title: The Effect of an Energy Restricted Low Glycemic Index Diet on Blood Lipids, Apolipoproteins and Lipoprotein (a) Among Adolescent Girls with Excess Weight: a Randomized Clinical Trial Glycemic index of foods: a physiological basis for carbohydrate exchange. Comparison of weight-loss diets with different compositions of fat, protein, and carbohydrates. Association between dietary glycemic index, glycemic load, and high-sensitivity C-reactive protein. A low-glycemic-load versus low-fat diet in the treatment of fatty liver in obese children. The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials Development of a prediction equation for insulin sensitivity from anthropometry and fasting insulin in prepubertal and early pubertal children. A randomized controlled trial to investigate the impact of a low glycemic index (GI) diet on body mass index in obese adolescents Dietary fiber, glycemic load, and risk of non-insulin-dependent diabetes mellitus in women. Comparison of two diets of varying glycemic index on carotid subclinical atherosclerosis in obese children Validation of surrogate estimates of insulin sensitivity and insulin secretion in children and adolescents. Higher protein diets consumed ad libitum improve cardiovascular risk markers in children of overweight parents from eight European countries. Dietary Fiber, Glycemic Load, and Risk of NIDDM in Men Role of carbohydrate modification in weight management among obese children: a randomized clinical trial. The Effect of Protein and Glycemic Index on Children's Body Composition: The DiOGenes Randomized Study A reduced-glycemic load diet in the treatment of adolescent obesity. Efficacy and safety of a high protein, low carbohydrate diet for weight loss in severely obese adolescents. Effects of a low glycemic load or a low-fat dietary intervention on body weight in obese Hispanic American children and adolescents: a randomized controlled trial.
abstract: Some studies focused on the effect of the dietary glycemic index on lipoproteins and apolipoproteins in adults ; however , little evidence exists among adolescents regarding the effect of a low glycemic index ( LGI ) diet on apolipoproteins and lipoprotein ( a ) ( Lpa ) . This study was conducted to evaluate the effect of an LGI diet on the lipid profile , apolipoproteins and Lpa among overweight and obese adolescent girls . For this parallel design ed r and omized clinical trial , 50 healthy overweight/obese girls at pubertal ages were r and omly allocated to an LGI or a healthy nutritional recommendations ( HNR ) based diet . Equal macronutrient distributed diets were prescribed to both groups . Biochemical measurements included lipid profile , apolipoprotein A , apolipoprotein B and Lpa were conducted before and after 10 weeks of intervention . Forty one adolescent girls completed the study . The dietary glycemic index in the LGI group was 42.67 ± 0.067 . There were no differences in the mean of blood lipid indices baseline and after intervention between two groups . There were no significant differences between the two groups regarding lipid profiles , apolipoproteins and Lpa . There were no significant differences in lipid profiles , apolipoproteins and Lpa  between the LGI diet and the HNR-based diet and the impact of these two diets on lipid profile was equal in this trial . Trial registry code : I RCT 201109272839N4 The determine the effect of different foods on the blood glucose , 62 commonly eaten foods and sugars were fed individually to groups of 5 to 10 healthy fasting volunteers .  