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Effects of a Low-Glycemic Load vs Low-Fat Diet in Obese Young Adults: A Randomized Trial

JAMA -- Abstract: Effects of a Low-Glycemic Load vs Low-Fat Diet in Obese Young Adults: A Randomized Trial, May 16, 2007, Ebbeling et al. 297 (19): 2092

Results Change in body weight and body fat percentage did not differ between the diet groups overall. However, insulin concentration at 30 minutes after a dose of oral glucose was an effect modifier (group x time x insulin concentration at 30 minutes: P = .02 for body weight and P = .01 for body fat percentage). For those with insulin concentration at 30 minutes above the median (57.5 µIU/mL; n = 28), the low–glycemic load diet produced a greater decrease in weight (–5.8 vs –1.2 kg; P = .004) and body fat percentage (–2.6% vs –0.9%; P = .03) than the low-fat diet at 18 months. There were no significant differences in these end points between diet groups for those with insulin concentration at 30 minutes below the median level (n = 28). Insulin concentration at 30 minutes after a dose of oral glucose was not a significant effect modifier for cardiovascular disease risk factors. In the full cohort, plasma high-density lipoprotein cholesterol and triglyceride concentrations improved more on the low–glycemic load diet, whereas low-density lipoprotein cholesterol concentration improved more on the low-fat diet.

Conclusions Variability in dietary weight loss trials may be partially attributable to differences in hormonal response. Reducing glycemic load may be especially important to achieve weight loss among individuals with high insulin secretion. Regardless of insulin secretion, a low–glycemic load diet has beneficial effects on high-density lipoprotein cholesterol and triglyceride concentrations but not on low-density lipoprotein cholesterol concentration.

Conclusion: If you are overweight and insulin resistant (have fat around the belly)- low carb is the way to go! HDL and triglycerides are huge risk factors, and low carb is the way to improve them.
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