scholarly journals Objective versus Self-Reported Energy Intake Changes During Low-Carbohydrate and Low-Fat Diets

2018 ◽  
Author(s):  
Juen Guo ◽  
Jennifer L. Robinson ◽  
Christopher Gardner ◽  
Kevin D. Hall

AbstractObjectiveTo examine objective versus self-reported energy intake changes (ΔEI) during a 12-month diet intervention.MethodsWe calculated ΔEI in subjects who participated in a 1-year randomized low-carbohydrate versus low-fat diet trial using repeated body weight measurements as inputs to an objective mathematical model (ΔEIModel) and compared these values with self-reported energy intake changes assessed by repeated 24-hr recalls (ΔEI24hrRecall).ResultsΔEI24hrRecall indicated a relatively persistent state of calorie restriction ≥500 kcal/d throughout the year with no significant differences between diets. ΔEIModel demonstrated large early decreases in calorie intake >800 kcal/d followed by an exponential return to approximately 100 kcal/d below baseline at the end of the year. The low-carbohydrate diet resulted in ΔEIModel that was 162±53 kcal/d lower than the low-fat diet over the first 3 months (p=0.002), but no significant diet differences were found at later times. Weight loss at 12 months was significantly related to ΔEIModel at all time intervals for both diets (p<0.0001).ConclusionsSelf-reported measurements of ΔEI were inaccurate. Model-based calculations of ΔEI found that instructions to follow the low-carbohydrate diet resulted in greater calorie restriction than the low-fat diet in the early phases of the intervention, but these diet differences were not sustained.What is already known about this subject?Diet assessments that rely on self-report, such as 24hr dietary recall, are known to underestimate actual energy intake as measured by doubly labeled water. However, it is possible that repeated self-reported measurements could accurately detect changes in energy intake over time if the absolute bias of self-reported of measurements is approximately constant for each subject.What this study addsWe compared energy intake changes measured using repeated 24hr dietary recall measurements collected over the course of the 1-year Diet Intervention Examining The Factors Interacting with Treatment Success (DIETFITS) trial versus energy intake changes calculated using repeated body weight measurements as inputs to a validated mathematical model.Whereas self-reported measurements indicated a relatively persistent state of calorie restriction, objective model-based measurements demonstrated a large early calorie restriction followed by an exponential rise in energy intake towards the pre-intervention baseline.Model-based calculations, but not self-reported measurements, found that low-carbohydrate diets led to significantly greater early decreases in energy intake compared to low-fat diets, but long-term energy intake changes were not significantly different.

2004 ◽  
Vol 107 (4) ◽  
pp. 365-369 ◽  
Author(s):  
Matthew J. SHARMAN ◽  
Jeff S. VOLEK

In recent years, it has become apparent that low-grade vascular inflammation plays a key role in all stages of the pathogenesis of atherosclerosis. Weight loss has been shown to improve blood inflammatory markers; however, it is unknown if weight-loss diets varying in macronutrient composition differentially affect inflammatory responses. The primary purpose of the present study was to compare a very-low-carbohydrate diet and a low-fat weight-loss diet on inflammatory biomarkers in overweight men. In a randomized cross-over design, 15 overweight men (body fat, >25%; body mass index, 34 kg/m2) consumed two experimental weight-loss diets for two consecutive 6-week periods: a very-low-carbohydrate diet (<10% energy via carbohydrate) and a low-fat diet (<30% energy via fat). Both the low-fat and the very-low-carbohydrate diets resulted in significant decreases in absolute concentrations of hsTNF-α (high-sensitivity tumour necrosis factor-α), hsIL-6 (high-sensitivity interleukin-6), hsCRP (high-sensitivity C-reactive protein) and sICAM-1 (soluble intercellular cell-adhesion molecule-1). There was no significant change in absolute sP-selectin (soluble P-selectin) concentrations after either diet. Normalized inflammatory values represented as the delta change per 1 kg reduction in body mass showed a significant difference between the two diets only for sP-selectin (P<0.05). In summary, energy-restricted low-fat and very-low-carbohydrate diets both significantly decreased several biomarkers of inflammation. These data suggest that, in the short-term, weight loss is primarily the driving force underlying the reductions in most of the inflammatory biomarkers.


Nutrients ◽  
2019 ◽  
Vol 11 (11) ◽  
pp. 2749 ◽  
Author(s):  
Seid ◽  
Rosenbaum

In the 1940s, the diet-heart hypothesis proposed that high dietary saturated fat and cholesterol intake promoted coronary heart disease in “at-risk“ individuals. This hypothesis prompted federal recommendations for a low-fat diet for “high risk” patients and as a preventive health measure for everyone except infants. The low carbohydrate diet, first used to treat type 1 diabetes, became a popular obesity therapy with the Atkins diet in the 1970s. Its predicted effectiveness was based largely on the hypothesis that insulin is the causa prima of weight gain and regain via hyperphagia and hypometabolism during and after weight reduction, and therefore reduced carbohydrate intake would promote and sustain weight loss. Based on literature reviews, there are insufficient randomized controlled inpatient studies examining the physiological significance of the mechanisms proposed to support one over the other. Outpatient studies can be confounded by poor diet compliance such that the quality and quantity of the energy intake cannot be ascertained. Many studies also fail to separate macronutrient quantity from quality. Overall, there is no conclusive evidence that the degree of weight loss or the duration of reduced weight maintenance are significantly affected by dietary macronutrient quantity beyond effects attributable to caloric intake. Further work is needed.


Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Tian Hu ◽  
Kristi Reynolds ◽  
Lu Yao ◽  
Calynn Bunol ◽  
Yanxi Liu ◽  
...  

The long-term effects of low-carbohydrate diets versus low-fat diets on endothelial dysfunction and insulin resistance are unclear. A total of 148 study participants with a body mass index of 30 - 45 kg/m2 (Mean: 35.4 kg/m2) who were free of diabetes, cardiovascular diseases and kidney disease were recruited. The participants were randomly assigned to either a low-carbohydrate diet (<40 g/day; N=75) or a low fat (<30% energy from fat, <10% from saturated fat; N=73) diet. Two 24-hour dietary recalls were conducted at each clinic visit (0, 3, 6 and 12 months of intervention). Participants met with a study dietitian weekly for the first month followed by group settings bi-weekly for 5 months and monthly for the last 6 months. Each group was provided the same behavioral curriculum related to diet emphasizing portion control and eating habits. Biomarkers for endothelial function and insulin resistance included E-selectin, Intercellular Adhesion Molecule 1 (ICAM-1), vascular cell adhesion molecule 1 (VCAM-1), Insulin-like growth Factor-1 (IGF-1), serum insulin, and glucose. Mixed-effect regression models including group, time and their interaction were used to analyze the data. Of the study participants, 60 in the low-fat group (81.1%) and 59 in the low-carbohydrate group (79.7%) completed the entire intervention. The mean age was 46.8 years, 88.5% were women and 55.1% were African-Americans. The low-carbohydrate group lost approximately 3.5 kg more body weight than did the low-fat group (P= 0.002) on average. Compared to the low-fat diet, the low-carbohydrate diet resulted in greater reductions in E-selectin (net change: -4.5, -4.3, and -3.8 ng/mL at 3, 6, and 12 months, respectively; overall P= 0.002) and ICAM-1 (net change: -7.3, -10.4, and -16.8 ng/mL at 3, 6, and 12 months, respectively; overall P= 0.06). There was no significant change in any other markers. Our findings suggest that the low-carbohydrate is at least as effective as the low-fat diet at improving endothelial dysfunction and insulin resistance.


2010 ◽  
Vol 170 (2) ◽  
pp. 136 ◽  
Author(s):  
William S. Yancy ◽  
Eric C. Westman ◽  
Jennifer R. McDuffie ◽  
Steven C. Grambow ◽  
Amy S. Jeffreys ◽  
...  

2010 ◽  
Vol 34 (8) ◽  
pp. 1239-1242 ◽  
Author(s):  
P A Essah ◽  
J R Levy ◽  
S N Sistrun ◽  
S M Kelly ◽  
J E Nestler

2017 ◽  
Vol 59 (2) ◽  
pp. 34
Author(s):  
Adil Razak ◽  
Abdul Aziez Isaacs

Background: Diabetes is a common non-communicable disease and complications are resulting in increased disability, reduced life expectancy and enormous health costs for virtually every society. Medical Nutrition Therapy is important for the prevention, treatment, and self-management of diabetes, and the prevention or delay in onset of diabetes-related complications. The current nutritional guidelines for diabetes state that carbohydrates should comprise 45–60% of the total nutritional intake and that lowcarbohydrate or high-protein diets offer no long-term success over healthy eating plans. Recent studies suggest that there may be merit in using low-carbohydrate diets in diabetic patients for weight reduction and improved cardiovascular markers. This study aimed to implement and evaluate a pilot programme for weight loss in diabetes mellitus type 2 patients by comparing a low-carbohydrate diet with the conventional low-fat diet. Methods: The study design was that of a two-group parallel design, with one group following a low-fat diet and the other a low-carbohydrate diet. Diabetic patients attending the Mitchell’s Plain Community Health Centre in Cape Town were recruited, with 10 participants in each group. Both groups received similar advice on exercise and behaviour change. Changes in weight, waist circumference, blood pressure and blood parameters (creatinine, lipids and HbA1c) were recorded at baseline and again after 12 weeks. Results: There were reductions in weight (1.85 kg vs. 0.1 kg gain) and HbA1c (1.72 vs. 0.32) in the low-carbohydrate diet group when compared with the low-fat diet group. No significant change was seen in other parameters including BP, total cholesterol and serum creatinine for either group. Conclusion: Low-carbohydrate diets may be effective in promoting weight loss and improving glucose control in diabetic patients. Implementation of this programme would require a paradigm shift for staff and further studies to assess its acceptability for patients. (Full text of the research articles are available online at www.medpharm.tandfonline.com/ojfp) S Afr Fam Pract 2017; DOI: 10.1080/20786190.2017.1329490


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