Blood glucose levels were measured over 2 h , and expressed as a percentage of the area under the glucose response curve when the same amount of carbohydrate was taken as glucose . The largest rises were seen with vegetables ( 70 + /- 5 % ) , followed by breakfast cereals ( 65 + /- 5 % ) , cereals and biscuits ( 60 + /- 3 % ) , fruit ( 50 + /- 5 % ) , dairy products ( 35 + /- 1 % ) , and dried legumes ( 31 + /- 3 % ) . A significant negative relationship was seen between fat ( p less than 0.01 ) and protein ( p less than 0.001 ) and postpr and ial glucose rise but not with fiber or sugar content BACKGROUND The possible advantage for weight loss of a diet that emphasizes protein , fat , or carbohydrates has not been established , and there are few studies that extend beyond 1 year . METHODS We r and omly assigned 811 overweight adults to one of four diets ; the targeted percentages of energy derived from fat , protein , and carbohydrates in the four diets were 20 , 15 , and 65 % ; 20 , 25 , and 55 % ; 40 , 15 , and 45 % ; and 40 , 25 , and 35 % . The diets consisted of similar foods and met guidelines for cardiovascular health . The participants were offered group and individual instructional sessions for 2 years . The primary outcome was the change in body weight after 2 years in two-by-two factorial comparisons of low fat versus high fat and average protein versus high protein and in the comparison of highest and lowest carbohydrate content . RESULTS At 6 months , participants assigned to each diet had lost an average of 6 kg , which represented 7 % of their initial weight ; they began to regain weight after 12 months . By 2 years , weight loss remained similar in those who were assigned to a diet with 15 % protein and those assigned to a diet with 25 % protein ( 3.0 and 3.6 kg , respectively ) ; in those assigned to a diet with 20 % fat and those assigned to a diet with 40 % fat ( 3.3 kg for both groups ) ; and in those assigned to a diet with 65 % carbohydrates and those assigned to a diet with 35 % carbohydrates ( 2.9 and 3.4 kg , respectively ) ( P>0.20 for all comparisons ) . Among the 80 % of participants who completed the trial , the average weight loss was 4 kg ; 14 to 15 % of the participants had a reduction of at least 10 % of their initial body weight . Satiety , hunger , satisfaction with the diet , and attendance at group sessions were similar for all diets ; attendance was strongly associated with weight loss ( 0.2 kg per session attended ) . The diets improved lipid-related risk factors and fasting insulin levels . CONCLUSIONS Reduced-calorie diets result in clinical ly meaningful weight loss regardless of which macronutrients they emphasize . ( Clinical Trials.gov number , NCT00072995 . OBJECTIVE This study examined the relation between quality of dietary carbohydrate intake , as measured by glycemic index ( GI ) and glycemic load ( GL ) , and serum high-sensitivity C-reactive protein ( hs-CRP ) levels . METHODS During a 1-y observational study , data were collected at baseline and at each quarter thereafter . GI and GL were calculated from multiple 24-h dietary recalls ( 24HRs ) , 3 r and omly selected 24HRs at every quarter , with up to 15 24HRs per participant . The  hs-CRP was measured in blood sample s collected at baseline and each of the four quarterly measurement points . Multivariable linear mixed models were used to examine the cross-sectional and longitudinal associations of GI , GL , and hs-CRP . RESULTS Among 582 adult men and women with at least two measurements of diet and hs-CRP , average daily GI score ( white bread = 100 ) was 85 and average GL was 198 , and average hs-CRP was 1.84 mg/L. Overall , there was no association between GI or GL and hs-CRP . Subgroup analyses revealed an inverse association between GL and hs-CRP  among obese individuals ( body mass index > or = 30 kg/m(2 ) ) . CONCLUSION Quality of dietary carbohydrates does not appear to be associated with serum hs-CRP levels .  