A randomized controlled trial on the efficacy of carbohydrate-reduced or fat-reduced diets in patients attending a telemedically guided weight loss program
Open accessAbstract
BACKGROUND: We investigated whether macronutrient composition of energy-restricted diets influences the efficacy of a telemedically guided weight loss program. METHODS: Two hundred overweight subjects were randomly assigned to a conventional low-fat diet and a low-carbohydrate diet group (target carbohydrate content: >55% energy and <40% energy, respectively). Both groups attended a weekly nutrition education program and dietary counselling by telephone, and had to transfer actual body weight data to our clinic weekly with added Bluetooth technology by mobile phone. Various fatness and fat distribution parameters, energy and macronutrient intake, and various biochemical risk markers were measured at baseline and after 6, and 12 months. RESULTS: In both groups, energy intake decreased by 400 kcal/d compared to baseline values within the first 6 months and slightly increased again within the second 6 months. Macronutrient composition differed significantly between the groups from the beginning to month 12. At study termination, weight loss was 5.8 kg (SD: 6.1 kg) in the low-carbohydrate group and 4.3 kg (SD: 5.1 kg) in the low-fat group (p = 0.065). In the low-carbohydrate group, triglyceride and HDL-cholesterol levels were lower at month 6 and waist circumference and systolic blood pressure were lower at month 12 compared with the low-fat group (P = 0.005-0.037). Other risk markers improved to a similar extent in both groups. CONCLUSION: Despite favourable effects of both diets on weight loss, the carbohydrate-reduced diet was more beneficial with respect to cardiovascular risk factors compared to the fat-reduced diet. Nevertheless, compliance with a weight loss program appears to be even a more important factor for success in prevention and treatment of obesity than the composition of the diet. TRIAL REGISTRATION: Clinicaltrials.gov as NCT00868387.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the low-carbohydrate group of that study, 76% of weight loss was from fat mass and 24% from lean body mass loss.
“Study results showed that both diets resulted in similar amounts of weight loss (5.8 kg vs. 4.3 kg, respectively; p = 0.065), with 76% of the weight loss from FM and 24% from LBM loss in the low-carbohydrate group [17].”
From Body Composition Changes in Weight Loss: Strategies and Supplementation for Maintaining Lean Body Mass, a Brief Review (2018) · cites this paper as [17]
In a 12-month study of 200 subjects, low-carbohydrate and low-fat diets resulted in similar amounts of weight loss (5.8 kg vs. 4.3 kg, p = 0.065).
“Study results showed that both diets resulted in similar amounts of weight loss (5.8 kg vs. 4.3 kg, respectively; p = 0.065), with 76% of the weight loss from FM and 24% from LBM loss in the low-carbohydrate group [17].”
From Body Composition Changes in Weight Loss: Strategies and Supplementation for Maintaining Lean Body Mass, a Brief Review (2018) · cites this paper as [17]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Lichtenstein, A. H., Appel, L. J., Brands, M., Carnethon, M., Daniels, S., Franch, H. A., Franklin, B., Kris-Etherton, P., Harris, W. S., Howard, B., et al. (2006) · Circulation · doi:10.1161/circulationaha.106.176158 · Cited by 2,705 · see citing works
Comparison of Weight-Loss Diets with Different Compositions of Fat, Protein, and Carbohydrates
Sacks, F. M., Bray, G. A., Carey, V. J., Smith, S. R., Ryan, D. H., Anton, S. D., McManus, K., Champagne, C. M., Bishop, L. M., Laranjo, N., et al. (2009) · New England Journal of Medicine · doi:10.1056/nejmoa0804748 · Cited by 1,966 · cited 1× · see citing works
“restricted diets in these earlier studies [12,13,29,30], and/ or a more pronounced carbohydrate restriction in the low-carbohydrate diets used [12-14,29,31].”
A Randomized Trial of a Low-Carbohydrate Diet for Obesity
Foster, G. D., Wyatt, H. R., Hill, J. O., McGuckin, B. G., Brill, C., Mohammed, B. S., Szapary, P. O., Rader, D. J., Edman, J. S., & Klein, S. (2003) · New England Journal of Medicine · doi:10.1056/nejmoa022207 · Cited by 1,794 · see citing works
A Low-Carbohydrate as Compared with a Low-Fat Diet in Severe Obesity
Samaha, F. F., Iqbal, N., Seshadri, P., Chicano, K. L., Daily, D. A., McGrory, J., Williams, T., Williams, M., Gracely, E. J., & Stern, L. (2003) · New England Journal of Medicine · doi:10.1056/nejmoa022637 · Cited by 1,267 · cited 1× · see citing works
“This may at least in part be due to two factors: the comparably higher weight loss by carbohydrate-restricted diets in these earlier studies [12, 13, 29, 30], and/or a more pronounced carbohydrate restriction in the low-carbohydrate diets used [ 12–14, 29, 31].”
