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Therefore, dietary compliance was maximal in the group receiving the balanced diet (100%), while it was estimated to be 84% in the group receiving the dissociated diet.
After baseline metabolic data were acquired, the patients were assigned to receive one of the two experimental diets whose composition is listed in Table 2.
Both systolic and diastolic blood pressure values decreased significantly in patients eating balanced diets.
Both systolic and diastolic blood pressure values decreased significantly in the group receiving balanced diet, but not in the other group.
To verify compliance with the diet and mainly for education purpose, patients completed a one day food record once a week during the 6 weeks of the study.
Nitrogen and sodium balance and sympathetic-nervous-system activity in obese subjects treated with a low-calorie protein or mixed diet.
The amount of weight loss was similar in response to the two diets (which had similar energy and macronutrients contents (Table 2 )) and was apparently independent of the substrate distribution within meals, being principally related to total energy intake, in accordance with previous works from our group and others.
Comparison of a low-fat, ad libitum complex-carbohydrate diet with a low-energy diet in moderately obese women.
International Journal of Obesity is a monthly, multi-disciplinary forum for papers describing basic, clinical and applied studies in biochemistry, genetics and nutrition, together with molecular, metabolic, psychological and epidemiological aspects of obesity and related disorders
Systolic and diastolic blood pressure values fell significantly in the group receiving balanced diet, but there were no differences between the groups in the change in blood pressure.
All subjects were instructed to eat all foods and a dietitian was present during each meal to improve compliance and education.
More specifically, both diets allowed a significant improvement in fasting plasma glucose, cholesterol and triacylglycerol values.
In conclusion, our results substantiate the lack of benefit of dissociated (food combining) vs balanced diets in terms of weight loss and further support that it is energy intake, not energy composition or distribution throughout daytime, that determines weight loss in response to low-energy diets.
Similar weight loss with low-energy food combining or balanced diets
The effects of variations in carbohydrate, protein and fat content of the diet upon weight loss, blood values and nutrient intake of adult obese women.
Total body weight, body mass index, waist and hip circumferences (as well as their ratio) decreased significantly in both groups and the magnitude of the changes did not vary as a function of the type of diet; nevertheless the group receiving the balanced diet showed a tendency to lose weight more than the group on the dissociated diet (7.
Concerning the influence of qualitative diet composition on weight loss, several authors7 ,8 ,9 ,10 agree that the total energy intake, and not its composition, determines the final weight loss.
Blood was drawn after a 14 h overnight fast before and after 2, 4 and 6 weeks of both balanced and dissociated diets for measurements of plasma glucose,24 plasma immunoreactive insulin,25 total cholesterol,26 high-density-lipoprotein (HDL)-cholesterol, and triacylglycerol concentrations.
CONCLUSION: In summary at identical energy intake and similar substrate composition, the dissociated (or 'food combining') diet did not bring any additional loss in weight and body fat.
Fasting plasma glucose, insulin, total cholesterol and triacylglycerol concentrations decreased significantly and similarly in patients receiving both diets.
Interestingly dietary salt content was similar in both diets and none of the patients in either group were on anti-hypertensive medications.
23 The balanced diet associated the three substrates during each meal, while dissociated diets did not allow simultaneous consumption of lipids and carbohydrates.
Nutritional education was provided by a registered dietitian twice a week (once in a group session and once individually).
In addition to a low calorie diet, subjects participated in a structured, multidisciplinary program that included physical activity, nutritional education and standard behavioural techniques.
Furthermore, significant decreases in total body fat and waist-to-hip circumference ratio were seen in both groups, and the magnitude of the changes did not vary as a function of the diet composition.
Acknowledgements
We are grateful to the members of the Dietary staff of the Department of Medicine for their assistance, in particular to P Rigoli, C Bussien and J Duffey.
Both diets contained similar amounts of saturated fat (14 g/day) and cholesterol (230 mg/day).
13 The latter is difficult to assess on an ambulatory basis where the main source of information relies on dietary diaries.
Values for age, systolic and diastolic blood pressure values, total body weight, BMI, waist and hip circumferences, and waist-to-hip ratio before the diets are given in Table 4.
Effects of aerobic exercise and dietary carbohydrate on energy expenditure and body composition during weight reduction in obese women.
Patient education and dietetic counselling are mandatory as the first steps in the therapeutic approach to obesity.
14 Theoretically, it should be easier to monitor and therefore improve patient dietary adherence in an in-hospital setting.
Table 5 lists values for fasting plasma glucose, insulin, cholesterol, HDL-cholesterol and triacylglycerol concentrations before and after 6 weeks of dietary intervention.
29 Daily nitrogen balance was calculated by subtracting total output (urine, stool/and integumental losses) from dietary input.
Group 1 (n=28, 21 F/7 M) received a balanced diet while group 2 (n=26, 20 F/6 M) received a dissociated diet.
OBJECTIVE: The goal of this study was to evaluate the effect of two diets ('food combining' or dissociated vs balanced) on body weight and metabolic parameters during a 6-week period in an in-hospital setting.
Consequently, the two diets were equally low in energy and substrate content (protein, fat and carbohydrate) but widely differed in substrate distribution throughout the day.
7 ,8 The theoretical energy expenditure with each diet was calculated using the Harris-Benedict formula.
These subjects had been referred to the Obesity Outpatient Clinic of the Department of Medicine at Geneva University Hospital for dietary treatment of their obesity.
Total fat weight loss was higher in balanced diets, although differences did not reach statistical significance.
Insulin sensitivity and lipid levels in obese subjects after slimming diets with different complex and simple carbohydrate content.
Weight loss on a low-fat diet: consequences of the imprecision of the control of food intake in humans.
5 MJ/day (1100 kcal/day) composed of either 25% protein, 47% carbohydrates and 25% lipids (dissociated diet) or 25% protein, 42% carbohydrates and 31% lipids (balanced diet).
Nevertheless, when it comes to long-term follow-up, mixed, varied and individually tailored diets achieve better compliance.
Discussion
In this study we evaluated the effects of two low-energy diets (balanced and dissociated) on both weight loss (total and fat body weight) and various metabolic parameters.
Itemized composition of meals from one day of the rotation menu for the balanced and dissociated diets are given in Table 3.
The aim of our study is to compare the medium-term (6 weeks) effects of a low-calorie (1000 kcal/day) dissociated vs balanced (1000 kcal/day) diet in an in-hospital setting.
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