Pediatr Obes. 2026 Jan;21(1):e70077. doi: 10.1111/ijpo.70077.

ABSTRACT

BACKGROUND: Low-carbohydrate (CHO) or ketogenic diets have been proposed as alternative interventions to caloric restriction to address the childhood obesity epidemic. However, empirical support for this dietary strategy has remained inconclusive in youth. The objective was to test the hypothesis that consumption of a meal lower in the proportion of CHO relative to fat acutely elicits greater satiety, and lower preference for sweet and high-fat foods and energy intake at the subsequent meal in adolescents with obesity.

METHODS: In a randomised crossover trial, 15 adolescents with obesity (7 females; 13.2 ± 1.8 years) consumed 3 isocaloric lunch meals on 3 different occasions: (i) moderate (52%), (ii) low (24%) or (iii) very low (7%) in CHO with commensurately adjusted fat content and matched for protein. Adolescents rated their appetite sensations at regular intervals throughout each test day (visual analogue scales). Food reward was recorded before and after the lunch meal, and prior to an ad libitum dinner (French version of the Leeds Food Preference Questionnaire [LFPQ-fr]), from which energy and macronutrient intake was quantified.

RESULTS: No significant differences in energy or macronutrient intake at dinner or daily appetite sensations were found between conditions. Similarly, the proportions of CHO and fat had no effect on liking or wanting for high-fat or sweet foods. Rather, choice frequency for sweet foods appeared to increase after consumption of each meal (p = 0.048).

CONCLUSION: In the context of isocaloric meals, lowering the CHO content with a commensurate increase in fat, does not significantly alter satiety, food reward or subsequent energy intake during a test meal in adolescents with obesity.

PMID:41369234 | DOI:10.1111/ijpo.70077

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