Weight loss on low-fat vs. low-carbohydrate diets by insulin resistance status among overweight adults and adults with obesity: a randomized pilot trial
Open accessAbstract
Objective: To test for differential weight loss response to low‐fat (LF) vs. low‐carbohydrate (LC) diets by insulin resistance status with emphasis on overall quality of both diets. Methods: Sixty‐one adults, BMI 28‐40 kg/m 2, were randomized in a 2 × 2 design to LF or LC by insulin resistance status in this pilot study. Primary outcome was 6‐month weight change. Participants were characterized as more insulin resistant (IR) or more insulin sensitive (IS) by median split of baseline insulin‐area‐under‐the‐curve from an oral glucose tolerance test. Intervention consisted of 14 one‐hour class‐based educational sessions. Results: Baseline % carbohydrate:% fat:% protein was 44:38:18. At 6 months, the LF group reported 57:21:22 and the LC group reported 22:53:25 (IR and IS combined). Six‐month weight loss (kg) was 7.4 ± 6.0 (LF‐IR), 10.4 ± 7.8 (LF‐IS), 9.6 ± 6.6 (LC‐IR), and 8.6 ± 5.6 (LC‐IS). No significant main effects were detected for weight loss by diet group or IR status; there was no significant diet × IR interaction. Significant differences in several secondary outcomes were observed. Conclusions: Substantial weight loss was achieved overall, but a significant diet × IR status interaction was not observed. Opportunity to detect differential response may have been limited by the focus on high diet quality for both diet groups and sample size.
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Diet-biology interactions for weight loss have not always been reproducible and likely explain only a fraction of individual variability.
“Unfortunately, diet-biology interactions for weight loss have not always been reproducible68,69 and likely explain only a fraction of the individual variability.”
From Maintenance of Lost Weight and Long-Term Management of Obesity (2018) · cites this paper as [69]
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- Authors
- Gardner, C. D., Offringa, L. C., Hartle, J. C., Kapphahn, K., & Cherin, R.
- Affiliations
- Stanford Medicine (US)
- Quantitative Sciences Unit, Department of Medicine Stanford University Medical School Stanford CA
- Venue
- Obesity
- Publisher
- Wiley
- Published
- 2015-12-06
- Volume
- 24
- Issue
- 1
- Pages
- 79-86
- ISSN
- 1930-7381 (ISSN-L)
- 1930-739X
- PMC
- PMC5898445
- OpenAlex
- W2182133999
- Cited by
- 47
- References
- 35
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 5 · 2023: 7 · 2022: 1 · 2021: 4 · 2020: 6 · 2019: 2 · 2018: 6 · 2017: 8 · 2016: 3
- FWCI
- 4.17
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Obesity (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (5k12gm088033-05, RR-00070, K12‐GM088033, 1K12GM088033)
- National Heart, Lung, and Blood Institute (T32HL007034)
- National Institute of General Medical Sciences (K12-GM088033, 1 K12 GM088033)
- National Institute of Diabetes and Digestive and Kidney Diseases (P30DK020579)
- National Center for Research Resources (M-01 RR 00070, M01RR000070)
- Topics
- Health Sciences › Medicine › Physiology › Diet and metabolism studies
- Health Sciences › Medicine › Physiology › Dietary Effects on Health
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- weight loss, low-fat diet, low-carbohydrate diet, insulin resistance, overweight adults, diet quality, macronutrient composition
- MeSH terms
- Adult, Female, Glucose Tolerance Test, Humans, Insulin, Insulin Resistance, Male, Middle Aged, Obesity, Pilot Projects, Weight Loss, Diet, Fat-Restricted, Overweight, Diet, Carbohydrate-Restricted
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