Among obese individuals , higher dietary GL appears to be related to lower hs-CRP levels . Due to the limited number of studies on this topic and their conflicting results , further investigation is warranted BACKGROUND Fatty liver is highly prevalent among obese children and represents a major risk factor for chronic liver diseases and severe metabolic complications . METHODS We r and omly assigned 17 obese children 8 - 17 years of age with fatty liver to either an experimental low-glycemic-load or conventional low-fat diet for 6 months . Participants in both groups received nutrition education and behavioral counseling of equal intensity . The primary outcome was hepatic lipid content measured by proton magnetic resonance spectroscopy . Secondary outcomes included change in visceral fat , BMI , anthropometrics , alanine aminotransferase ( ALT ) , and insulin resistance . RESULTS A total of 16 participants completed the study . Reported glycemic load decreased in the low-glycemic-load group and reported dietary fat decreased in the low-fat group . At baseline , liver fat was 23.8 % [ st and ard deviation ( SD ) 12.2 ] in the low-glycemic-load group and 29.3 % ( 14.1 ) in the low-fat group . Liver fat decreased substantially in both groups at 6 months expressed as absolute percentage change , with no between-group differences [ -8.8 ( st and ard error ( SE ) 4.1 ) vs. -10.5 (3.7)% , respectively , p=0.76 for group × time interaction ] . Secondary outcomes also improved on both diets , with no between-group differences . Baseline and change in ALT were strongly associated with hepatic fat content . CONCLUSIONS Weight-reducing diets focused either on glycemic load or dietary fat improved hepatic steatosis over 6 months . Additional research is needed to determine whether these diets differ in effectiveness over the long term . TRIAL REGISTRATION clinical trials.gov Identifier : NCT00480922 Flaws in the design , conduct , analysis , and reporting of r and omised trials can cause the effect of an intervention to be underestimated or overestimated . The Cochrane Collaboration ’s tool for assessing risk of bias aims to make the process clearer and more OBJECTIVE To test the utility of homeostasis model assessment ( HOMA ) in predicting insulin sensitivity [ x10(- 4 ) min(-1)/(microIU/ml ) ] in children and to develop and compare two new prediction equations for insulin sensitivity in children using demographic and anthropometric measures in the presence or absence of fasting insulin . RESEARCH DESIGN AND METHODS We studied 156 white and African-American children with complete data ( mean age 9.7 + /- 1.8 years , 87.8 % Tanner Stage 1 or 2 ) . For development of new equations , two-thirds of the children were r and omly assigned to a development group , whereas the remaining children were assigned to a cross-validation group . RESULTS A modified HOMA equation accurately predicted insulin sensitivity , but its utility is similar to fasting insulin alone . Demographic and anthropometric measures alone did not predict insulin sensitivity accurately , even when precise measures of body composition were included in the prediction model . Ethnicity , calf skinfold , and fasting insulin together explained 73 % of the variance in insulin sensitivity and accurately predicted insulin sensitivity . The regression of measured versus predicted insulin sensitivity in the cross-validation group was not significantly different from the line of identity ( P > 0.05 ) . Mean difference between measured and predicted insulin sensitivity was also not significant ( P > 0.05 ) . Some bias was apparent , particularly in white boys . CONCLUSIONS Ethnicity , calf skinfold , and fasting insulin can accurately predict insulin sensitivity with greater precision than HOMA or fasting insulin alone ( R(2 ) = 0.73 ) . Future studies , however , are needed to examine whether a universal equation is possible . A cross-vali date d prediction equation may be useful in population -based studies when complex measures of insulin sensitivity are not available Background The role of a low glycemic index ( GI ) diet in the management of adolescent obesity remains controversial . In this study , we aim to evaluate the impact of low GI diet versus a conventional Chinese diet on the body mass index ( BMI ) and other obesity indices of obese adolescents . Methods Obese adolescents aged 15–18 years were identified from population -recruited , territory-wide surveys . Obesity was defined as BMI ≥95th percentile of Hong Kong local age- and sex-specific references . Eligible subjects were r and omized to either an intervention with low GI diet ( consisting of 45 - 50 % carbohydrate , 30 - 35 % fat and 15 - 20 % protein ) or conventional Chinese diet as control ( consisting of 55 - 60 % carbohydrate , 25 - 30 % fat and 10 - 15 % protein ) . We used r and om intercept mixed effects model to compare the differential changes across the time points from baseline to month 6 between the 2 groups . Results 104 obese adolescents were recruited ( 52 in low GI group and 52 in control group ; 43.3 % boys ) . Mean age was 16.7 ± 1.0 years and 16.8 ±1.0 years in low GI and control group respectively . 