Gardner, C. D., Kiazand, A., Alhassan, S., Kim, S., Stafford, R. S., Balise, R. R., Kraemer, H. C., & King, A. C. (2007) · JAMA · doi:10.1001/jama.297.9.969 · Cited by 1,051 · see citing works
Stern, L., Iqbal, N., Seshadri, P., Chicano, K. L., Daily, D. A., McGrory, J., Williams, M., Gracely, E. J., & Samaha, F. F. (2004) · Annals of Internal Medicine · doi:10.7326/0003-4819-140-10-200405180-00007 · Cited by 831 · see citing works
A self-regulation program for maintenance of weight loss
Wing, R. R., Tate, D. F., Gorin, A. A., Raynor, H. A., & Fava, J. L. (2006) · New England Journal of Medicine · doi:10.1056/nejmoa061883 · Cited by 830 · see citing works
McKeown, N. M., Meigs, J. B., Liu, S., Saltzman, E., Wilson, P. W. F., & Jacques, P. F. (2004) · Diabetes Care · doi:10.2337/diacare.27.2.538 · Cited by 786 · see citing works
Flagged first, then by citations
Research works printed but not linked: 24
- Caballero B The global epidemic of obesity: An overview Epidemiol Rev 2007 8 1 5 10.1093/epirev/mxm012 17569676 · DOI
- Ogden CL Carroll MD Curtin LR McDowell MA Tabak CJ Flegal KM Prevalence of overweight and obesity in the United States, 1999–2004 JAMA 2006 8 1549 1555 10.1001/jama.295.13.1549 16595758 · DOI · Paper page
- Liu S Manson JE Stampfer MJ Hu FB Franz M Sampson L Hennekens CH Manson JE A prospective study of whole-grain intake and risk of type 2 diabetes mellitus in US women Am J Public Health 2000 8 1409 1415 10.2105/AJPH.90.9.1409 10983198 PMC1447620 · DOI
- Gross LS Li L Ford ES Liu S Increased consumption of refined carbohydrates and the epidemic of type 2 diabetes in the United States: an ecologic assessment Am J Clin Nutr 2004 8 774 779 15113714
- World Health Organisation (WHO) Obesity: Preventing and managing the global epidemic Technical Report Series 894, Geneva 2000 11234459
- Yancy WS Jr Westma EC French PA Califf RM Diets and clinical coronary events: the truth is out there Circulation 2003 8 10 16 10.1161/01.CIR.0000049205.35749.00 12515734 · DOI
- Brehm BJ D'Alessio DA Weight loss and metabolic benefits with diets of varying fat and carbohydrate content: separating the wheat from the chaff Nat Clin Pract Endocrinol Metab 2008 8 140 146 10.1038/ncpendmet0730 18227817 · DOI · Paper page
- Brehm BJ Seeley RJ Daniels SR D'Alessio DA A randomized trial comparing a very low carbohydrate diet and a calorie-restricted low fat diet on body weight and cardiovascular risk factors in healthy women J Clin Endocrinol Metab 2003 8 1617 1623 10.1210/jc.2002-021480 12679447 · DOI · Paper page
- Heska S Anderson JW Atkinson RL Greenway FL Hill JO Phinney SD Kolotkin RL Miller-Kovach K Pi-Sunyer FX Weight loss with self-help compared with a structured commercial program: a randomized trial JAMA 2003 8 1792 1798 10.1001/jama.289.14.1792 12684357 · DOI · Paper page
- Körtke H Frisch S Zittermann A Berthold HK El-Arousy M Götting C Kleesiek K Stehle P Körfer R [A telemetrically-guided program for weight reduction in overweight subjects (the SMART study)] Dtsch Med Wochenschr 2008 8 1297 1303 10.1055/s-2008-1077256 18528796 · DOI
- Stehle P Dissemination of nutritional knowledge in Germany – nutrition circle, 3D food pyramid and 10 nutrition guidelines Ann Nutr Metab 2007 8 suppl 2 21 25 10.1159/000103563 · DOI
- Ebbeling CB Leidig MM Sinclair KB Seger-Shippee LG Feldman HA Ludwig DS Effects of an ad libitum low-glycemic load diet on cardiovascular disease risk factors in obese young adults Am J Clin Nutr 2005 8 976 982 15883418
- Alberti KG Zimmet P Shaw J Metabolic syndrome-a new world-wide definition. A consensus statement from the international diabetes federation Diabet Med 2006 8 469 480 10.1111/j.1464-5491.2006.01858.x 16681555 · DOI · Paper page
- Volkert D Kreuel K Heseker H Stehle P Energy and nutrient intake of young-old, old-old, and very-old elderly in Germany Eur J Clin Nutr 2004 8 1190 1200 10.1038/sj.ejcn.1601950 15054435 · DOI
