Skip to main content
Top
Published in: Obesity Surgery 8/2011

01-08-2011 | Clinical Research

Short-Term Carbohydrate-Restricted Diet for Weight Loss in Severely Obese Women

Authors: Andresa de Toledo Triffoni-Melo, Ingrid Dick-de-Paula, Guilherme Vannucchi Portari, Alceu Afonso Jordao, Paula Garcia Chiarello, Rosa Wanda Diez-Garcia

Published in: Obesity Surgery | Issue 8/2011

Login to get access

Abstract

Background

Weight loss in bariatric pre-surgery period reduces surgical complications, surgery time, blood loss, and length of hospital stay. Carbohydrate-restricted diets have been used as an alternative for weight loss. We tested the efficacy of a low-calorie carbohydrate-restricted diet (RD) for short-term weight loss in women with severe obesity and evaluate its metabolic effects in relation to a conventional low-calorie diet (CD).

Methods

The subjects received a 1,200-kcal diet with or without carbohydrate restriction for a period of 1 week in the hospital. Nineteen obesity class III women were distributed into two groups: experimental (n = 10) and control (n = 9). The following variables were assessed at the beginning and end of the study: anthropometric measurements, body composition, resting energy expenditure, substrate oxidation, and biochemical tests.

Results

Compared with CD, RD led to larger weight loss (2.6 and 4.4 kg, respectively; p = 0.01) and waist circumference reduction (p < 0.01). Among the assessed biochemical indicators, only plasma and urine acetone levels were different (p < 0.01); higher values were found in the experimental group with no symptoms and other diet-related complaints. There was also a significant decrease in triglycerides and carbohydrate oxidation, as well as a significant enhancement in lipid oxidation in the RD group.

