Conclusions Large r and omized controlled trials of at least 6 months duration with carbohydrate restriction appear superior in improving lipid markers when compared with low-fat diets .
Context Carbohydrate-restricted diets may increase low-density lipoprotein cholesterol and thereby cardiovascular risk .
Objective A systematic review and meta-analyses were conducted to compare the effects of very low , low , and moderate carbohydrate , higher fat diets versus high-carbohydrate , low-fat diets on low-density lipoprotein cholesterol and other lipid markers in overweight/obese adults .
A randomized trial of a low-carbohydrate diet vs orlistat plus a low-fat diet for weight loss.
BACKGROUND Two potent weight loss therapies , a low-carbohydrate , ketogenic diet ( LCKD ) and orlistat therapy combined with a low-fat diet ( O + LFD ) , are available to the public but , to our knowledge , have never been compared . METHODS Overweight or obese out patients ( n = 146 ) from the Department of Veterans Affairs primary care clinics in Durham , North Carolina , were r and omized to either LCKD instruction ( initially , < 20 g of carbohydrate daily ) or orlistat therapy , 120 mg orally 3 times daily , plus low-fat diet instruction ( < 30 % energy from fat , 500 - 1000 kcal/d deficit ) delivered at group meetings over 48 weeks . Main outcome measures were body weight , blood pressure , fasting serum lipid , and glycemic parameters . RESULTS The mean age was 52 years and mean body mass index was 39.3 ( calculated as weight in kilograms divided by height in meters squared ) ; 72 % were men , 55 % were black , and 32 % had type 2 diabetes mellitus . Of the study participants , 57 of the LCKD group ( 79 % ) and 65 of the O + LFD group ( 88 % ) completed measurements at 48 weeks . Weight loss was similar for the LCKD ( expected mean change , -9.5 % ) and the O + LFD ( -8.5 % ) ( P = .60 for comparison ) groups . The LCKD had a more beneficial impact than O + LFD on systolic ( -5.9 vs 1.5 mm Hg ) and diastolic ( -4.5 vs 0.4 mm Hg ) blood pressures ( P < .001 for both comparisons ) . High-density lipoprotein cholesterol and triglyceride levels improved similarly within both groups . Low-density lipoprotein cholesterol levels improved within the O + LFD group only , whereas glucose , insulin , and hemoglobin A(1c ) levels improved within the LCKD group only ; comparisons between groups , however , were not statistically significant . CONCLUSION In a sample of medical out patients , an LCKD led to similar improvements as O + LFD for weight , serum lipid , and glycemic parameters and was more effective for lowering blood pressure . TRIAL REGISTRATION clinical trials.gov Identifier : NCT00108524
Conclusions Large r and omized controlled trials of at least 6 months duration with carbohydrate restriction appear superior in improving lipid markers when compared with low-fat diets .
Context Carbohydrate-restricted diets may increase low-density lipoprotein cholesterol and thereby cardiovascular risk .
Objective A systematic review and meta-analyses were conducted to compare the effects of very low , low , and moderate carbohydrate , higher fat diets versus high-carbohydrate , low-fat diets on low-density lipoprotein cholesterol and other lipid markers in overweight/obese adults .