Weight loss with a low-carbohydrate, Mediterranean, or low-fat diet

被引：1355

作者：

Shai, Iris ^{[1
]}

Schwarzfuchs, Dan ^{[2
]}

Henkin, Yaakov ^{[3
]}

Shahar, Danit R. ^{[1
]}

Witkow, Shula ^{[1
]}

Greenberg, Ilana ^{[1
]}

Golan, Rachel ^{[1
]}

Fraser, Drora ^{[1
]}

Bolotin, Arkady ^{[1
]}

Vardi, Hilel ^{[1
]}

Tangi-Rozental, Osnat ^{[1
]}

Zuk-Ramot, Rachel ^{[2
]}

Sarusi, Benjamin ^{[2
]}

Brickner, Dov ^{[2
]}

Schwartz, Ziva ^{[2
]}

Sheiner, Einat ^{[2
]}

Marko, Rachel ^{[2
]}

Katorza, Esther ^{[2
]}

Thiery, Joachim ^{[4
]}

Fiedler, Georg Martin ^{[4
]}

Blueher, Matthias ^{[5
]}

Stumvoll, Michael ^{[5
]}

Stampfer, Meir J. ^{[6
,7
,8
,9
]}

机构：

[1] Ben Gurion Univ Negev, S Daniel Abraham Int Ctr Hlth & Nutr, Dept Epidemiol & Hlth Syst Evaluat, IL-84105 Beer Sheva, Israel

[2] Nucl Res Ctr Negev, Dimona, Israel

[3] Soroka Univ, Med Ctr, Dept Cardiol, Beer Sheva, Israel

[4] Univ Hosp Leipzig, Inst Lab Med, Leipzig, Germany

[5] Univ Leipzig, Dept Med, Leipzig, Germany

[6] Brigham & Womens Hosp, Dept Med, Channing Lab, Boston, MA 02115 USA

[7] Harvard Univ, Sch Med, Boston, MA USA

[8] Harvard Univ, Sch Publ Hlth, Dept Epidemiol, Boston, MA 02115 USA

[9] Harvard Univ, Sch Publ Hlth, Dept Nutr, Boston, MA 02115 USA

来源：

NEW ENGLAND JOURNAL OF MEDICINE | 2008年 / 359卷 / 03期

关键词：

D O I：

10.1056/NEJMoa0708681

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background: Trials comparing the effectiveness and safety of weight-loss diets are frequently limited by short follow-up times and high dropout rates. Methods: In this 2-year trial, we randomly assigned 322 moderately obese subjects (mean age, 52 years; mean body-mass index [the weight in kilograms divided by the square of the height in meters], 31; male sex, 86%) to one of three diets: low-fat, restricted-calorie; Mediterranean, restricted-calorie; or low-carbohydrate, non-restricted-calorie. Results: The rate of adherence to a study diet was 95.4% at 1 year and 84.6% at 2 years. The Mediterranean-diet group consumed the largest amounts of dietary fiber and had the highest ratio of monounsaturated to saturated fat (P<0.05 for all comparisons among treatment groups). The low-carbohydrate group consumed the smallest amount of carbohydrates and the largest amounts of fat, protein, and cholesterol and had the highest percentage of participants with detectable urinary ketones (P<0.05 for all comparisons among treatment groups). The mean weight loss was 2.9 kg for the low-fat group, 4.4 kg for the Mediterranean-diet group, and 4.7 kg for the low-carbohydrate group (P<0.001 for the interaction between diet group and time); among the 272 participants who completed the intervention, the mean weight losses were 3.3 kg, 4.6 kg, and 5.5 kg, respectively. The relative reduction in the ratio of total cholesterol to high-density lipoprotein cholesterol was 20% in the low-carbohydrate group and 12% in the low-fat group (P=0.01). Among the 36 subjects with diabetes, changes in fasting plasma glucose and insulin levels were more favorable among those assigned to the Mediterranean diet than among those assigned to the low-fat diet (P<0.001 for the interaction among diabetes and Mediterranean diet and time with respect to fasting glucose levels). Conclusions: Mediterranean and low-carbohydrate diets may be effective alternatives to low-fat diets. The more favorable effects on lipids (with the low-carbohydrate diet) and on glycemic control (with the Mediterranean diet) suggest that personal preferences and metabolic considerations might inform individualized tailoring of dietary interventions. (ClinicalTrials.gov number, NCT00160108.).

引用

页码：229 / 241

页数：13

共 35 条

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