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 compare
d with a standard reduced-fat diet in the management of pediatric obesity.
Design: Retrospective cohort study of children attending an outpatient pedi
atric 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 weigh
t 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 foll
ow-up, with 3.3 vs 3.3 mean number of visits, respectively. Body mass index
(-1.53 kg/m(2) [95% confidence interval, -1.94 to -1.12] vs -0.06 kg/m(2)
[-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 t
he 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 modific
ation sessions, and treatment duration. Significantly more patients in the
lo low-GI group experienced a decrease in BMI of at least 3 kg/m(2) (11 kg/
m(2) [17.2%] vs 1 kg/m(2) [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 need
ed.