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October 2000, Volume 24, Number 10, Pages 1310-1318
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Paper
Randomized controlled trial of changes in dietary carbohydrate/fat ratio and simple vs complex carbohydrates on body weight and blood lipids: the CARMEN study
W H M Saris1, A Astrup2, A M Prentice3, H J F Zunft4, X Formiguera5, W P H G Verboeket-van de Venne1, A Raben2, S D Poppitt3, B Seppelt4, S Johnston5, T H Vasilaras2 and G F Keogh3

1Nutrition and Toxicology Research Institute Maastricht (NUTRIM), Maastricht University, Maastricht, The Netherlands

2Research Department of Human Nutrition, the Royal Veterinary and Agricultural University, Copenhagen, Denmark

3MRC Dunn Clinical Nutrition Centre, Cambridge, UK

4German Institute of Human Nutrition, Potsdam, Germany

5The Eating Disorders Unit, University Hospital Germans Trias i Pujol, Badalona, Spain

Correspondence to: W HM Saris, Nutrition and Toxicology Research Institute Maastricht (NUTRIM), PO Box 616, 6200 MD Maastricht, The Netherlands.W.Saris@HB.UNIMAAS.NL

Abstract

OBJECTIVE: To investigate the long-term effects of changes in dietary carbohydrate/fat ratio and simple vs complex carbohydrates.

DESIGN: Randomized controlled multicentre trial (CARMEN), in which subjects were allocated for 6 months either to a seasonal control group (no intervention) or to one of three experimental groups: a control diet group (dietary intervention typical of the average national intake); a low-fat high simple carbohydrate group; or a low-fat high complex carbohydrate group.

SUBJECTS: Three hundred and ninety eight moderately obese adults.

MEASUREMENTS: The change in body weight was the primary outcome; changes in body composition and blood lipids were secondary outcomes.

RESULTS: Body weight loss in the low-fat high simple carbohydrate and low-fat high complex carbohydrate groups was 0.9 kg (P<0.05) and 1.8 kg (P<0.001), while the control diet and seasonal control groups gained weight (0.8 and 0.1 kg, NS). Fat mass changed by-1.3 kg (P<0.01),-1.8 kg (P<0.001) and+0.6 kg (NS) in the low-fat high simple carbohydrate, low-fat high complex carbohydrate and control diet groups, respectively. Changes in blood lipids did not differ significantly between the dietary treatment groups.

CONCLUSION: Our findings suggest that reduction of fat intake results in a modest but significant reduction in body weight and body fatness. The concomitant increase in either simple or complex carbohydrates did not indicate significant differences in weight change. No adverse effects on blood lipids were observed. These findings underline the importance of this dietary change and its potential impact on the public health implications of obesity.

International Journal of Obesity (2000) 24, 1310-1318

Keywords

obesity; dietary carbohydrate/fat ratio; simple and complex carbohydrates; body weight; blood lipids; randomized controlled trial

Received 16 February 2000; revised 9 June 2000; accepted 5 July 2000
October 2000, Volume 24, Number 10, Pages 1310-1318
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