58.7 % subjects completed the study at 6 months ( 65.4 % in low GI group and 51.9 % in control group ) . After adjustment for age and sex , subjects in the low GI group had a significantly greater reduction in obesity indices including BMI , body weight and waist circumference ( WC ) compared to subjects in the control group ( all p < 0.05 ) . After further adjustment for physical activity levels , WC was found to be significantly lower in the low GI group compared to the conventional group ( p = 0.018 ) . Conclusion Low GI diet in the context of a comprehensive lifestyle modification program may be an alternative to conventional diet in the management of obese adolescents . Trial registration number Clinical Trials.gov Ref . No : OBJECTIVE To examine prospect ively the relationship between glycemic diets , low fiber intake , and risk of non-insulin-dependent diabetes mellitus .  DESIGN Cohort study . SETTING In 1986 , a total of 65173 US women 40 to 65 years of age and free from diagnosed cardiovascular disease , cancer , and diabetes completed a detailed dietary question naire from which we calculated usual intake of total and specific sources of dietary fiber , dietary glycemic index , and glycemic load . MAIN OUTCOME MEASURE Non-insulin-dependent diabetes mellitus . RESULTS During 6 years of follow-up , 915 incident cases of diabetes  were documented . The dietary glycemic index was positively associated with risk of diabetes after adjustment for age , body mass index , smoking , physical activity , family history of diabetes , alcohol and cereal fiber intake , and total energy intake . Comparing the highest with the lowest quintile , the relative risk ( RR ) of diabetes was 1.37 ( 95 % confidence interval [ CI ] , 1.09 - 1.71 , P trend=.005 ) . The glycemic load ( an indicator of a global dietary insulin dem and ) was also positively associated with diabetes ( RR= 1.47 ; 95 % CI , 1.16 - 1.86 , P trend=.003 ) . Cereal fiber intake was inversely associated with risk of diabetes when comparing the extreme quintiles ( RR=0.72 , 95 % CI , 0.58 - 0.90 , P trend=.001 ) . The combination of a high glycemic load and a low cereal fiber intake further increased the risk of diabetes ( RR=2.50 , 95 % CI , 1.14 - 5.51 ) when compared with a low glycemic load and high cereal fiber intake . CONCLUSIONS Our results support the hypothesis that diets with a high glycemic load and a low cereal fiber content increase risk of diabetes in women . Further , they suggest that grains should be consumed in a minimally refined form to reduce the incidence of diabetes Childhood obesity is associated with an increased carotid intima-media thickness ( IMT ) and stiffness . Increased carotid wall thickening and rigidity are considered markers of sub clinical atherosclerosis . The aim of the present study was to test the effect of two hypocaloric diets of varying glycemic index on weight loss and markers of sub clinical atherosclerosis in obese children . Seventy consecutive obese children attending the Outpatient Weight Clinic of the Department of Pediatrics were invited to participate in an intensive dietary protocol . Twenty-six accepted and were r and omly assigned to two different groups : the first group followed a hypocaloric low-glycemic index diet and the second a hypocaloric high-glycemic index diet .  