Effects of Low Fat Versus Low Carbohydrate Diets on Energy Metabolism

Conditions

Healthy, Healthy Volunteers

Keywords

Accelerometry, Body Composition, Body Weight Regulation, Calories, Energy Expenditure

Brief summary

Background: Researchers want to learn how different diets affect hormone levels, body weight, energy expenditure, liver fat, and more. To do this, they will use specialized techniques and food plans. This is not a weight loss study. Objective: To better understand how low-fat and low-carbohydrate foods affect health. Eligibility: Men and women ages 18-50 who have a stable body weight and can exercise daily Design: Participants will have a screening visit that lasts 4-6 hours. It will include: Medical history Physical exam Fasting blood and urine tests Questionnaires Trying foods from the study Participants will be admitted to the Clinical Center and will stay for 4 weeks without leaving. They can have visitors. Participants will wear activity and glucose monitors throughout the study. They will be weighed daily and will complete daily exercise. They will eat 3 meals daily, plus snacks. They will give urine, saliva, and blood samples. They will fill out questionnaires and rate their hunger, appetite, and sense of taste. They will have body scans. For the scans, they will lie in a machine that takes X-ray pictures of the body. Participants will complete activities to measure how many calories they burn and how the diets affect them: Participants will drink special liquids to measure calories burned, sugar, and sense of taste. Participants will wear a plastic hood while resting. Participants will stay alone in a special room for 24 hours. Participants will eat a low-carb, high-fat diet for 2 weeks and a high-carb, low-fat diet for 2 weeks. Participants may be dismissed if they purposefully use the study to try to change their body weight. Sponsoring Institution: National Institute of Diabetes and Digestive and Kidney Diseases ...

Detailed description

Competing theories about obesity and its treatment contrast the relative roles of dietary fat versus carbohydrate on promotion of excessive calorie intake. Advocates of low-carbohydrate diets propose that diets high in carbohydrates lead to elevated insulin secretion and increased calorie intake. Alternatively, proponents of low-fat diets argue that diets high in fat promote passive overconsumption due to the high energy density and low satiety index of high-fat foods. Therefore, we will conduct a feeding study in 20 adult men and women to investigate the differences in ad libitum energy intake resulting from consuming two test diets for a pair of 2-week periods in a randomized, crossover design during a single 4-week inpatient period. The test diets presented to participants will be matched for calories and protein, but the low-carbohydrate diet (approximately10% of calories) will be high in fat (approximately75% of calories) whereas the low-fat diet will be high in carbohydrates (approximately75% of calories) and low in fat (approximately 10% of calories).

Jaime-Lara RB, Franks AT, Nawal N, Steck MC, Chao AM, Allen C, Brooks BE, Atkinson M, Courville AB, Guo J, Yang S, Marzouk M, Darcey VL, Chung S, Forde CG, Hall KD, Joseph PV.

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Effect of a plant-based, low-fat diet versus an animal-based, ketogenic diet on ad libitum energy intake.

Hall KD, Guo J, Courville AB, Boring J, Brychta R, Chen KY, Darcey V, Forde CG, Gharib AM, Gallagher I, Howard R, Joseph PV, Milley L, Ouwerkerk R, Raisinger K, Rozga I, Schick A, Stagliano M, Torres S, Walter M, Walter P, Yang S, Chung ST.

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Interventions

DIETARY_SUPPLEMENTLCHF diet

low-carbohydrate, high-fat (LCHF)diet

DIETARY_SUPPLEMENTLFHC diet

low-fat, high-carbohydrate (LFHC) diet

Study design

Allocation

RANDOMIZED

Intervention model

CROSSOVER

Primary purpose

BASIC_SCIENCE

Masking

NONE

Eligibility

Sex/Gender

ALL

Age

18 Years to 50 Years

Healthy volunteers

Yes

Inclusion criteria

* INCLUSION CRITERIA: 1. Adults age 18-50 years, male and female 2. Weight stable (less than or equal to 5 % over past 6 months) as determined by volunteer report 3. Body mass index (BMI) greater that or equal to 20kg/m2 4. Body weight greater than or equal to 53 kg 5. Able to complete daily bouts of stationary cycling at a moderate rate and intensity with a heart rate (HR) equal to or greater than 0.3(SqrRoot) (220-age-HRrest)+HRrest but not exceeding 0.4(SqrRoot) (220-age-HRrest)+HRrest and no signs of arrhythmia

