"Most weight loss studies have determined that a very low carbohydrate diet is not a good method to reduce weight," said lead author Daniela Jakubowicz, MD, of the Hospital de Clinicas, Caracas, Venzezuela. "It exacerbates the craving for carbohydrates and slows metabolism. As a result, after a short period of weight loss, there is a quick return to obesity."

Only five percent of carbohydrate-restrictive diets are successful after two years, Jakubowicz said. Most carbohydrate-restrictive diets, she said, do not address addictive eating impulses.

With scientists from Virginia Commonwealth University in Richmond, Jakubowicz and her colleagues conducted a study, which they said shows that a diet's long-term effectiveness depends on its ability to increase a sense of fullness and bring down carb cravings. They compared their new diet with a strict low-carb diet in 94 obese, physically inactive women. Both diets were low in fat and total calories but differed in the carbohydrate distribution.

Forty-six women were on the very-low-carb diet, which allowed them to eat 1,085 calories a day. The diet consisted of 17 grams of carbohydrates, 51 grams of protein and 78 grams of fat a day. The smallest meal was breakfast, at 290 calories. For breakfast the dieters were permitted only 7 grams of carbohydrates, such as bread, fruit, cereal and milk. Dieters could eat just 12 grams of protein, such as meat and eggs, in the morning.

On the modified low-carb diet, or "big-breakfast diet," the other 48 dieters ate 1,240 calories a day. Although lower in total fat (46 grams) than the other diet, the new diet had higher daily allotments of carbs (97 grams) and protein (93 grams). Dieters ate a 610-calorie big breakfast, consisting of 58 grams of carbs, 47 grams of protein and 22 fat grams. The diet schedule for lunch was 395 calories (34, 28 and 13 grams of carbs, protein and fat, respectively); dinner was 235 calories (5, 18 and 26 grams, respectively).

The first half of the eight-month study focused on weight loss, and the last four months on weight maintenance. At four months, the women on the strict low-carb diet dropped an average of about 28 pounds, and the women on the big-breakfast diet lost nearly 23 pounds on average, which according to Jakubowicz was not significantly different. But at 8 months, the low-carb dieters regained an average of 18 pounds, while the big-breakfast group continued to lose weight, shedding another 16.5 pounds. Those on the new diet lost more than 21 percent of their body weight, compared with just 4.5 percent for the low-carb group. Furthermore, the study found that women who ate a big breakfast reported feeling less hungry, especially before lunch, and having fewer cravings for carbs than the other women did.

Jakubowicz said the big-breakfast diet works because it controls appetite and cravings for sweets and starches. It also is healthier than an extremely low-carbohydrate diet, according to Jakubowicz, because it allows people to eat more fruit and therefore get enough fiber and vitamins. She said she has successfully used the diet in her patients for more than 15 years.

endo-society/