Carbohydrate-Restricted Diet: A Successful Strategy for Short-Term Management in Youth with Severe Obesity-An Observational Study.

Background: Obesity affects ∼20% of children in the United States and reports of successful dietary treatment are lacking. This study aimed to determine the change in body weight in severely obese youth after carbohydrate-restricted dietary intervention. Methods: This single-center study of a carbohydrate-restricted diet (≤30 grams per day), with unlimited calories, fat, and protein for 3-4 months, examined two groups of severely obese youth of ages 5-18 years: Group A, retrospectively reviewed charts of severely obese youth referred to the Pediatric Obesity Clinic at Hoops Family Children's Hospital and the Ambulatory Division of Marshall Pediatrics, Marshall University School of Medicine, in Huntington, WV, between July 1, 2014 and June 30, 2017 (n = 130), and Group B, prospective participants, referred between July 1, 2018 and December 31, 2018, followed with laboratory studies pre- and postdietary intervention (n = 8). Results: In Group A, 310 participants began the diet, 130 (42%) returned after 3-4 months. Group B had 14 enrollees who began the diet, and 8 followed up at 3-4 months (57%). Girls compared with boys were more likely to complete the diet (P = 0.02). Participants <12 years age were almost twice as likely to complete the diet compared with those 12-18 years (64% vs. 36%, P < 0.01); however, the older group subjects who completed the diet had the same percentage of weight loss compared with those <12 years (6.9% vs. 6.9%). Group A had reductions in weight of 5.1 kg (P < 0.001), body mass index (BMI) 2.5 kg/m2 (P < 0.001), and percentage weight loss 6.9% (P < 0.001). Group B had reductions in weight 9.6 kg (P < 0.01), BMI 4 kg/m2 (P < 0.01), and percentage weight loss 9% (P < 0.01). In addition, participants had significant reductions of fasting serum insulin (P < 0.01), triglycerides (P < 0.01), and 20-hydroxyeicosatetraenoic acid (P < 0.01). Conclusions: This study demonstrated a carbohydrate-restricted diet, utilized short term, effectively reduced weight in a large percentage of severely obese youth, and can be replicated in a busy primary care office.

Unlimited energy, restricted carbohydrate diet improves lipid parameters in obese children.

BACKGROUND: Childhood obesity is a leading health concern. We have previously demonstrated the effectiveness of a restricted-carbohydrate, unlimited energy diet for weight reduction in elementary school-aged children. To our knowledge, there are no studies that have looked at the effect of this diet on lipid profiles in elementary school-aged children. Therefore, the objective of this pilot study was to examine the effect of a restricted-carbohydrate, unlimited protein, unlimited energy diet on lipid profiles in obese children 6 to 12 years of age. METHODS: Overweight children (body mass index >97%) referred to our obesity clinic were treated with a restricted-carbohydrate (<30 grams daily), unlimited protein, and unlimited energy diet. Weight, height, body mass index, and fasting lipid profiles were obtained at baseline and at 10 weeks on each patient. RESULTS: Twenty-seven patients were enrolled in our study, with a total of 18 patients returning for our 10 week follow-up (67%). The study group included 10 males and 8 females, with an age range of 6 to 12 years. Both total serum cholesterol and triglyceride levels showed a significant reduction; 24.2 (P = 0.018) and 56.9 (P = 0.015) mg/dL, respectively. CONCLUSIONS: We have demonstrated a significant decrease in total cholesterol and triglycerides in elementary school-aged children after 10 weeks of a restricted-carbohydrate, unlimited protein, and unlimited energy diet. We suggest that this diet may decrease cardiovascular risk factors in obese children. Long-term studies will be needed to substantiate these data.

Effect of low-carbohydrate, unlimited calorie diet on the treatment of childhood obesity: a prospective controlled study.

BACKGROUND: Childhood obesity has been recognized as the new epidemic in developed countries. Caloric restriction with physical activity is the main therapeutic treatment available for these children. We compared two different dietary protocols to assess treatment efficacy. METHODS: Obese children from the Pediatric Endocrinology clinic were prospectively recruited for the study. Children and their parents were allowed to choose one of two dietary protocols: (1) carbohydrate restricted diet (<30 g/day), with unlimited calories, protein, and fat (High protein, Low CHO Diet), and (2) calorie restricted diet (Low Cal Diet). Anthropometric data were measured at baseline and at the 2 month follow up appointment. RESULTS: Thirty-seven children completed the study of whom 27 chose High Protein, Low CHO Diet and 10 chose Low Cal diet. No differences in gender ratio, age, or BMI were observed at baseline. At 2 months, children in the High Protein, Low CHO Diet lost an average of 5.21 +/- 3.44 kg (p < 0.001) and decreased their BMI by 2.42 +/- 1.3 points (p < 0.001), compared to the children in the Low Cal Diet who gained an average of 2.36 +/- 2.54 kg and 1.00 point on the BMI value (p < 0.001). CONCLUSIONS: A high protein, low carbohydrate, unlimited calorie diet was superior to a restricted calorie protocol for weight loss in obese school age children; moreover, compliance was better.