- Frey I Berg A Grathwohl D Keul J [Freiburg Questionnaire of physical activity development, evaluation and application] Soz Praventivmed 1999 8 55 64 [in German] 10.1007/BF01667127 10407953 · DOI
- Ainsworth BE Haskell WL Leon AS Jacobs DR Jr Montoye HJ Sallis JF Paffenbarger RS Jr Compendium of physical activities: classification of energy costs of human physical activities Med Sci Sports Exerc 1993 8 71 80 10.1249/00005768-199301000-00011 8292105 · DOI · Paper page
- Ainsworth BE Haskell WL Whitt MC Irwin ML Swartz AM Strath SJ O'Brien WL Bassett DR Jr Schmitz KH Emplaincourt PO Jacobs DR Jr Leon AS Compendium of physical activities: an update of activity codes and MET intensities Med Sci Sports Exerc 2000 8 Suppl S498 504 10.1097/00005768-200009001-00009 10993420 · DOI · Paper page
- Yancy WS Jr Olsen MK Guyton JR Bakst RP Westman EC A low-carbohydrate, ketogenic diet versus a low-fat diet to treat obesity and hyperlipidemia: a randomized, controlled trial Ann Intern Med 2004 8 769 777 15148063
- Shai I Schwarzfuchs D Henkin Y Shahar DR Witkow S Greenberg I Golan R Fraser D Bolotin A Vardi H Tangi-Rozental O Zuk-Ramot R Sarusi B Brickner D Schwartz Z Sheiner E Marko R Katorza E Thiery J Fiedler GM Blüher M Stumvoll M Stampfer MJ Dietary Intervention Randomized Controlled Trial (DIRECT) Group. Weight loss with a low-carbohydrate, Mediterranean, or low-fat diet N Engl J Med 2008 8 229 241 10.1056/NEJMoa0708681 18635428 · DOI · Paper page
- Hatahet W Cole L Kudchodkar BJ Fungwe TV Dietary fats differentially modulate the expression of lecithin:cholesterol acyltransferase, apoprotein-A1 and scavenger receptor b1 in rats J Nutr 2003 8 689 694 12612138
- Dansinger ML Gleason JA Griffith JL Selker HP Schaefer EJ Comparison of the Atkins, Ornish, Weight Watcher, and Zone diets for weight loss and heart disease risk reduction JAMA 2005 8 43 53 10.1001/jama.293.1.43 15632335 · DOI · Paper page
- Festa A D'Agostino R Jr Howard G Mykkänen L Tracy RP Haffner SM Chronic subclinical inflammation as part of the insulin resistance syndrome: the Insulin Resistance Atherosclerosis Study (IRAS) Circulation 2000 8 42 47 10880413
- Stühlinger MC Abbasi F Chu JW Lamendola C McLaughlin TL Cooke JP Reaven GM Tsao PS Relationship between insulin resistance and an endogenous nitric oxide synthase inhibitor JAMA 2002 8 1420 1426 10.1001/jama.287.11.1420 11903029 · DOI
- Zhu W Cheng KK Vanhoutte PM Lam KS Xu A Vascular effects of adiponectin: molecular mechanisms and potential therapeutic intervention Clin Sci 2008 8 361 374 10.1042/CS20070347 18230060 · DOI
Cited by
Sorted by citations
2013 AHA/ACC/TOS Guideline for the Management of Overweight and Obesity in Adults
Jensen, M. D., Ryan, D. H., Apovian, C. M., Ard, J. D., Comuzzie, A. G., Donato, K. A., Hu, F. B., Hubbard, V. S., Jakicic, J. M., Kushner, R. F., et al. (2014) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2013.11.004 · Cited by 4,058 · see citing works
2013 AHA/ACC/TOS Guideline for the Management of Overweight and Obesity in Adults
Jensen, M. D., Ryan, D. H., Apovian, C. M., Ard, J. D., Comuzzie, A. G., Donato, K. A., Hu, F. B., Hubbard, V. S., Jakicic, J. M., Kushner, R. F., et al. (2014) · Circulation · doi:10.1161/01.cir.0000437739.71477.ee · Cited by 2,735 · see citing works
Garvey, W. T., Mechanick, J. I., Brett, E. M., Garber, A. J., Hurley, D. L., Jastreboff, A. M., Nadolsky, K., Pessah-Pollack, R., & Plodkowski, R. (2016) · Endocrine Practice · doi:10.4158/ep161365.gl · Cited by 1,914 · see citing works
Widmer, R. J., Collins, N. M., Collins, C. S., West, C. P., Lerman, L. O., & Lerman, A. (2015) · Mayo Clinic Proceedings · doi:10.1016/j.mayocp.2014.12.026 · Cited by 416 · see citing works
