British Journal of Nutrition

Full Papers

Human and Clinical Nutrition

Effects of a low-carbohydrate diet on weight loss and cardiometabolic profile in Chinese women: a randomised controlled feeding trial

Xin Liua1, Geng Zhanga1, Xingwang Yea1, Huaixing Lia1, Xiafei Chena2, Lixin Tanga2, Ying Fenga2, Iris Shaia3, Meir J. Stampfera4a5 c1, Frank B. Hua4a5 c1 and Xu Lina1 c1

a1 Key Laboratory of Nutrition and Metabolism, Institute for Nutritional Sciences, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences and Graduate School of the Chinese Academy of Sciences, 294 Tai-Yuan Road, Shanghai 200031, People's Republic of China

a2 Huadong Hospital, Fudan University, 221 West Yan-An Road, Shanghai 200040, People's Republic of China

a3 Department of Epidemiology, Faculty of Health Sciences, The S. Daniel Abraham International Center for Health and Nutrition, Ben-Gurion University of the Negev, PO Box 653, Beer-Sheva 84105, Israel

a4 Departments of Nutrition and Epidemiology, Harvard School of Public Health, 655 Huntington Avenue, Boston, MA 02115, USA

a5 Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, 181 Longwood Avenue, Boston, MA 02115, USA


Little is known about the potential adherence to and the effectiveness of a low-carbohydrate (LC) diet on weight loss and cardiometabolic risk factors in Chinese adults with a habitually high carbohydrate intake. In the present controlled feeding trial, fifty overweight or obese women (age 47·9 (sem 0·9) years; BMI 26·7 (sem 0·3) kg/m2) were randomly assigned to a LC non-energy-restricted diet (initial carbohydrate intake 20 g/d, with a 10 g increase weekly) or an energy-restricted (ER) diet (carbohydrate intake 156–205 g/d, ER to 5021 or 6276 kJ/d, 35 % average energy reduction) for 12 weeks. Over the intervention period, the two diets had comparable compliance (96 %) and self-reported acceptability. At week 12, carbohydrate intake in the LC and ER groups contributed to 36·1 and 51·1 % of total energy, respectively (P< 0·001). Although both diets showed similarly decreased mean body weight (LC − 5·27 (95 % CI − 6·08, − 4·46) kg; ER − 5·09 (95 % CI − 5·50, − 4·67) kg, P= 0·67) and percentage of fat mass measured by dual-energy X-ray absorptiometry (LC − 1·19 (95 % CI − 1·88, − 0·50) %; ER − 1·56 (95 % CI − 2·20, − 0·92) %, P= 0·42), participants in the LC group had greater reductions in the ratio of total cholesterol:HDL-cholesterol (P= 0·03) and also in the ratio of TAG:HDL-cholesterol (P= 0·01) than those in the ER group. The present 12-week diet trial suggested that both a LC non-energy-restricted diet and an ER diet were acceptable to Chinese women and both diets were equally effective in reducing weight and fat mass. Moreover, the LC diet showed beneficial effects on blood lipid profiles.

(Received August 10 2012)

(Revised January 28 2013)

(Accepted January 28 2013)

(Online publication March 25 2013)

Key Words:

  • Low-carbohydrate diet;
  • Overweight;
  • Obesity;
  • Randomised controlled trials


c1 Corresponding authors:Dr M. J. Stampfer, fax +1 617 525 2008, email; Dr F. B. Hu, fax +1 617 432 2435, email; Dr X. Lin, fax +86 21 54 920249, email


  Abbreviations: ER, energy-restricted; GGT, γ-glutamyl transferase; LC, low carbohydrate; UN, urea N