Comparison of the Atkins, Zone, Ornish, and LEARN Diets for Change in Weight and Related Risk Factors Among Overweight Premenopausal Women . Potential benefits and risks have not been tested adequately. Objective. Secondary outcomes included lipid profile (low- density lipoprotein, high- density lipoprotein, and non. Outcomes were assessed at months 0, 2, 6, and 1. The Tukey studentized range test was used to adjust for multiple testing. Results. Mean 1. 2- month weight loss was as follows: Atkins, . Weight loss was not statistically different among the Zone, LEARN, and Ornish groups. At 1. 2 months, secondary outcomes for the Atkins group were comparable with or more favorable than the other diet groups. Conclusions. While questions remain about long- term effects and mechanisms, a low- carbohydrate, high- protein, high- fat diet may be considered a feasible alternative recommendation for weight loss. Trial Registration. National dietary weight loss guidelines (ie, energy- restricted, low in fat, high in carbohydrate)7 have been challenged, particularly by proponents of low- carbohydrate diets. However, limited evidence has been available to effectively evaluate other diets. Several recent trials compared low- carbohydrate vs traditional low- fat, high- carbohydrate weight- loss diets. The primary study objective was to examine the effects of diets and gradations of carbohydrate intake on weight loss and related metabolic variables in overweight and obese premenopausal women. Premenopausal women aged 2. Women were excluded if they self- reported hypertension (except for those whose blood pressure was stable using antihypertension medications); type 1 or 2 diabetes mellitus; heart, renal, or liver disease; cancer or active neoplasms; hyperthyroidism unless treated and under control; any medication use known to affect weight/energy expenditure; alcohol intake of at least 3 drinks/d; or pregnancy, lactation, no menstrual period in the previous 1. Race/ethnicity data were collected by self- report to be used for descriptive purposes and possible ancillary analyses of subgroups. All study participants provided written informed consent. The study was approved annually by the Stanford University Human Subjects Committee. Randomization was conducted in blocks of 2. My 4 day Weight Loss Program will show you how to Lose Weight Fast in 4 Days! The best weight loss plan for Fast Weight Loss. If cooking every meal throughout the day isn! Frozen food delivery makes starting the Atkins program as. The ongoing obesity epidemic, 1 along with its health costs and consequences 2 and the health benefits of weight loss, 3- 6 have been well established. Participants were assigned 1 of 4 diet books: Dr Atkins' New Diet Revolution,8. Enter the Zone,9. The LEARN Manual for Weight Management,1. Eat More, Weigh Less by Ornish. Low-carb, high-protein diet plan not only burns fats from your body but also crops the release. Weight Loss Coaching Online. The key to your weight loss success. A customized program for you. The menu of the month. Each diet group attended 1- hour classes led by a registered dietitian once per week for 8 weeks and covered approximately one eighth of their respective books per class. The same dietitian taught all classes to all groups in all 4 cohorts and was rated by participants at the end of the 8- week sessions for enthusiasm and knowledge of the material (rating scale of 1- 5, from . The LEARN program is intended to be a 1. Efforts to maximize retention in the study included e- mail and telephone reminders for appointments, e- mail or telephone contact from staff between the 2- and 6- month and between the 6- and 1. Each group received specific target goals according to the emphasis of the assigned diet. The Atkins group aimed for 2. The Zone group's primary emphasis was a 4. The LEARN group was instructed to follow a prudent diet that included 5. The primary emphasis for the Ornish group was no more than 1. Additional recommendations given for physical activity, nutritional supplements, and behavioral strategies were consistent with those presented in each diet book. The guidelines for the Zone and LEARN diets incorporated specific goals for energy restriction, while for the Atkins and Ornish diets, there were no specific energy restriction goals. Texas woman becomes weight loss sensation after ditching diets, losing 160 pounds with healthy food choices 8/20/2015 6:34:55 PM - Forget fad diets. Popular diets have become increasingly prevalent and controversial. 1 More than 1000 diet books are now available, 2 with many popular ones departing substantially. A range of behavior modification techniques were discussed during the 2- month classes. The Ornish and Zone books suggest some stimulus- control strategies but on the whole do not emphasize behavior modification, whereas both the Atkins and LEARN books suggest multiple strategies, such as relapse preparation and planning strategies and goal setting. Overall, the LEARN manual has the greatest emphasis on behavior modification strategies. Dietary intake data were collected by telephone- administered, 3- day, unannounced, 2. Nutrition Data System for Research software, versions 4. Nutrition Coordinating Center, University of Minnesota, Minneapolis). Data collectors were trained and certified by the Nutrition Coordinating Center. The recalls occurred on 2 weekdays and 1 weekend day per time point, on nonconsecutive days whenever possible. Local foods not found in the comprehensive database were added to the database manually. Energy expenditure was assessed using the well- established Stanford 7- day physical activity recall. Anthropometric Data. Height was measured to the nearest millimeter using a standard wall- mounted stadiometer. Body weight was measured to the nearest 0. Waist and hip circumference were measured to the nearest millimeter by standard procedures using a 1. Whole- body fat (percentage of body mass) was determined by dual- energy x- ray absorptiometry using pencil- beam mode on the Hologic QDR- 2. Hologic QDR 4. 