A short-term clinical trial suggests that reducing 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 vs. low-fat diets in women 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 women with lipedema, an obesity-like disease characterized by excessive fat accumulation in the lower extremities.
Why lipedema differs from obesity in appetite control
Lipedema, a chronic condition that mainly affects women, is often misdiagnosed as obesity, although the two conditions often coexist. It affects women during periods of hormonal fluctuations such as puberty, pregnancy and menopause.
Many factors contribute to lipedema, including fat cell hypertrophy, inflammation, and impaired blood vessel formation. Inflammation in lipedema may affect appetite regulatory mechanisms by modulating brain signaling pathways.
Appetite regulation is a complex process involving a balance between internal biological cues that maintain energy balance and external reward-driven (hedonic) factors. Hedonic appetite is a type of hunger driven by pleasure rather than normal energy requirements. It plays a vital role in regulating eating behavior, often leading to overconsumption of highly palatable foods.
Disordered eating behaviors such as emotional eating, binge eating, and binge eating are associated with increased caloric intake, which subsequently increases the risk of overweight and obesity.
Despite being subject to significant health-related stigma, lipedema in women has been understudied. The physical manifestations of lipedema can significantly contribute to a negative body image and unhealthy self-perceptions.
Regarding therapeutic interventions, existing evidence suggests that low-carbohydrate diets work better in reducing pain in women with lipedema than low-fat diets. However, it remains largely unknown how these dietary patterns influence hedonic hunger and eating behaviors in this population.
The present study aimed to investigate whether appetite regulation and eating behavior change differently in lipidomic and obese women following low-carbohydrate and low-fat diets.
Randomized trial comparing low-carbohydrate and low-fat diets
The study analyzed the 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 women with lipedema and obesity. A total of 70 participants were randomly categorized into two intervention groups.
Participants in the low-carb 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, the energy and protein intake was the same for the 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 investigated using validated questionnaires.
The low-carbohydrate diet reduced responding to food cues
The study found a significant improvement in a component of hedonic hunger, assessed using the Power of Food scale, among participants consuming a low-carb diet. However, no such improvement was seen among participants consuming a low-fat diet.
In the low-carb group, participants reported a significant reduction in emotional eating, which is the tendency to eat in response to negative emotions. Participants in the low-fat group, on the other hand, reported an increase in restrained eating, which represents a person’s cognitive ability to control or limit food intake to reduce or maintain body weight.
No significant differences were observed between the two dietary groups for the overall dietary behavior categories, indicating that some findings were limited to within-group changes.
Carbohydrate restriction shows possible appetite benefits
The study finds that low-carbohydrate diets may be more effective than low-fat diets in improving hedonic hunger and eating behaviors in women with lipid 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 Tried. The study found a significant reduction in the Food Present subscale at the end of an 8-week low-carbohydrate dietary intervention period. Observed changes in this subscale over time were significantly different between the two dietary intervention groups.
The Food Present subscale of the food strength scale represents the desire to eat when the food is present but not yet tasted, such as when exposed to the sight or smell of attractive foods. The observed reduction in the desire to eat attractive foods in response to food cues may be explained by the effect of low-carbohydrate diets on the brain’s 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.
In addition, low-fat diets have been found to increase tonic dopamine in the brain’s reward regions and influence food choice in a way that may hinder dietary adherence. These findings support the current study’s 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 one component of emotional eating among participants who consumed a low-carb diet. Existing evidence suggests that ketogenic diets, characterized by high fat 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 that the superiority of low-carbohydrate diets may offer advantages over low-fat diets for appetite regulation in women with lipidemia and obesity.
