Current Management on Obesity

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Current management on obesity

2.1 DIETS

Low-fat diets

The Dietary Guidelines for Americans (along with My Pyramid) provides one example of a low-

fat (LF) eating plan! The Dietary Guidelines are based on eviden"e that eating a LF (#$-%&')

diet helps manage weight promote health and redu"e the ris of "hroni" disease The guidelines

in"lude re"ommendations for *foods to redu"e+ (ie saturated and trans fat "holesterol sodium

added sugar refined grains al"ohol) and *foods to in"rease+ (ie fruits vegetables whole

grains low-fat dairy and protein foods oils) in order to maximi,e the nutrient "ontent and health

promoting potential of the diet ther examples of a LF diet are the ./01 diet and those

re"ommended by the /meri"an .iabetes /sso"iation# /meri"an 1eart /sso"iation% and

/meri"an Can"er 0o"iety2 as well as "ommer"ial programs lie 3eight 3at"hers

Efficacy, health effects, and sustainability

Low-fat diets are the best studied of all dietary approa"hes to weight loss Three large multi-

"enter randomi,ed studies (ie the P45M654 trial .iabetes Prevention Program and the

Finnish .iabetes Prevention study) have demonstrated that greater weight loss is a"hieved in

groups "onsuming LF diets "ompared to "ontrols re"eiving standard lifestyle

re"ommendations&Furthermore they suggest that "onsumption of a low-fat low "alorie diet in

the "ontext of intensive group and7or individual "ounseling has positive effe"ts on "omorbid

"onditions as long as they are followed / more detailed des"ription has been reported

previously

More re"ent studies have reported similar findings The Loo /head Trial8 was a large

multi"enter randomi,ed "lini"al trial that "ompared the effe"ts of an intensive lifestyle

intervention (6L6) to diabetes support and edu"ation (.05) on the in"iden"e of ma9or

"ardiovas"ular disease (C:.) events in overweight or obese individuals with type # diabetes

Parti"ipants in the 6L6 group were assigned a "alorie restri"ted LF diet re"eived fre;uent

behavioral therapy and extended "onta"t Those in the .05 group were given standard

instru"tion on % o""asions ea"h year for eating a healthy diet and engaging in physi"al a"tivity

3eight loss in the 6L6 group was signifi"antly greater than the .05 group ea"h year over the"ourse of four years with maximal weight loss o""urring at ! year 6ndividuals in the 6L6 group

also displayed greater improvements in hemoglobin /!C (1b/!C) blood pressure high density

lipoprotein (1.L) and tria"ylgly"erides (T/<) over the "ourse of the study ther studies

pres"ribing LF diets with treatment phases ranging from = 8 months to > !# months have

reported weight losses of approximately 8-!! g after 8 and !# month 2-& g after #2-%8 months

and 2?' initial body weight at 2@ monthsThe 3omanAs 1ealth 6nitiative .ietary Modifi"ation

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3222874/#R1














trial showed that following a LF diet without instru"tion for "alorie restri"tion "an help to

maintain weight loss slightly better than following a diet higher in fat!#Taen together these

findings suggest that a LF diet is an effe"tive weight "ontrol strategy in the short- and long-term

as long as it is followed

Weight Loss Outcomes of Studies 6 Months or Greater in Duration

/dheren"e to a "alorie "ontrolled diet appears to be one of the biggest barriers to the long-term

su""ess of weight loss maintenan"e LF eating is not immune to poor long-term adheren"e

4esear"hers have investigated various strategies from varying the per"entage of fat in the diet to

mat"hing diets with food preferen"es in an attempt to promote better long-term dietary

adheren"e ne study "omparing weight loss and C:. ris fa"tors in individuals "onsuming

"alorie "ontrolled #$' or %$' fat diets showed that although both diets produ"ed a similar

amount of weight loss after ? months weight loss was maintained better and C:. ris fa"tors

were redu"ed more after !2 months in those following the %$' fat diet 6t appears that intae was

more restri"tive in the #$' fat diet group maing it more diffi"ult to follow over the long-term

and resulting in greater weight regain / limited number of studies have investigated the effe"ts

of mat"hing treatment preferen"es with weight loss out"omes / re"ent study found that whether

individuals were randomi,ed to their preferred LF diet or not (ie standard or la"to-ovo

vegetarian) they lost similar amounts of weight after 8 monthsB however differen"es in weight

regain patterns emerged after 8 months Curiously those who were assigned their preferred diet

began regaining weight sooner (ie 8 vs !# months) and regained more weight (ie 2&' vs

