This Article  • Full text  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on ISI (103)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Obesity  • Alert me on articles by topic

Leslie E. Spieth, PhD; Jennifer D. Harnish, PhD; Carine M. Lenders, MD, MS; Lauren B. Raezer, PhD; Mark A. Pereira, PhD; S. Jan Hangen, MS, RD; David S. Ludwig, MD, PhD

Arch Pediatr Adolesc Med. 2000;154:947-951.

Context  Conventional dietary approaches for the treatment of obesity have generally yielded disappointing results.

Objective  To examine the effects of a low–glycemic index (GI) diet compared with a standard reduced-fat diet in the management of pediatric obesity.

Design  Retrospective cohort study of children attending an outpatient pediatric obesity program from September 1997 to December 1998.

Setting  Academic medical center.

Participants  One hundred seven obese but otherwise healthy children.

Main Outcome Measures  Changes in body mass index (BMI [calculated as weight in kilograms divided by the square of height in meters]) and body weight from first to last clinic visit.

Results  A total of 64 patients received the low glycemic index diet and 43 received the reduced-fat diet for 4.3 vs 4.2 months' mean duration of follow-up, with 3.3 vs 3.3 mean number of visits, respectively. Body mass index (-1.53 kg/m² [95% confidence interval, -1.94 to -1.12] vs -0.06 kg/m² [-0.56 to + 0.44], P<.001) and body weight (-2.03 kg [95% confidence interval -3.19 to -0.88] vs +1.31 kg [ -0.11 to + 2.72], P<.001) decreased more in the low-GI group compared with the reduced-fat group. In multivariate models, these differences remained significant (P<.01) after adjustment for age, sex, ethnicity, BMI or baseline weight, participation in behavioral modification sessions, and treatment duration. Significantly more patients in the low-GI group experienced a decrease in BMI of at least 3 kg/m² (11 kg/m² [17.2%] vs 1 kg/m² [2.3%], P = .03).

Conclusions  A low-GI diet seems to be a promising alternative to standard dietary treatment for obesity in children. Long-term randomized controlled trials of a low-GI diet in the prevention and treatment of obesity are needed.

From the Optimal Weight for Life Program, Department of Psychiatry (Drs Spieth, Harnish, and Raezer), and the Department of Medicine (Drs Lenders, Pereira, and Ludwig, and Ms Hangen), Children's Hospital, Boston, Mass.

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

State of the Art Reviews: Glycemic Index, Obesity, and Chronic Disease
Marsh and Brand-Miller
AMERICAN JOURNAL OF LIFESTYLE MEDICINE 2008;2:142-150.
ABSTRACT  

The Role of Sugar-Sweetened Beverage Consumption in Adolescent Obesity: A Review of the Literature
Harrington
The Journal of School Nursing 2008;24:3-12.
ABSTRACT  

The Effects of 6-Week Low Glycemic Load Diet Based on Low Glycemic Index Foods in Overweight/Obese Children - Pilot Study
Fajcsak et al.
J. Am. Coll. Nutr. 2008;27:12-21.
ABSTRACT | FULL TEXT  

Glycemic response and health a systematic review and meta-analysis: the database, study characteristics, and macronutrient intakes
Livesey et al.
Am. J. Clin. Nutr. 2008;87:223S-236S.
ABSTRACT | FULL TEXT  

Recommendations for Treatment of Child and Adolescent Overweight and Obesity
Spear et al.
Pediatrics 2007;120:S254-S288.
ABSTRACT | FULL TEXT  

Associations of dietary sugar and glycemic index with adiposity and insulin dynamics in overweight Latino youth
Davis et al.
Am. J. Clin. Nutr. 2007;86:1331-1338.
ABSTRACT | FULL TEXT  

An 18-mo randomized trial of a low-glycemic-index diet and weight change in Brazilian women
Sichieri et al.
Am. J. Clin. Nutr. 2007;86:707-713.
ABSTRACT | FULL TEXT  

A low-glycemic-load diet improves symptoms in acne vulgaris patients: a randomized controlled trial
Smith et al.
Am. J. Clin. Nutr. 2007;86:107-115.
ABSTRACT | FULL TEXT  

Glycemic Index-Based Nutritional Education Improves Blood Glucose Control in Japanese Adults: A randomized controlled trial
Amano et al.
Diabetes Care 2007;30:1874-1876.
FULL TEXT  

Are Dietary Intakes and Eating Behaviors Related to Childhood Obesity? A Comprehensive Review of the Evidence
Newby
J Law Med Ethics 2007;35:35-60.
 

