Article Contents
Clin Exp Pediatr > Volume 67(4); 2024 |
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Study | Country | Subjects | Intervention duration (*) | Intervention details | Main findings |
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Sondike et al. (2003) [32] | USA | Overweight adolescents (n=39; aged 12–18 yr; BMI >95th percentile) | 12 Weeks (none) | Low-CHO (LC; <20-g/day CHO for 2 weeks and ≤40-g/day CHO for 10 weeks, ad libitum PRO, FAT) | The LC diet group showed more significant weight loss than the LF diet group. Non-HDL-cholesterol decreased in both diet groups, but more greatly reduced in the LC diet group. TG levels were significantly improved in the LC diet group, but no significant differences were observed between the 2 groups. Both TC and LDL-cholesterol levels significantly decreased only in LF diet groups, but changed levels of LDL-cholesterol were significantly different between the 2 groups. |
Low-FAT (LF; <40-g/day FAT, 5 servings of starch, ad libitum intake of fat-free dairy foods, fruits, and vegetables) | |||||
Rolland-Cachera et al. (2004) [33] | France | Massively obese children (n=121, 32 boys, 89 girls; aged 11–16 yr; BMI>97th percentile) | 9 Months (1&2 yr) | PROT - (54% CHO, 15% PRO, 31% FAT) | Both PROT- and PROT+ diet groups showed weight loss during the intervention period. However, body weight increased in both groups during the follow-up period. In addition, the changed values of body weight were not significantly different between 2 diet groups. |
PROT + (50% CHO, 19% PRO, 31% FAT) | |||||
*Energy intake 1,750 kcal/day until reaching the body weight goal. After, progressively increased at 1-week intervals to about 2,200 kcal/day on average. | |||||
Demol et al. (2009) [34] | Israel | Obese adolescents (n=55, 21 boys, 34 girls; aged 12– 18 yr; BMI >95th percentile) | 12 Weeks (12 mo) | Low-CHO, low-FAT (LCLF; 1,200–1,500 kcal/day: 60-g CHO (up to 20%), 50% PRO, 30% FAT) | All types of diet groups (LCLF, LCHF, and HCLF) had improvement in anthropometric parameters such as BMI, BMI-SDS, and mean body fat (%) after the intervention, but the changed values were not significantly different among the groups. Insulin and HOMA levels decreased in LC groups. Lipid parameters were significantly improved, but changed values were not different among the groups. The LC diet had no apparent advantage over the HCLF diet group. |
Low-CHO, high-FAT (LCHF; 1,200–1,500 kcal/day: 60-g CHO (up to 20%), 20% PRO, 60% FAT) | |||||
High-CHO, low-FAT (HCLF; 1,200–1,500 kcal/day: 50–60% CHO, 20% PRO, 30% FAT) | |||||
Krebs et al. (2010) [35] | USA | Severely overweight adolescents (n=46, 21 boys, 25 girls; aged 12–18 yr; primary obesity or ≥175 % of ideal body weight: 50th percentile) | 12 Weeks (24&36 wk) | High-PRO, low-CHO (HPLC; ≤20 g/day CHO, high lean PRO intake: 2.0- to 2.5-g protein/kg ideal body weight per day) | Both HPLC and LF diet groups showed decreased BMI z scores. However, the HPLC diet group showed a greater improvement than LF diet group. In addition, reduced BMI z scores were maintained during the follow-up period. Insulin resistance related- and cardiovascular risk related-parameters were improved in both diet groups. The HPLC diet is more effective on insulin resistance related-parameters than the LF diet. |
Low-FAT (LF; ≤30% FAT, 70% daily energy of resting energy expenditure) | |||||
