RESTRICTED CARBOHYDRATE INTAKE IN OBESITY TREATMENT
Keywords:
diet, obesity, low carbohydrateAbstract
Dietary changes and inactivity have been associated with the obesity epidemie, which involve a complex interaction among genetic, metabolic, psychosocial and cultural factors. Excess weight is associated with risk for atherosclerosis, diabetes mellitus type 2 and some cancers. Additionally, obesity cause adverse effects in metabolism such as a rise in blood pressure, dyslipidemias and insulin resistance. To treat obesity, it is important to consider ai! causative factors and multidisciplinary action is advised. The usual recommendation is to improve lifestyle but in some cases medications and surgery are necessary Among the nutrition interventions, the low carbohydrate diets have become more and more popular. The aim of this work was to show the main results of the studies in the last ten years regarding low carbohydrate diets in treating obesity. The studies are heterogeneous, therefore comparing them was complicated. Weight loss seems to be more associated with calorie restriction, responsible for a negative energy balance, than with the carbohydrate content of the diets. Although some authors report improvement of serum lipids, blood glucose and blood insulin after low carbohydrate diets, we are sti/1 far from a consensus. ln conclusion, there is insufficient evidence to make recommendations for or against these diets.
Downloads
References
Monteiro CA. Evolução do perfil nutricional da população brasileira. ln: Saúde em foco: Nutrição em saúde coletiva. Tendências e desafios. Informe Epidemiológico em Saúde do Rio de Janeiro. 1999; 18:4-8.
Francischi RPP, Pereira LO, Freitas CS, Klopfer M, Santos, RC, Vieira P, et ai. Obesidade: atualização sobre sua etiologia, morbidade e tratamento. Rev Nutr. 2000; 13(1):17-28.
Organização Mundial de Saúde. Sobrepeso e obesidade. [acesso em 25 jun. 2004]. Disponível em: http://www.who.int/dietphisycalactivity/pubIications/ facts/obesity/en
Sociedade Brasileira de Cardiologia. Ili Diretrizes Brasileiras sobre Dislipidemia e Diretriz da Prevenção da Aterosclerose. Arq Bras Cardiol. 2001; 77(Supl 3):1-48.
Dansinger ML, Gleason JA, Griffith JL, Selker HP, Schaefer EJ. Comparison of the Atkins, Ornish, Weight Watchers, and Zone diets for weight loss and heart disease risk reduction: a randomized triai. JAMA. 2005; 293(1):96-7.
Dessein PH, Shipton EA, Stanwix AE, Joffe BI, Ramokgadi J. Beneficial effects of weight loss associated with moderate calorie/carbohydrate restriction, and lipoprotein leveis in gout: a pilot study. Ann Rheum Dis. 2000; 59(7):539-43.
Kennedy ET, Bowman SA, Spence JT, Freedman M, King J. Popular diets: correlation to health, nutrition, and obesity. J Am Diet Assoe. 2001; 101(4):411-20.
Golay A, Allaz AF, Morei Y, De Tonnac N, Tankova S, Reaven G. Similar weight loss with low or high-carbohydrate diets. Am J Clin Nutr. 1996; 63(2): 174-8.
Baba NH, Sawaya S, Torbay N, Habbal Z, Azar S, Hashim SA. High protein vs carbohydrate hypoenergetic diet for the treatment of obese hyperinsulinemic subjects. lnt J Obes Relat Metab Disord. 1999; 23(11):1202-6.
O. Vazquez JA, Kazi U, Madani N. Protein metabolism during weight reduction with very-low-energy diets: evaluation of the independent effects of protein and carbohydrate on protein sparing. Am J Clin Nutr. 1995; 62(1):93-103.
Westman EC, Yancy WS, Edman JS, Tomlin KF, Perkins CE. Effect of 6-month adherence to a very low carbohydrate diet program. Am J Med. 2000; 113(1):30-6.
Foster GD, Wyatt HR, Hill JO, Mcgunckin BG, Bill C, Mohammed BS, et ai. A randomized triai of a low-carbohydrate diet for obesity. N Engl J Med. 2003; 348(21):2082-90.
