Abstract P126: Identifying Successful Predictors Of Body Fat Reduction In The Dietfits Trial

Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Anthony Crimarco ◽  
Priya Fielding-Singh ◽  
Matt Landry ◽  
Christopher D Gardner

Background: Reducing excess body fat is important for overall health, but individual success at reducing body fat varies considerably. Because dietary modification plays a key role in reducing body fat and maintaining a healthy body weight, there has been speculation if one particular dietary pattern is superior to another for losing weight. Previously we reported no significant differences in the effectiveness of either a low-carbohydrate diet or a low-fat diet for weight loss in the DIETFITs Trial. However, there is less literature that has specifically focused on body fat reduction. Therefore the purpose of this study was to assess if 12-month dietary changes were associated with body fat reduction. Methods: Participants were men and women with overweight or obesity that participated in the DIETFITS trial, a randomized clinical trial comparing the effectiveness of a healthy low-fat diet to a healthy low-carbohydrate diet for weight loss. The primary outcome was body fat percent loss, which was measured with dual-energy x-ray absorptiometry (DEXA) scans. Demographic information was collected from online surveys at baseline, dietary data were assessed from participants 24-hour recalls, and physical activity was assessed with the Stanford Seven-Day Physical Activity Recall questionnaire. Linear regression models were conducted to assess the association between changes in energy intake, dietary fat, and carbohydrates with body fat reduction, while controlling for demographic variables and physical activity. Results: Data were available for 272 participants with DEXA scans and dietary data. In the main model both baseline physical activity (coef = -0.26, p = 0.016) and changes in physical activity (coef = -0.36, p < 0.01) were significantly associated with body fat reduction. When stratified by dietary assignment, changes in physical activity remained significant for each group (low-carb group: coef = -0.30, p = 0.002 and low-fat group coef = -0.35, p = 0.006), while changes in dietary fat, as a percentage of energy intake, was associated with body fat reduction in the low-fat group only (coef = 0.15, p = 0.006). Race was also significantly associated with body fat reduction in all models, indicating non-White participants gained more body fat at the end of the intervention compared to Whites. Conclusions: The reduction in body fat appears to be mostly driven from participants increasing their physical activity levels. Identifying other predictors of body fat reduction warrant further study.

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.


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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