#!') at !@ months than those who were not assigned to their preferred diet 0imilar findings

were re"ently reported for both LF and low "arbohydrate dietsorradaile et al found that the

group assigned their preferred diet lost less weight (-?? g) than the group who did not re"eive

their preferred diet (-D? g) or who did not report a strong preferen"e at baseline (-!!#

g)!8 <iven this seemingly "ounterintuitive finding it may be useful for future studies to

elaborate on *preferen"e+ (eg is their preferen"e based on a preferred way of eating or on an

alternative to their preferred way of eating)

Go to:

Very-low-fat diets

0ome investigators have suggested that a fat intae of = #$' of total "alories is ne"essary foroptimal health.iets that provide !$'-#$' fat are defined as very low-fat The Pritiin and

rnish diets are examples of very low-fat diets They are primarily plant-based diets (eg fruits

vegetables whole grains beans and soy) with limited amounts of redu"ed fat dairy eggs lean

meats and fish Enlie LF plans whi"h in"orporate all foods the very low-fat diets strongly

dis"ourage "onsumption of foods "ontaining high amounts of refined "arbohydrate



http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3222874/



http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3222874/




/ limited number of studies have examined the effi"a"y of very low-fat diets 6n our earlier

review& we summari,ed results from the Lifestyle 1eart Trial showing that a very low-fat

vegetarian diet-- "ombined with a behavior modifi"ation program in"luding moderate aerobi"

a"tivity stress management and smoing "essation-- was effe"tive in redu"ing weight and the progression of "oronary atheros"lerosis 0in"e this study was published others have shown that

parti"ipants following the rnish diet experien"ed similar weight loss and improvements in C:.

ris fa"tors as parti"ipants following other popular diet strategies 1owever "ompared to other

diets the rnish diet showed a trend toward higher attrition and poorer adheren"e These

findings suggest that very low-fat diets may be more diffi"ult to sustain over time

More re"ently arnard et al "ompared weight loss in parti"ipants with type # diabetes who

"onsumed either a vegan diet (ie !$' energy from fat) or a diet based on the guidelines of the

/meri"an .iabetes /sso"iation diet (ie approximately #$'-#&' fat) /fter ## and ?2 wees

both diets resulted in weight loss and improved gly"emi" "ontrol 4edu"tions in weight were

signifi"antly greater in the vegan group at ## wees but not at ?2 wees .ietary adheren"e was

greater in the vegan group at ## wees but not at ?2 wees Parti"ipants rated both diets as

a""eptable This resear"h group also "ompared weight loss in individuals who "onsumed a vegan

(ie !$' energy from fat) and ational Cholesterol 5du"ation Program (C5P) low-fat diet

(ie %$' energy from fat) for !2 wees and found that the vegan group had greater weight loss

than the C5P group at ! and # years These studies suggest that very low-fat diets are effe"tive

in redu"ing weight and unlie the studies above may be sustainable over the long-term

Moderate-fat diets

<iven that LF diets "an "ontain up to %&' fat moderate fat (MF) diets are generally those that

"ontain between %&'-2&' fat Many people e;uate MF diets with Mediterranean diets but the

fat "ontent of Mediterranean diets "an vary "onsiderably 0ome have reported fat "ontents as

high as 2?'#2 while others have found them to be as low as #&' fat therefore although some

Mediterranean diets "an be "onsidered moderate in fat it should not be assumed that they all are


Previous studies have shown that weight loss was better maintained over time in individuals who

followed a MF diet and suggested that it may be easier to adhere to MF diets than LF diets over

the long term& 4e"ent studies that have "ompared MF (ie %&'-28' fat) and LF (ie #&'-

%$') diets have reported similar to slightly better weight losses with MF diets These diets were

similar to Mediterranean diets in that they "ontained a high proportion of monounsaturated fatty

a"ids (MEF/s) primarily from MEF/ ri"h oils and emphasi,ed high intae of plant foods (ie










fruits vegetables whole grains legumes and nuts) and fiber and limited amounts of saturated fat

from animal foods / meta-analysis of !8 randomi,ed "ontrolled trials of the effe"t of

