Weight Loss with a Low-Carbohydrate, Mediterranean, or Low-Fat Diet

@article{citeulike:3014975, abstract = {Background Trials comparing the effectiveness and safety of weight-loss diets are frequently limited by short follow-up times and high dropout rates. Methods In this 2-year trial, we randomly assigned 322 moderately obese subjects (mean age, 52 years; mean body-mass index [the weight in kilograms divided by the square of the height in meters], 31; male sex, 86\%) to one of three diets: low-fat, restricted-calorie; Mediterranean, restricted-calorie; or low-carbohydrate, non-restricted-calorie. Results The rate of adherence to a study diet was 95.4\% at 1 year and 84.6\% at 2 years. The Mediterranean-diet group consumed the largest amounts of dietary fiber and had the highest ratio of monounsaturated to saturated fat (P<0.05 for all comparisons among treatment groups). The low-carbohydrate group consumed the smallest amount of carbohydrates and the largest amounts of fat, protein, and cholesterol and had the highest percentage of participants with detectable urinary ketones (P<0.05 for all comparisons among treatment groups). The mean weight loss was 2.9 kg for the low-fat group, 4.4 kg for the Mediterranean-diet group, and 4.7 kg for the low-carbohydrate group (P<0.001 for the interaction between diet group and time); among the 272 participants who completed the intervention, the mean weight losses were 3.3 kg, 4.6 kg, and 5.5 kg, respectively. The relative reduction in the ratio of total cholesterol to high-density lipoprotein cholesterol was 20\% in the low-carbohydrate group and 12\% in the low-fat group (P=0.01). Among the 36 subjects with diabetes, changes in fasting plasma glucose and insulin levels were more favorable among those assigned to the Mediterranean diet than among those assigned to the low-fat diet (P<0.001 for the interaction among diabetes and Mediterranean diet and time with respect to fasting glucose levels). Conclusions Mediterranean and low-carbohydrate diets may be effective alternatives to low-fat diets. The more favorable effects on lipids (with the low-carbohydrate diet) and on glycemic control (with the Mediterranean diet) suggest that personal preferences and metabolic considerations might inform individualized tailoring of dietary interventions. (ClinicalTrials.gov number, NCT00160108 .) 10.1056/NEJMoa0708681}, author = {Shai, Iris and Schwarzfuchs, Dan and Henkin, Yaakov and Shahar, Danit R. and Witkow, Shula and Greenberg, Ilana and Golan, Rachel and Fraser, Drora and Bolotin, Arkady and Vardi, Hilel and Tangi-Rozental, Osnat and Zuk-Ramot, Rachel and Sarusi, Benjamin and Brickner, Dov and Schwartz, Ziva and Sheiner, Einat and Marko, Rachel and Katorza, Esther and Thiery, Joachim and Fiedler, Georg M. and Bluher, Matthias and Stumvoll, Michael and Stampfer, Meir J. and The}, citeulike-article-id = {3014975}, doi = {http://dx.doi.org/10.1056/NEJMoa0708681}, journal = {N Engl J Med}, keywords = {atkins, diet}, month = {July}, number = {3}, pages = {229--241}, posted-at = {2008-07-17 20:38:33}, priority = {2}, title = {Weight Loss with a Low-Carbohydrate, Mediterranean, or Low-Fat Diet}, url = {http://dx.doi.org/10.1056/NEJMoa0708681}, volume = {359}, year = {2008} }

TY - JOUR ID - citeulike:3014975 L3 - citeulike-article-id:3014975 N2 - Background Trials comparing the effectiveness and safety of weight-loss diets are frequently limited by short follow-up times and high dropout rates. Methods In this 2-year trial, we randomly assigned 322 moderately obese subjects (mean age, 52 years; mean body-mass index [the weight in kilograms divided by the square of the height in meters], 31; male sex, 86%) to one of three diets: low-fat, restricted-calorie; Mediterranean, restricted-calorie; or low-carbohydrate, non-restricted-calorie. Results The rate of adherence to a study diet was 95.4% at 1 year and 84.6% at 2 years. The Mediterranean-diet group consumed the largest amounts of dietary fiber and had the highest ratio of monounsaturated to saturated fat (P<0.05 for all comparisons among treatment groups). The low-carbohydrate group consumed the smallest amount of carbohydrates and the largest amounts of fat, protein, and cholesterol and had the highest percentage of participants with detectable urinary ketones (P<0.05 for all comparisons among treatment groups). The mean weight loss was 2.9 kg for the low-fat group, 4.4 kg for the Mediterranean-diet group, and 4.7 kg for the low-carbohydrate group (P<0.001 for the interaction between diet group and time); among the 272 participants who completed the intervention, the mean weight losses were 3.3 kg, 4.6 kg, and 5.5 kg, respectively. The relative reduction in the ratio of total cholesterol to high-density lipoprotein cholesterol was 20% in the low-carbohydrate group and 12% in the low-fat group (P=0.01). Among the 36 subjects with diabetes, changes in fasting plasma glucose and insulin levels were more favorable among those assigned to the Mediterranean diet than among those assigned to the low-fat diet (P<0.001 for the interaction among diabetes and Mediterranean diet and time with respect to fasting glucose levels). Conclusions Mediterranean and low-carbohydrate diets may be effective alternatives to low-fat diets. The more favorable effects on lipids (with the low-carbohydrate diet) and on glycemic control (with the Mediterranean diet) suggest that personal preferences and metabolic considerations might inform individualized tailoring of dietary interventions. (ClinicalTrials.gov number, NCT00160108 .) 10.1056/NEJMoa0708681 IS - 3 JF - N Engl J Med EP - 241 TI - Weight Loss with a Low-Carbohydrate, Mediterranean, or Low-Fat Diet VL - 359 SP - 229 KW - atkins KW - diet AU - Shai, Iris AU - Schwarzfuchs, Dan AU - Henkin, Yaakov AU - Shahar, Danit AU - Witkow, Shula AU - Greenberg, Ilana AU - Golan, Rachel AU - Fraser, Drora AU - Bolotin, Arkady AU - Vardi, Hilel AU - Tangi-Rozental, Osnat AU - Zuk-Ramot, Rachel AU - Sarusi, Benjamin AU - Brickner, Dov AU - Schwartz, Ziva AU - Sheiner, Einat AU - Marko, Rachel AU - Katorza, Esther AU - Thiery, Joachim AU - Fiedler, Georg AU - Bluher, Matthias AU - Stumvoll, Michael AU - Stampfer, Meir AU - The PY - 2008/07/17/ UR - http://dx.doi.org/10.1056/NEJMoa0708681 ER -