Mixed
A carbohydrate-restricted diet (≤30g carbs/day) produces greater weight loss and greater improvements in triglyceride levels and insulin sensitivity compared to a calorie- and fat-restricted diet in severely obese subjects over six months.
If you are severely obese (BMI 35+) and have diabetes or metabolic syndrome, restricting carbohydrates to 30 grams per day for six months leads to significantly more weight loss and better triglyceride levels than a standard low-fat, calorie-restricted diet. However, adherence is difficult, with nearly half of participants dropping out, so strong support and counseling are essential.
Severely obese subjects with a high prevalence of diabetes or the metabolic syndrome lost more weight during six months on a carbohydrate-restricted diet than on a calorie- and fat-restricted diet, with a relative improvement in insulin sensitivity and triglyceride levels, even after adjustment for the amount of weight lost.
Why this rating
Randomized controlled trial with a large sample size (n=132) and severe obesity, but limited by high dropout rates (47-48%) and short duration (6 months).
Source
A Low-Carbohydrate as Compared with a Low-Fat Diet in Severe Obesity
Frederick F. Samaha et al. · New England Journal of Medicine · 2003
DOI 10.1056/nejmoa022637
More from this paper
- In severely obese subjects, a carbohydrate-restricted diet improves insulin sensitivity independently of the amount of weight lost, compared to a low-fat diet.Moderate
- A carbohydrate-restricted diet reduces triglyceride levels more effectively than a low-fat diet in severely obese subjects, particularly in those who lose more than 5% of their baseline weight.Moderate
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