Klein S. Clinicai triai experience with fat-restricted vs. Carbohydrate-restricted weight-loss diets. Obes Res. 2004; 12(Suppl 2):141S-4S.
Hauner H. Low-carbohydrate or low-fat diet for weight loss: which is better? Recenti Prog Med. 2004; 95(9):427-31.
Samaha FF, lqbal N, Seshadri P, Chicana KL, Daily DA, Mcgrory J, et ai. A low-carbohydrate as compareci with a low-fat diet in severe obesity. N Engl J Med. 2003; 348(21):2074-81.
AZIZ 1. Low-carbohydrate as compareci with low-fat diets. N Engl J Med. 2003; 349(1O):1000.
Golay A, Eigenheer C, Morei Y, Kujawski P, Lehmann T, De Tonnac N. Weight-loss with low or high carbohydrate diet? lnt J Obes Metab Disord. 1996; 20(12):1067-72
Landry N, Bergeron N, Archer R, Samson P, Corneau L, Bergeron J, et ai. Whole-body fat oxidation rate and plasma triacylglicerol concentration in men consuming an ad libitum high-carbohydrate diet. Am Clin Nutr. 2003; 77(3):580-6.
Cha MC, Johnson JA, Hsu CY, Boozer CN. High-fat hypocaloric diet modifies carbohydrate utilization of obese rats during weight loss. Am J Physiol Endocrinol Metab. 2001; 280(5):E797-803.
Bravata DM, Sanders L, Huang J, Krumholz HM, Olkin 1, Gardner CD. Efficacy and safety of low-carbohydrate diets: a systematic review. JAMA. 2003; 289(14):b 1837-50.
Bray GA. Low-carbohydrate diets and realities of weight loss. JAMA. 2003; 289(14):1853-5.
Ornish D. Was Dr. Atikins right? J Am Diet Assoe. 2004; 104(4):537-542.
Ornish D, Wadden ln: Stephenson J. Low-carb, low-fat diets gurus face off. JAMA. 2003; 289(14): 1767-73.
Holtmeier KB, Seim HC. The diet prescription for obesity. What works? Minn Med. 2000; 83(11): 28-32.
Smith U. Carbohydrate, fat, and insulin action. Am J Clin Nutr. 1994; 59(3 Suppl):686S-689S.
Pi-Sunyer, FX. Obesidade. ln: Shils ME. Tratado de Nutrição moderna na saúde e na doença. 9. ed. Barueri: Manole; 2003. p.1493-5.
Pereira LO, Francischi RP, Lancha Jr. AH. Obesidade: hábitos nutricionais, sedentarismo e resistência à insulina. Arq Bras Endo Metab. 2003; 47(2):111-27.
Roust LR, Kottke BA, Jensen MD. Serum lipid responses to a eucaloric high-complex carbohydrate diet in different obesity phenotypes. Mayo Clin Proc. 1994; 69(10):930-6.
Schwarz JM, Linfoot P, Dare D, Aghajanian K. Hepatic de novo lipogenesis in normoinsulinemic and hyperinsulinemic subjects consuming high-fat, low-carbohydrate and low-fat, high-carbohydrate isoenergetic diets. Am J Clin Nutr. 2003; 77(1): 43-50.
Tapper-Gardizina Y, Cotugna N, Vickery CE. Should you recommend a low-carb, high-protein diet? Nurse Pract. 2002; 27(4):52-3, 55-6, 58-9.
Garrido JA. Low-carbohydrate as compareci with low-fat diets [letter]. N Engl J Med. 2003; 349(1O): 1000-2.
Duggirala MK, Mundell WC. Low-carbohydrate as compareci with low-fat diets [letter]. N Engl J Med. 2003; 349(1O):1000.
Samaha FF, Stern L, lqbal NA. Low-carbohydrate as compareci with low-fat diets [letter]. N Engl J Med. 2003; 349(10):1001-2.