PMID- 37226271 OWN - NLM STAT- MEDLINE DCOM- 20230526 LR - 20231101 IS - 1741-7015 (Electronic) IS - 1741-7015 (Linking) VI - 21 IP - 1 DP - 2023 May 24 TI - The effect of dietary carbohydrate and calorie restriction on weight and metabolic health in overweight/obese individuals: a multi-center randomized controlled trial. PG - 192 LID - 10.1186/s12916-023-02869-9 [doi] LID - 192 AB - BACKGROUND: Both low-carbohydrate (LC) and calorie-restricted (CR) diets have been shown to have metabolic benefits. However, the two regimens have yet to be thoroughly compared. We conducted a 12-week randomized trial to compare the effects of these diets separately and in combination on both weight loss and metabolic risk factors in overweight/obese individuals. METHODS: A total of 302 participants were randomized to LC diet (n = 76), CR diet (n = 75), LC + CR diet (n = 76), or normal control (NC) diet (n = 75) using a computer-based random number generator. The primary outcome was the change in body mass index (BMI). The secondary outcomes included body weight, waist circumference, waist-to-hip ratio, body fat, and metabolic risk factors. All participants attended health education sessions during the trial. RESULTS: A total of 298 participants were analyzed. BMI change over 12 weeks was - 0.6 (95% CI, - 0.8 to - 0.3) kg/m(2) in NC, - 1.3 (95% CI, - 1.5 to - 1.1) kg/m(2) in CR, - 2.3 (95% CI, - 2.6 to - 2.1) kg/m(2) in LC, and - 2.9 (95% CI, - 3.2 to - 2.6) kg/m(2) in LC + CR. LC + CR diet was more effective than LC or CR diet alone at reducing BMI (P = 0.001 and P < 0.001, respectively). Furthermore, compared with the CR diet, the LC + CR diet and LC diet further reduced body weight, waist circumference, and body fat. Serum triglycerides were significantly reduced in the LC + CR diet group compared with the LC or CR diet alone. Plasma glucose, homeostasis model assessment of insulin resistance, and cholesterol concentrations (total, LDL, and HDL) did not change significantly between the groups during the 12-week intervention. CONCLUSIONS: The reduction of carbohydrate intake without restricting caloric intake is more potent to achieve weight loss over 12 weeks when compared to a calorie-restricted diet in overweight/obese adults. The combination of restricting carbohydrate and total calorie intake may augment the beneficial effects of reducing BMI, body weight, and metabolic risk factors among overweight/obese individuals. TRIAL REGISTRATION: The study was approved by the institutional review board of Zhujiang Hospital of Southern Medical University and registered at the China Clinical Trial Registration Center (registration number: ChiCTR1800015156). CI - (c) 2023. The Author(s). FAU - Sun, Jia AU - Sun J AD - Department of Endocrinology and Metabolism, Zhujiang Hospital, Southern Medical University, No. 253, Industrial Avenue, Haizhu Square, Guangzhou, Guangdong, China. sunjia@smu.edu.cn. FAU - Ruan, Yuting AU - Ruan Y AD - Department of Endocrinology and Metabolism, Zhujiang Hospital, Southern Medical University, No. 253, Industrial Avenue, Haizhu Square, Guangzhou, Guangdong, China. FAU - Xu, Ningning AU - Xu N AD - Department of Endocrinology and Metabolism, Zhujiang Hospital, Southern Medical University, No. 253, Industrial Avenue, Haizhu Square, Guangzhou, Guangdong, China. FAU - Wu, Peili AU - Wu P AD - Department of Endocrinology and Metabolism, Zhujiang Hospital, Southern Medical University, No. 253, Industrial Avenue, Haizhu Square, Guangzhou, Guangdong, China. FAU - Lin, Nie AU - Lin N AD - Department of Endocrinology and Metabolism, Zhujiang Hospital, Southern Medical University, No. 253, Industrial Avenue, Haizhu Square, Guangzhou, Guangdong, China. FAU - Yuan, Kun AU - Yuan K AD - Department of Endocrinology and Metabolism, Zhujiang Hospital, Southern Medical University, No. 253, Industrial Avenue, Haizhu Square, Guangzhou, Guangdong, China. FAU - An, Shengli AU - An S AD - Department of Bio-Statistics, Southern Medical University, No.1023 Sha Tai Nan Lu, Baiyun Square, Guangzhou, Guangdong, China. FAU - Kang, Pei AU - Kang P AD - Department of Bio-Statistics, Southern Medical University, No.1023 Sha Tai Nan Lu, Baiyun Square, Guangzhou, Guangdong, China. FAU - Li, Shu