Nonalcoholic Fatty Liver Disease and Obesity
Saadeh
Nutr Clin Pract 2007;22:1-10.
ABSTRACT | FULL TEXT  

Lack of evidence on diets for obesity for children: a systematic review
Gibson et al.
Int J Epidemiol 2006;35:1544-1552.
ABSTRACT | FULL TEXT  

Glycemic index and glycemic load in relation to changes in body weight, body fat distribution, and body composition in adult Danes.
Hare-Bruun et al.
Am. J. Clin. Nutr. 2006;84:871-879.
ABSTRACT | FULL TEXT  

Burger king and subway: key nutrients, glycemic index, and glycemic load of nutritionally promoted items.
Bove et al.
The Diabetes Educator 2006;32:675-690.
ABSTRACT | FULL TEXT  

Short-term meal replacements followed by dietary macronutrient restriction enhance weight loss in polycystic ovary syndrome
Moran et al.
Am. J. Clin. Nutr. 2006;84:77-87.
ABSTRACT | FULL TEXT  

Low-Glycemic Index Carbohydrates: An Effective Behavioral Change for Glycemic Control and Weight Management in Patients With Type 1 and 2 Diabetes
Burani and Longo
The Diabetes Educator 2006;32:78-88.
ABSTRACT | FULL TEXT  

Dietary Glycemic Index and Glycemic Load, Carbohydrate and Fiber Intake, and Measures of Insulin Sensitivity, Secretion, and Adiposity in the Insulin Resistance Atherosclerosis Study
Liese et al.
Diabetes Care 2005;28:2832-2838.
ABSTRACT | FULL TEXT  

A Low-Glycemic Load Diet Facilitates Greater Weight Loss in Overweight Adults With High Insulin Secretion but Not in Overweight Adults With Low Insulin Secretion in the CALERIE Trial
Pittas et al.
Diabetes Care 2005;28:2939-2941.
FULL TEXT  

Strategies for Healthy Weight Loss: From Vitamin C to the Glycemic Response
Johnston
J. Am. Coll. Nutr. 2005;24:158-165.
ABSTRACT | FULL TEXT  

Association between Dietary Carbohydrates and Body Weight
Ma et al.
Am J Epidemiol 2005;161:359-367.
ABSTRACT | FULL TEXT  

No difference in body weight decrease between a low-glycemic-index and a high-glycemic-index diet but reduced LDL cholesterol after 10-wk ad libitum intake of the low-glycemic-index diet
Sloth et al.
Am. J. Clin. Nutr. 2004;80:337-347.
ABSTRACT | FULL TEXT  

Low Glycemic Index Breakfasts and Reduced Food Intake in Preadolescent Children
Warren et al.
Pediatrics 2003;112:e414-414.
ABSTRACT | FULL TEXT  

Sugars, energy metabolism, and body weight control
Saris
Am. J. Clin. Nutr. 2003;78:850S-857.
ABSTRACT | FULL TEXT  

Whole Grain Intake Is Associated with Lower Body Mass and Greater Insulin Sensitivity among Adolescents
Steffen et al.
Am J Epidemiol 2003;158:243-250.
ABSTRACT | FULL TEXT  

A Reduced-Glycemic Load Diet in the Treatment of Adolescent Obesity
Ebbeling et al.
Arch Pediatr Adolesc Med 2003;157:773-779.
ABSTRACT | FULL TEXT  

Prolongation of Satiety After Low Versus Moderately High Glycemic Index Meals in Obese Adolescents
Ball et al.
Pediatrics 2003;111:488-494.
ABSTRACT | FULL TEXT  

International table of glycemic index and glycemic load values: 2002
Foster-Powell et al.
Am. J. Clin. Nutr. 2002;76:5-56.
ABSTRACT | FULL TEXT  

Glycemic index and obesity
Brand-Miller et al.
Am. J. Clin. Nutr. 2002;76:281S-285.
ABSTRACT | FULL TEXT  

The Glycemic Index: Physiological Mechanisms Relating to Obesity, Diabetes, and Cardiovascular Disease
Ludwig
JAMA 2002;287:2414-2423.
ABSTRACT | FULL TEXT