Conclusion

Short-term RD was more efficient than CD regarding quick weight loss and waist circumference reduction, which may favor gastroplasty. Also, RD did not lead adverse metabolic effects.
Literature
1.
go back to reference Obesity: preventing and managing the global epidemic. Report of a WHO Consultation. World Health Organ Tech Rep Ser 2000; 894: i-xii, 1-253 Obesity: preventing and managing the global epidemic. Report of a WHO Consultation. World Health Organ Tech Rep Ser 2000; 894: i-xii, 1-253
3.
go back to reference IBGE Fundação Instituto Brasileiro de Geografia e Estatística / Ministério do Planejamento, Orçamento e Gestão, Ministério da Saúde. Pesquisa de Orçamentos Familiares 2002-2003. Análise da disponibilidade domiciliar de alimentos e do estado nutricional no Brasil. Rio de Janeiro, Brasil: IBGE; 2004. IBGE Fundação Instituto Brasileiro de Geografia e Estatística / Ministério do Planejamento, Orçamento e Gestão, Ministério da Saúde. Pesquisa de Orçamentos Familiares 2002-2003. Análise da disponibilidade domiciliar de alimentos e do estado nutricional no Brasil. Rio de Janeiro, Brasil: IBGE; 2004.
4.
go back to reference Santos LMP, Oliveira IV, Peters LR, et al. Trends in morbid obesity and in bariatric surgeries covered by the Brazilian public health system. Obes Surg; 2008. Santos LMP, Oliveira IV, Peters LR, et al. Trends in morbid obesity and in bariatric surgeries covered by the Brazilian public health system. Obes Surg; 2008.
5.
go back to reference Pardela M, Wiewióra M, Sitkiewicz T, et al. The progress in bariatric surgery. J Physiol Pharm. 2005;56 Suppl 6:35–44. Pardela M, Wiewióra M, Sitkiewicz T, et al. The progress in bariatric surgery. J Physiol Pharm. 2005;56 Suppl 6:35–44.
6.
go back to reference World Health Organization. Obesity: preventing and managing the global epidemic. Report of a WHO consultation on obesity. Geneva: WHO; 1998. World Health Organization. Obesity: preventing and managing the global epidemic. Report of a WHO consultation on obesity. Geneva: WHO; 1998.
7.
go back to reference Fandiño J, Benchimol AK, Coutinho WF, et al. Cirurgia bariátrica: aspectos clinico-cirúrgicos e psiquiátricos. Rev Psiquiatr Rio Gd Sul. 2004;26:47–51.CrossRef Fandiño J, Benchimol AK, Coutinho WF, et al. Cirurgia bariátrica: aspectos clinico-cirúrgicos e psiquiátricos. Rev Psiquiatr Rio Gd Sul. 2004;26:47–51.CrossRef
8.
go back to reference Segal A, Fandiño J. Indicações e contra-indicações para realização das operações bariátricas. Rev Bras Psiquiatr. 2002;24(Supl 3):68–72.CrossRef Segal A, Fandiño J. Indicações e contra-indicações para realização das operações bariátricas. Rev Bras Psiquiatr. 2002;24(Supl 3):68–72.CrossRef
9.
go back to reference Cartagena R. Preoperative evaluation of patients with obesity and obstructive sleep apnea. Anesthesiol Clin North America. 2005;23:463–78.PubMedCrossRef Cartagena R. Preoperative evaluation of patients with obesity and obstructive sleep apnea. Anesthesiol Clin North America. 2005;23:463–78.PubMedCrossRef
10.
go back to reference Alami RS, Morton JM, Schuster R, et al. Is there a benefit to preoperative weight loss in gastric bypass patients? A prospective randomized trial. Surg Obes Relat Dis. 2007;3:141–5. discussion 145-6.PubMedCrossRef Alami RS, Morton JM, Schuster R, et al. Is there a benefit to preoperative weight loss in gastric bypass patients? A prospective randomized trial. Surg Obes Relat Dis. 2007;3:141–5. discussion 145-6.PubMedCrossRef
11.
go back to reference Ali MR, Baucom-Pro S, Broderick-Villa GA, et al. Weight loss before gastric bypass: feasibility and effect on postoperative weight loss and weight loss maintenance. Surg Obes Relat Dis. 2007;3:515–20.PubMedCrossRef Ali MR, Baucom-Pro S, Broderick-Villa GA, et al. Weight loss before gastric bypass: feasibility and effect on postoperative weight loss and weight loss maintenance. Surg Obes Relat Dis. 2007;3:515–20.PubMedCrossRef
12.
go back to reference Tarnoff M, Kaplan LM, Shikora S. An evidenced-based assessment of preoperative weight loss in bariatric surgery. Obes Surg. 2008;18:1059–61.PubMedCrossRef Tarnoff M, Kaplan LM, Shikora S. An evidenced-based assessment of preoperative weight loss in bariatric surgery. Obes Surg. 2008;18:1059–61.PubMedCrossRef
13.
go back to reference Volek JS, Sharman MJ, Gómez AL, et al. Comparison of a very low-carbohydrate and low-fat diet on fasting lipids, LDL subclasses, insulin resistance, and postprandial lipemic responses in overweight women. J Am Coll Nutr. 2004;23:177–84.PubMed Volek JS, Sharman MJ, Gómez AL, et al. Comparison of a very low-carbohydrate and low-fat diet on fasting lipids, LDL subclasses, insulin resistance, and postprandial lipemic responses in overweight women. J Am Coll Nutr. 2004;23:177–84.PubMed
14.
go back to reference Astrup A, Larsen TM, Harper A. Atkins and other low-carbohydrate diets: hoax or an effective tool for weight loss? Lancet. 2004;364:897–9.PubMedCrossRef Astrup A, Larsen TM, Harper A. Atkins and other low-carbohydrate diets: hoax or an effective tool for weight loss? Lancet. 2004;364:897–9.PubMedCrossRef
