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Exploring the acceptability of, and adherence to, a carbohydrate-restricted, higher fat diet as an instrument for weight loss in women aged 40-55 years
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It is well recognised that aging in females is associated with a predilection for weight gain. Women with abdominal obesity are known to be at especially high risk of cardiovascular and metabolic disease, as well as associated poorer overall health outcomes. Many of these metabolic disorders however, can be alleviated through weight loss. The increasing evidence around the impact of hormonal function on weight gain and body composition validates the need for further investigation into the dietary effect on menopause-affected hormones. Current dietary and weight-loss guidelines, considered to be ‘best practice’, equate to promotion of a diet with a macronutrient profile comprising high levels of carbohydrate, moderate amounts of protein, and minimal fat. In contrast to this traditional ‘best practice’ approach, an alternative weight-loss strategy promoting a model of eating that is lower in carbohydrate, moderate in protein, and higher in fat has been posited as an effective weight-loss option. The low carbohydrate, high fat (LCHF) dietary approach recognises that the macronutrient composition of the diet itself may have a positive impact on weight loss due to hormonal interactions. This exploratory study investigated the acceptance of, and adherence to, a LCHF diet in women aged 40 – 55 years. The primary outcome measures of this study were barriers to and motivators for acceptance of and adherence to this way of eating. Secondary outcomes included mood state, adherence, satiety levels, and weight loss. The aim of this study was to determine factors affecting women aged 40 – 55 years in modifying dietary behaviours and maintaining those behaviours while undertaking a LCHF way of eating. The hypothesis underpinning this study was that LCHF - through its macronutrient profile - has the potential to enhance an individual’s adherence to the behavioural lifestyle modifications required to reduce weight and improve metabolic health outcomes. Furthermore, adherence to dietary modifications could be maximised by the combination of appropriate health behaviour theories (HBT), the web-based nature of the study, and the satiating effect of LCHF food options. Overall, mean percentage weight loss from baseline to study completion was 5.6%. Weight loss was greatest in participants with the highest average adherence levels across the study period. The overall average adherence level of 83.5% was a positive outcome and reflected focus group results around factors that impacted adherence. These key findings included support by family members, in particular spouses, who appeared to act as both a barrier and motivator to adherence, satiety, or feeling of fullness, and being prepared, in particular having acceptable LCHF options readily available. Findings from this study suggest that a LCHF way of eating was both acceptable and feasible for study participants. Furthermore this way of eating elicited weight loss and allowed adherence to the dietary intervention, possibly through the mechanism of improved satiety. While findings suggest that LCHF may be a promising weight loss approach for this population, further research is required for this target group.