, Volume 4, Issue 2, pp 86-88
Date: 23 Feb 2010

Weight-Loss Diet Studies: Is the Most Rigorous Trial To Date Generalizable to Public Health?

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Sacks FM, Bray GA, Carey VJ, et al.: Comparison of weight-loss diets with different compositions of fat, protein, and carbohydrates. N Engl J Med 2009, 360:859–873.

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•• Of major importance.

Introduction

There is ongoing debate over the relative effectiveness of diets of varying macronutrient composition on weight loss. Previous trials have produced inconsistent results and have been limited by small sample size, short duration, under-representation of men, poor dietary adherence data, and large loss to follow-up.

Aims

The authors sought to compare the effect of four diets of varying macronutrient composition on change in body weight in overweight and obese adults after 2 years using 2 × 2 factorial comparisons of low-fat or high-fat X average protein or high-protein (resulting in four different levels of carbohydrate, ranging from lower to higher). Secondary outcomes included an extensive set of related metabolic and behavioral factors.

Methods

The investigators randomized 811 overweight