Anthropometric measures and biochemical tests were performed in all children . Quantitative B-mode ultrasound scans were used to measure intima-media thickness ( IMT ) and diameters of the common carotid artery . Considering both groups together , at 6 months , body mass index decreased from 28.3 ± 3.1 to 25.8 ± 3.3 kg/m2 , systolic blood pressure from 119 ± 12 to 110 ± 11 mmHg ( P < 0.001 ) , diastolic blood pressure from 78 ± 8 to 74 ± 7 mmHg ( P < 0.001 ) , IMT from 0.48 ± 0.05 to 0.43 ± 0.07 mm ( P < 0.001 ) , stiffness from 3.57 ± 1.04 to 2.98 ± 0.94 mm ( P = 0.002 ) , and high-sensitivity C-reactive protein from 1.5 ± 0.9 ( values log transformed ) to 0.4 ± 1.1 ( P < 0.001 ) . No differences were detectable in fasting serum triglycerides , total cholesterol , and high-density lipoprotein cholesterol . Insulin resistance ( calculated by the HOmeostatic Model Assessment index [ HOMA ] score ) significantly reduced only in the low-glycemic-index diet group ( P < 0.04 ) . In conclusion , this study confirms a benefit of hypocaloric diets on carotid IMT and stiffness in obese children and demonstrates , for the first time , an amelioration of insulin sensitivity in obese children after a low-glycemic index diet . These results justify the advice to obese children to follow a low-glycemic index diet in order to improve their cardiometabolic profile OBJECTIVES To compare insulin sensitivity and pancreatic beta-cell function measured by the euglycemic and the hyperglycemic clamp , with simple estimates of insulin sensitivity and pancreatic beta-cell function in youth . Study design We measured insulin sensitivity with a euglycemic clamp and first- and second-phase insulin secretion with a hyperglycemic clamp in 156 AA and white youths . Estimates of insulin sensitivity ( fasting insulin level [ I(F ) ] , the ratio of fasting glucose [ G(F ) ] to I(F ) [ G(F)/I(F ) ] , homeostasis model assessment estimate of insulin sensitivity [ HOMA IS ] , and quantitative insulin sensitivity check index [ QUICKI ] ) and estimates of pancreatic beta-cell function ( I(F ) , the ratio of I(F ) to G(F ) [ I(F)/G(F ) ] , and homeostasis model assessment estimate of pancreatic beta-cell function [ HOMA % B ] ) were derived from fasting measurements . RESULTS In the total group , IS(Eu ) correlated strongly with I(F ) ( r=-0.92 ) , G(F)/I(F ) ( r=0.92 ) , HOMA IS ( r=0.91 ) , and QUICKI ( r=0.91 ) ( P<.01 ) . First-phase and second-phase insulin secretion correlated with I(F ) , I(F)/G(F ) , and HOMA % B ( first-phase insulin secretion : r=0.76 , 0.79 , 0.82 ; second-phase insulin secretion : r=0.83 , 0.86 , 0.86 , respectively ; P<.01 ) . CONCLUSIONS Simple estimates of insulin sensitivity and pancreatic beta-cell function using fasting insulin and glucose levels serve as surrogate measures of insulin sensitivity and secretion in nondiabetic youths . The validity of these conclusions in children with impaired glucose tolerance and type 2 diabetes mellitus remains to be determined Dietary strategies to improve early cardiovascular markers in overweight children are needed . We investigated the effect of dietary protein and glycemic index ( GI ) on cardiovascular markers and metabolic syndrome ( MetS ) scores in 5- to 18-y-old children of overweight/obese parents from 8 European centers . Families were r and omized to 1 of 5 diets consumed ad libitum : high protein ( HP ) or low protein ( LP ) combined with high GI ( HGI ) or low GI ( LGI ) , or a control diet . At 6 centers , families received dietary instruction ( instruction centers ) ; at 2 centers , free foods were also provided ( supermarket centers ) . Diet , anthropometry , blood pressure , and serum cardiovascular markers ( lipid profile , glucose regulation , and inflammation ) were measured in 253 children at baseline , 1 mo , and /or 6 mo . Protein intake was higher in the HP groups ( 19.9 ± 1.3 % energy ) than in the LP groups at 6 mo ( 16.8 ± 1.2 % energy ) ( P = 0.001 ) . The GI was 4.0 points lower ( 95 % CI : 2.1 , 6.1 ) in the LGI compared with the HGI groups ( P < 0.001 ) . In the supermarket centers , the HP and LP groups differed more in protein intake than did the groups in the instruction centers ( P = 0.009 ) , indicating better compliance . The HP diets evoked a 2.7-cm ( 95 % CI : 0.9 , 5.1 ) smaller waist circumference and a 0.25-mmol/L ( 95 % CI : 0.09 , 0.41 ) lower serum LDL cholesterol compared with the LP diets at 6 mo ( P < 0.007 ) . In a separate supermarket center analysis , the HP compared with LP diets reduced waist circumference ( P = 0.004 ) , blood pressure ( P < 0.01 ) , serum insulin ( P = 0.013 ) , and homeostasis model of assessment -insulin resistance ( P = 0.016 ) . In the instruction centers , the HP compared with the  LP diets reduced LDL cholesterol ( P = 0.004 ) . No consistent effect of GI was seen and the MetS scores were not affected . In conclusion , increased protein intake improved cardiovascular markers in high-risk children , particularly in those undergoing most intensive intervention OBJECTIVE Intake of carbohydrates that provide a large glycemic response has been hypothesized to increase the risk of NIDDM , whereas dietary fiber is suspected to reduce incidence . These hypotheses have not been evaluated prospect ively . RESEARCH DESIGN AND METHODS We examined the relationship between diet and risk of NIDDM in a cohort of 42,759 men without NIDDM or cardiovascular disease , who were 40–75 years of age in 1986 .  Diet was assessed at baseline by a vali date d semiquantitative food frequency question naire . During 6-years of follow-up , 523 incident cases of NIDDM were documented . RESULTS The dietary glycemic index ( an indicator of carbohydrate 's ability to raise blood glucose levels ) was positively associated with risk of NIDDM after adjustment for age , BMI , smoking , physical activity , family history of diabetes , alcohol consumption , cereal fiber , and total energy intake . Comparing the highest and lowest quintiles , the relative risk ( RR ) of NIDDM was 1.37 ( 95 % CI , 1.02–1.83 , P trend = 0.03 ) .  Cereal fiber  was inversely associated with risk of NIDDM ( RR = 0.70 ; 95 % CI , 0.51–0.96 , P trend = 0.007 ; for > 8.1 g/day vs. < 3.2 g/day ) . The combination of a high glycemic load and a low cereal fiber intake further increased the risk of NIDDM ( RR = 2.17 , 95 % CI , 1.04–4.54 ) when compared with a low glycemic load and high cereal fiber intake . CONCLUSIONS These findings support the hypothesis that diets with a high glycemic load and a low cereal fiber content increase risk of NIDDM  in men . Further , they suggest that grains should be consumed in a minimally refined form to reduce the incidence of NIDDM OBJECTIVE To compare the effectiveness and safety of carbohydrate (CHO)-modified diets with a st and ard portion-controlled ( PC ) diet in obese children . STUDY DESIGN Obese children ( n=102 ) aged 7 - 12 years were r and omly assigned to a 3-month intervention of a low-CHO ( LC ) , reduced glycemic load ( RGL ) , or st and ard PC diet , along with weekly dietary counseling and biweekly group exercise .  Anthropometry , dietary adherence , and clinical measures were evaluated at baseline and 3 , 6 , and 12 months . Analyses applied intention-to-treat longitudinal mixed models . RESULTS Eighty-five children ( 83 % ) completed the 12-month assessment . Daily caloric intake decreased from baseline to all time points for all diet groups ( P<.0001 ) , although LC diet adherence was persistently lower ( P<.0002 ) . At 3 months , body mass index z score was lower in all diet groups ( LC , -0.27 ± 0.04 ; RGL , -0.20 ± 0.04 ; PC , -0.21 ± 0.04 ; P<.0001 ) and was maintained at 6 months , with similar results for waist circumference and percent body fat . At 12 months , participants in all diet groups had lower body mass index z scores than at baseline ( LC , -0.21 ± 0.04 ; RGL , -0.28 ± 0.04 ; PC , -0.31 ± 0.04 ; P<.0001 ) , and lower percent body fat , but no reductions in waist circumference were maintained . All diets demonstrated some improved clinical measures . CONCLUSION Diets with modified CHO intake were as effective as a PC diet  for weight management in obese children . However , the lower adherence to the LC diet suggests that this regimen is more difficult for children to follow , particularly in the long term OBJECTIVE : To