Mediterranean diets on body weight suggested that Mediterranean diets resulted in greater

weight losses "ompared to a "ontrol diet parti"ularly when asso"iated with energy restri"tion and

physi"al a"tivity f the studies in"luded in the meta analysis that reported fat intae only onestudy reported total fat intae as less than %&' fat (ie %$' fat) Compared to LF diets higher

fat Mediterranean style diets have also been shown to be superior in in"reasing 1.L and

redu"ing atherogeni" index (ie ratio of total to 1.L "holesterol) and C-rea"tive protein in

individuals with hyperlipidemia or "oronary heart disease They also are "omparable in

improving blood pressure 1.L 1b/!C and fasting glu"ose and insulin in individuals with type

# diabetes

ne study fo"used on the effi"a"y of MF diets on weight maintenan"e 6n this study parti"ipants

who lost at least @' of their initial body weight on an @ wee low energy diet were randomi,ed

to one of three ad libitum diets for 8 monthsG !) MF Mediterranean type diet (%&'-2&' fat withH #$' MEF/)B #) LF (#$'-%$' fat)B or %) "ontrol (%&' fat with H!&' saturated fat) /fter 8

months all parti"ipants regained weight with no signifi"ant differen"es between groups (MF #&

gB LF ## gB "ontrol %@ g) 1owever body fat regain was lower in the MF and LF groups

The MF diet showed favorable effe"ts on diabetes ris fa"tors (ie redu"tion in fasting insulin

and improvements in homeostasis model assessment of insulin resistan"e I1M/-64J) and C:.

ris fa"tors (ie redu"ed ratio of low-density lipoprotein IL.LJ to 1.L)

The high -protein diet

There is no standard definition of a *high-protein dietB+ however intaes greater than #&' total

energy or !8g7g per day of body weight "an be "onsidered high%# The Kone diet (%$' protein

2$' "arbohydrate and %$' fat) is an example of a high-protein (1P) diet The most prominent

differen"e between a 1P diet su"h as the Kone and a low-"arbohydrate diet lie the /tins ew

.iet 4evolution is that a 1P diet is typi"ally low in fat


0everal earlier studies have reported greater weight loss and improvements in body "omposition

(ie de"reases in waist "ir"umferen"e waist-to-hip ratio and intra abdominal adipose tissue and

better preservation of lean body mass) in individuals pres"ribed 1P diets than LF diets These

studies have been des"ribed in more detail previously <iven that high waist-to-hip ratios and

levels of intra abdominal adipose tissue are positively "orrelated with "ertain "hroni" "onditions

interest in 1P diets has grown Findings from more re"ent studies are mixed /lthough several

studies have not found signifi"ant advantages on body weight and "omposition some trials have






supported previous findings that diets higher in protein have benefi"ial effe"ts on weight loss and

body "omposition This appears parti"ularly true in individuals with elevated ris of C:. and

metaboli" syndrome or in individuals who "ombine a 1P diet with resistan"e training

There is no "lear explanation for these in"onsistent results 6nade;uate nutrition "ounseling and

poor dietary adheren"e parti"ularly in longer studies may "ontribute to the la" of differen"es

between dietary groups Poor long-term adheren"e has been reported in several studies

"omparing 1P and LF diets on weight loss and body "omposition and is not limited to 1P diets

For example .ansinger et al reported that only #&' of parti"ipants in ea"h of four dietary

groups (ie /tins Kone 3eight 3at"hers and rnish) sustained a "lini"ally meaningful

adheren"e level M"Cauley et alreported that by &# wees adheren"e to ma"ronutrient goals

de"lined "onsiderably as did Clifton et alwho found that by 82 wees ma"ronutrient intae had

shifted to a point at whi"h the diets "onverged and there was not a large enough differen"e in

diets to be of signifi"an"e /s su"h data in the latter study were reanaly,ed based on a"tual

intaes of protein and #2-hr urinary urea a marer of protein intae instead of the assignedintervention 3hen a"tual high- and low-protein intae groups were "ompared the resear"hers

found that weight loss was greater in the 1P group than the low-protein group These findings

differed from those in the initial analysis in whi"h no between group differen"es in weight were

observed

6n order to better understand "omplian"e and long-term "hanges in body "omposition and blood

lipids Layman et al"ompared 1P and LF diets in obese but healthy adults over !# months This

study was divided into # phasesG !) 2 months of weight lossB #) @ months of weight maintenan"e