AU - Li S AD - Department of Endocrinology, Huizhou Municipal Center Hospital, No. 41, Eling North Road, Huizhou, Guangdong, China. FAU - Huang, Qiya AU - Huang Q AD - Department of Endocrinology, Qing Yuan People's Hospital, Qingyuan, Guangdong, China. FAU - Yingzhang AU - Yingzhang AD - Department of Endocrinology, The Third Affiliated Hospital of Guangzhou Medical University, No. 63, DuoBao Road, Liwan Square, Guangzhou, Guangdong, China. FAU - Li, Yuzhong AU - Li Y AD - Department of Endocrinology, Dongguan Kanghua Hospital, 1000 Dongguan Avenue, Dongguan, Guangdong, China. FAU - Su, Jialin AU - Su J AD - Department of Endocrinology, He Xian Memorial Hospital, No. 2, Qinghe East Road, Panyu District, Guangzhou, Guangdong, China. FAU - Ma, Wenjun AU - Ma W AD - Department of Nutrition, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, No. 106, Zhongshan Second Road, Yuexiu District, Guangzhou, Guangdong, China. FAU - Chen, Bo AU - Chen B AD - Department of Endocrinology, Guangdong Second Provincial General Hospital, No.466, Xing Gang Middle Road, Haizhu District, Guangzhou, Guangdong, China. FAU - Zhang, Xiuwei AU - Zhang X AD - Department of Endocrinology, Dongguan People's Hospital, Wandao Road (South), Xinguchong, Wanjiang District, Dongguan, Guangdong, China. FAU - Chen, Xiaoming AU - Chen X AD - Department of Endocrinology, Affiliated Hospital of Guangdong Medical University, No. 57, Renmin Avenue South, Xiashan District, Zhanjiang, Guangdong, China. FAU - Liang, Yongqian AU - Liang Y AD - Department of Endocrinology and Metabolism, Shunde Hospital of Southern Medical University, No. 1, Lunjiao Jiazi Road, Shunde District, Foshan, Guangdong, China. FAU - Lu, Zeyuan AU - Lu Z AD - Department of Endocrinology, The Eighth Affiliated Hospital of Sun Yat-Sen University, No. 3025, Shennan Road, Shenzhen, Guangdong, China. FAU - Deng, Guobao AU - Deng G AD - Department of Endocrinology, Shaoguan First People's Hospital, No. 3, Dongdi South Road, Zhenjiang District, Shaoguan, Guangdong, China. FAU - Zhang, Zhen AU - Zhang Z AD - Department of Endocrinology and Metabolism, Zhujiang Hospital, Southern Medical University, No. 253, Industrial Avenue, Haizhu Square, Guangzhou, Guangdong, China. FAU - Wang, Yuqin AU - Wang Y AD - Pansonglou Health Management Center, Guangzhou First People's Hospital, Guangzhou, China. AD - Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, No. 1838 Guangzhou Dadao Bei, Baiyun Square, Guangzhou, Guangdong, China. FAU - Wen, Weiheng AU - Wen W AD - Department of Endocrinology and Metabolism, Zhujiang Hospital, Southern Medical University, No. 253, Industrial Avenue, Haizhu Square, Guangzhou, Guangdong, China. FAU - Zhang, Huijie AU - Zhang H AD - Pansonglou Health Management Center, Guangzhou First People's Hospital, Guangzhou, China. huijezhang2005@126.com. AD - Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, No. 1838 Guangzhou Dadao Bei, Baiyun Square, Guangzhou, Guangdong, China. huijezhang2005@126.com. FAU - Chen, Hong AU - Chen H AD - Department of Endocrinology and Metabolism, Zhujiang Hospital, Southern Medical University, No. 253, Industrial Avenue, Haizhu Square, Guangzhou, Guangdong, China. chenhong123@smu.edu.cn. LA - eng SI - ChiCTR/ChiCTR1800015156 PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20230524 PL - England TA - BMC Med JT - BMC medicine JID - 101190723 RN - 0 (Dietary Carbohydrates) SB - IM MH - Adult MH - Humans MH - *Overweight MH - *Dietary Carbohydrates MH - Caloric Restriction MH - Obesity MH - Diet, Carbohydrate-Restricted PMC - PMC10210464 OTO - NOTNLM OT - Calorie-restricted diet OT - Low-carbohydrate diet OT - Metabolic risk factors OT - Overweight/obese OT - Weight loss COIS- The authors declare that they have no competing interests. EDAT- 2023/05/25 01:07 MHDA- 2023/05/26 06:42 PMCR- 2023/05/24 CRDT- 2023/05/24 23:54 PHST- 2022/07/19 00:00 [received] PHST- 2023/04/17 00:00 [accepted] PHST- 2023/05/26 06:42 [medline] PHST- 2023/05/25 01:07 [pubmed] PHST- 2023/05/24 23:54 [entrez] PHST- 2023/05/24 00:00 [pmc-release] AID - 10.1186/s12916-023-02869-9 [pii] AID - 2869 [pii] AID - 10.1186/s12916-023-02869-9 [doi] PST - epublish SO - BMC Med. 2023 May 24;21(1):192. doi: 10.1186/s12916-023-02869-9.