scholarly journals Effects of Low-Fat, Mediterranean, or Low-Carbohydrate Weight Loss Diets on Serum Urate and Cardiometabolic Risk Factors - A Secondary Analysis of the Dietary Intervention Randomized Controlled Trial (DIRECT)

2020 ◽  
Author(s):  
Chio Yokose ◽  
Natalie McCormick ◽  
Sharan K. Rai ◽  
Na Lu ◽  
Gary Curhan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Weight Loss ◽  
Cardiometabolic Risk ◽  
Dietary Intervention ◽  
Controlled Trial ◽  
Serum Urate ◽  
Group Comparison ◽  
Low Fat ◽  
Randomized Controlled ◽  
Low Carbohydrate

Objectives: <a>Weight loss diets may reduce serum urate (SU) by lowering insulin resistance while providing cardiometabolic benefits, something urate-lowering drugs have not shown in trials. </a>We aim to examine the effects of weight loss diets on SU and cardiometabolic risk factors. <p>Research Design and Methods: Secondary study of the Dietary Intervention Randomized Controlled Trial (DIRECT) using stored samples from 235 participants with moderate obesity randomly assigned to low-fat, restricted-calorie (n=85), Mediterranean, restricted-calorie (n=76), or low-carbohydrate, non-restricted-calorie (n=74) diets. We examined SU changes at 6- and 24-months overall, and among those with hyperuricemia (SU³416 μmol/L), a relevant subgroup at risk for gout.</p> <p>Results: Among all participants, average SU decreases were 48 μmol/L at 6-months and 18 μmol/L at 24-months, with no differences between diets (p>0.05). Body weight, HDL-C, total cholesterol to HDL-C ratio, triglycerides, and insulin concentrations also improved in all three groups (p<0.05 at 6 months). Adjusting for covariates, changes in weight and fasting plasma insulin concentrations remained associated with SU changes (p<0.05). SU reductions among those with hyperuricemia were 113, 119, and 143 μmol/L at 6 months for low-fat, Mediterranean, and low-carbohydrate diets (all p for within-group comparison <0.001; p>0.05 for between-group comparisons), and 65, 77, and 83 μmol/L, respectively, at 24-months (all p for within-group comparison <0.01; p>0.05 for between-group comparisons).</p> <a>Conclusions</a>: <a>Non-purine-focused weight loss diets may simultaneously improve SU and cardiovascular risk factors, likely mediated by reducing adiposity and insulin resistance. </a>These dietary options could provide personalized pathways to suit patient comorbidity and preferences for adherence.

scholarly journals Effects of Low-Fat, Mediterranean, or Low-Carbohydrate Weight Loss Diets on Serum Urate and Cardiometabolic Risk Factors - A Secondary Analysis of the Dietary Intervention Randomized Controlled Trial (DIRECT)

2020 ◽  
Author(s):  
Chio Yokose ◽  
Natalie McCormick ◽  
Sharan K. Rai ◽  
Na Lu ◽  
Gary Curhan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Weight Loss ◽  
Cardiometabolic Risk ◽  
Dietary Intervention ◽  
Controlled Trial ◽  
Serum Urate ◽  
Group Comparison ◽  
Low Fat ◽  
Randomized Controlled ◽  
Low Carbohydrate

