This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Obesity, insulin resistance, and hyperlipidemia are major problems in the elderly. Because of these maladies, dietary interventions that promote long-term weight-loss, improve insulin sensitivity, and reduce lipid levels are extremely important. In recent years, low-carbohydrate diets such as Atkins', Zone, and Protein Power have become extremely popular. It has been reported that 40 million people have tried the Atkins' Diet. Recent studies have shown that the Atkins' Diet is efficacious with regard to weight loss and improvements in the blood lipid profile in young and middle-aged individuals. However, the effectiveness of this diet in elderly individuals who have greater visceral fat depots and insulin resistance has not been previously demonstrated. We propose to compare 12 months of the of the ad libitum Atkins' diet to an ad libitum self-selected control diet and to a group of individuals who will undertake an ad libitum high carbohydrate, high-fiber, low-fat diet. We have previously shown that the high-carbohydrate, high-fiber, low fat diet will result in substantial and statistically significant weight-loss. Proposed dependent variables are body composition changes, insulin stimulated glucose disposal (ISGD), appetite, resting metabolic rate, intramuscular triglyceride (IMTG), blood lipids, carnitine palmitoyl transferase I activity, tests of congnitive function and the whole blood inflammatory response. Older (60-85), obese (body mass index: 28-33 kg/m2), men and women will serve as subjects in the proposed investigation. We hypothesize that greater weight, and fat losses will be observed on the Atkins' diet than the high-carbohydrate diet which will be greater than the control diet. Additionally, we hypothesize that ISGD will be greater on the Atkins' diet than the Hi-CHO diet which will be greater than that observed on the control treatment due to the effects of these diets on weight-loss. In addition, we hypothesize that intramuscular triglycerides will be inversely related to ISGD. The study will be the first to scientifically examine the efficacy of the Atkins' diet in the elderly. Because of the widespread use and recent beneficial findings regarding the Atkins' diet in younger and middle-aged individuals and since this diet does not agree with current dietary guidelines for improved health, this investigation will have profound implications for the treatment of obesity and related manifestations in the elderly.
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