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Background: Childhood obesity has been recognized as the new epidemic in developed countries. Caloric restriction with physical activity is the main therapeutic treatment available for these children. We compared two different dietary protocols to assess treatment efficacy.

Methods: Obese children from the Pediatric Endocrinology clinic were prospectively recruited for the study. Children and their parents were allowed to choose one of two dietary protocols: (1) carbohydrate restricted diet (<30 g/day), with unlimited calories, protein, and fat (High protein, Low CHO Diet), and (2) calorie restricted diet (Low Cal Diet). Anthropometric data were measured at baseline and at the 2 month follow up appointment.

Results: Thirty-seven children completed the study of whom 27 chose High Protein, Low CHO Diet and 10 chose Low Cal diet. No differences in gender ratio, age, or BMI were observed at baseline. At 2 months, children in the High Protein, Low CHO Diet lost an average of 5.21 ± 3.44 kg (p < 0.001) and decreased their BMI by 2.42 ± 1.3 points (p < 0.001), compared to the children in the Low Cal Diet who gained an average of 2.36 ± 2.54 kg and 1.00 point on the BMI value (p < 0.001).

Conclusions: A high protein, low carbohydrate, unlimited calorie diet was superior to a restricted calorie protocol for weight loss in obese school age children; moreover, compliance was better.