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

International Journal of Obesity volume 30, pages 552–560 (2006)Cite this article

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 ⩾30 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.

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References

  1. Obesity: Preventing and Managing the Global Epidemic. Report of a WHO Consultation Technical Report Series, 2000.

  2. Tuomilehto J, Lindstrom J, Eriksson JG, Valle TT, Hamalainen H, Ilanne-Parikka P et al., Finnish Diabetes Prevention Study Group. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med 2001; 344: 1343–1350.

    Article  CAS  PubMed  Google Scholar 

  3. Knowler WC, Barrett-Connor E, Fowler SE, Hamman RF, Lachin JM, Walker EA et al., Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med 2002; 346: 393–403.

    Article  CAS  PubMed  Google Scholar 

  4. Astrup A, Grunwald GK, Melanson EL, Saris WHM, Hill JO . The role of low-fat diets in body weight control: a meta-analysis of ad libitum intervention studies. Int J Obes Relat Metab Disord 2000; 24: 1545–1552.

    Article  CAS  PubMed  Google Scholar 

  5. Toubro S, Astrup A . Randomised comparison of diets for maintaining obese subjects’ weight after major weight loss: ad lib, low fat, high carbohydrate diet v fixed energy intake. BMJ 1997; 314: 29–34.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Saris WHM, Astrup A, Prentice AM, Zunft HJH, Formiguera X, Verboeket-van de Venne WPHG et al. Randomized controlled trial of changes in dietary carbohydrate/fat ratio and simple vs complex carbohydrates on body weight and blood lipids: the CARMEN study. Int J Obes Relat Metab Disord 2000; 24: 1310–1318.

    Article  CAS  PubMed  Google Scholar 

  7. Due A, Toubro S, Skov AR, Astrup A . Effect of normal-fat diets, either medium or high in protein, on body weight in overweight subjects: a randomised 1-year trial. Int J Obes Relat Metab Disord 2004; 28: 1283–1290.

    Article  CAS  PubMed  Google Scholar 

  8. Golay A, Eigenheer C, Morel Y, Kujawski P, Lehmann T, de Tonnac N . Weight-loss with low or high carbohydrate diet? Int J Obes Relat Metab Disord 1996; 20: 1067–1072.

    CAS  PubMed  Google Scholar 

  9. Lean ME, Han TS, Prvan T, Richmond PR, Avenell A . Weight loss with high and low carbohydrate 1200 kcal diets in free living women. Eur J Clin Nutr 1997; 51: 243–248.

    Article  CAS  PubMed  Google Scholar 

  10. Mensink RP, Katan MB . Effect of dietary fatty acids on serum lipids and lipoproteins. A meta-analysis of 27 trials. Arterioscler Thromb 1992; 12: 911–919.

    Article  CAS  PubMed  Google Scholar 

  11. Mensink RP, Zock PL, Kester AD, Katan MB . Effects of dietary fatty acids and carbohydrates on the ratio of serum total to HDL cholesterol and on serum lipids and apolipoproteins: a meta-analysis of 60 controlled trials. Am J Clin Nutr 2003; 77: 1146–1155.

    Article  CAS  PubMed  Google Scholar 

  12. Bisschop PH, de Metz J, Ackermans MT, Endert E, Pijl H, Kuipers F et al. Dietary fat content alters insulin-mediated glucose metabolism in healthy men. Am J Clin Nutr 2001; 73: 554–559.

    Article  CAS  PubMed  Google Scholar 

  13. Verdich C, Madsen JL, Toubro S, Buemann B, Holst JJ, Astrup A . Effect of obesity and major weight reduction on gastric emptying. Int J Obes Relat Metab Disord 2000; 24: 899–905.

    Article  CAS  PubMed  Google Scholar 

  14. Friedewald WT, Levy RI, Fredrickson DS . Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem 1972; 18: 499–502.

    CAS  PubMed  Google Scholar 

  15. Gadbury GL, Coffey CS, Allison DB . Modern statistical methods for handling missing repeated measurements in obesity trial data: beyond LOCF. Obes Rev 2003; 4: 175–184.

    Article  CAS  PubMed  Google Scholar 

  16. Prentice AM, Black AE, Coward WA, Davies HL, Goldberg GR, Murgatroyd PR et al. High levels of energy expenditure in obese women. BMJ 1986; 292: 983–987.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Goris AH, Westerterp-Plantenga MS, Westerterp KR . Undereating and underrecording of habitual food intake in obese men: selective underreporting of fat intake. Am J Clin Nutr 2000; 71: 130–134.

    Article  CAS  PubMed  Google Scholar 

  18. Heitmann BL . The influence of fatness, weight change, slimming history and other lifestyle variables on diet reporting in Danish men and women aged 35–65 years. Int J Obes Relat Metab Disord 1993; 17: 329–336.

