Low-carbohydrate interventions for adolescent obesity: Nutritional adequacy and guidance for dietetic practice

摘要

Background: Low-carbohydrate dietary patterns are re-emerging as a popular method of weight reduction in adults and in the media. Research has shown that low-carbohydrate approaches are an effective alternative to standard care for the management of adolescent obesity in the short-term and may provide additional benefit to adolescents with insulin resistance or type 2 diabetes. However, their nutritional adequacy to meet the needs of growing adolescents is an important consideration. Aim: To design theoretical low-carbohydrate meal plans for clinical use in the management of adolescent obesity and assess nutritional adequacy. Methods: Meal plans were created for three levels of carbohydrate restriction (30 g/day, 50 g/day and < 120 g/ day) without energy, protein or total fat restriction. Nutrient analysis was conducted using FoodWorks Australia Ltd software (databases: AUSNUT 2013, AusBrands 2017, AusFoods 2017, NUTTAB 2010, New Zealand FOODfiles 2016), and compared to Australian Nutrient Reference Values for male and female adolescents aged 15 years. Results: All low-carbohydrate meal plans met the Recommended Dietary Intake, Adequate Intake or Estimated Average Requirements for most micronutrients at an energy intake of 6.3-7.2 MJ/ day. The proportion of energy from saturated fat was high across all models (11.3-17.1%). Dietary manipulation was required to minimise saturated fat and reach micronutrient adequacy, particularly for calcium in males and females, and iron for females. In practice, this may be challenging considering individual lifestyle and preferences. Conclusions: The use of low-carbohydrate approaches with adolescents should be monitored by a dietitian toensure nutritional adequacy and adaptation to individuallifestyle.