Casazza et al. (2012) [36] | USA | Overweight/obese African American (n=26, girls; aged 9–14 yr; BMI≥92nd percentile) | 16 Weeks (none) | Reduced-CHO (SPEC; 42% CHO, 18% PRO, 40% FAT) | Both STAN and SPEC diet groups had decreased body weight and adiposity, but no significant differences were observed between the 2 groups. The SPEC diet group showed a more decreased TG levels than the STAN diet group. In the solid meal test, glucose/insulin homeostasis were improved in the SPEC diet group up to 3-hr postingestion. |
Standard-CHO (STAN; 55% CHO, 18% PRO, 27% FAT) | |||||
*5-Week eucaloric (weight-stable), 11 week hypocaloric (weight loss, 1,000 kcal reduction) | |||||
Partsalaki et al. (2012) [37] | Greece | Obese children/adolescents (n=58, 27 boys, 31 girls; aged 8–18 yr; BMI >95th percentile) | 6 Months (none) | Ketogenic diet (aimed for <20-g/day CHO, If indicate ketosis, gradual increase towards 30–40 g/day) | Ketogenic and hypocaloric diet groups showed reduction of body weight, BMI, fat mass, and waist circumference. Glycemic parameters such as fasting insulin, WBISI, and HOMA-IR were improved in both groups. The ketogenic diet group had increased adiponectin levels, but no changes in lipid profile, fat-free mass, and blood pressure. No significant differences were observed between the 2 groups, but the values were relatively more improved in the ketogenic diet group. |
Hypocaloric diet (reduce caloric intake by 500 kcal; 50%–55% CHO, 28%–33 % FAT) | |||||
Kirk et al. (2012) [38] | USA | Obese children (n=102, 43 boys, 59 girls; aged 7–12 yr; BMI z score of 1.60–2.65; with fasting blood glucose ≤100 mg/dL) | 3 Months (6&12 mo) | Low-CHO (LC; induction phase with ≤20-g/day CHO, after induction; increased by 5- to 10-g/week CHO and up to maximum of 60-g/day) | All diet groups had decreased BMI z scores and body fat (%) after the intervention. This effect was maintained for 12 months. But no significant differences were observed among the groups. LC diet group had improved TG and HDL-cholesterol levels. PC and RGL are relatively more effective in lowering fasting insulin and glucose levels. However, diet adherence was significantly lower in the LC diet group than others. |
Reduced glycemic load; (RGL; limit intake of high-GI food) | |||||
Portion-controlled (PC; 55%–60% CHO, 10%–15% PRO, 30% FAT, 500-kcal deficit) | |||||
Mirza et al. (2013) [39] | USA | Obese Hispanic children (n=113, 58 boys, 55 girls; aged 7–15 yr; BMI≥95th percentile) | 12 Weeks (1&2 yr) | Low-glycemic load diet (LGD; 45%– 50% low-GI CHO, 20%–25% PRO, 30%–35% FAT) | Both LGD and LFD diet groups had reduced BMI z scores, waist circumference, and systolic blood pressure after the intervention. However, no significant differences were observed between the 2 groups. |
Low-FAT diet (LFD; 55%–60% CHO (no discrimination by GI), 15%–20% PRO, 25%–30% FAT) | |||||
Truby et al. (2016) [40] | Australia | Obese adolescents (n=87, 24 boys, 63 girls; aged 10– 17 yr; BMI>90th percentile) | 12 Weeks (none) | Control | Both SLF and SMC diet groups showed weight loss and improved body composition, lipid profile, and HOMA-IR compared with the control diet group. But no significant differences were observed between SLF and SMC diet groups. |
Structured-low FAT (SLF; 55% CHO, 20 % PRO, 25% FAT) | |||||
Structured-modified CHO (SMC; 35% CHO; 30% PRO, 35% FAT) |
BMI, body mass index; SDS, standard deviation score; CHO, carbohydrate; LC, low-carbohydrate; PRO, protein; FAT, fat; LF, low-fat; HDL, high-density lipoprotein; TG, triglyceride; TC, total cholesterol; LDL, low-density lipoprotein; HOMA-IR, homeostasis model assessment-insulin resistance; GI, glycemic index; PROT, protein; SPEC, specialized diet; STAN, standard diet; WBISI, whole-body insulin sensitivity index.