Skip to main content

Advertisement

SpringerLink
Log in

Effects of two weight-loss diets on health-related quality of life

  • Published:
Quality of Life Research Aims and scope Submit manuscript

Abstract

Purpose

To compare the effects of two diets on health-related quality of life (HRQOL).

Methods

Overweight volunteers (n = 119) were randomized to follow a low-carbohydrate, ketogenic diet (LCKD) or a low-fat diet (LFD) for 24 weeks. HRQOL was measured every 4 weeks using the Short Form-36 and analyzed using linear mixed-effects models.

Results

The mean age was 45 years and mean baseline body mass index was 34 kg/m2; 76% were women. At 24 weeks, five subscales (Physical Functioning, Role-Physical, General Health, Vitality, Social Functioning) and the Physical Component Summary score improved similarly in both diet groups. Bodily Pain improved in the LFD group only, whereas the Role-Emotional and Mental Health subscales and the Mental Component Summary (MCS) score improved in the LCKD group only. In comparison with the LFD group, the LCKD group had a statistically significant greater improvement in MCS score (3.1; 95%CI 0.2–6.0; effect size = 0.44) and a borderline significant greater improvement in the Mental Health subscale (5.0; 95%CI −0.3–10.4; effect size = 0.37).

Conclusions

Mental aspects of HRQOL improved more in participants following an LCKD than an LFD, possibly resulting from the LCKD’s composition, lack of explicit energy restriction, higher levels of satiety or metabolic effects.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Arterburn, D. E., Maciejewski, M. L., & Tsevat, J. (2005). Impact of morbid obesity on medical expenditures in adults. International Journal of Obesity (London), 29, 334–339. doi:10.1038/sj.ijo.0802896.

    Article  CAS  Google Scholar 

  2. Calle, E. E., Rodriguez, C., Walker-Thurmond, K., & Thun, M. J. (2003). Overweight, obesity and mortality from cancer in a prospectively studied cohort of U.S. adults. The New England Journal of Medicine, 348, 1625–1638. doi:10.1056/NEJMoa021423.

    Article  PubMed  Google Scholar 

  3. Field, A. E., Coakley, E. H., Must, A., et al. (2001). Impact of overweight on the risk of developing common chronic diseases during a 10-year period. Archives of Internal Medicine, 161, 1581–1586. doi:10.1001/archinte.161.13.1581.

    Article  PubMed  CAS  Google Scholar 

  4. Finkelstein, E. A., Fiebelkorn, I. C., & Wang, G. (2003). National medical spending attributable to overweight and obesity: How much, and who’s paying? Health Affairs (Project Hope), (Suppl Web Exclusives), W3-219–226.

  5. Katz, D. A., Mchorney, C. A., & Atkinson, R. L. (2000). Impact of obesity on health-related quality of life in patients with chronic illness. Journal of General Internal Medicine, 15, 789–796. doi:10.1046/j.1525-1497.2000.90906.x.

    Article  PubMed  CAS  Google Scholar 

  6. Doll, H. A., Petersen, S. E., & Stewart-Brown, S. L. (2000). Obesity and physical and emotional well-being: Associations between body mass index, chronic illness, and the physical and mental components of the SF-36 questionnaire. Obesity Research, 8, 160–170. doi:10.1038/oby.2000.17.

    Article  PubMed  CAS  Google Scholar 

  7. Yancy, W. S., Jr., Olsen, M. K., Westman, E. C., et al. (2002). Relationship between obesity and health-related quality of life in men. Obesity Research, 10, 1057–1064. doi:10.1038/oby.2002.143.

    Article  PubMed  Google Scholar 

  8. Kolotkin, R. L., Meter, K., & Williams, G. R. (2001). Quality of life and obesity. Obesity Reviews, 2, 219–229. doi:10.1046/j.1467-789X.2001.00040.x.

    Article  PubMed  CAS  Google Scholar 

  9. Maciejewski, M. L., Patrick, D. L., & Williamson, D. F. (2005). A structured review of randomized controlled trials of weight loss showed little improvement in health-related quality of life. Journal of Clinical Epidemiology, 58, 568–578. doi:10.1016/j.jclinepi.2004.10.015.