    CAS  PubMed  Google Scholar 

  19. Stubbs RJ, Prentice AM, James WP . Carbohydrates and energy balance. Ann NY Acad Sci 1997; 819: 44–69.

    Article  CAS  PubMed  Google Scholar 

  20. Helge JW . Long-term fat diet adaptation effects on performance, training capacity, and fat utilization. Med Sci Sports Exerc 2002; 34: 1499–1504.

    Article  CAS  PubMed  Google Scholar 

  21. Stubbs RJ, Ritz P, Coward WA, Prentice AM . Covert manipulation of the ratio of dietary fat to carbohydrate and energy density: effect on food intake and energy balance in free-living men eating ad libitum. Am J Clin Nutr 1995; 62: 330–337.

    Article  CAS  PubMed  Google Scholar 

  22. Blundell JE, Stubbs RJ . High and low carbohydrate and fat intakes: limits imposed by appetite and palatability and their implications for energy balance. Eur J Clin Nutr 1999; 53: S148–S165.

    Article  PubMed  Google Scholar 

  23. Bouchard C, Tremblay A . Genetic influences on the response of body fat and fat distribution to positive and negative energy balances in human identical twins. J Nutr 1997; 127: S943–S947.

    Article  Google Scholar 

  24. Leenen R, van der KK, Meyboom S, Seidell JC, Deurenberg P, Weststrate JA . Relative effects of weight loss and dietary fat modification on serum lipid levels in the dietary treatment of obesity. J Lipid Res 1993; 34: 2183–2191.

    CAS  PubMed  Google Scholar 

Download references

Acknowledgements

The study was supported by the European Community (Contract no. QLK1-CT-2000-00618). The funding organization had no role in the preparation of the manuscript.

Author information

Author notes

  1. C Verdich & T I A Sørensen

    Present address: The NUGENOB Co-ordination Centre, Institute of Preventive Medicine, Oester Soegade 18.1, DK-1357, Copenhagen K, Denmark

  2. M Petersen and M A Taylor: These authors have contributed equally to this work.

  3. NUGENOB 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

Authors and Affiliations

  1. Institute of Human Nutrition, The Royal Veterinary and Agricultural University, Copenhagen, Denmark

    M Petersen, S Toubro, T I A Sørensen & A Astrup

  2. School of Biomedical Sciences, University of Nottingham Medical School, Queen's Medical Centre, Nottingham, UK

    M A Taylor & I Macdonald

  3. Department of Human Biology, Nutrition and Toxicology Research Centre NUTRIM, Maastricht University, Maastricht, The Netherlands

    W H M Saris

  4. Institute of Preventive Medicine, Danish Epidemiology Science Centre, Copenhagen University Hospital, Copenhagen, Denmark

    C Verdich & C Holst

  5. Department of Medicine, The Obesity Unit, Karolinska Institute, Huddinge University Hospital, Sweden

    S Rössner

  6. Department of Sports Medicine, Centre of Preventive Medicine, Third Faculty of Medicine, Charles University, Praha, Czech Republic

    V Stich

  7. Department of Nutrition, Hôtel-Dieu, Paris, France

    B Guy-Grand

  8. Obesity Research Unit Inserm U586, Louis Bugnard Institute and Clinical Investigation Centre, Toulouse University Hospitals, Paul Sabatier University, Toulouse, France

    D Langin

  9. Department Physiology and Nutrition, University of Navarra, Pamplona, Spain

    J A Martinez

  10. Steno Diabetes Centre, Gentofte, Denmark

    O Pedersen

Authors
  1. M Petersen
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  2. M A Taylor
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  3. W H M Saris
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  4. C Verdich
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  5. S Toubro
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  6. I Macdonald
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  7. S Rössner
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  8. V Stich
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  9. B Guy-Grand
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  10. D Langin
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  11. J A Martinez
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  12. O Pedersen
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  13. C Holst
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  14. T I A Sørensen
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  15. A Astrup
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Consortia

and The Nugenob Consortium

Corresponding author

Correspondence to A Astrup.

Additional information

Conflict of interest

None of the authors have any conflict of interest.

