Preliminary data from Children's Hospital Boston and Brigham and Women's Hospital, published in the November 24 JAMA, suggest that weight-loss diets may be more effective when dieters seek to reduce glycemic load the amount their blood glucose rises after a meal rather than limit fat intake. The findings indicate that a low-glycemic diet may overcome the body's natural tendency to slow metabolism and turn on hunger cues to "make up" the missing calories.

The low-glycemic-load (low-GL) diet reduces carbohydrates that are rapidly digested and that raise blood sugar and insulin to high levels -- such as white bread, refined breakfast cereals, and concentrated sugars. Instead, it emphasizes carbohydrates that release sugar more slowly, including whole grains, most fruits, vegetables, nuts, and legumes. "Our data suggest that the type of calories consumed independent of the amount can alter metabolic rate," says Dr. David Ludwig, director of the Optimal Weight for Life (OWL) obesity program at Children's Hospital Boston and the study's senior investigator. "That hasn't been shown before. The idea that 'a calorie is a calorie is a calorie' doesn't really explain why conventional weight-loss diets usually don't work for more than a few months."

Ludwig and colleagues randomized 46 overweight or obese adults aged 18 to 40 to consume one of two diets: a standard low-fat diet or a low-GL diet. Both diets provided approximately 1500 calories/day and were designed to produce a 10% weight loss in 6 to 10 weeks. However, the low-GL diet was higher in fat and made various carbohydrate substitutions, such as steel-cut oats instead of instant oatmeal, blueberries instead of raisins, and cracked-wheat bread instead of tortilla chips.

The 39 subjects who remained in the study succeeded in losing about 10% of their initial body weight. The low-GL dieters had smaller decreases in resting energy expenditure (averaging 96 kcal/day, or 5.9%) than the lo
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Contact: Bess Andrews
elizabeth.andrews@childrens.harvard.edu
617-355-6420
Children's Hospital Boston
23-Nov-2004

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