    Article  PubMed  Google Scholar 

  10. Brehm, B. J., Seeley, R. J., Daniels, S. R., & D’alessio, D. A. (2003). A randomized trial comparing a very low carbohydrate diet and a calorie-restricted low fat diet on body weight and cardiovascular risk factors in healthy women. The Journal of Clinical Endocrinology and Metabolism, 88, 1617–1623. doi:10.1210/jc.2002-021480.

    Article  PubMed  CAS  Google Scholar 

  11. Dansinger, M. L., Gleason, J. A., Griffith, J. L., et al. (2005). Comparison of the Atkins, Ornish, Weight Watchers, and Zone diets for weight loss and heart disease risk reduction: A randomized trial. Journal of the American Medical Association, 293, 43–53. doi:10.1001/jama.293.1.43.

    Article  PubMed  CAS  Google Scholar 

  12. Foster, G. D., Wyatt, H. R., Hill, J. O., et al. (2003). A randomized trial of a low-carbohydrate diet for obesity. The New England Journal of Medicine, 348, 2082–2090. doi:10.1056/NEJMoa022207.

    Article  PubMed  CAS  Google Scholar 

  13. Gardner, C. D., Kiazand, A., Alhassan, S., et al. (2007). Comparison of the Atkins, Zone, Ornish, and LEARN diets for change in weight and related risk factors among overweight premenopausal women: The A TO Z Weight Loss Study: A randomized trial. Journal of the American Medical Association, 297, 969–977. doi:10.1001/jama.297.9.969.

    Article  PubMed  CAS  Google Scholar 

  14. Samaha, F. F., Iqbal, N., Seshadri, P., et al. (2003). A low-carbohydrate as compared with a low-fat diet in severe obesity. The New England Journal of Medicine, 348, 2074–2081. doi:10.1056/NEJMoa022637.

    Article  PubMed  CAS  Google Scholar 

  15. Stern, L., Iqbal, N., Seshadri, P., et al. (2004). The effects of low-carbohydrate versus conventional weight loss diets in severely obese adults: One-year follow-up of a randomized trial. Annals of Internal Medicine, 140, 778–785.

    PubMed  Google Scholar 

  16. Yancy, W. S., Jr., Olsen, M. K., Guyton, J. R., et al. (2004). A low-carbohydrate, ketogenic diet versus a low-fat diet to treat obesity and hyperlipidemia: A randomized, controlled trial. Annals of Internal Medicine, 140, 769–777.

    PubMed  Google Scholar 

  17. Atkins, R. C. (1998). Dr. Atkins’ new diet revolution. New York: Simon & Schuster.

    Google Scholar 

  18. Anonymous. (1994). Step by step. Eating to lower your high blood cholesterol. American Heart Association. U.S. Department of Health and Human Services. Public Health Service. National Institutes of Health. National Heart, Lung, and Blood Institute, NIH Publication No. 94-2920.

  19. Anonymous. (2000). The practical guide: Identification, evaluation and treatment of overweight and obesity in adults. U.S. Department of Health and Human Services, Public Health Service, NIH Publication No. 00-4084.

  20. Duyff, R. L. (1998). The American Dietetic Association’s complete food and nutrition guide. Minneapolis: Chronimed Publishing.

    Google Scholar 

  21. Anonymous. (1994). How to score the SF-36 Health Survey. Boston: Medical Outcomes Trust.

  22. Ware, J. E., & Sherbourne, C. D. (1992). The MOS 36-Item Short-Form Health Survey (SF-36), I: Conceptual framework and item selection. Medical Care, 30, 473–483. doi:10.1097/00005650-199206000-00002.

    Article  PubMed  Google Scholar 

  23. Mchorney, C. A., Ware, J. E., & Rogers, W. (1992). The validity and relative precision of MOS Short- and Long-Form Health Status Scales of Dartmouth COOP charts. Medical Care, 30(Suppl 5), MS253–MS265. doi:10.1097/00005650-199205001-00025.

    Article  PubMed  CAS  Google Scholar 

  24. Brazier, J. E., Harper, R., & Jones, N. M. B. (1992). Validating the SF-36 Health Survey Questionnaire: New outcome measure for primary care. BMJ (Clinical Research Ed.), 305, 160–164.

