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A randomized trial of a low-carbohydrate diet vs orlistat plus a low-fat diet for weight loss.

Publication ,  Journal Article
Yancy, WS; Westman, EC; McDuffie, JR; Grambow, SC; Jeffreys, AS; Bolton, J; Chalecki, A; Oddone, EZ
Published in: Arch Intern Med
January 25, 2010

BACKGROUND: Two potent weight loss therapies, a low-carbohydrate, ketogenic diet (LCKD) and orlistat therapy combined with a low-fat diet (O + LFD), are available to the public but, to our knowledge, have never been compared. METHODS: Overweight or obese outpatients (n = 146) from the Department of Veterans Affairs primary care clinics in Durham, North Carolina, were randomized to either LCKD instruction (initially, <20 g of carbohydrate daily) or orlistat therapy, 120 mg orally 3 times daily, plus low-fat diet instruction (<30% energy from fat, 500-1000 kcal/d deficit) delivered at group meetings over 48 weeks. Main outcome measures were body weight, blood pressure, fasting serum lipid, and glycemic parameters. RESULTS: The mean age was 52 years and mean body mass index was 39.3 (calculated as weight in kilograms divided by height in meters squared); 72% were men, 55% were black, and 32% had type 2 diabetes mellitus. Of the study participants, 57 of the LCKD group (79%) and 65 of the O + LFD group (88%) completed measurements at 48 weeks. Weight loss was similar for the LCKD (expected mean change, -9.5%) and the O + LFD (-8.5%) (P = .60 for comparison) groups. The LCKD had a more beneficial impact than O + LFD on systolic (-5.9 vs 1.5 mm Hg) and diastolic (-4.5 vs 0.4 mm Hg) blood pressures (P < .001 for both comparisons). High-density lipoprotein cholesterol and triglyceride levels improved similarly within both groups. Low-density lipoprotein cholesterol levels improved within the O + LFD group only, whereas glucose, insulin, and hemoglobin A(1c) levels improved within the LCKD group only; comparisons between groups, however, were not statistically significant. CONCLUSION: In a sample of medical outpatients, an LCKD led to similar improvements as O + LFD for weight, serum lipid, and glycemic parameters and was more effective for lowering blood pressure. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00108524.

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Published In

Arch Intern Med

DOI

EISSN

1538-3679

Publication Date

January 25, 2010

Volume

170

Issue

2

Start / End Page

136 / 145

Location

United States

Related Subject Headings

  • Weight Loss
  • Orlistat
  • Obesity
  • Middle Aged
  • Male
  • Lactones
  • Humans
  • General & Internal Medicine
  • Female
  • Diet, Fat-Restricted
 

Citation

APA
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ICMJE
MLA
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Yancy, W. S., Westman, E. C., McDuffie, J. R., Grambow, S. C., Jeffreys, A. S., Bolton, J., … Oddone, E. Z. (2010). A randomized trial of a low-carbohydrate diet vs orlistat plus a low-fat diet for weight loss. Arch Intern Med, 170(2), 136–145. https://doi.org/10.1001/archinternmed.2009.492
Yancy, William S., Eric C. Westman, Jennifer R. McDuffie, Steven C. Grambow, Amy S. Jeffreys, Jamiyla Bolton, Allison Chalecki, and Eugene Z. Oddone. “A randomized trial of a low-carbohydrate diet vs orlistat plus a low-fat diet for weight loss.Arch Intern Med 170, no. 2 (January 25, 2010): 136–45. https://doi.org/10.1001/archinternmed.2009.492.
Yancy WS, Westman EC, McDuffie JR, Grambow SC, Jeffreys AS, Bolton J, et al. A randomized trial of a low-carbohydrate diet vs orlistat plus a low-fat diet for weight loss. Arch Intern Med. 2010 Jan 25;170(2):136–45.
Yancy, William S., et al. “A randomized trial of a low-carbohydrate diet vs orlistat plus a low-fat diet for weight loss.Arch Intern Med, vol. 170, no. 2, Jan. 2010, pp. 136–45. Pubmed, doi:10.1001/archinternmed.2009.492.
Yancy WS, Westman EC, McDuffie JR, Grambow SC, Jeffreys AS, Bolton J, Chalecki A, Oddone EZ. A randomized trial of a low-carbohydrate diet vs orlistat plus a low-fat diet for weight loss. Arch Intern Med. 2010 Jan 25;170(2):136–145.

Published In

Arch Intern Med

DOI

EISSN

1538-3679

Publication Date

January 25, 2010

Volume

170

Issue

2

Start / End Page

136 / 145

Location

United States

Related Subject Headings

  • Weight Loss
  • Orlistat
  • Obesity
  • Middle Aged
  • Male
  • Lactones
  • Humans
  • General & Internal Medicine
  • Female
  • Diet, Fat-Restricted