Comparison of Weight-Loss Diets

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"Reduced-calorie diets result in clinically meaningful weight loss regardless of which macronutrients they emphasize." The below papers are free full-text and a free-to-view CR advertisement, it seems to me. There are many who believe it is too little CR/weight loss to too little final CR/weight.

http://www.reuters.com/article/healthNews/idUSTRE51O7S020090225?sp=true

1. EditorialWeight-Loss Diets for the Prevention and Treatment of ObesityM. B. Katan N Engl J Med 2009;360:923-925Extract | FREE Full Text http://content.nejm.org/cgi/content/full/360/9/859

Editor's note: Participate in a poll and contribute your comments in our Clinical Directions feature — Comparison of Weight-Loss Diets. Commenting closes March 11, 2009.

Comparison of Weight-Loss DietsOpen for CommentsFebruary 25 - March 11, 2009

On February 25, 2009, we published an article and an accompanying editorial on a randomized trial comparing the effects of reduced-calorie diets with various compositions of fat, carbohydrates, and protein on weight loss over a two-year period. Although compliance with the diets was not high, no difference in weight loss was observed among the various diets. Reduced-calorie diets appear to have similar effects on weight loss regardless of their particular compositions. In this Clinical Directions feature, we invite you to respond to questions raised by the results of the trial, to contribute your own thoughts, and to read the comments of others.

Is the composition of the diet important in weight loss? Contribute your thoughts below.

View All (5)

1 of 5Diets vs. macroeconomic changes BoynePhysicianDisclosure: NoneUniversity of the West IndiesKingston, JamaicaFebruary 25, 2009

A welcomed study despite some of its methodological flaws. I think that the arguments about dietary composition are a distraction from tackling the more real issues of behavioral factors and instituting sensible macroeconomic changes.

2 of 5

cecilia wangPhysicianDisclosure: None

Univ ColoradoDenver, ColoradoFebruary 25, 2009

This study confirms what we have seen in past studies; that macronutrient composition of a weight loss diet doesn't matter in terms of how much weight someone loses; it's how well the patient can adhere to the diet. I believe in the wisdom of differentiating between weight loss and (long-term) weight maintenance phases and the the importance of physical activity.

Etcetera

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This article has been cited by other articles: (2009). Four Low-Calorie Diets Yield the Same Mediocre Results. JWatch General 2009: 1-1

2. SUMMARY AND COMMENTFour Low-Calorie Diets Yield the Same Mediocre ResultsFree JWatch General 2009: 1-1 February 25, 2009 Abigail Zuger, MDhttp://general-medicine.jwatch.org/cgi/content/full/2009/225/1?q=featured_jw

Dieters ate different amounts of protein, fat, and carbohydrate — but, after 2 years, most were still obese.

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Perhaps the average dieter’s enthusiasm for counting out 14 walnut halves for a high-fat dinner simply wanes, rendering the nutrient composition of all limited-calorie eating plans pretty much the same.

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Reviewing: N Engl J Med 2009 Feb 26 3. Comparison of Weight-Loss Diets with Different Compositions of Fat, Protein, and CarbohydratesF. M. Sacks and Others N Engl J Med 2009;360:859-873.FREE Full Texthttp://content.nejm.org/cgi/content/full/360/9/859

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.

-- Al Pater, alpater@...