    Article  CAS  Google Scholar 

  25. Ware, J. E., Jr., Snow, K. K., Kosinski, M., & Gandek, B. (1993). SF-36 Health Survey: Manual and interpretation guide. Boston: The Health Institute, New England Medical Center.

    Google Scholar 

  26. Samsa, G., Edelman, D., Rothman, M. L., et al. (1999). Determining clinically important differences in health status measures: A general approach with illustration to the Health Utilities Index Mark II. PharmacoEconomics, 15, 141–155. doi:10.2165/00019053-199915020-00003.

    Article  PubMed  CAS  Google Scholar 

  27. Cnaan, A., Laird, N. M., & Slasor, P. (1997). Tutorial in biostatistics: Using the general linear mixed model to analyse unbalanced repeated measures and longitudinal data. Statistics in Medicine, 16, 2349–2380. doi:10.1002/(SICI)1097-0258(19971030)16:20<2349::AID-SIM667>3.0.CO;2-E.

    Article  PubMed  CAS  Google Scholar 

  28. Verbeke, G., & Molenberghs, G. (2000). Linear mixed models for longitudinal data. New York: Springer-Verlag.

    Google Scholar 

  29. Rosenbaum, P. R. (1984). The consquences of adjustment for a concomitant variable that has been affected by the treatment. Journal of the Royal Statistical Society. Series A, (Statistics in Society), 147, 656–666.

    Google Scholar 

  30. Rejeski, W. J., Focht, B. C., Messier, S. P., et al. (2002). Obese, older adults with knee osteoarthritis: Weight loss, exercise, and quality of life. Health Psychology, 21, 419–426. doi:10.1037/0278-6133.21.5.419.

    Article  PubMed  Google Scholar 

  31. Fujioka, K., Seaton, T. B., Rowe, E., et al. (2000). Weight loss with sibutramine improves glycaemic control and other metabolic parameters in obese patients with type 2 diabetes mellitus. Diabetes, Obesity & Metabolism, 2, 175–187. doi:10.1046/j.1463-1326.2000.00081.x.

    Article  CAS  Google Scholar 

  32. Nguyen, N. T., Goldman, C., Rosenquist, C. J., et al. (2001). Laparoscopic versus open gastric bypass: A randomized study of outcomes, quality of life, and costs. Annals of Surgery, 234, 279–289 (discussion 289–291). doi:10.1097/00000658-200109000-00002.

  33. Kaukua, J., Pekkarinen, T., Sane, T., & Mustajoki, P. (2002). Health-related quality of life in WHO class II-III obese men losing weight with very-low-energy diet and behaviour modification: A randomised clinical trial. International Journal of Obesity and Related Metabolic Disorders, 26, 487–495. doi:10.1038/sj.ijo.0801953.

    Article  PubMed  CAS  Google Scholar 

  34. Grimm, R. H., Jr., Grandits, G. A., Cutler, J. A., et al. (1997). Relationships of quality-of-life measures to long-term lifestyle and drug treatment in the Treatment of Mild Hypertension Study. Archives of Internal Medicine, 157, 638–648. doi:10.1001/archinte.157.6.638.

    Article  PubMed  Google Scholar 

  35. Rippe, J. M., Price, J. M., Hess, S. A., et al. (1998). Improved psychological well-being, quality of life, and health practices in moderately overweight women participating in a 12-week structured weight loss program. Obesity Research, 6, 208–218.

    PubMed  CAS  Google Scholar 

  36. O’brien, P. E., Dixon, J. B., Laurie, C., et al. (2006). Treatment of mild to moderate obesity with laparoscopic adjustable gastric banding or an intensive medical program: A randomized trial. Annals of Internal Medicine, 144, 625–633.

    PubMed  Google Scholar 

  37. Macrodimitris, S. D., & Endler, N. S. (2001). Coping, control, and adjustment in Type 2 diabetes. Health Psychology, 20, 208–216. doi:10.1037/0278-6133.20.3.208.

    Article  PubMed  CAS  Google Scholar 

  38. Eastwood, J. A., Doering, L., Roper, J., & Hays, R. D. (2008). Uncertainty and health-related quality of life 1 year after coronary angiography. American Journal of Critical Care, 17, 232–242. (quiz 243).

