The ketogenic diet (KD), popularly known as the "keto" diet, has garnered substantial attention for its potential to promote weight loss and improve metabolic health in adults. A recent study published in the Journal of the American Medical Association provides new insights into the effects of a low-carbohydrate diet on adolescents with obesity, focusing on its safety and effectiveness compared to other dietary interventions.
119 adolescents aged 13 to 18 with obesity were randomly assigned to either a low-carbohydrate diet (LCD) or a low-fat diet (LFD) over a 12-week period. Both diets were energy-restricted, meaning they were designed to provide fewer calories than needed to maintain current body weight. The LCD group aimed for 5% of total energy from carbohydrates, 70% from fat, and 25% from protein, while the LFD group aimed for 55% of total energy from carbohydrates, 30% from fat, and 15% from protein.
The primary outcome measured was the change in body mass index (BMI) z score, a metric that standardizes BMI according to a child’s age and sex to provide a more accurate assessment of body fat in growing children. The researchers found that both diet groups experienced significant reductions in BMI z scores, but there was no statistically significant difference between the groups.
"Many adolescents were presenting to our hospital weight management clinics already following this diet or wanting to try this, yet there had not been any research to inform safety and effectiveness," Lister told MedPage. "In Australia, there are few treatment options for adolescents with obesity, which is associated with poorer immediate and long-term physical and mental health and well-being." This statement underscores a critical gap in clinical guidance and the need for evidence-based recommendations for young individuals with obesity.
The study also brings to light the challenges of dietary adherence and the social and psychological aspects of dieting in adolescents. Participants in both groups found it difficult to adhere strictly to their assigned diets, a common issue in dietary studies, particularly among younger populations who might lack the autonomy and resources to make consistent dietary choices. Adolescents are at a developmental stage where peer influence, body image, and social dynamics play a significant role, which can complicate adherence and long-term success.
While the ketogenic diet and other low-carbohydrate diets show promise in aiding weight loss and improving metabolic health markers in adolescents with obesity, healthcare providers must approach these interventions with caution. The lack of long-term data and the potential psychological and social impacts highlight the importance of individualized, holistic approaches to managing adolescent obesity.
Sources: Journal of the American Medical Association, MedPage