Comparison of weight-loss diets with different compositions of fat, protein, and carbohydrates
- PMID: 19246357
- PMCID: PMC2763382
- DOI: 10.1056/NEJMoa0804748
Comparison of weight-loss diets with different compositions of fat, protein, and carbohydrates
Abstract
Background: The possible advantage for weight loss of a diet that emphasizes protein, fat, or carbohydrates has not been established, and there are few studies that extend beyond 1 year.
Methods: We randomly assigned 811 overweight adults to one of four diets; the targeted percentages of energy derived from fat, protein, and carbohydrates in the four diets were 20, 15, and 65%; 20, 25, and 55%; 40, 15, and 45%; and 40, 25, and 35%. The diets consisted of similar foods and met guidelines for cardiovascular health. The participants were offered group and individual instructional sessions for 2 years. The primary outcome was the change in body weight after 2 years in two-by-two factorial comparisons of low fat versus high fat and average protein versus high protein and in the comparison of highest and lowest carbohydrate content.
Results: At 6 months, participants assigned to each diet had lost an average of 6 kg, which represented 7% of their initial weight; they began to regain weight after 12 months. By 2 years, weight loss remained similar in those who were assigned to a diet with 15% protein and those assigned to a diet with 25% protein (3.0 and 3.6 kg, respectively); in those assigned to a diet with 20% fat and those assigned to a diet with 40% fat (3.3 kg for both groups); and in those assigned to a diet with 65% carbohydrates and those assigned to a diet with 35% carbohydrates (2.9 and 3.4 kg, respectively) (P>0.20 for all comparisons). Among the 80% of participants who completed the trial, the average weight loss was 4 kg; 14 to 15% of the participants had a reduction of at least 10% of their initial body weight. Satiety, hunger, satisfaction with the diet, and attendance at group sessions were similar for all diets; attendance was strongly associated with weight loss (0.2 kg per session attended). The diets improved lipid-related risk factors and fasting insulin levels.
Conclusions: Reduced-calorie diets result in clinically meaningful weight loss regardless of which macronutrients they emphasize. (ClinicalTrials.gov number, NCT00072995.)
2009 Massachusetts Medical Society
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Comment in
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Weight-loss diets for the prevention and treatment of obesity.N Engl J Med. 2009 Feb 26;360(9):923-5. doi: 10.1056/NEJMe0810291. N Engl J Med. 2009. PMID: 19246365 No abstract available.
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Comparison of weight-loss diets.N Engl J Med. 2009 May 21;360(21):2247; author reply 2247-8. doi: 10.1056/NEJMc096106. N Engl J Med. 2009. PMID: 19458373 No abstract available.
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Obesity: Calories or content: what is the best weight-loss diet?Nat Rev Endocrinol. 2009 Aug;5(8):419-20. doi: 10.1038/nrendo.2009.145. Nat Rev Endocrinol. 2009. PMID: 19629063
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Diets with different targets for intake of fat, protein, and carbohydrates achieved similar weight loss in obese adults.Evid Based Nurs. 2009 Oct;12(4):109. doi: 10.1136/ebn.12.4.109. Evid Based Nurs. 2009. PMID: 19779076 No abstract available.
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[Type of diet has no effect on long-term weight loss].Praxis (Bern 1994). 2010 Jan 6;99(1):66-7. doi: 10.1024/1661-8157/a000009. Praxis (Bern 1994). 2010. PMID: 20052642 German. No abstract available.
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Is there a magic diet? Studying the balance of macronutrients needed for best weight loss.Curr Diab Rep. 2010 Jun;10(3):165-9. doi: 10.1007/s11892-010-0105-7. Curr Diab Rep. 2010. PMID: 20425577 No abstract available.
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Weight-loss maintenance--mind over matter?N Engl J Med. 2010 Nov 25;363(22):2159-61. doi: 10.1056/NEJMe1011361. N Engl J Med. 2010. PMID: 21105799 No abstract available.
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