Appendix A. Contributorship of the authors and the NUGENOB Consortium

Appendix A. Contributorship of the authors and the NUGENOB Consortium

Project partners: 1: Institute of Preventive Medicine, Danish Epidemiology Science Centre, Copenhagen University Hospital, Copenhagen, Denmark; 2: Department of Human Nutrition, The Royal Veterinary and Agricultural University, Copenhagen, Denmark; 3: Steno Diabetes Centre, Gentofte, Denmark; 4: Department of Human Genetics, Institute of Biology, Institute Pasteur de Lille, France; 5: Department of Human Biology, Nutrition and Toxicology Research Centre NUTRIM, Maastricht University, Maastricht, The Netherlands; 6: The Lipid Laboratory, Department of Medicine, Karolinska Institute, Huddinge University Hospital, Sweden; 7: The Obesity Unit, Department of Medicine, Karolinska Institute, Huddinge University Hospital, Sweden; 8: School of Biomedical Sciences, University of Nottingham Medical School, Queen's Medical Centre, Nottingham, UK; 9: Department of Sports Medicine, Centre of Preventive Medicine, Third Faculty of Medicine, Charles University, Praha, Czech Republic; 10: Department of Nutrition, Hôtel-Dieu, Paris, France; 11: Obesity Research Unit Inserm U586, Louis Bugnard Institute and Clinical Investigation Centre, Toulouse University Hospitals, Paul Sabatier University, Toulouse, France; 12: Department Physiology and Nutrition, University of Navarra, Pamplona, Spain.

Project Steering Committee: Thorkild IA Sørensen (chair)1, Arne Astrup2, Oluf Pedersen3, Philippe Froguel4, Wim HM Saris5, Peter Arner6, Stephan Rössner7, Ian Macdonald8, Vladimir Stich9, Bernard Guy-Grand10, Dominique Langin11, Alfredo J Martinez12. Camilla Verdich1, Søren Toubro2 and Søren M Echwald3 were associated co-ordinating members of the committee.

Project Co-ordination: Thorkild IA Sørensen (project co-ordinator)1, Camilla Verdich (assistant co-ordinator)1, Gabby Hul (co-ordinator of biobank procedures)5, Moira A Taylor (co-ordinator of dietary assessment and intervention)8, Claus Holst (senior statistician)1, Lene Aa Hansen (administrator)1 and Birgitte Bredesen (secretary)1.

Work package responsibility: Thorkild IA Sørensen (study population and recruitment, database and statistical analysis)1, Wim HM Saris (baseline clinical investigation)5 and Arne Astrup (dietary intervention)2.

Development of standard operational procedures: Thorkild IA Sørensen (study population, recruitment)1, Søren Toubro (in–exclusion criteria)2, Claus Holst (randomization)1, Gabby Hul (baseline clinical investigation)5, Moira A Taylor (dietary assessment and intervention)8 and Camilla Verdich (database management)1.

Clinical investigators group: Arne Astrup2, Martin Petersen2, Søren Toubro2, Kirsten Bryde Resmussen2, Wim HM Saris5, Ellen Blaak5, Gabby Hul5, Patrik Löfgren6, Ingalena Andersson7, Gun Åberg7, Ian Macdonald8, Moira A Taylor8, Sue Bridgewater8, Jonathan Webber8, Kishor Patel8, Vladimir Stich9, Blanka Richterova9, Petra Sramkova9, Bernard Guy-Grand10, Jean-Michel Oppert10, Pierre Barbe11, Alfredo J Martinez12 and Idoia Labayen12.

Biobank and laboratory analysis group: Gabby Hul5, Ellen Blaak5, Jos Stegen5 and Wim HM Saris5.

Dietitian group: Gitte Wenneberg2, Tine B Christensen2, Ulla Pedersen2, Marja van der Hulst5, Brigit Rooyakkers5, Ingalena Andersson7, Gun Åberg7, Sue Bridgewater8, Moira A Taylor (chair)8, Eva Chocenska9, Blanka Richterova9, Vladimira Smejkalova9, Maelle Coustillet10, Françoise L’Hôte11, Idoia labayen12 and Iva Marques12.

Database management: Claus Holst1 and Camilla Verdich1.

Statistical analysis: Claus Holst1, Martin Petersen2, Moira A Taylor8, Camilla Verdich1, Liselotte Petersen1 and Thorkild IA Sørensen1.

Manuscript drafting: Martin Petersen2, Moira A Taylor (equal with Martin Petersen)8, Camilla Verdich1, Søren Toubro2, Claus Holst1, Ian Macdonald8, Thorkild IA Sørensen1 and Arne Astrup2.

Manuscript revision for important content: Oluf Pedersen3, Wim HM Saris5, Stephan Rössner7, Vladimir Stich9, Bernard Guy-Grand10, Dominique Langin11 and Alfredo J Martinez12.

Guarantor: Thorkild IA Sørensen1.

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Petersen, M., Taylor, M., Saris, W. et al. Randomized, multi-center trial of two hypo-energetic diets in obese subjects: high- versus low-fat content. Int J Obes 30, 552–560 (2006). https://doi.org/10.1038/sj.ijo.0803186

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