Original Article

International Journal of Obesity (2006) 30, 552–560. doi:10.1038/sj.ijo.0803186; published online 6 December 2005

Randomized, multi-center trial of two hypo-energetic diets in obese subjects: high- versus low-fat content

M Petersen1,11, M A Taylor2,11, W H M Saris3, C Verdich4, S Toubro1, I Macdonald2, S Rössner5, V Stich6, B Guy-Grand7, D Langin8, J A Martinez9, O Pedersen10, C Holst4, T I A Sørensen1, A Astrup1 and and The Nugenob Consortium12,13

  1. 1Institute of Human Nutrition, The Royal Veterinary and Agricultural University, Copenhagen, Denmark
  2. 2School of Biomedical Sciences, University of Nottingham Medical School, Queen's Medical Centre, Nottingham, UK
  3. 3Department of Human Biology, Nutrition and Toxicology Research Centre NUTRIM, Maastricht University, Maastricht, The Netherlands
  4. 4Institute of Preventive Medicine, Danish Epidemiology Science Centre, Copenhagen University Hospital, Copenhagen, Denmark
  5. 5The Obesity Unit, Department of Medicine, Karolinska Institute, Huddinge University Hospital, Sweden
  6. 6Department of Sports Medicine, Centre of Preventive Medicine, Third Faculty of Medicine, Charles University, Praha, Czech Republic
  7. 7Department of Nutrition, Hôtel-Dieu, Paris, France
  8. 8Obesity Research Unit Inserm U586, Louis Bugnard Institute and Clinical Investigation Centre, Toulouse University Hospitals, Paul Sabatier University, Toulouse, France
  9. 9Department Physiology and Nutrition, University of Navarra, Pamplona, Spain
  10. 10Steno Diabetes Centre, Gentofte, Denmark

Correspondence: Professor A Astrup, Department of Human Nutrition, Centre for Advanced Food Studies, Rolighedsvej 30, 1958 Frederiksberg C, Denmark. E-mail: ast@kvl.dk

11These authors have contributed equally to this work.

12Current address: The NUGENOB Co-ordination Centre, Institute of Preventive Medicine, Oester Soegade 18.1, DK-1357 Copenhagen K, Denmark. E-mail: tias@ipm.hosp.dk or cv@ipm.hosp.dk

13NUGENOB is the acronym of the project 'Nutrient-Gene interactions in human obesity – implications for dietary guidelines' supported by the European Community (Contract no. QLK1-CT-2000-00618), see the web-site www.nugenob.org

Received 7 January 2005; Revised 1 May 2005; Accepted 29 May 2005; Published online 6 December 2005.

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Abstract

Objective:

 

To investigate whether a hypo-energetic low-fat diet is superior to a hypo-energetic high-fat diet for the treatment of obesity.

Design:

 

Open-label, 10-week dietary intervention comparing two hypo-energetic (-600 kcal/day) diets with a fat energy percent of 20–25 or 40–45.

Subjects:

 

Obese (BMI greater than or equal to30 kg/m2) adult subjects (n=771), from eight European centers.

Measurements:

 

Body weight loss, dropout rates, proportion of subjects who lost more than 10% of initial body weight, blood lipid profile, insulin and glucose.

Results:

 

The dietary fat energy percent was 25% in the low-fat group and 40% in the high-fat group (mean difference: 16 (95% confidence interval (CI) 15–17)%). Average weight loss was 6.9 kg in the low-fat group and 6.6 kg in the high-fat group (mean difference: 0.3 (95% CI -0.2 to 0.8) kg). Dropout was 13.6% (n=53) in the low-fat group and 18.3% (n=70) in the high-fat group (P=0.001). Among completers, more subjects lost >10% in the low-fat group than in the high-fat group ((20.8%, n=70) versus (14.7%, n=46), P=0.02). Fasting plasma total, low-density lipoprotein- and high-density lipoprotein-cholesterol decreased in both groups, but more so in the low-fat group than in the high-fat group. Fasting plasma insulin and glucose were lowered equally by both diets.

Conclusions:

 

The low-fat diet produced similar mean weight loss as the high-fat diet, but resulted in more subjects losing >10% of initial body weight and fewer dropouts. Both diets produced favorable changes in fasting blood lipids, insulin and glucose.

Keywords:

blood lipids, lipoprotein-cholesterol, drop-out rate, low-carbohydrate diet

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