50. Hologic Inc, Waltham, Mass). Metabolic Measures. Blood samples were collected after a 1. Plasma total cholesterol and triglycerides (free glycerol blank subtracted) were measured enzymatically using Stanford Clinical Chemistry Laboratory. Clinic and laboratory staff members were blinded to treatment assignment. The selected minimal clinically significant between- group difference in weight change was 2. Based on previous trials, we projected a 6. SD of weight change. The primary analysis was conducted applying intention- to- treat methods with baseline values carried forward for missing values. Thus, with 4 treatment groups and a projected 7. Dietary composition data (energy intake; percentage carbohydrate, fat, and protein; and grams of saturated fat and fiber) were analyzed using raw, unadjusted means (SDs) (ie, no imputation for missing data). Between- group differences in dietary intake at each time point were tested by analysis of variance (ANOVA). For weight and for all secondary outcome measures, analyses were conducted using all time points and all diets and were tested for diet group. Triglyceride data were log- transformed to attain normal distributions for testing; for ease of interpretation, values presented in the text and figures are untransformed. Differences among diets for 1. ANOVA. For statistically significant ANOVAs, all pairwise comparisons among the 4 diets were tested using the Tukey studentized range adjustment. Statistical testing of changes from baseline to 2 months and to 6 months using pairwise comparisons are presented for descriptive purposes. For exploratory purposes, ancillary analyses were conducted to determine the effect of diet group assignment on secondary outcomes at 1. Also for exploratory purposes, all analyses of weight and secondary outcome measures were tested using only available data, without using baseline values carried forward for missing data or other imputation methods. There were no substantive differences in any of these findings compared with the analyses with baseline values carried forward and, therefore, only the primary analyses are presented. Multiple regression was used to examine potential interactions between race/ethnicity and diet group for effects on weight loss; there were no significant interactions. All statistical tests were 2- tailed using a significance level of . Figure 1 shows participant flow; Table 1 shows baseline characteristics. In all 4 diet groups, 8. Attendance was not different by diet group (P. Retention at 1. 2 months was 8. Atkins, Zone, LEARN, and Ornish groups, respectively, and was not significantly different among groups (P. Participant ratings for class instructor enthusiasm and knowledge of material were very high for both among all diet groups and were not significantly different among groups; average scores ranged from 4. However, relative to baseline, there was a significant mean decrease in reported energy intake at all postrandomization time points (P<. At subsequent time points the diets were statistically different in carbohydrate content, progressing from low to high across the Atkins, Zone, LEARN, and Ornish groups. This same pattern was observed for fiber intake. The reverse pattern, higher to lower intakes, was statistically significant for protein, fat, and saturated fat at all time points. Between- group differences in patterns of nutrient intake were largest at 2 months. At 1. 2 months, the patterns of nutrient differences between groups were still present, but the magnitude of differences was diminished. Total energy expenditure was slightly higher for the Ornish group vs the other 3 groups at baseline but was not significantly different among groups at any subsequent time point (Table 1). Relative to baseline, there was a modest and significant mean increase (P<. SD, 2. 8), +0. 4 (SD, 2. SD, 3. 0) kcal/kg per day at 2, 6, and 1. At the 2- and 6- month intermediate time points, the weight change for the Atkins group was significantly greater than for all other groups (P<. Weight change among the Zone, LEARN, and Ornish groups did not differ significantly at any time point. The pattern of changes in body mass index, percentage of body fat, and waist- hip ratio among groups paralleled the changes in weight, although the between- group differences at 1. P. Four of the LDL- C values could not be calculated because of triglyceride concentrations greater than 4. L (4. 5. 2 mmol/L) and were treated as missing data. At all time points, the statistically significant findings for HDL- C and triglycerides concentrations favored the Atkins group (Table 3). Changes in LDL- C concentrations at 2 months favored the LEARN and Ornish diets over the Atkins diet; however, these differences diminished and were no longer significant at 6 and 1. Non- HDL- C differences among groups were not significant at any time point. Weight loss news, articles and information: TV. Natural. News. com is. They cover topics like health, environment and freedom. Lists diseases, foods, herbs and more. An error occurred while setting your user cookie. Please set your. browser to accept cookies to continue. This cookie stores just a. ID; no other information is captured. Accepting the NEJM cookie is.
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