The diets were iso"alori" and e;ual in fat but differed in protein "ontent The 1P group were

pres"ribed %$' protein (providing !8 g protein7g7day) while those in the LF group were

pres"ribed !&' protein 5a"h group re"eived a menu plan with meals for ea"h day throughout

the !#-month study Parti"ipants met with a dietitian ea"h wee who reviewed diet re"ords

answered ;uestions provided feedba" and measured weight /dheren"e to the diet was

monitored with plasma T/< a marer of "arbohydrate intae and urinary urea

3eight loss did not differ between groups at 2 monthsB however the 1P group had a greater loss

of body fat "ompared to the LF group /t 2 months urinary urea as well as plasma T/<

measurements indi"ated that both groups were adherent to their ma"ronutrient goals and were

"onsistent with diet re"ords /dheren"e in the 1P and LF groups also appeared to be good at @

and !# months respe"tively /t !# months there were no differen"es in "hanges in weight or

lean mass but the 1P group had a greater loss of fat mass <reater redu"tions in weight and fat

mass (ie total and abdominal) have also been observed in studies of obese women with

elevated T/< "on"entrations oaes et alreported that obese women with elevated T/<

"on"entrations who "onsumed a 1P diet for !# wees lost &$' more body fat than those who

"onsumed an iso"alori" LF diet



Layman et al reported that 1P diets redu"ed T/< 1.L "holesterol and T/<G1.L more than

LF diets at 2 months These effe"ts were sustained at !# months Tbe greater redu"tion in T/<

with 1P diets is a relatively "onsistent finding observed in several studies in"luding those of

obese women with elevated T/< "on"entrations%% and overweight insulin resistant

women Clifton et al pooled data from three "lini"al trials and reported that T/< "on"entrationsde"reased to a greater extent on the 1P diet "ompared to the LF diet (ie #D' 1P vs !?' LF)

6n addition this analysis showed that patients with elevated T/< who "onsumed a 1P diet had

greater redu"tions in total "holesterol than those on a LF diet These resear"hers also found larger

redu"tions in low-density lipoprotein (L.L) "holesterol in individuals with impaired glu"ose

toleran"e (6<T) who were on the 1P diet Taen together these findings suggest that 1P diets

might be of some benefit to individuals with or at high ris for diabetes dyslipidemia C:. and

metaboli" syndrome

3eight "hange over the "ourse of # years was evaluated in a large study of @!! overweight adults

randomi,ed to one of four "alorie-restri"ted dietsG !) #$' !&' and 8&' for fat protein and"arbohydrate respe"tivelyB #) #$' #&' and &&'B %) 2$' !&' and 2&'B or 2) 2$' #&' and

%&' 6ndividuals re"eived group lifestyle modifi"ation % of every 2 wees for the first 8 months

and then bi-weely from 8 months to # years 6ndividual "ounseling sessions were also provided

every @ wees over the "ourse of the study 3eight loss was similar at two years in parti"ipants

assigned to !&' and #&' protein (%$ g and %8 g respe"tively) /dheren"e to protein intae

targets was asso"iated with more weight loss in the high protein group 1owever adheren"e to

ma"ronutrient goals diminished after 8 months indi"ating that parti"ipants had diffi"ulty

maintaining spe"ifi" ma"ronutrient targets over time despite intensive "ounseling /ll diets

redu"ed ris fa"tors for C:. and diabetes

Few studies have evaluated 1P for weight maintenan"e 1owever a large pan-5uropean study

.iet besity and <enes (.6<550) Pro9e"t assessed the effi"a"y of ad libitum MF diets

varying in protein and <6 for weight maintenan"e2% /fter an initial @-wee weight loss program

??% parti"ipants were randomi,ed to one of five LF dietsG !) low protein low gly"emi" index

(<6)B #) low protein high <6B %) high protein low <6B 2) high protein high <6B or &) "ontrol diet

(ie moderate protein no <6 instru"tion) .ietary "ounseling was provided biweely for the first

8 wees and monthly thereafter /lthough parti"ipants did not a"hieve the targeted !#'

differen"e in protein intae between groups those in the 1P group "onsumed &' more protein as

a proportion of total energy than the low protein group etter weight maintenan"e was observedin individuals who "onsumed higher amounts of protein than in those who "onsumed smaller

amounts 3eight regain was $D g less in those assigned a high protein diet than those assigned

a low protein diet








There has been "on"ern regarding the overall safety of 1P diets o adverse effe"ts have been

observed for marers of idney or liver fun"tion or bone turnover 1owever the effe"ts of 1P

diets in "ompromised individuals is unnown

Low-carbohydrate diets

The low-"arbohydrate (LC) diet is one of the most re"ogni,ed approa"hes to weight loss Many

versions of the LC diet exist (ie /tins ew .iet 4evolution 0outh ea"h .uan diet) ea"h

with a uni;ue interpretation of optimal LC eating Enlie LF diets the F./ has not established a

