Effects of a low glycemic load or a low-fat dietary intervention on body weight in obese Hispanic American children and adolescents: a randomized controlled trial

doi:10.3945/ajcn.112.042630

The American Journal of Clinical Nutrition

Volume 97, Issue 2, February 2013, Pages 276-285

https://doi.org/10.3945/ajcn.112.042630 Get rights and content

Under an Elsevier user license

open archive

ABSTRACT

Background:

In Hispanic children and adolescents, the prevalence of obesity and insulin resistance is considerably greater than in non-Hispanic white children. A low–glycemic load diet (LGD) has been proposed as an effective dietary intervention for pediatric obesity, but to our knowledge, no published study has examined the effects of an LGD in obese Hispanic children.

Objective:

We compared the effects of an LGD and a low-fat diet (LFD) on body composition and components of metabolic syndrome in obese Hispanic youth.

Design:

Obese Hispanic children (7–15 y of age) were randomly assigned to consume an LGD or an LFD in a 2-y intervention program. Body composition and laboratory assessments were obtained at baseline and 3, 12, and 24 mo after intervention.

Results:

In 113 children who were randomly assigned, 79% of both groups completed 3 mo of treatment; 58% of LGD and 55% of LFD subjects attended 24-mo follow-up. Compared with the LFD, the LGD decreased the glycemic load per kilocalories of reported food intakes in participants at 3 mo (P = 0.02). Both groups had a decreased BMI z score (P < 0.003), which was expressed as a standard z score relative to CDC age- and sex-specific norms, and improved waist circumference and systolic blood pressure (P < 0.05) at 3, 12, and 24 mo after intervention. However, there were no significant differences between groups for changes in BMI, insulin resistance, or components of metabolic syndrome (all P > 0.5).

Conclusions:

We showed no evidence that an LGD and an LFD differ in efficacy for the reduction of BMI or aspects of metabolic syndrome in obese Hispanic youth. Both diets decreased the BMI z score when prescribed in the context of a culturally adapted, comprehensive weight-reduction program. This trial was registered at clinicaltrials.gov as NCT01068197.

Cited by (0)

^¹: From the Children’s National Medical Center, Washington, DC (NMM, MGP, KBS, RM, and JH); the New Balance Foundation Obesity Prevention Center, Boston Children’s Hospital, Boston, MA (CBE and DSL); and the Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, Department of Health and Human Services, Bethesda, MD (NMM and JAY).

^²: The National Center for Research Resources and the National Institute of Diabetes and Digestive and Kidney Diseases had no role in the preparation, review, or approval of the manuscript.

^³: Supported by NIH grants K23-RR022227 (NMM), MO1-RR-020359, and UL1RR031988, which were awarded by the National Center for Research Resources to support the General Clinical Research Center and the Children’s Research Institute at Children’s National Medical Center, and ZIA-HD-00641 (JAY) and the following foundations and organizations: Consumer Health Foundation, The Jessie Ball DuPont Foundation, and United Way of the National Capital Area. JAY is supported by the Intramural Research Program of the Eunice Kennedy Shriver National Institute of Child Health and Human Development and the National Institute on Minority Health and Health Disparities of the NIH. DL is supported in part by career award K24DK082730 from the National Institute of Diabetes and Digestive and Kidney Diseases.

^⁴: Address correspondence to N Mirza, Department of Pediatrics, Children’s National Medical Center, Washington, DC 20010. E-mail: [email protected].

^⁵: Abbreviations used: CNMC, Children’s National Medical Center; GCRC, General Clinical Research Center; GI, glycemic index; GL, glycemic load; LFD, low-fat diet; LGD, low–glycemic load diet; LGI, low glycemic index; T2D, type 2 diabetes.