Exclusion criteria

1. Evidence of metabolic or cardiovascular disease, or disease that may influence metabolism (e.g. cancer, diabetes, thyroid disease) 2. Taking any prescription medication or other drug that may influence metabolism (e.g. diet/weight-loss medication, asthma medication, blood pressure medication, psychiatric medications, corticosteroids, or other medications at the discretion of the PI and/or study team) 3. Positive pregnancy test or lactation as determined by volunteer report (women only) 4. Participating in a regular exercise program (\> 2h/week of vigorous activity) as determined by volunteer report 5. Hematocrit \<37% (women only) 6. Hematocrit \< 40% (men only) 7. Caffeine consumption \> 300 mg/day as determined by volunteer report 8. Regular use of alcohol (\> 2 drinks per day), tobacco (smoking or chewing) amphetamines, cocaine, heroin, or marijuana over past 6 months as determined by volunteer report 9. Psychological conditions such as (but not limited to) eating disorders, claustrophobia, clinical depression, bipolar disorders, that would be incompatible with safe and successful participation in this study, as determined by investigators. 1. Past or present history of eating disorders as determined by volunteer report 2. Past or present history of claustrophobia since part of the protocol will involve being confined to a small room for whole-body indirect calorimetry and being in an MRI scanner for liver fat measures 10. Implants, devices, or foreign objects implanted in the body that interfere with the Magnetic Resonance procedures 11. Volunteers with strict dietary concerns (e.g. vegetarian or kosher diet, food allergies) 12. Volunteers unwilling or unable to give informed consent 13. Non-English speakers due to unavailability of required questionnaires in other languages

Design outcomes

Primary

Measure	Time frame	Description
Ad Libitum Energy Intake	14 days	Ad libitum energy intake averaged over 14 days for each diet, measured in kilocalories (kcal) per day.

Secondary

Measure	Time frame	Description
Change in Body Weight	Baseline and day 14	Change in body weight from baseline to day 14 for each diet, measured in kilograms (kg)
Change in Body Fat Mass	Baseline and day 14	Change in body fat mass from baseline to day 14 for each diet, measured in kilograms (kg). Body fat mass was measured using Dual-energy X-ray absorptiometry (DXA) measurements.
Change in Cholesterol	Baseline and day 14	Change in cholesterol from baseline to day 14 for each diet
Mean Glucose During Oral Glucose Tolerance Test (OGTT)	Day 14	An OGTT was performed at the end of each 14 day period and the mean glucose was calculated
Change in TSH	Baseline and day 14	Change in thyroid stimulating hormone (TSH) from baseline to day 14 for each diet
Change in C-peptide	Baseline and day 14	Change in C-peptide from baseline to day 14 for each diet
Change in CRP	Baseline and day 14	Change in C-reactive protein (CRP) from baseline to day 14 for each diet
Change in Triglycerides	Baseline and day 14	Change in triglycerides from baseline to day 14 for each diet

Countries

United States

Participant flow

Participants by arm

Arm	Count
LCHF Diet Then LFHC Diet Low carbohydrate, high fat (LCHF) diet then low fat, high carbohydrate diet (LFHC) diet	11
LFHC Diet Then LCHF Diet Low fat, high carbohydrate diet (LFHC) diet then low carbohydrate, high fat (LCHF) diet	10
Total	21

Withdrawals & dropouts

Period	Reason	FG000	FG001
Overall Study	Adverse Event	1	0

Baseline characteristics

Characteristic	LCHF Diet Then LFHC Diet	Total	LFHC Diet Then LCHF Diet
Age, Continuous	28.7 Years STANDARD_DEVIATION 7.1	30.1 Years STANDARD_DEVIATION 6.4	31.6 Years STANDARD_DEVIATION 5.5
Ethnicity (NIH/OMB) Hispanic or Latino	2 Participants	4 Participants	2 Participants
Ethnicity (NIH/OMB) Not Hispanic or Latino	9 Participants	17 Participants	8 Participants
Ethnicity (NIH/OMB) Unknown or Not Reported	0 Participants	0 Participants	0 Participants
Race (NIH/OMB) American Indian or Alaska Native	0 Participants	0 Participants	0 Participants
Race (NIH/OMB) Asian	1 Participants	2 Participants	1 Participants
Race (NIH/OMB) Black or African American	4 Participants	8 Participants	4 Participants
Race (NIH/OMB) More than one race	0 Participants	0 Participants	0 Participants
Race (NIH/OMB) Native Hawaiian or Other Pacific Islander	0 Participants	0 Participants	0 Participants
Race (NIH/OMB) Unknown or Not Reported	1 Participants	1 Participants	0 Participants
Race (NIH/OMB) White	5 Participants	10 Participants	5 Participants
Region of Enrollment United States	11 participants	21 participants	10 participants
Sex: Female, Male Female	5 Participants	9 Participants	4 Participants
Sex: Female, Male Male	6 Participants	12 Participants	6 Participants

Adverse events

Event type	EG000 affected / at risk	EG001 affected / at risk
deaths Total, all-cause mortality	0 / 21	0 / 20
other Total, other adverse events	1 / 21	0 / 20
serious Total, serious adverse events	0 / 21	0 / 20

Outcome results

Primary

Ad Libitum Energy Intake

Ad libitum energy intake averaged over 14 days for each diet, measured in kilocalories (kcal) per day.

Time frame: 14 days

Arm	Measure	Value (MEAN)	Dispersion
LC Diet	Ad Libitum Energy Intake	2752 kcal per day	Standard Error 52
LF Diet	Ad Libitum Energy Intake	2063 kcal per day	Standard Error 52

Secondary

Change in Body Fat Mass

Change in body fat mass from baseline to day 14 for each diet, measured in kilograms (kg). Body fat mass was measured using Dual-energy X-ray absorptiometry (DXA) measurements.