism. J Physiol. 1949;109:1–9.
- Frayn KN. Calculation of substrate oxidation rates in vivo from gaseous exchange. J Appl Physiol. 1983;55:628–34.
- Schutz Y. The basis of direct and indirect calorimetry and their potentials. Diabetes Metab Rev. 1995;11:383–408. CrossRef
- Friedewald WT, Levy RI, Fredrickson DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem. 1972;18:499–502.
- Matthews DR, Hosker JP, Rudenski AS, et al. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985;28:412–9. CrossRef
- Portari GV, Marchini JS, Jordão AA. Validation of a manual headspace gas chromatography method for determining volatile compounds in biological fluids. Lab Med. 2008;39:42–5. CrossRef
- AOAC. Association of Official Analytical Chemists. Official methods of analysis, 16 ed. Washington 1995; 1 (cap12): 7.
- Schall R. Estimation in generalized linear models with random effects. Biometrika. 1991;78:719–27. CrossRef
- R Development Core Team. R: A language and environment for statistical computing. Vienna: R Foundation for Statistical Computing; 2008.
- Noble CA, Kushner RF. An update on low-carbohydrate, high-protein diets. Curr Opin Gastroenterol. 2006;22:153–9. CrossRef
- Stern L, Iqbal N, Seshadri P, et al. The effects of low-carbohydrate versus conventional weight loss diets in severely obese adults: one-year follow-up of a randomized trial. Ann Intern Med. 2004;140:778–86.
- Last AR, Wilson SA. Low-carbohydrate diets. Am Fam Physician. 2006;73:1942–8.
- Erlanson-Albertsson C, Mei J. The effect of low carbohydrate on energy metabolism. Int J Obes (Lond). 2005;29 Suppl 2:S26–30. CrossRef
- Volek JS, Westman EC. Very low-carbohydrate weight-loss diets revisited. Cleve J Med 2002; 69: 849, 853, 856-8 passim.
- Westerterp-Plantenga MS. The significance of protein in food intake and body weight regulation. Curr Opin Clin Nutr Metab Care. 2003;6:635–8. CrossRef
- Alnasir FA, Fateha BE. Low carbohydrate diet. Its effects on selected body parameters of obese patients. Saudi Med J. 2003;24:949–52.
- Daly ME, Piper J, Paisey R, et al. Efficacy of carbohydrate restriction in obese type 2 diabetes patients (Abstr. A98). Diabet Med. 2006;23 Suppl 2:26–7.
- Denke MA. Metabolic effects of high-protein, low-carbohydrate diets. Am J Cardiol. 2001;88:59–61. CrossRef
- Das SK, Roberts SB, McCrory MA, et al. Long-term changes in energy expenditure and body composition after massive weight loss induced by gastric bypass surgery. Am J Clin Nutr. 2003;78:22–30.
- Adam-Perrot A, Clifton P, Brouns F. Low-carbohydrate diets: nutritional and physiological aspects. Obes Rev. 2006;7:49–58. CrossRef
- VanItallie TB, Nufert TH. Ketones: metabolism’s ugly duckling. Nutr Rev. 2003;61:327–41. CrossRef
- Tay J, Brinkworth GD, Noakes M, et al. Metabolic effects of weight loss on a very low-carbohydrate diet compared with an isocaloric high-carbohydrate diet in abdominally obese subjects. J Am Coll Cardiol. 2008;51:59–67. CrossRef
- Sacks FM, Bray GA, Carey VJ, et al. Comparison of weight-loss diets with different compositions of fat, protein, and carbohydrates. N Engl J Med. 2009;360:859–73. CrossRef
- Volek JS, Sharman ML, Forsythe CE. Modification of lipoproteins by very low-carbohydrate diets. J Nutr. 2005;135:1339–42.
- Grieb P, Klapcinska B, Smol E, et al. Long-term consumption of a carbohydrate-restricted diet does not induce deleterious metabolic effects. Nutr Res. 2008;28:825–33. CrossRef
- Al-Zaid NS, Dashti HM, Mathew TC, et al. Low carbohydrate ketogenic diet enhances cardiac tolerance to global ischaemia. Acta Cardiol. 2007;62:381–9. CrossRef
- Colles SL, Dixon JB, Marks P, et al. Preoperative weight loss with a very low-energy diet: quantitation of changes in liver and abdominal fat by serial imaging. Am J Clin Nutr. 2006;84:304–11.
- Meckling KA, O’sullivan C, Saari D. Comparison of a low-fat diet to a low-carbohydrate diet on weight loss, body composition, and risk factors for diabetes and cardiovascular disease in free-living, overweight men and women. J Clin Endocrinol Metab. 2004;89:2717–23. CrossRef
- Short-Term Carbohydrate-Restricted Diet for Weight Loss in Severely Obese Women
Volume 21, Issue 8 , pp 1194-1202
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- Low-carbohydrate diet
- Weight loss
- Morbid obesity
- Industry Sectors
- Author Affiliations
- 1. Department of Internal Medicine, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
- 2. Clinical Hospital, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
- 3. Faculty of Nutrition, Federal University of Triangulo Mineiro, Uberaba, MG, Brazil
- 4. Nutrition and Metabolism, Department of Internal Medicine, School of Medicine of Ribeirão Preto, University of São Paulo, Av. Bandeirantes, 3900, 14048-900, Ribeirão Preto, SP, Brazil