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Open Access Study protocol

The Eat Smart Study: A randomised controlled trial of a reduced carbohydrate versus a low fat diet for weight loss in obese adolescents

Helen Truby1*, Kimberley A Baxter2, Paula Barrett34, Robert S Ware56, John C Cardinal7, Peter SW Davies2, Lynne A Daniels8 and Jennifer A Batch9

Author Affiliations

1 Department of Nutrition and Dietetics, Monash University, Victoria, 3168, Australia

2 Children's Nutrition Research Centre, Royal Children's Hospital, Herston, Queensland, 4029, Australia

3 Pathways Health and Research Centre, 88 Boundary Street, West End, Queensland, 4102, Australia

4 School of Education, University of Queensland, Queensland, 4029, Australia

5 School of Population Health, University of Queensland, Queensland, 4029, Australia

6 Queensland Children's Medical Research Institute, Herston, Queensland, 4029, Australia

7 Chemical Pathology, Pathology Queensland, Herston, Queensland 4029, Australia

8 Institute of Health and Biomedical Innovation Health, School of Public Health, Queensland University of Technology, Kelvin Grove, Queensland, 4001, Australia

9 Department of Endocrinology and Diabetes, Royal Children's Hospital, Herston, Queensland, 4029, Australia

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BMC Public Health 2010, 10:464  doi:10.1186/1471-2458-10-464

Published: 9 August 2010



Despite the recognition of obesity in young people as a key health issue, there is limited evidence to inform health professionals regarding the most appropriate treatment options. The Eat Smart study aims to contribute to the knowledge base of effective dietary strategies for the clinical management of the obese adolescent and examine the cardiometablic effects of a reduced carbohydrate diet versus a low fat diet.

Methods and design

Eat Smart is a randomised controlled trial and aims to recruit 100 adolescents over a 2 1/2 year period. Families will be invited to participate following referral by their health professional who has recommended weight management. Participants will be overweight as defined by a body mass index (BMI) greater than the 90th percentile, using CDC 2000 growth charts. An accredited 6-week psychological life skills program 'FRIENDS for Life', which is designed to provide behaviour change and coping skills will be undertaken prior to volunteers being randomised to group. The intervention arms include a structured reduced carbohydrate or a structured low fat dietary program based on an individualised energy prescription. The intervention will involve a series of dietetic appointments over 24 weeks. The control group will commence the dietary program of their choice after a 12 week period. Outcome measures will be assessed at baseline, week 12 and week 24. The primary outcome measure will be change in BMI z-score. A range of secondary outcome measures including body composition, lipid fractions, inflammatory markers, social and psychological measures will be measured.


The chronic and difficult nature of treating the obese adolescent is increasingly recognised by clinicians and has highlighted the need for research aimed at providing effective intervention strategies, particularly for use in the tertiary setting. A structured reduced carbohydrate approach may provide a dietary pattern that some families will find more sustainable and effective than the conventional low fat dietary approach currently advocated. This study aims to investigate the acceptability and effectiveness of a structured reduced dietary carbohydrate intervention and will compare the outcomes of this approach with a structured low fat eating plan.

Trial Registration

The protocol for this study is registered with the International Clinical Trials Registry (ISRCTN49438757).