To the Editor: Dietary composition altered both REE and TEE in amounts that could prevent the usual, daily caloric imbalance that can lead to the development of obesity in adults in a study by Dr Ebbeling and colleagues.1 The very low-carbohydrate diet was most effective at maintaining energy expenditure as well as producing the greatest improvements in various components of the metabolic syndrome compared with the low-fat diet; the low–glycemic index diet was intermediate in these outcomes. However, there were 2 potentially deleterious results noted: an increase in urinary cortisol excretion and an increase in serum CRP with the very low-carbohydrate diet.
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