15.
16.
go back to reference Yancy Jr WS, Foy M, Chalecki AM, et al. A low-carbohydrate, ketogenic diet to treat type 2 diabetes. Nutr Metab (Lond). 2005;2:34.CrossRef Yancy Jr WS, Foy M, Chalecki AM, et al. A low-carbohydrate, ketogenic diet to treat type 2 diabetes. Nutr Metab (Lond). 2005;2:34.CrossRef
17.
go back to reference Shai I, Schwarzfuchs D, Henkin Y, et al. Weight loss with a low-carbohydrate, Mediterranean, or low-fat diet. N Engl J Med. 2008;359:229–41.PubMedCrossRef Shai I, Schwarzfuchs D, Henkin Y, et al. Weight loss with a low-carbohydrate, Mediterranean, or low-fat diet. N Engl J Med. 2008;359:229–41.PubMedCrossRef
18.
go back to reference Weir JB. New methods for calculating metabolic rate with special reference to protein metabolism. J Physiol. 1949;109:1–9.PubMed Weir JB. New methods for calculating metabolic rate with special reference to protein metabolism. J Physiol. 1949;109:1–9.PubMed
19.
go back to reference Frayn KN. Calculation of substrate oxidation rates in vivo from gaseous exchange. J Appl Physiol. 1983;55:628–34.PubMed Frayn KN. Calculation of substrate oxidation rates in vivo from gaseous exchange. J Appl Physiol. 1983;55:628–34.PubMed
20.
go back to reference Schutz Y. The basis of direct and indirect calorimetry and their potentials. Diabetes Metab Rev. 1995;11:383–408.PubMedCrossRef Schutz Y. The basis of direct and indirect calorimetry and their potentials. Diabetes Metab Rev. 1995;11:383–408.PubMedCrossRef
21.
go back to reference Friedewald WT, Levy RI, Fredrickson DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem. 1972;18:499–502.PubMed Friedewald WT, Levy RI, Fredrickson DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem. 1972;18:499–502.PubMed
22.
go back to reference Matthews DR, Hosker JP, Rudenski AS, et al. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985;28:412–9.PubMedCrossRef Matthews DR, Hosker JP, Rudenski AS, et al. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985;28:412–9.PubMedCrossRef
23.
go back to reference Portari GV, Marchini JS, Jordão AA. Validation of a manual headspace gas chromatography method for determining volatile compounds in biological fluids. Lab Med. 2008;39:42–5.CrossRef Portari GV, Marchini JS, Jordão AA. Validation of a manual headspace gas chromatography method for determining volatile compounds in biological fluids. Lab Med. 2008;39:42–5.CrossRef
24.
go back to reference AOAC. Association of Official Analytical Chemists. Official methods of analysis, 16 ed. Washington 1995; 1 (cap12): 7. AOAC. Association of Official Analytical Chemists. Official methods of analysis, 16 ed. Washington 1995; 1 (cap12): 7.
25.
go back to reference Schall R. Estimation in generalized linear models with random effects. Biometrika. 1991;78:719–27.CrossRef Schall R. Estimation in generalized linear models with random effects. Biometrika. 1991;78:719–27.CrossRef
26.
go back to reference R Development Core Team. R: A language and environment for statistical computing. Vienna: R Foundation for Statistical Computing; 2008. R Development Core Team. R: A language and environment for statistical computing. Vienna: R Foundation for Statistical Computing; 2008.
27.
go back to reference Noble CA, Kushner RF. An update on low-carbohydrate, high-protein diets. Curr Opin Gastroenterol. 2006;22:153–9.PubMedCrossRef Noble CA, Kushner RF. An update on low-carbohydrate, high-protein diets. Curr Opin Gastroenterol. 2006;22:153–9.PubMedCrossRef
28.
go back to reference Stern L, Iqbal N, Seshadri P, et al. The effects of low-carbohydrate versus conventional weight loss diets in severely obese adults: one-year follow-up of a randomized trial. Ann Intern Med. 2004;140:778–86.PubMed Stern L, Iqbal N, Seshadri P, et al. The effects of low-carbohydrate versus conventional weight loss diets in severely obese adults: one-year follow-up of a randomized trial. Ann Intern Med. 2004;140:778–86.PubMed
29.
go back to reference Last AR, Wilson SA. Low-carbohydrate diets. Am Fam Physician. 2006;73:1942–8.PubMed Last AR, Wilson SA. Low-carbohydrate diets. Am Fam Physician. 2006;73:1942–8.PubMed
30.
go back to reference Erlanson-Albertsson C, Mei J. The effect of low carbohydrate on energy metabolism. Int J Obes (Lond). 2005;29 Suppl 2:S26–30.CrossRef Erlanson-Albertsson C, Mei J. The effect of low carbohydrate on energy metabolism. Int J Obes (Lond). 2005;29 Suppl 2:S26–30.CrossRef
31.
go back to reference Volek JS, Westman EC. Very low-carbohydrate weight-loss diets revisited. Cleve J Med 2002; 69: 849, 853, 856-8 passim. Volek JS, Westman EC. Very low-carbohydrate weight-loss diets revisited. Cleve J Med 2002; 69: 849, 853, 856-8 passim.
32.
go back to reference Westerterp-Plantenga MS. The significance of protein in food intake and body weight regulation. Curr Opin Clin Nutr Metab Care. 2003;6:635–8.PubMedCrossRef Westerterp-Plantenga MS. The significance of protein in food intake and body weight regulation. Curr Opin Clin Nutr Metab Care. 2003;6:635–8.PubMedCrossRef
