Effect of Low Carbohydrate Versus Low Fat Diet in the Treatment of Dyslipidemia in Obese Children With Metabolic Syndrome

The University of Alabama at Birmingham

Status: Completed

Conditions: Dyslipidemias; Obesity; Metabolic Syndrome

Treatments: Other: Carbohydrate restricted group; Other: Standard low fat diet

Study type: Interventional

Funder types: Other; NIH

Identifiers

NCT03937960

P30DK056336 (U.S. NIH Grant/Contract)

IRB-300002816

Details and patient eligibility

About

Two-arm, parallel design with children between the ages of 10 - 18 with obesity and metabolic syndrome randomized (15 per group) to reduced-carbohydrate diet or a reduced-fat diet for 8 weeks.

Full description

Two-arm, parallel design with participants randomized (15 per group) to reduced-carbohydrate diet or a reduced-fat diet for 8 weeks. Anthropometric evaluations, lab work for lipid levels, insulin and C peptide levels, resting energy expenditure evaluation, DXA scan and cardiovascular markers will occur at baseline during the initial clinic visit. Individual dietary counseling will be provided at baseline and as well as weekly diet-specific support will be provided with a phone call from the PI. Dietary intake will be assessed with weekly food records (weeks 1-8). The return visit on week 8 will include a visit identical to the initial visit except the resting energy expenditure will not be revaluated, and the participants will be asked to answer a questionnaire about the diet they were consuming.

Enrollment: 30 patients

Sex: All

Ages: 10 to 18 years old

Volunteers: No Healthy Volunteers

Inclusion and exclusion criteria

Inclusion Criteria: 3 out of 5 of the following criteria

• Metabolic syndrome with dyslipidemia
• (HDL <40mg/dL
• Triglyceride (TG) TG>150mg/dL)
• Glucose intolerance (fasting blood sugar >100mg/dL)
• Central adiposity (Waist circumference ≥90th percentile or adult cutoff if lower)
• Systolic BP ≥130 mm Hg or diastolic BP ≥85 mm Hg or treatment of previously diagnosed hypertension

Exclusion Criteria:

• Patient on medications known to induce dyslipidemia (systemic steroids, immunosuppressants)
• Pregnancy
• Untreated thyroid disease, heart disease, cancer, kidney disease
• Children on statin/fibrate treatments or other lipid-lowering medications
• Prior surgical procedure for weight control or current weight loss medication

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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30 participants in 2 patient groups

Carbohydrate restricted group

Active Comparator group

Description:

This diet is designed to minimize intake of carbohydrate sources such as added sugars, high glycemic grains, and fructose. It will provide a fixed amount of carbohydrate, and a total calorie goal - with proteins and fats to satiety. During the first two weeks of the intervention, carbohydrate (CHO) sources will be primarily derived from leafy greens and non-starchy vegetables and CHO intake will be equally distributed across meals throughout the day. At week three, additional CHO sources will be added back to the diet prescription including nuts, unsweetened yogurt, and low-glycemic fruits such as apples and berries.

Treatment:

Other: Carbohydrate restricted group

Standard/Low fat diet group

Active Comparator group

Description:

The control, low-fat diet will contain 55:25:20 %energy from CHO: protein: fat based on the United States Department of Agriculture (USDA) My Plate Daily Food Plan and our groups previous work. For example, an 1800 kcal/d plan will include 5 ounces lean meats, 3 cups low-fat dairy, 6 ounces of whole grains, 1 ½ cups fruit, 2 ½ cups vegetables (starchy and non-starchy) and limited fats.

Treatment:

Other: Standard low fat diet