"lear definition for *low+ "arbohydrate 1owever LC diets often "onsist of limited amounts of

"arbohydrate (#$-&$ gram7day or about !$' of "alories from "arbohydrate) gradually in"reasing

over time and relatively high amounts of fat (approximately 8$' fat) whi"h differentiates LC

diets from 1P diets LC approa"hes en"ourage "onsumption of "ontrolled amounts of nutrient

dense "arbohydrate "ontaining foods (eg low <6 vegetables whole grain produ"ts) and

eliminate intae of refined "arbohydrate /lthough "onsumption of foods that do not "ontain"arbohydrate (eg meats poultry fish butter oil) is not restri"ted ;uality rather than ;uantity is

emphasi,ed


6n our earlier review& we des"ribed findings from several short-term (= !# months) studies

"omparing the effe"ts of LC and a "alorie-"ontrolled LF diets on weight body "omposition and

"ardiovas"ular ris fa"tors in obese adults 6n summary parti"ipants who followed a LC diet lost

signifi"antly more weight than those who adhered to a LF diet during the first 8 months of

treatment 1owever differen"es in weight loss did not persist at ! year / meta-analysis

published in #$$822 also found no signifi"ant differen"es in weight loss between diets at ! year

suggesting that LC diets are as effe"tive as LF diets for weight loss

0in"e our last report several studies "omparing weight loss in individuals who "onsumed LC and

LF diets from ! to # years have been published These studies were similar in LC and LF diet

pres"riptions but varied in the amount of professional support they offered /mong the studies

that examined weight loss over a !-year period two observed signifi"antly greater weight losses

with a LC diet than a LF diet at 8 monthsbut no signifi"ant differen"es in weight were observed

between these two diets at ! year in any of these studies supporting earlier findings /dheren"e

to the ma"ronutrient targets of the diets de"reased over time in these studies parti"ularly in theLC "arb group in one study# and attrition was higher in the LC group than the LF group in

another study This suggests that a LC diet may be more diffi"ult to sustain than a LF diet over

time and may explain why there were no differen"es in weight loss at ! year

Findings from studies of longer duration (ie # years) are mixed Two studies reported no

differen"es in weight loss between LC and LF diets at # years while another reported greater








redu"tions in weight at # years with the LC diet "ompared to a LF diet but similar redu"tions

"ompared to a Mediterranean type diet Maximal weight loss o""urred at 8 months in these

studies with weight regain beginning between 8 and !# months .ietary adheren"e findings

were similar to studies shorter in duration despite more intensive "onta"t with study staff The

study in whi"h better weight loss out"omes were reported with a LC diet provided parti"ipantswith food and portion si,e guidan"e for the main meal of the day Taen together these findings

suggest that LF and LC diets are e;ually effe"tive in redu"ing weight

There have been "on"erns about the effe"ts of LC diets on C:. ris and bone health 3ith

regard to C:. ris most studies found that LC diets de"reased T/< and very-low-density

lipoproteins (:L.L) and in"reased 1.L more than LF diets in the short-term 1owever these

"hanges were not sustained in the long-term with the ex"eption of 1.L 0ustained in"reases in

1.L were shown in two studies%D2& <iven our "urrent understanding it does not appear that LC

diets trigger any adverse effe"ts on lipid variables 6n addition no differen"es in body

"omposition or bone mineral density were observed between a LF and LC diet at any point in a #year study2&

Low-glycemic index (G! diet

Carbohydrates vary in the degree to whi"h they raise blood glu"ose and insulin levels The term

*gly"emi" index+ (<6) refers to a property of "arbohydrate-"ontaining food that affe"ts the

"hange in blood glu"ose following food "onsumption28 Carbohydrate "ontaining foods are

raned in relation to glu"ose or white bread whi"h both have a <6 of !$$ Thus foods with a <6

between $-&& are "onsidered low <6 foods those with a <6 of ?$ or greater are "onsidered high

<6 foods and those that fall between these two ranges are "ategori,ed as intermediate <6 foods/ variety of fa"tors su"h as "arbohydrate type amount and type of fiber degree of pro"essing

