112009DietStudy

112009DietStudy - 20 08 THE OBESITY SOCIETY Annual...

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Christopher Gardner, PhD Andrea Bersamin, PhD Soowon Kim, PhD Sofiya Alhassan, PhD Mindy Dopler-Nelson, PhD Beibei Oelrich, MD Abby King, PhD Stanford Prevention Research Center Stanford University, Department of Medicine Insulin Resistance An Effect Moderator of Weight Loss Success on Low-Carb vs. Low-Fat Diets 20 08 THE OBESITY SOCIETY Annual Scientific Meeting Phoenix, AZ October 3-7, 2008 Phoenix Convention Center
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Outline Original A TO Z weight loss study Ebbeling 2007, Cornier 2005, Pittas 2005: Insulin Resistance – Effect Moderator A TO Z: Exploratory Analysis Conclusions
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A Weight Loss Diet Study A Weight Loss Diet Study
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Z one A tkins T raditional (L.E.A.R.N.) O rnish
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100 80 60 40 20 0 Protein Fat Carbohydrate % Energy From Low-Carb to Low-Fat
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Atkins n=77 Zone n=79 LEARN n=79 Ornish n=76 Base- line 6 months 311 overweight (BMI 27-40) women, 25-50 years old Weekly Classes Primary outcome: Weight Change Secondary outcomes: Lipids, blood pressure, body composition, insulin, glucose Behavioral / psychosocial measures Appetite / food preference measures 1 year 8 weeks
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Percent weight change across time, by group Intention-to-treat, baseline value carried forward for drop-outs Atkins Zone LEARN Ornish 77 79 79 76 72 72 72 71 71 66 64 65 68 61 60 58 % Retention 1-year 88% 77% 76% 78% Participants with available data Gardner et al. JAMA 2007;297:969-77
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-9 -8 -7 -6 -5 -4 -3 -2 -1 0 Base- line 2 months 6 months 12 months Atkins Zone Ornish Percent weight change across time, by group Intention-to-treat, baseline value carried forward for drop-outs Atkins Zone LEARN Ornish 77 79 79 76 72 72 72 71 71 66 64 65 68 61 60 58 % Retention 1-year 88% 77% 76% 78% Participants with available data LEARN Weight change as % of baseline p<0.03 (Tukey’s studentized range test) A vs. Z Gardner et al. JAMA 2007;297:969-77
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12-month net weight change (kg): Individual results -30 -25 -20 -15 -10 -5 0 5 10 15 20 -30 -25 -20 -15 -10 -5 0 5 10 15 20 -30 -25 -20 -15 -10 -5 0 5 10 15 20 -30 -25 -20 -15 -10 -5 0 5 10 15 20
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12-month net weight change (kg): Individual results -30 -25 -20 -15 -10 -5 0 5 10 15 20 -30 -25 -20 -15 -10 -5 0 5 10 15 20 -30 -25 -20 -15 -10 -5 0 5 10 15 20 -30 -25 -20 -15 -10 -5 0 5 10 15 20
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LEARN Atkins Zone Ornish Carb Fat Protein 8 weeks 17% 55% 28% 42% 34% 24% 50% 30% 20% 63% 21% 16% Each macronutrient was significantly different for every diet group vs. every other diet group
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LEARN Atkins Zone Ornish 8 weeks 17% 55% 28% 42% 34% 24% 50% 30% 20% 63% 21% 16% 6 months 30% 47% 23% 44% 36% 20% 49% 32% 19% 53% 29% 18% Carb Fat Protein
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LEARN Atkins Zone Ornish 6 months 30% 47% 23% 44% 36% 20% 49% 32% 19% 53% 29% 18% 1 year 32% 46% 22% 46% 34% 20% 48% 33% 19% 52% 29% 19% 17% 55% 28% 42% 34% 24% 50% 30% 20% 63% 21% 16% 8 weeks Carb Fat Protein 3,137 24-hr recalls (NDS) At 1 year, group differences in carb, fat and protein statistically significant (ANOVA)
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Outline Original A TO Z weight loss study Ebbeling 2007, Cornier 2005, Pittas 2005: Insulin Resistance: Effect Moderator A TO Z: Exploratory Analysis Conclusions
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0 6 12 18 Time (months) 0 6 12 18 0 6 12 18 Low-glycemic load diet (40:35:25 – carb:fat:protein) Low-fat diet (55:20:25 – carb:fat:protein) Ebbeling, JAMA 2007;297-2092-102 Change from baseline (kg) p=0.99 p=0.90 p=0.02 Low-GL n=36 Low-fat n=37 Insulin concentration < 57.5 ulU/mL at 30 min after 75-g dose of oral glucose LGL n=15 Low-fat n=13 Insulin concentration >57.5 ulU/mL at 30 min after 75-g dose of oral glucose LGL n=15 Low-fat n=13 Insulin sensitive Insulin resistant 5 0 -5 -10
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112009DietStudy - 20 08 THE OBESITY SOCIETY Annual...

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