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Use of Low-Carbohydrate, High-Protein Diets Among Americans: Correlates, Duration and Weight Loss

Posted: Monday, May 22, 2006

Low carbohydrate, high protein diets (LCHP) were equally prevalent across sociodemographic subgroups and many users reported significant weight loss.

Although low-carbohydrate, high-protein (LCHP) diets reemerged as popular diets, there are scant data on patterns of use in the general US population.

We examined the prevalence of reported LCHP diet use (eg, Sugar Busters, The Zone, The Carbohydrate Addict's Diet, The Atkins Diet), associated weight control behaviors, diet duration, and amount of weight loss while on the diet.

Telephone survey of US adults conducted from September 2002 to December 2002 (N = 9300). We used multivariable logistic regression models to determine predictors of current LCHP diet use.

At the time of the survey, 12.5% of Americans reported ever using a LCHP diet, and 3.4% reported current use. Prevalence of current use was similar across sex, race/ethnicity, and education levels. Among those trying to lose weight (n = 3790), 5.9% reported currently using an LCHP diet. Among current users, mean weight loss was 18.3 (median, 11.7) lb, with 18.2% reporting = 30 lb weight loss, 34.0% = 20 lb weight loss, and 8.8% no weight loss. More men than women reported a duration of use of more than 12 months (42.2% vs 29.6%, P = .04) and median duration was greater in men than women (5.7 vs 2.8 months, P = .08). Among those trying to control weight, a significantly higher proportion of current LCHP diet users reported eating fewer calories and meeting physical activity recommendations (38.0%) compared with nonusers (29.8%).

Despite a lack of advice about caloric intake in most LCHP diet materials, the majority of current LCHP diet users (70.1%) reported eating fewer calories as a strategy to control their weight. It is possible that consuming fewer calories is not a direct strategy but rather results from a satiating effect of a LCHP diet.[23,24] About half of LCHP diet users met minimal PA recommendations for health. A little more than a third (38.0%) of LCHP diet users reported both eating fewer calories and meeting PA recommendations for health compared with 29.8% of nonusers. These results suggest that many people trying to manage weight, regardless of LCHP diet status, are not following minimal public health recommendations for health[25] to both consume fewer calories and engage in recommended amounts of PA.

Current LCHP dieters were also more likely to have reported past year use of meal-replacement products and herbal diet aids compared with others trying to manage their weight. Past year use of foods supplied by a weight loss program or use of special (convenient or prepared) meals, however, was similar among LCHP diet users and nonusers. This result was not entirely unexpected because our survey primarily took place in the fall of 2002 and very few special meals at that time had carb-related marketing and labeling. For example, in 2002, 2.1% (about 350) of new food and beverages launched in the United States were no- or low-carb products. In 2004, however, more than 20% (about 3375) of new food and beverages launched were marketed as no- or low-carb products.[26]

Although we lack evidence regarding changes in the use of these diets since the fielding of our survey, we speculate that changes in media and advertising coverage and store-shelf space dedicated to LCHP diet plans and products has probably changed the absolute percentage of Americans using LCHP diets at any given time. Despite this, our study of US adults provides novel information on factors related to use of LCHP diets, including that this type of diet plan was equally prevalent across many subgroups including both men and women, among non-Hispanic whites, non-Hispanic blacks, and Hispanic individuals as well as across education levels. This analysis also included unique information on substantial weight loss and long-term use of this type of diet. Although we lack information on actual carbohydrate intake among participants, a long duration of use could imply tolerance and even some degree of adherence to this type of dietary approach. Dansinger and Schaefer[27] recently noted in an editorial on the Women's Health Initiative Dietary Modification Trial[28] that much work is needed in the area of facilitating high long-term adherence levels, an important factor in successful weight loss and maintenance. Our finding that about one third of current LCHP dieters had been on the diet for more than 1 year suggests that this dieting strategy is tolerated by a subset of diet users. However, further long-term research is needed to determine both the safety and efficacy of this dieting approach.

From the result is was concluded that LCHP diets were equally prevalent across sociodemographic subgroups and many users reported significant weight loss. Approximately 40% of male users and 30% of female users reported long-term use of the diet, suggesting that for some, this dietary approach may be well tolerated.


Source: Diabetes In Control: Medscape General Medicine 8(2):5, 2006

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