"ooing storage a"idity food stru"ture and ma"ronutrient "ontent "an all affe"t <6 <ly"emi"

load (<L) is a similar "on"ept but taes into a""ount both the type of "arbohydrate and the

amount of "arbohydrate "onsumed

/ low <6 or <L diet is a uni;ue blend of low-fat and low-"arbohydrate "on"epts

4e"ommendations for this dietary approa"h are based not only on the <6 values of foods but also

on the overall nutritional "ontent of the diet2? The overall goal of low <6 eating is to obtain

ade;uate energy and nutrients without "ausing large spies in insulin and blood glu"ose levels


There has been "onsiderable dis"ussion regarding whether "lini"ians should re"ommend low-<6

diets to overweight and obese patients Findings from studies of adults published in our earlier

review suggested that there were no advantages in terms of weight loss when <6 was altered and

energy and ma"ronutrient "omposition were held "onstant Findings did suggest however that















low <6 diets may play an important role in the prevention and treatment of metaboli" and

"ardiovas"ular disease

More re"ent studies of adults support previous findings /lthough a number of feeding studies

suggest that low <6 foods in"rease satiety more than high <6 foods does not appear that the effe"t

on appetite affe"ts energy intae enough to impa"t body weight& ne re"ent study "ompared the

effe"ts of ad libitum low and high <6 diets on weight loss in overweight and obese

hyperinsulinemi" women Two additional studies "ompared energy "ontrolled iso"alori" low and

high <L diets one in adults with at least one "riterion for metaboli" syndrome and the other in

obese adults with type # diabetes The ad libitum study was a randomi,ed "rossover intervention

in"luding two !#-wee periods in whi"h women in"orporated low <6 or high <6 foods into their

diet / differen"e of @2 <6 units (ie &&& vs 8%D) differentiated the low and high <6 dietary

periods 0imple substitution of low and high <6 foods did not redu"e energy intae or lead to

weight loss 6n fa"t weight in"reased during both intervention periods with no differen"e

between groups

lemsdal et al randomi,ed parti"ipants with varying degrees of metaboli" syndrome to either a

low <L diet or a LF diet / &$$ "al7day defi"it was re"ommended /lthough greater redu"tions

in weight were observed at % and 8 months in parti"ipants pres"ribed the low <L diet !-year

weight loss was almost identi"al indi"ating greater weight regain in the low <L group between 8

and !# months 6nterestingly at ! year the "hange in waist "ir"umferen"e was signifi"antly

greater in the LF than in the low <L group (-&@ "m vs -2! "m) /lthough no differen"es

between groups were observed for systoli" pressure diastoli" blood pressure was redu"ed more

in the low <L "ompared to the LF group (-2$ mm1g vs -!! mm1g)

<iven their potential to affe"t glu"ose and insulin responses the effe"ts of low and high <67<L

diets in individuals with diabetes is of parti"ular interest Therefore as part of a 2$ wee lifestyle

modifi"ation program overweight and obese men and women with type # diabetes were

randomi,ed to either a !&$$ "al LF or low <L diet 3eight loss and "hanges in 1b/!" were the

primary out"ome measures in this study o signifi"ant between group differen"es were observed

for redu"tions in body weight 1owever parti"ipants pres"ribed the low <L diet experien"ed

greater redu"tions in 1b/!" than those following the LF diet at #$ (-$?' vs -$%') and 2$

wees (-$@' vs -$!') There were no signifi"ant differen"es in fasting glu"ose insulin

1M/-64 lipids or blood pressure 3hile other studies have not observed differen"es in

1b/!" findings from this study suggest that low <L diets may provide a metaboli" advantage

for patients with type # diabetes despite the fa"t that they were no more effe"tive than LF diets

in redu"ing weight More resear"h is needed to better understand the metaboli" and

anthropometri" effe"ts of low and high <6 diets in individuals with type # diabetes and metaboli"

syndrome There is some eviden"e to suggest that individuals with higher insulin se"retion lose

more weight on a low <L than a high <L diet



nly a limited number of studies have evaluated the effe"ts of <6 on weight maintenan"e and

findings are mixed ne study reported no differen"e in body weight in individuals who had lost

8' of their initial weight and were then randomi,ed to a high <67<L or low <67<L diet for 2

months /nother study showed that weight maintenan"e was better in parti"ipants who followed

an ad libitum low <6 diet Furthermore parti"ipants who "onsumed a low <6 high protein diet"ontinued to lose weight after initial weight loss while those who "onsumed a high <6 low

protein diet regained weight

2.2 EXE!ISE

Current Management on Obesity

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