Abstract:
Background & Aims: Obesity remains a major public health concern in Portugal. Hypocaloric diets with reduced carbohydrate content have shown promise in promoting weight loss and improving metabolic health, but long-term adherence remains a challenge. This study aimed to evaluate the effects of a hypocaloric and low-carbohydrate diet on body composition and adherence over 12 months in overweight and obese adults attending a hospital-based nutrition clinic.
Methods: This retrospective cohort study included adults with a body mass index (BMI) ≥ 25 kg/m² followed at the Nutrition Outpatient Clinic of the Algarve Local Health Unit. Anthropometric and body composition data were collected at baseline and at 1, 3, 6, and 12 months. Statistical analysis was performed using IBM SPSS Statistics®, version 27.
Results: Significant reductions were observed in weight (97.0±19.7 to 88.2±21.8 kg), BMI (35.6 ± 5.3 to 32.5 ± 5.4kg/m2) and visceral fat (VF; 13.3±5.5 to 11.3±5.3kg) over time, particularly within the first six months (n = 41; P < 0.01). Among those who completed the 12 months follow-up (n = 11), average weight loss was 8.6 %. BMI was strongly associated with VF (ρ = 0.739) and inversely associated with FFM (ρ = –0.616). Age was positively associated with dropout (ρ = 0.371) and VF (ρ = 0.353).
Conclusions: This intervention resulted in clinically meaningful reductions in body weight and visceral adiposity. The findings suggest that participants who attended the nutrition consultations for longer periods achieved more significant results. However, the high dropout rate highlighted the importance of tailored strategies to support long-term adherence, particularly in older individuals.
