A short-term clinical trial suggests that cutting carbohydrates, not fat, may be better for curbing food cues and emotional eating in women living with lipedema.
Study: Hedonic hunger and eating behavior after low-carbohydrate versus low-fat diets in females with lipedema and obesity. Image credit: sweet marshmallow/Shutterstock.com
A recent study published in Frontiers in Nutrition highlights that low-carbohydrate diets may be more effective than low-fat diets in improving hedonic hunger and eating behavior in females with lipedema, an obesity-like disease characterized by excessive fat accumulation in the lower limbs.
Why lipedema differs from obesity in appetite control
Lipedema, a chronic condition primarily affecting females, is often misdiagnosed as obesity, although the two conditions frequently coexist. It affects females during periods of hormonal fluctuations, such as puberty, pregnancy, and menopause.
Multiple factors contribute to the onset of lipedema, including fat cell hypertrophy, inflammation, and impaired blood vessel formation. Inflammation in lipedema can affect appetite regulatory mechanisms by modulating brain signaling pathways.
Appetite regulation is a complex process that involves a balance between internal biological cues that maintain energy balance and external reward-driven factors (hedonic). Hedonic appetite is a type of hunger that is driven by pleasure rather than physiological energy requirements. It plays a vital role in modulating eating behavior, often leading to overconsumption of highly palatable foods.
Impaired eating behaviors, such as emotional eating, binge eating, and uncontrolled eating, are associated with increased calorie intake, which subsequently increases the risk of overweight and obesity.
Despite being subject to significant health-related stigma, lipedema in females has not been studied adequately. Physical manifestations of lipedema may significantly contribute to a negative body image and unhealthy self-perceptions.
Regarding therapeutic interventions, existing evidence indicates that low-carbohydrate diets work better in reducing pain in females with lipedema than low-fat diets. However, it remains largely unknown how these dietary patterns impact hedonic hunger and eating behaviors in this population.
The current study aimed to investigate whether appetite regulation and eating behavior change differently in females with lipedema and obesity following low-carbohydrate and low-fat diets.
Randomized trial compares low-carb and low-fat diets
The study analyzed findings of a secondary analysis from a randomized clinical trial that compared the effects of a low-carbohydrate diet and a low-fat diet on pain in females with lipedema and obesity. A total of 70 participants were randomly categorized into two intervention groups.
Participants in the low-carbohydrate group consumed 75 grams of carbohydrates per day, while those in the low-fat group consumed 180 grams of carbohydrates and 27 grams of fat per day for the same 8-week period. In both groups, energy and protein intakes were the same for participants, i.e., 1200 kcal of energy and 60 grams of protein per day.
The impact of these dietary interventions on hedonic hunger and eating behavior was explored using validated questionnaires.
Low-carb diet reduced food cue responsiveness
The study found a significant improvement in one component of hedonic hunger, assessed using the Power of Food Scale, among participants who consumed a low-carbohydrate diet. However, no such improvement was observed among participants who consumed a low-fat diet.
In the low-carbohydrate group, participants reported a significant reduction in emotional eating, which is the tendency to eat in response to negative emotions. The low-fat group participants, on the other hand, reported an increase in restrained eating, which represents the cognitive ability of a person to control or limit food intake to reduce or maintain body weight.
No significant differences were observed between the two dietary groups for overall eating behavior categories, indicating that some findings were limited to within-group changes.
Carbohydrate restriction shows potential appetite advantages
The study finds that low-carbohydrate diets may be more effective than low-fat diets in improving hedonic hunger and eating behaviors in females with lipedema and obesity.
The study used the Power of Food Scale to assess hedonic hunger. This scale has three categories: Food Available, Food Present, and Food Tasted. The study found a significant reduction in the Food Present subcategory at the end of an 8-week low-carbohydrate dietary intervention period. The observed changes in this subcategory over time were significantly different between the two dietary intervention groups.
The Food Present subcategory in the power of food scale represents the urge to eat when food is present but not yet tasted, such as when exposed to the sight or smell of appealing foods. The observed reduction in the urge to eat appealing foods in response to food cues may be explained by the influence of low-carbohydrate diets on the brain reward system.
Ghrelin and insulin are two hormones that play vital roles in regulating brain reward signaling by modulating dopaminergic pathways. Existing evidence suggests that low-carbohydrate diets have a greater ability than low-fat diets to suppress the secretion of these hormones and improve insulin sensitivity.
Furthermore, low-fat diets have been found to increase tonic dopamine in brain-reward regions and affect food choice in a way that may hinder dietary adherence. These findings support the current study findings of a more favorable change in hedonic hunger and eating behavior among participants consuming a low-carbohydrate diet.
The study found a significant reduction in a component of emotional eating among participants consuming a low-carbohydrate diet. Existing evidence indicates that ketogenic diets, characterized by high fat intake and low carbohydrate intake, can promote emotional stability by increasing the inhibitory neurotransmitter GABA and reducing neuroinflammation. Although the present intervention was not explicitly ketogenic, these findings provide contextual support for the observed changes.
Overall, the study adds new information to the existing evidence and highlights the superiority of low-carbohydrate diets may offer advantages over low-fat diets for appetite regulation in females with lipedema and obesity.