investigate the effect of protein and glycemic index ( GI ) on body composition among European children in the r and omized , 6-month dietary intervention DiOGenes ( diet , obesity , and genes ) family-based study . PATIENTS AND METHODS : In the study , 827 children ( 381 boys and 446 girls ) , aged 5 to 18 years , completed baseline examinations . Families with parents who lost ≥8 % of their weight during an 8-week run-in low-calorie diet period were r and omly assigned to 1 of 5 ad libitum diets : low protein (LP)/low glycemic index ( LGI ) ; LP/high GI ( HGI ) ; high protein (HP)/LGI ; HP/HGI ; and control diet . The target difference was 15 GI U between the LGI/HGI groups and 13 protein percentage points between the LP/HP groups . There were 658 children examined after 4 weeks . Advice on food-choice modification was provided at 6 visits during this period . No advice on weight loss was provided because the focus of the study was the ability of the diets to affect outcomes through appetite regulation . Anthropometric measurements and body composition were assessed at baseline , week 4 , and week 26 . RESULTS : In the study , 465 children ( 58.1 % ) completed all assessment s. The achieved differences between the GI and protein groups were 2.3 GI U and 4.9 protein percentage points , respectively . The LP/HGI group increased body fat percentage significantly more than the other groups ( P = .040 ; partial η2 = 0.039 ) , and the percentage of overweight/obese children in the HP/LGI group decreased significantly during the intervention ( P = .031 ) . CONCLUSIONS : Neither GI nor protein had an isolated effect on body composition . However , the LP/HGI combination increased body fat , whereas the HP/LGI combination was protective against obesity in this sample of children BACKGROUND The incidence of type 2 diabetes increases markedly for obese children after puberty . However , the effect of dietary composition on body weight and diabetes risk factors has not been studied in adolescents . OBJECTIVE To compare the effects of an ad libitum , reduced-glycemic load ( GL ) diet with those of an energy-restricted , reduced-fat diet in obese adolescents . DESIGN R and omized control trial consisting of a 6-month intervention and a 6-month follow-up . MAIN OUTCOME MEASURES Body composition ( body mass index [ BMI ; calculated as weight in kilograms divided by the square of height in meters ] and fat mass ) and insulin resistance ( homeostasis model assessment ) were measured at 0 , 6 , and 12 months . Seven-day food diaries were used as a process measure . SUBJECTS Sixteen obese adolescents aged 13 to 21 years . Intervention Experimental ( reduced-GL ) treatment emphasized selection of foods characterized by a low to moderate glycemic index , with 45 % to 50 % of energy from carbohydrates and 30 % to 35 % from fat . In contrast , conventional ( reduced-fat ) treatment emphasized selection of low-fat products , with 55 % to 60 % of energy from carbohydrates and 25 % to 30 % from fat . RESULTS Fourteen subjects completed the study ( 7 per group ) . The GL decreased significantly in the experimental group , and dietary fat decreased significantly in the conventional group ( P<.05 for both ) . At 12 months , mean + /- SEM BMI ( -1.3 + /- 0.7 vs 0.7 + /- 0.5 ; P = .02 ) and fat mass ( -3.0 + /- 1.6 vs 1.8 + /- 1.0 kg ; P = .01 ) had decreased more in the experimental compared with the conventional group , differences that were material ly unchanged in an intention-to-treat model ( n = 16 ) ( BMI , P = .02 ; fat mass , P = .01 ) . Insulin resistance as measured by means of homeostasis model assessment increased less in the experimental group during the intervention period ( -0.4 + /- 0.9 vs 2.6 + /- 1.2 ; P = .02 ) . In post hoc analyses , GL was a significant predictor of treatment response among both groups ( R2 = 0.51 ; P = .006 ) , whereas dietary fat was not ( R2 = 0.14 ; P = .22 ) . CONCLUSIONS An ad libitum reduced-GL diet appears to be a promising alternative to a conventional diet in obese adolescents . Large-scale r