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Mit höchster Evidenz: Low-Carb schlägt Low-Fat - Nicolai Worm - 18.08.2008
Sehr geehrte LOGIanerInnen!
Soeben ist in der Zeitschrift "Obesity Reviews" ein Systematisches Review
(das entspricht der höchten Evidenzstufe: 1a) zur Frage der Wirksamkeit von Low-Carb im
Vergleich zu Low-Fat erschienen (siehe unten).
Ergebnis: Low-Carb ermöglicht eine größere Gewichtsabnahme, günstigere
Risikofaktor-Konstellation und bessere Compliance!
Die DGE - ganz "der Wissenschaft verpflichtet" - hat es geschafft, dieses
Thema seit 4 Jahren völlig auszuklammern. Ihr letzter Kommentar dazu
http://www.dge.de/modules.php?name=News&file=article&sid=401
forderte mehr Evidenz. Da die nun da ist, wird die DGE bestimmt ganz schnell
reagieren und ihrem Auftrag folgen und ihre Mitglieder und die
Ernährungsberater und die deutschen Bürger und die Deutschen Krankenkassen
über dieses erfreuliche Ergebnis informieren. Der AID - ganz der DGE
verpflichtet - wird dann bestimmt auch ganz schnell folgen...
Vergnügte Grüße,
Nicolai Worm
M. Hession, C. Rolland, U. Kulkarni, A. Wise and J. Broom. Systematic review of randomized controlled trials of
low-carbohydrate vs. low-fat/low-calorie diets in the management of obesity and its comorbidities. Obesity Reviews 2008;
doi: 10.1111/j.1467-789X.2008.00518.x
Summary
There are few studies comparing the effects of low-carbohydrate/high-protein
diets with low-fat/high-carbohydrate diets for obesity and cardiovascular disease
risk. This systematic review focuses on randomized controlled trials of lowcarbohydrate
diets compared with low-fat/low-calorie diets. Studies conducted
in adult populations with mean or median body mass index of 28 kg m-2 were
included. Thirteen electronic databases were searched and randomized controlled
trials from January 2000 to March 2007 were evaluated. Trials were included
if they lasted at least 6 months and assessed the weight-loss effects of lowcarbohydrate
diets against low-fat/low-calorie diets. For each study, data were
abstracted and checked by two researchers prior to electronic data entry. The
computer program Review Manager 4.2.2 was used for the data analysis. Thirteen
articles met the inclusion criteria. There were significant differences between the
groups for weight, high-density lipoprotein cholesterol, triacylglycerols and systolic
blood pressure, favouring the low-carbohydrate diet. There was a higher
attrition rate in the low-fat compared with the low-carbohydrate groups suggesting
a patient preference for a low-carbohydrate/high-protein approach as opposed
to the Public Health preference of a low-fat/high-carbohydrate diet. Evidence
from this systematic review demonstrates that low-carbohydrate/high-protein
diets are more effective at 6 months and are as effective, if not more, as low-fat
diets in reducing weight and cardiovascular disease risk up to 1 year. More
evidence and longer-term studies are needed to assess the long-term cardiovascular
benefits from the weight loss achieved using these diets.