Objectives: <a>Weight loss diets may reduce serum urate (SU) by lowering insulin resistance while providing cardiometabolic benefits, something urate-lowering drugs have not shown in trials. </a>We aim to examine the effects of weight loss diets on SU and cardiometabolic risk factors. <p>Research Design and Methods: Secondary study of the Dietary Intervention Randomized Controlled Trial (DIRECT) using stored samples from 235 participants with moderate obesity randomly assigned to low-fat, restricted-calorie (n=85), Mediterranean, restricted-calorie (n=76), or low-carbohydrate, non-restricted-calorie (n=74) diets. We examined SU changes at 6- and 24-months overall, and among those with hyperuricemia (SU³416 μmol/L), a relevant subgroup at risk for gout.</p> <p>Results: Among all participants, average SU decreases were 48 μmol/L at 6-months and 18 μmol/L at 24-months, with no differences between diets (p>0.05). Body weight, HDL-C, total cholesterol to HDL-C ratio, triglycerides, and insulin concentrations also improved in all three groups (p<0.05 at 6 months). Adjusting for covariates, changes in weight and fasting plasma insulin concentrations remained associated with SU changes (p<0.05). SU reductions among those with hyperuricemia were 113, 119, and 143 μmol/L at 6 months for low-fat, Mediterranean, and low-carbohydrate diets (all p for within-group comparison <0.001; p>0.05 for between-group comparisons), and 65, 77, and 83 μmol/L, respectively, at 24-months (all p for within-group comparison <0.01; p>0.05 for between-group comparisons).</p> <a>Conclusions</a>: <a>Non-purine-focused weight loss diets may simultaneously improve SU and cardiovascular risk factors, likely mediated by reducing adiposity and insulin resistance. </a>These dietary options could provide personalized pathways to suit patient comorbidity and preferences for adherence.

scholarly journals Halo effect of a weight-loss trial on spouses: the DIRECT-Spouse study

2009 ◽  
Vol 13 (4) ◽  
pp. 544-549 ◽  
Author(s):  
Rachel Golan ◽  
Dan Schwarzfuchs ◽  
Meir J Stampfer ◽  
Iris Shai
Keyword(s):  
Weight Loss ◽  
Weight Change ◽  
Dietary Intervention ◽  
Controlled Trial ◽  
Halo Effect ◽  
Research Centre ◽  
Food Groups ◽  
Low Fat ◽  
Low Carbohydrate Diet ◽  
Low Carbohydrate

AbstractObjectiveWe examined the halo effect of a 2-year weight-loss diet trial, the Dietary Intervention Randomized Controlled Trial (DIRECT), on the weight and nutritional patterns of participants' spouses.DesignDIRECT participants in a research centre workplace were randomly assigned to one of three diets: Low-fat, Mediterranean or Low-carbohydrate. A sample of wives of the DIRECT participants, who attended support update meetings specific to their husband's diet during the first 6 months, were followed for 2 years.SettingSouth Israel.SubjectsSeventy-four women (mean age = 51 years, mean BMI =26·6 kg/m2).ResultsAmong the wives of husbands randomised to the Low-fat, Mediterranean and Low-carbohydrate diet, self-reported weight change was respectively −1·48 kg, −2·30 kg and −4·62 kg after 6 months, and +0·39 kg, −3·00 kg and −2·30 kg after 2 years. Weight loss among wives whose husbands were in the alternative diet groups combined (Mediterranean+Low-carbohydrate) was significantly greater than among wives whose husbands were in the Low-fat group after 6 months (P = 0·031) and 2 years (P = 0·034). Overweight wives experienced more weight loss. The weight change of couples was significantly correlated (r = 0·42, P < 0·001). Across all dietary groups, wives had significant improvement in their dietary patterns in all food groups according to their husbands' diets, mainly by a larger significant decrease in carbohydrate consumption in the Low-carbohydrate group (P = 0·013 compared to Low-fat). Six-month weight change among the seventy-four DIRECT participants whose wives took part in the group support sessions was −5·2 kg, compared to −3·5 kg among the 248 DIRECT participants whose wives did not take part in these sessions (P = 0·020).ConclusionsFocusing on the couple as a unit could provide a cost-effective approach to weight-loss programmes.

A RANDOMIZED TRIAL OF A VERY LOW CARBOHYDRATE KETOGENIC DIET V/S LOW FAT/CALORIE RESTRICTED DIET FOR WEIGHT LOSS AMONG OVERWEIGHT/OBESE ADULTS

2021 ◽  
pp. 6-8
Author(s):  
Maitri Hathi ◽  
Sudesh Kumar ◽  
Himanshu Nagar
Keyword(s):  
Weight Loss ◽  
Randomized Controlled Trial ◽  
Ketogenic Diet ◽  
Controlled Trial ◽  
Dietary Advice ◽  
Low Fat ◽  
Obese Adults ◽  
Randomized Controlled ◽  
Short Period ◽  
Low Carbohydrate

