Ketogenic low-carbohydrate diets have no metabolic advantage over nonketogenic low-carbohydrate diets

Carol Johnston, Sherrie L. Tjonn, Pamela Swan, Andrea White, Heather Hutchins, Barry Sears

Research output: Contribution to journalArticle

77 Citations (Scopus)

Abstract

Background: Low-carbohydrate diets may promote greater weight loss than does the conventional low-fat, high-carbohydrate diet. Objective: We compared weight loss and biomarker change in adults adhering to a ketogenic low-carbohydrate (KLC) diet or a nonketogenic low-carbohydrate (NLC) diet. Design: Twenty adults [body mass index (in kg/m2): 34.4 ± 1.0] were randomly assigned to the KLC (60% of energy as fat, beginning with ≈5% of energy as carbohydrate) or NLC (30% of energy as fat; ≈40% of energy as carbohydrate) diet. During the 6-wk trial, participants were sedentary, and 24-h intakes were strictly controlled. Results: Mean (±SE) weight losses (6.3 ± 0.6 and 7.2 ± 0.8 kg in KLC and NLC dieters, respectively; P = 0.324) and fat losses (3.4 and 5.5 kg in KLC and NLC dieters, respectively; P = 0.111) did not differ significantly by group after 6 wk. Blood β-hydroxybutyrate in the KLC dieters was 3.6 times that in the NLC dieters at week 2 (P = 0.018), and LDL cholesterol was directly correlated with blood β-hydroxybutyrate (r = 0.297, P = 0.025). Overall, insulin sensitivity and resting energy expenditure increased and serum γ-glutamyltransferase concentrations decreased in both diet groups during the 6-wk trial (P < 0.05). However, inflammatory risk (arachidonic acid:eicosapentaenoic acid ratios in plasma phospholipids) and perceptions of vigor were more adversely affected by the KLC than by the NLC diet. Conclusions: KLC and NLC diets were equally effective in reducing body weight and insulin resistance, but the KLC diet was associated with several adverse metabolic and emotional effects. The use of ketogenic diets for weight loss is not warranted.

Original languageEnglish (US)
Pages (from-to)1055-1061
Number of pages7
JournalAmerican Journal of Clinical Nutrition
Volume83
Issue number5
StatePublished - May 1 2006

Fingerprint

Ketogenic Diet
Carbohydrate-Restricted Diet
low carbohydrate diet
Carbohydrates
carbohydrates
Weight Loss
weight loss
Hydroxybutyrates
energy
lipids
Fats
insulin resistance
ketogenic diet
Insulin Resistance
high carbohydrate diet
Diet
resting energy expenditure
blood
Eicosapentaenoic Acid
eicosapentaenoic acid

Keywords

  • Adults
  • Insulin resistance
  • Ketogenic low-carbohydrate diets
  • Nonketogenic low-carbohydrate diets
  • Weight loss

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Food Science

Cite this

Ketogenic low-carbohydrate diets have no metabolic advantage over nonketogenic low-carbohydrate diets. / Johnston, Carol; Tjonn, Sherrie L.; Swan, Pamela; White, Andrea; Hutchins, Heather; Sears, Barry.

In: American Journal of Clinical Nutrition, Vol. 83, No. 5, 01.05.2006, p. 1055-1061.

Research output: Contribution to journalArticle

Johnston, Carol ; Tjonn, Sherrie L. ; Swan, Pamela ; White, Andrea ; Hutchins, Heather ; Sears, Barry. / Ketogenic low-carbohydrate diets have no metabolic advantage over nonketogenic low-carbohydrate diets. In: American Journal of Clinical Nutrition. 2006 ; Vol. 83, No. 5. pp. 1055-1061.
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AU - Hutchins, Heather

AU - Sears, Barry

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N2 - Background: Low-carbohydrate diets may promote greater weight loss than does the conventional low-fat, high-carbohydrate diet. Objective: We compared weight loss and biomarker change in adults adhering to a ketogenic low-carbohydrate (KLC) diet or a nonketogenic low-carbohydrate (NLC) diet. Design: Twenty adults [body mass index (in kg/m2): 34.4 ± 1.0] were randomly assigned to the KLC (60% of energy as fat, beginning with ≈5% of energy as carbohydrate) or NLC (30% of energy as fat; ≈40% of energy as carbohydrate) diet. During the 6-wk trial, participants were sedentary, and 24-h intakes were strictly controlled. Results: Mean (±SE) weight losses (6.3 ± 0.6 and 7.2 ± 0.8 kg in KLC and NLC dieters, respectively; P = 0.324) and fat losses (3.4 and 5.5 kg in KLC and NLC dieters, respectively; P = 0.111) did not differ significantly by group after 6 wk. Blood β-hydroxybutyrate in the KLC dieters was 3.6 times that in the NLC dieters at week 2 (P = 0.018), and LDL cholesterol was directly correlated with blood β-hydroxybutyrate (r = 0.297, P = 0.025). Overall, insulin sensitivity and resting energy expenditure increased and serum γ-glutamyltransferase concentrations decreased in both diet groups during the 6-wk trial (P < 0.05). However, inflammatory risk (arachidonic acid:eicosapentaenoic acid ratios in plasma phospholipids) and perceptions of vigor were more adversely affected by the KLC than by the NLC diet. Conclusions: KLC and NLC diets were equally effective in reducing body weight and insulin resistance, but the KLC diet was associated with several adverse metabolic and emotional effects. The use of ketogenic diets for weight loss is not warranted.

AB - Background: Low-carbohydrate diets may promote greater weight loss than does the conventional low-fat, high-carbohydrate diet. Objective: We compared weight loss and biomarker change in adults adhering to a ketogenic low-carbohydrate (KLC) diet or a nonketogenic low-carbohydrate (NLC) diet. Design: Twenty adults [body mass index (in kg/m2): 34.4 ± 1.0] were randomly assigned to the KLC (60% of energy as fat, beginning with ≈5% of energy as carbohydrate) or NLC (30% of energy as fat; ≈40% of energy as carbohydrate) diet. During the 6-wk trial, participants were sedentary, and 24-h intakes were strictly controlled. Results: Mean (±SE) weight losses (6.3 ± 0.6 and 7.2 ± 0.8 kg in KLC and NLC dieters, respectively; P = 0.324) and fat losses (3.4 and 5.5 kg in KLC and NLC dieters, respectively; P = 0.111) did not differ significantly by group after 6 wk. Blood β-hydroxybutyrate in the KLC dieters was 3.6 times that in the NLC dieters at week 2 (P = 0.018), and LDL cholesterol was directly correlated with blood β-hydroxybutyrate (r = 0.297, P = 0.025). Overall, insulin sensitivity and resting energy expenditure increased and serum γ-glutamyltransferase concentrations decreased in both diet groups during the 6-wk trial (P < 0.05). However, inflammatory risk (arachidonic acid:eicosapentaenoic acid ratios in plasma phospholipids) and perceptions of vigor were more adversely affected by the KLC than by the NLC diet. Conclusions: KLC and NLC diets were equally effective in reducing body weight and insulin resistance, but the KLC diet was associated with several adverse metabolic and emotional effects. The use of ketogenic diets for weight loss is not warranted.

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