    PubMed  Google Scholar 

  39. Schifter, D. E., & Ajzen, I. (1985). Intention, perceived control, and weight loss: An application of the theory of planned behavior. Journal of Personality and Social Psychology, 49, 843–851. doi:10.1037/0022-3514.49.3.843.

    Article  PubMed  CAS  Google Scholar 

  40. Boden, G., Sargrad, K., Homko, C., et al. (2005). Effect of a low-carbohydrate diet on appetite, blood glucose levels, and insulin resistance in obese patients with type 2 diabetes. Annals of Internal Medicine, 142, 403–411.

    PubMed  CAS  Google Scholar 

  41. Fontani, G., Corradeschi, F., Felici, A., et al. (2005). Blood profiles, body fat and mood state in healthy subjects on different diets supplemented with Omega-3 polyunsaturated fatty acids. European Journal of Clinical Investigation, 35, 499–507. doi:10.1111/j.1365-2362.2005.01540.x.

    Article  PubMed  CAS  Google Scholar 

  42. Shai, I., Schwarzfuchs, D., Henkin, Y., et al. (2008). Weight loss with a low-carbohydrate, Mediterranean, or low-fat diet. The New England Journal of Medicine, 359, 229–241. doi:10.1056/NEJMoa0708681.

    Article  PubMed  CAS  Google Scholar 

  43. Thachil, A. F., Mohan, R., & Bhugra, D. (2007). The evidence base of complementary and alternative therapies in depression. Journal of Affective Disorders, 97, 23–35. doi:10.1016/j.jad.2006.06.021.

    Article  PubMed  CAS  Google Scholar 

  44. Fochtmann, L. J., & Gelenberg, A. J. (2005). Guideline watch: Practice guideline for the treatment of patients with major depressive disorder. Arlington: American Psychiatric Association.

    Google Scholar 

  45. Karasu, T. B., Gelenberg, A., Merriam, A., & Wang, P. (2000). Practice guideline for the treatment of patients with major depressive disorder. Arlington: American Psychiatric Association.

    Google Scholar 

Download references

Acknowledgements

Special thanks to Keith Tomlin, Bill Bryson, Juanita Hepburn, and Adele Hite for their assistance with data collection and entry. Funding for conducting the clinical trial was provided by the Robert C. Atkins Foundation, New York, NY. Dr. Yancy is supported by Health Services Research Career Development Award RCD 02-183-1 from the Department of Veterans Affairs, Washington, DC. This material is the result of work supported with resources and the use of facilities at the Durham VA Medical Center. The views expressed in this presentation are those of the authors and do not necessarily represent the views of the Department of Veterans Affairs.

Author information

Authors and Affiliations

  1. Center for Health Services Research in Primary Care, Department of Veterans Affairs Medical Center, 508 Fulton Street, Durham, NC, 27705, USA

    William S. Yancy Jr., Daniel Almirall, Matthew L. Maciejewski & Jennifer R. McDuffie

  2. Department of Medicine, Duke University Medical Center, Durham, NC, USA

    William S. Yancy Jr., Matthew L. Maciejewski, Jennifer R. McDuffie & Eric C. Westman

  3. Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, NC, USA

    Daniel Almirall

  4. Division of Pharmaceutical Outcomes and Policy, School of Pharmacy, University of North Carolina, Chapel Hill, NC, USA

    Matthew L. Maciejewski

  5. Obesity and Quality of Life Consulting, Durham, NC, USA

    Ronette L. Kolotkin

  6. Department of Community and Family Medicine, Duke University Medical Center, Durham, NC, USA

    Ronette L. Kolotkin

Authors
  1. William S. Yancy Jr.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Daniel Almirall
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Matthew L. Maciejewski
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ronette L. Kolotkin
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Jennifer R. McDuffie
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Eric C. Westman
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to William S. Yancy Jr..

Rights and permissions

Reprints and permissions

About this article

Cite this article

Yancy, W.S., Almirall, D., Maciejewski, M.L. et al. Effects of two weight-loss diets on health-related quality of life. Qual Life Res 18, 281–289 (2009). https://doi.org/10.1007/s11136-009-9444-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11136-009-9444-8

Keywords

Search

Navigation