Carbohydrate-Restricted Diet: A Successful Strategy for Short-Term Management in Youth with Severe Obesity-An Observational Study.

Abstract

Background: Obesity affects ∼20% of children in the United States and reports of successful dietary treatment are lacking. This study aimed to determine the change in body weight in severely obese youth after carbohydrate-restricted dietary intervention. Methods: This single-center study of a carbohydrate-restricted diet (≤30 grams per day), with unlimited calories, fat, and protein for 3-4 months, examined two groups of severely obese youth of ages 5-18 years: Group A, retrospectively reviewed charts of severely obese youth referred to the Pediatric Obesity Clinic at Hoops Family Children s Hospital and the Ambulatory Division of Marshall Pediatrics, Marshall University School of Medicine, in Huntington, WV, between July 1, 2014 and June 30, 2017 (n\u2009=\u2009130), and Group B, prospective participants, referred between July 1, 2018 and December 31, 2018, followed with laboratory studies pre- and postdietary intervention (n\u2009=\u20098). Results: In Group A, 310 participants began the diet, 130 (42%) returned after 3-4 months. Group B had 14 enrollees who began the diet, and 8 followed up at 3-4 months (57%). Girls compared with boys were more likely to complete the diet (P\u2009=\u20090.02). Participants <12 years age were almost twice as likely to complete the diet compared with those 12-18 years (64% vs. 36%, P\u2009<\u20090.01); however, the older group subjects who completed the diet had the same percentage of weight loss compared with those <12 years (6.9% vs. 6.9%). Group A had reductions in weight of 5.1\u2009kg (P\u2009<\u20090.001), body mass index (BMI) 2.5\u2009kg/m2 (P\u2009<\u20090.001), and percentage weight loss 6.9% (P\u2009<\u20090.001). Group B had reductions in weight 9.6\u2009kg (P\u2009<\u20090.01), BMI 4\u2009kg/m2 (P\u2009<\u20090.01), and percentage weight loss 9% (P\u2009<\u20090.01). In addition, participants had significant reductions of fasting serum insulin (P\u2009<\u20090.01), triglycerides (P\u2009<\u20090.01), and 20-hydroxyeicosatetraenoic acid (P\u2009<\u20090.01). Conclusions: This study demonstrated a carbohydrate-restricted diet, utilized short term, effectively reduced weight in a large percentage of severely obese youth, and can be replicated in a busy primary care office.