Untuk menilai efektifitas diet terhadap penurunan berat badan dan variabel metabolisme para ahli membandingkan 4 macam spektrum diet, mulai dari diet rendah karbohidrat tinggi lemak (Atkins) sampai diet tinggi karbohidrat rendah lemak.
Partisipan menjalankan diet yang ditentukan selama 12 bulan sambil dilakukan monitoring. Setelah 12 bulan ternyata kelompok diet Atkins mengalami penurunan berat badan yang paling besar dibanding diet yang lain. Demikian pula untuk profil lipid, persen lemak tubuh, rasio pinggang panggul, kadar insulin, kadar gula darah dan tekanan darah, kelompok diet Atkins lebih baik dibanding diet yang lain.
Sehingga dapat disimpulkan bahwa diet rendah karbohidrat tinggi protein dan lemak efektif untuk menurunkan berat badan, namun demikian benefit dan risiko jangka panjang masih memerlukan penelitian lebih lanjut.
Namun harus diingat bahwa penelitian ini dilakukan pada wanita premenopause di USA dengan pola diet yang memang rendah karbohidrat. Untuk populasi orang Indonesia hasilnya belum tentu sama.
Comparison of the Atkins, Zone, Ornish, and LEARN Diets for Change in Weight and Related Risk Factors Among Overweight Premenopausal Women The A TO Z Weight Loss Study: A Randomized Trial
Christopher D. Gardner, PhD; Alexandre Kiazand, MD; Sofiya Alhassan, PhD; Soowon Kim, PhD; Randall S. Stafford, MD, PhD; Raymond R. Balise, PhD; Helena C. Kraemer, PhD; Abby C. King, PhD
JAMA. 2007;297:969-977.
Context Popular diets, particularly those low in carbohydrates, have challenged current recommendations advising a low-fat, high-carbohydrate diet for weight loss. Potential benefits and risks have not been tested adequately.
Objective To compare 4 weight-loss diets representing a spectrum of low to high carbohydrate intake for effects on weight loss and related metabolic variables.
Design, Setting, and Participants Twelve-month randomized trial conducted in the United States from February 2003 to October 2005 among 311 free-living, overweight/obese (body mass index, 27-40) nondiabetic, premenopausal women.
Intervention Participants were randomly assigned to follow the Atkins (n =77), Zone (n = 79), LEARN (n = 79), or Ornish (n = 76) diets and received weekly instruction for 2 months, then an additional 10-month follow-up.
Main Outcome Measures Weight loss at 12 months was the primary outcome. Secondary outcomes included lipid profile (low-density lipoprotein, high-density lipoprotein, and non-high-density lipoprotein cholesterol, and triglyceride levels), percentage of body fat, waist-hip ratio, fasting insulin and glucose levels, and blood pressure. Outcomes were assessed at months 0, 2, 6, and 12. The Tukey studentized range test was used to adjust for multiple testing.
Results Weight loss was greater for women in the Atkins diet group compared with the other diet groups at 12 months, and mean 12-month weight loss was significantly different between the Atkins and Zone diets (P<.05). Mean 12-month weight loss was as follows: Atkins, -4.7 kg (95% confidence interval [CI], -6.3 to -3.1 kg), Zone, -1.6 kg (95% CI, -2.8 to -0.4 kg), LEARN, -2.6 kg (-3.8 to -1.3 kg), and Ornish, -2.2 kg (-3.6 to -0.8 kg). Weight loss was not statistically different among the Zone, LEARN, and Ornish groups. At 12 months, secondary outcomes for the Atkins group were comparable with or more favorable than the other diet groups.
Conclusions In this study, premenopausal overweight and obese women assigned to follow the Atkins diet, which had the lowest carbohydrate intake, lost more weight and experienced more favorable overall metabolic effects at 12 months than women assigned to follow the Zone, Ornish, or LEARN diets. While questions remain about long-term effects and mechanisms, a low-carbohydrate, high-protein, high-fat diet may be considered a feasible alternative recommendation for weight loss.
Trial Registration clinicaltrials.gov Identifier: NCT00079573
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