Comparison of a low-fat diet to a low-carbohydrate diet on weight loss, body composition, and risk factors for diabetes and cardiovascular disease in free-living, overweight men and women

J Clin Endocrinol Metab. 2004 Jun;89(6):2717-23. doi: 10.1210/jc.2003-031606.


Overweight and obese men and women (24-61 yr of age) were recruited into a randomized trial to compare the effects of a low-fat (LF) vs. a low-carbohydrate (LC) diet on weight loss. Thirty-one subjects completed all 10 wk of the diet intervention (retention, 78%). Subjects on the LF diet consumed an average of 17.8% of energy from fat, compared with their habitual intake of 36.4%, and had a resulting energy restriction of 2540 kJ/d. Subjects on the LC diet consumed an average of 15.4% carbohydrate, compared with habitual intakes of about 50% carbohydrate, and had a resulting energy restriction of 3195 kJ/d. Both groups of subjects had significant weight loss over the 10 wk of diet intervention and nearly identical improvements in body weight and fat mass. LF subjects lost an average of 6.8 kg and had a decrease in body mass index of 2.2 kg/m2, compared with a loss of 7.0 kg and decrease in body mass index of 2.1 kg/m2 in the LC subjects. The LF group better preserved lean body mass when compared with the LC group; however, only the LC group had a significant decrease in circulating insulin concentrations. Group results indicated that the diets were equally effective in reducing systolic blood pressure by about 10 mm Hg and diastolic pressure by 5 mm Hg and decreasing plasminogen activator inhibitor-1 bioactivity. Blood beta-hydroxybutyrate concentrations were increased in the LC only, at the 2- and 4-wk time points. These data suggest that energy restriction achieved by a very LC diet is equally effective as a LF diet strategy for weight loss and decreasing body fat in overweight and obese adults.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • 3-Hydroxybutyric Acid / blood
  • Adult
  • Blood Pressure
  • Body Composition
  • Cardiovascular Diseases / diet therapy*
  • Cardiovascular Diseases / epidemiology
  • Diabetes Mellitus / diet therapy*
  • Diabetes Mellitus / epidemiology
  • Diet, Fat-Restricted
  • Dietary Carbohydrates / administration & dosage*
  • Dietary Fats / administration & dosage*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Obesity*
  • Plasminogen Activator Inhibitor 1 / metabolism
  • Risk Factors
  • Risk Reduction Behavior
  • Weight Loss


  • Dietary Carbohydrates
  • Dietary Fats
  • Plasminogen Activator Inhibitor 1
  • 3-Hydroxybutyric Acid