33.
go back to reference Alnasir FA, Fateha BE. Low carbohydrate diet. Its effects on selected body parameters of obese patients. Saudi Med J. 2003;24:949–52.PubMed Alnasir FA, Fateha BE. Low carbohydrate diet. Its effects on selected body parameters of obese patients. Saudi Med J. 2003;24:949–52.PubMed
34.
go back to reference Daly ME, Piper J, Paisey R, et al. Efficacy of carbohydrate restriction in obese type 2 diabetes patients (Abstr. A98). Diabet Med. 2006;23 Suppl 2:26–7. Daly ME, Piper J, Paisey R, et al. Efficacy of carbohydrate restriction in obese type 2 diabetes patients (Abstr. A98). Diabet Med. 2006;23 Suppl 2:26–7.
35.
go back to reference Denke MA. Metabolic effects of high-protein, low-carbohydrate diets. Am J Cardiol. 2001;88:59–61.PubMedCrossRef Denke MA. Metabolic effects of high-protein, low-carbohydrate diets. Am J Cardiol. 2001;88:59–61.PubMedCrossRef
36.
go back to reference Das SK, Roberts SB, McCrory MA, et al. Long-term changes in energy expenditure and body composition after massive weight loss induced by gastric bypass surgery. Am J Clin Nutr. 2003;78:22–30.PubMed Das SK, Roberts SB, McCrory MA, et al. Long-term changes in energy expenditure and body composition after massive weight loss induced by gastric bypass surgery. Am J Clin Nutr. 2003;78:22–30.PubMed
37.
go back to reference Adam-Perrot A, Clifton P, Brouns F. Low-carbohydrate diets: nutritional and physiological aspects. Obes Rev. 2006;7:49–58.PubMedCrossRef Adam-Perrot A, Clifton P, Brouns F. Low-carbohydrate diets: nutritional and physiological aspects. Obes Rev. 2006;7:49–58.PubMedCrossRef
38.
39.
go back to reference Tay J, Brinkworth GD, Noakes M, et al. Metabolic effects of weight loss on a very low-carbohydrate diet compared with an isocaloric high-carbohydrate diet in abdominally obese subjects. J Am Coll Cardiol. 2008;51:59–67.PubMedCrossRef Tay J, Brinkworth GD, Noakes M, et al. Metabolic effects of weight loss on a very low-carbohydrate diet compared with an isocaloric high-carbohydrate diet in abdominally obese subjects. J Am Coll Cardiol. 2008;51:59–67.PubMedCrossRef
40.
go back to reference Sacks FM, Bray GA, Carey VJ, et al. Comparison of weight-loss diets with different compositions of fat, protein, and carbohydrates. N Engl J Med. 2009;360:859–73.PubMedCrossRef Sacks FM, Bray GA, Carey VJ, et al. Comparison of weight-loss diets with different compositions of fat, protein, and carbohydrates. N Engl J Med. 2009;360:859–73.PubMedCrossRef
41.
go back to reference Volek JS, Sharman ML, Forsythe CE. Modification of lipoproteins by very low-carbohydrate diets. J Nutr. 2005;135:1339–42.PubMed Volek JS, Sharman ML, Forsythe CE. Modification of lipoproteins by very low-carbohydrate diets. J Nutr. 2005;135:1339–42.PubMed
42.
go back to reference Grieb P, Klapcinska B, Smol E, et al. Long-term consumption of a carbohydrate-restricted diet does not induce deleterious metabolic effects. Nutr Res. 2008;28:825–33.PubMedCrossRef Grieb P, Klapcinska B, Smol E, et al. Long-term consumption of a carbohydrate-restricted diet does not induce deleterious metabolic effects. Nutr Res. 2008;28:825–33.PubMedCrossRef
43.
go back to reference Al-Zaid NS, Dashti HM, Mathew TC, et al. Low carbohydrate ketogenic diet enhances cardiac tolerance to global ischaemia. Acta Cardiol. 2007;62:381–9.PubMedCrossRef Al-Zaid NS, Dashti HM, Mathew TC, et al. Low carbohydrate ketogenic diet enhances cardiac tolerance to global ischaemia. Acta Cardiol. 2007;62:381–9.PubMedCrossRef
44.
go back to reference Colles SL, Dixon JB, Marks P, et al. Preoperative weight loss with a very low-energy diet: quantitation of changes in liver and abdominal fat by serial imaging. Am J Clin Nutr. 2006;84:304–11.PubMed Colles SL, Dixon JB, Marks P, et al. Preoperative weight loss with a very low-energy diet: quantitation of changes in liver and abdominal fat by serial imaging. Am J Clin Nutr. 2006;84:304–11.PubMed
45.
go back to reference Meckling KA, O’sullivan C, Saari D. Comparison of a low-fat diet to a low-carbohydrate diet on weight loss, body composition, and risk factors for diabetes and cardiovascular disease in free-living, overweight men and women. J Clin Endocrinol Metab. 2004;89:2717–23.PubMedCrossRef Meckling KA, O’sullivan C, Saari D. Comparison of a low-fat diet to a low-carbohydrate diet on weight loss, body composition, and risk factors for diabetes and cardiovascular disease in free-living, overweight men and women. J Clin Endocrinol Metab. 2004;89:2717–23.PubMedCrossRef
Metadata
Title
Short-Term Carbohydrate-Restricted Diet for Weight Loss in Severely Obese Women
Authors
Andresa de Toledo Triffoni-Melo
Ingrid Dick-de-Paula
Guilherme Vannucchi Portari
Alceu Afonso Jordao
Paula Garcia Chiarello
Rosa Wanda Diez-Garcia
Publication date
01-08-2011
Publisher
Springer-Verlag
Published in
Obesity Surgery / Issue 8/2011
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-010-0110-6

Other articles of this Issue 8/2011

Obesity Surgery 8/2011 Go to the issue