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



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


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.


Obese (BMI 30 kg/m2) adult subjects (n=771), from eight European centers.


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


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.


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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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.

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Correspondence to A Astrup.

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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).

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

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