BACKGROUND: Ketogenic diet is now in trend. But very less researches were conducted in India to check signicant effects on weight loss of Ketogenic Diet among overweight/obese adults compared to calorie restricted Low Fat diet. OBJECTIVE:To compare the effect of Very Low Carbohydrate Ketogenic (VLCK) diet and energy restricted Low-Fat (LF) diets on weight loss in overweight/obese healthy adults. Design: An interventional randomized controlled trial of 6 months was initiated. PARTICIPANTS: 113 overweight/obese adults with a body mass index of 25 kg/m2 or greater; with no abnormalities and more than 20 years of age. INTERVENTION: Among 113 overweight/obese adults, we conducted a six-month randomized controlled trial of two sets of dietary advice, each providing approximately 12,00-1500 calories per day but differing in protein, ber, fat and carbohydrate content. RESULTS: We found that dieters given VLCK advice tended to lose more weight than those given a LF diet. CONCLUSION: For short period of time VLCK diet is more effective than conventional LF diet for weight loss. But for long term effects further studies are required.

Abstract MP060: Effect of Low Carbohydrate Diets versus Low Fat Diets on Cardiovascular Risk Factors: A Meta-Analysis of Randomized Controlled Trials

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Tian Hu ◽  
Katherine Mills ◽  
Lu Yao ◽  
Kathryn Demanelis ◽  
Mohamed Eloustaz ◽  
...  
Keyword(s):  
Risk Factors ◽  
Body Mass Index ◽  
Weight Loss ◽  
Randomized Controlled Trials ◽  
Hdl Cholesterol ◽  
Controlled Trials ◽  
Low Fat ◽  
Randomized Controlled ◽  
Low Carbohydrate ◽  
Fat Diets

Obesity is a major public health problem in the US population. Low carbohydrate diets are popular as a means of weight loss; however, there is concern for adverse effects on cardiovascular (CV) risk factors. We conducted a meta-analysis of randomized controlled trials comparing the effect of low carbohydrate diets (≤45% of energy from carbohydrates) versus low fat diets (≤30% of energy from fat) on CV risk factors, including systolic and diastolic blood pressure, total cholesterol, high-density-lipoprotein (HDL) cholesterol, low-density-lipoprotein (LDL) cholesterol, triglycerides, body mass index, waist circumference, fasting blood glucose and serum insulin. We searched MEDLINE, EMBASE, Web of Science and the Cochrane Database of Systematic Reviews, and manually examined references in selected articles and relevant literature reviews. Information on participant characteristics, trial design and duration, dietary composition, and CV risk factors were extracted using a standardized protocol. Random effects models were used to pool mean differences between CV risk factors on the two diets. From 785 potentially relevant publications, 23 randomized controlled trials compared low carbohydrate diets with low fat diets with intervention duration ≥ 6 months and reported CV risk factors as primary outcomes. These studies included data from 2,961 participants in total. The average percent of energy from carbohydrate intake was 20.7% on low carbohydrate diets and the average percent of energy from fats was 25.9% on low fat diets. Compared to participants on low fat diets, those on low carbohydrate diets showed favorable changes in HDL cholesterol, triglycerides and body mass index, with pooled net changes (95% CI) of 3.2 mg/dL (1.9, 4.5), -13.0 mg/dL (-17.3, -7.8) and -0.4 kg/m2 (-0.7, -0.1), respectively. After removing studies without intention-to-treat analysis, the change in body mass index was no longer significant (N=16). Changes in total and LDL cholesterol favored low fat diets, but after accounting for publication bias, results were no longer significant for total, LDL and HDL cholesterol. In conclusion, our findings show that low carbohydrate diets were at least as effective as low fat diets for weight loss, and did not have significant adverse effects on other CV risk factors. In fact, low carbohydrate diets had a significant and favorable impact on triglycerides. These findings suggest that low carbohydrate diets can be recommended to obese persons with CV risk factors for the purpose of weight loss.

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