Gastrointestinal hormones and subjective ratings of appetite after low-carbohydrate vs low-fat low-energy diets in females with lipedema - a randomized controlled trial
Abstract
BACKGROUND
Ketosis seems to attenuate, or prevent, the rise in both ghrelin concentrations and subjective hunger ratings that follow weight loss. However, most of the previous studies have employed very-low energy diets (VLED) and are therefore limited in terms of generalizability.
OBJECTIVES
To compare changes in ghrelin plasma concentrations after a low-carbohydrate (LCD) versus an isocaloric low-fat low energy diet (LED) in females with lipedema. Secondary objectives were to determine potential differences between diets in changes in satiety hormones, and subjective ratings of appetite.
METHODS
Females with obesity and lipedema were randomized to either an LCD (75g carbohydrates) or low-fat diet (180g carbohydrates) for 8 weeks. Plasma concentrations of ghrelin, peptide YY, cholecystokinin (CCK), and glucagon-like peptide 1 (GLP-1), and subjective ratings of appetite were measured in the fasting and postprandial states, pre and post intervention.
RESULTS
55 females (30 in LCD) were included (age 47.9±11.3 years, BMI 36.8±5.1 kg/m2). Both LCD and low-fat groups lost weight (10.3%, P<0.001 and 7.3%, P<0.001, respectively), but the LCD lost significantly more. No within or between groups differences were found for ghrelin in the fasting state. A reduction in postprandial (tAUC) ghrelin was seen only in the LCD group (P=0.002), and this change was significantly different from the low-fat group (P=0.046). The LCD group also reported an increase in postprandial (both iAUC and…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design.
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