Hu, T., Mills, K. T., Yao, L., Demanelis, K., Eloustaz, M., Yancy, W. S., Kelly, T. N., He, J., & Bazzano, L. A. (2012) · American Journal of Epidemiology · doi:10.1093/aje/kws264 · Cited by 417 · see citing works
Tobias, D. K., Chen, M., Manson, J. E., Ludwig, D. S., Willett, W., & Hu, F. B. (2015) · The Lancet Diabetes & Endocrinology · doi:10.1016/s2213-8587(15)00367-8 · Cited by 373 · see citing works
Santos, F. L., Esteves, S. S., da Costa Pereira, A., Yancy Jr, W. S., & Nunes, J. P. L. (2012) · Obesity Reviews · doi:10.1111/j.1467-789x.2012.01021.x · Cited by 318 · see citing works
Naude, C. E., Schoonees, A., Senekal, M., Young, T., Garner, P., & Volmink, J. (2014) · PLoS ONE · doi:10.1371/journal.pone.0100652 · Cited by 252 · see citing works
Schwingshackl, L., & Hoffmann, G. (2013) · Journal of the Academy of Nutrition and Dietetics · doi:10.1016/j.jand.2013.07.010 · Cited by 218 · see citing works
Willoughby, D., Hewlings, S., & Kalman, D. (2018) · Nutrients · doi:10.3390/nu10121876 · Cited by 214 · see citing works
Chawla, S., Tessarolo Silva, F., Amaral Medeiros, S., Mekary, R., & Radenkovic, D. (2020) · Nutrients · doi:10.3390/nu12123774 · Cited by 185 · see citing works
The low-carbohydrate diet and cardiovascular risk factors: evidence from epidemiologic studies
Hu, T., & Bazzano, L. A. (2014) · Nutrition Metabolism and Cardiovascular Diseases · doi:10.1016/j.numecd.2013.12.008 · Cited by 112 · see citing works
Gjuladin-Hellon, T., Davies, I. G., Penson, P., & Amiri Baghbadorani, R. (2019) · Nutrition Reviews · doi:10.1093/nutrit/nuy049 · Cited by 108 · see citing works
A systematic review of the effect of semaglutide on lean mass: insights from clinical trials
Bikou, A., Dermiki-Gkana, F., Penteris, M., Constantinides, T. K., & Kontogiorgis, C. (2024) · Expert Opinion on Pharmacotherapy · doi:10.1080/14656566.2024.2343092 · Cited by 97 · see citing works
Fechner, E., Smeets, E., Schrauwen, P., & Mensink, R. (2020) · Nutrients · doi:10.3390/nu12040991 · Cited by 64 · see citing works
“Frisch [25] 2009 Parallel Isocaloric with ER 12 months 200 overweight participants −64 −4.”
Dietary protein in weight management: a review proposing protein spread and change theories
Bosse, J. D., & Dixon, B. M. (2012) · Nutrition & Metabolism · doi:10.1186/1743-7075-9-81 · Cited by 31 · see citing works
- Authors
- Frisch, S., Zittermann, A., Berthold, H. K., Götting, C., Kuhn, J., Kleesiek, K., Stehle, P., & Körtke, H.
- Affiliations
- Heart and Diabetes Center North Rhine-Westphalia (DE)
- Ruhr University Bochum (DE)
- Charité – Universitätsmedizin Berlin (DE)
- University of Bonn (DE)
- Corresponding author
- Frisch, Sabine
- Venue
- Cardiovascular Diabetology
- Published
- 2009
- Volume
- 8
- Issue
- 1
- Pages
- 36
- ISSN
- 1475-2840 (ISSN-L)
- PMC
- PMC2722581
- OpenAlex
- W2141548060
- Cited by
- 92
- References
- 8
- Citations by year
- 2026: 1 · 2025: 5 · 2024: 4 · 2023: 3 · 2022: 12 · 2020: 5 · 2019: 3 · 2018: 6 · 2017: 3 · 2016: 7 · 2015: 7 · 2014: 8 · 2013: 11 · 2012: 7
- FWCI
- 3.55
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Cardiovascular Diabetology (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Medicine › Physiology › Diet and metabolism studies
- Health Sciences › Medicine › Physiology › Dietary Effects on Health
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Keywords
- low-carbohydrate diet, low-fat diet, hypocaloric diet, macronutrient composition, telemedicine, weight loss, obesity, overweight, nutrition counseling, cardiovascular risk factors, triglycerides, HDL cholesterol, waist circumference, blood pressure, dietary adherence
- MeSH terms
- Adult, Body Composition, Female, Humans, Male, Middle Aged, Obesity, Patient Education as Topic, Weight Loss, Telemedicine, Diet, Fat-Restricted, Overweight, Diet, Carbohydrate-Restricted
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
