Macro partitioning
In severely obese adults with high prevalence of diabetes or metabolic syndrome, a low-carbohydrate diet (<30g carbs/day) produces more favorable metabolic outcomes (lower triglycerides, preserved HDL, improved HbA1c in diabetics) than a conventional low-fat diet, despite similar weight loss.
If you are severely obese and have diabetes or metabolic syndrome, switching to a very low-carbohydrate diet (under 30g carbs daily) can significantly improve your blood fats and blood sugar control compared to a standard low-fat diet, even if you lose the same amount of weight. This requires strict adherence and likely professional support to maintain.
Participants on a low-carbohydrate diet had more favorable overall outcomes at 1 year than did those on a conventional diet. Weight loss was similar between groups, but effects on atherogenic dyslipidemia and glycemic control were still more favorable with a low-carbohydrate diet after adjustment for differences in weight loss.
Why this rating
Randomized controlled trial with 132 participants, 1-year duration, and rigorous statistical adjustment, though limited by high dropout (34%) and suboptimal adherence.
Source
The Effects of Low-Carbohydrate versus Conventional Weight Loss Diets in Severely Obese Adults: One-Year Follow-up of a Randomized Trial
Linda Stern et al. · Annals of Internal Medicine · 2004
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