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Obesity

Calories or content: what is the best weight-loss diet?

Nature Reviews Endocrinology volume 5, pages 419–420 (2009)Cite this article

Researchers have randomly assigned 811 overweight adults to low-calorie diets with differing percentages of energy derived from protein, carbohydrate, and fat; participants were followed up for 2 years. All groups experienced modest weight loss and improvements in cardiac and diabetes risk factors. Does this finding mean that clinicians can finally advise their patients on the best way to lose weight?

Most overweight and obese patients and their clinicians remain alert for 'the' diet that results in meaningful and sustained weight loss. The most obvious answer is to simply eat less. This advice is logically satisfying as energy balance is clearly tipped in a negative direction, at least temporarily, and serves as a conveniently simple treatment sound-bite for a 15 min doctor's visit. However, evidence that meaningful weight loss is sustained for more than a few years following a low-calorie diet is hard to find.1 The reason for this lack of sustainability is thought to include both environmental influences and a complex regulatory system in the body, which is geared towards limiting weight loss during hypocaloric states and restoring baseline body weight, even when that baseline weight is considered socially and medically undesirable.2

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References

  1. Tsai, A. G. & Wadden, T. A. Systematic review: an evaluation of major commercial weight loss programs in the United States. Ann. Intern. Med. 142, 56–66 (2005).

    Article  PubMed  Google Scholar 

  2. Morton, G. J., Cummings, D. E., Baskin, D. G., Barsh, G. S. & Schwartz, M. W. Central nervous system control of food intake and body weight. Nature 443, 289–295 (2006).

    Article  CAS  PubMed  Google Scholar 

  3. Sacks, F. M. et al. Comparison of weight-loss diets with different compositions of fat, protein, and carbohydrates. N. Engl. J. Med. 360, 859–873 (2009).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Ernst, N. D., Sempos, C. T., Briefel, R. R. & Clark, M. B. Consistency between US dietary fat intake and serum total cholesterol concentrations: the National Health and Nutrition Examination Surveys. Am. J. Clin. Nutr. 66, S965–S972 (1997).

    Article  Google Scholar 

  5. Dansinger, M. L., Gleason, J. A., Griffith, J. L., Selker, H. P. & Schaefer, E. J. Comparison of the Atkins, Ornish, Weight Watchers, and Zone diets for weight loss and heart disease risk reduction: a randomized trial. JAMA 293, 43–53 (2005).

    Article  CAS  PubMed  Google Scholar 

  6. Shai, I. et al. Weight loss with a low-carbohydrate, Mediterranean, or low-fat diet. N. Engl. J. Med. 359, 229–241 (2008).

    Article  CAS  PubMed  Google Scholar 

  7. Gardner, C. D. et al. Comparison of the Atkins, Zone, Ornish, and LEARN diets for change in weight and related risk factors among overweight premenopausal women: the A to Z Weight Loss Study: a randomized trial. JAMA 297, 969–977 (2007).

    Article  CAS  PubMed  Google Scholar 

  8. Knowler, W. C. et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N. Engl. J. Med. 346, 393–403 (2002).

    Article  CAS  PubMed  Google Scholar 

  9. Klem, M. L., Wing, R. R., McGuire, M. T., Seagle, H. M. & Hill, J. O. A descriptive study of individuals successful at long-term maintenance of substantial weight loss. Am. J. Clin. Nutr. 66, 239–246 (1997).

    Article  CAS  PubMed  Google Scholar 

  10. Katan, M. B. Weight-loss diets for the prevention and treatment of obesity. N. Engl. J. Med. 360, 923–925 (2009).

    Article  CAS  PubMed  Google Scholar 

Download references

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  1. Division of Endocrinology, Diabetes, and Clinical Nutrition, Oregon Health & Science University, OR, USA

    Jonathan Q. Purnell

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  1. Jonathan Q. Purnell
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Correspondence to Jonathan Q. Purnell.

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Purnell, J. Calories or content: what is the best weight-loss diet?. Nat Rev Endocrinol 5, 419–420 (2009). https://doi.org/10.1038/nrendo.2009.145

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