and omized controlled trials are needed to further evaluate the effectiveness of reduced-GL and -glycemic index diets in the treatment of obesity and prevention of type 2 diabetes OBJECTIVE To evaluate the efficacy and safety of a carbohydrate restricted versus a low fat diet on weight loss , metabolic markers , body composition , and cardiac function tests in severely obese adolescents . STUDY DESIGN Subjects were r and omly assigned to 1 of 2 diets : a high protein , low carbohydrate ( 20 g/d ) diet ( high protein , low carbohydrate , HPLC ) or low fat ( 30 % of calories ) regimen for 13 weeks ; close monitoring was maintained to evaluate safety . After the intervention , no clinical contact was made until follow-up measurements were obtained at 24 and 36 weeks from baseline . The primary outcome was change in body mass index Z-score for age and sex ( BMI -Z ) at 13 , 24 , and 36 weeks . RESULTS Forty-six subjects ( 24 HPLC , 22 in low fat ) initiated and 33 subjects completed the intervention ; follow-up data were available on approximately half of the subjects . Significant reduction in ( BMI -Z ) was achieved in both groups during intervention and was significantly greater for the HPLC group ( P = .03 ) . Both groups maintained significant BMI -Z reduction at follow-up ; changes were not significantly different between groups . Loss of lean body mass was not spared in the HPLC group . No serious adverse effects were observed related to metabolic profiles , cardiac function , or subjective complaints . CONCLUSIONS The HPLC diet is a safe and effective option for medically supervised weight loss in severely obese adolescents BACKGROUND In Hispanic children and adolescents , the prevalence of obesity and insulin resistance is considerably greater than in non-Hispanic white children . A low-glycemic load diet ( LGD ) has been proposed as an effective dietary intervention for pediatric obesity , but to our knowledge , no published study has examined the effects of an LGD in obese Hispanic children . OBJECTIVE We compared the effects of an LGD and a low-fat diet ( LFD ) on body composition and components of metabolic syndrome in obese Hispanic youth . DESIGN Obese Hispanic children ( 7 - 15 y of age ) were r and omly assigned to consume an LGD or an LFD in a 2-y intervention program .  Body composition and laboratory assessment s were obtained at baseline and 3 , 12 , and 24 mo after intervention . RESULTS In 113 children who were r and omly assigned , 79 % of both groups completed 3 mo of treatment ; 58 % of LGD and 55 % of LFD subjects attended 24-mo follow-up . Compared with the LFD , the LGD decreased the glycemic load per kilocalories of reported food intakes in participants at 3 mo ( P = 0.02 ) . Both groups had a decreased BMI z score ( P < 0.003 ) , which was expressed as a st and ard z score relative to CDC age- and sex-specific norms , and improved waist circumference and systolic blood pressure ( P < 0.05 ) at 3 , 12 , and 24 mo after intervention . However , there were no significant differences between groups for changes in BMI , insulin resistance , or components of metabolic syndrome ( all P > 0.5 ) . CONCLUSIONS We showed no evidence that an LGD and an LFD differ in efficacy for the reduction of BMI or aspects of metabolic syndrome in obese Hispanic youth . Both diets decreased the BMI z score when prescribed in the context of a culturally adapted , comprehensive weight-reduction program
target: Other parameters under investigation were not affected by either low or high glycaemic indices .
  The present systematic review and meta- analysis provides evidence of a beneficial effect of a low glycaemic index/load diet in children and adolescents being either overweight or obese .
background: The objective of the present systematic review and meta- analysis was to synthesize the available literature data investigating the effects of low glycaemic index/low glycamic load dietary regimens on anthropometric parameters , blood lipid profiles , and indicators of glucose metabolism in children and adolescents .