Skip to main content
SpringerLink
Log in

Macronutrient Content of the Diet: What Do We Know About Energy Balance and Weight Maintenance?

Current Obesity Reports volume 5, pages 208–213 (2016)Cite this article

Abstract

The 2013 AHA/ACC Clinical Guideline for the Management of Overweight and Obesity recommends a reduced energy diet for weight loss regardless of the macronutrient content. However, diet composition may affect the maintenance of weight loss. In general, a healthful dietary pattern with reduced portion sizes, low energy dense foods, and physical activity are successful for many. Certain populations, such as those with insulin resistance, may find reductions in carbohydrate and higher levels of unsaturated fats to be more effective and promote greater adherence. Of importance is that metabolic adaptations following weight loss also may impact weight loss maintenance and should be considered in the transition from weight loss to weight stabilization. Thus, weight loss and weight maintenance strategies are both important in an intervention for sustaining long-term behavior change.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

USD 39.95

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance

  1. Hill JO, Peters JC, Jortberg BT. The step diet book. New York: Workman Publishing Co; 2004.

    Google Scholar 

  2. Hill JO, Thompson H, Wyatt H. Weight maintenance: what’s missing? J Am Diet Assoc. 2005;105(5 Suppl 1):S63–6.

    Article  PubMed  Google Scholar 

  3. Wycherley TP, Moran LJ, Clifton PM, Noakes M, Brinkworth GD. Effects of energy-restricted high-protein, low-fat compared with standard-protein, low-fat diets: a meta-analysis of randomized controlled trials. Am J Clin Nutr. 2012;96:1281–98.

    Article  CAS  PubMed  Google Scholar 

  4. Ajala O, English P, Pinkney J. Systematic review and meta-analysis of different dietary approaches to the management of type 2 diabetes. Am J Clin Nutr. 2013;96:1281–98.

    Google Scholar 

  5. Johnston BC, Kanters S, Bandayrel K, Wu P, Naji F, Siemieniuk RA, et al. Comparison of weight loss among named diet programs in overweight and obese adults. A meta-analysis. JAMA. 2014;312:923–33. This meta-analysis examines the weight loss outcomes for popular diets based on macronutrient composition.

    Article  PubMed  Google Scholar 

  6. Dutton GR, Laitner MH, Perri MG. Lifestyle interventions for cardiovascular disease risk reduction: a systematic review of the effects of diet composition, food provision, and treatment modality on weight loss. Curr Atheroscler Rep. 2014;16:442.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Atallah R, Filion KB, Wakil SM, Genest J, Joseph L, Poirier P, et al. Long-term effects of 4 popular diets on weight loss and cardiovascular risk factors: a systematic review of randomized controlled trials. Circ Cardiovasc Qual Outcomes. 2014;7:815–27.

    Article  PubMed  Google Scholar 

  8. Tobias DK, Chen M, Manson JE, Ludwig DS, Willett W, Hu FB. Effect of low-fat diet interventions versus other diet interventions on long-term weight change in adults: a systematic review and meta-analysis. Lancet Diabetes Endocrinol. 2015;3(12):968–79. This systematic review and meta-analysis examines the effectiveness of low-fat diets versus other diet interventions for long term weight loss.

    Article  PubMed  Google Scholar 

  9. Jensen MD, Ryan DH, Apovian CM, Ard JD, Comuzzie AG, Donato KA, et al. 2013 AHA/ACC/TOS guideline for the management of overweight and obesity in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society. Circulation. 2014;129 Suppl 2:S102–38.

    Article  PubMed  Google Scholar 

  10. Ebbeling CB, Leidig MM, Feldman HA, Lovesky MM, Ludwig DS. Effects of a low-glycemic load vs low-fat diet in obese young adults: a randomized trial. JAMA. 2007;297:2092–102.

    Article  CAS  PubMed  Google Scholar 

  11. Jeppesen J, Schaaf P, Jones C, Zhou MY, Chen YD, Reaven GM. Effects of low-fat, high-carbohydrate diets on risk factors for ischemic heart disease in postmenopausal women. Am J Clin Nutr. 1997;65(4):1027–33.

    CAS  PubMed  Google Scholar 

  12. Pittas AG, Das SK, Hajduk CL, Golden J, Saltzman E, Stark PC, et al. A low-glycemic load diet facilitates greater weight loss in overweight adults with high insulin secretion but not in overweight adults with low insulin secretion in the CALERIE Trial. Diabetes Care. 2005;28(12):2939–41.

    Article  PubMed  Google Scholar 

  13. Wolever TM, Mehling C. Long-term effect of varying the source or amount of dietary carbohydrate on postprandial plasma glucose, insulin, triacylglycerol, and free fatty acid concentrations in subjects with impaired glucose tolerance. Am J Clin Nutr. 2003;77(3):612–21.

    CAS  PubMed  Google Scholar 

  14. McClain AD, Otten JJ, Hekler EB, Gardner CD. Adherence to a low-fat vs. low-carbohydrate diet differs by insulin resistance status. Diabetes Obes Metab. 2013;15:87–90. This manuscript describes how insulin resistance status may affect dietary adherence to weight loss diets.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Barte JCM, ter Bogt NCW, Bogers RP, Teixeira PJ, Blissmer B, Mori TA, et al. Maintenance of weight loss after lifestyle interventions for overweight and obesity, a systematic review. Obes Rev. 2011;11:899–906.

    Article  Google Scholar 

  16. Mitchell NS, Catenacci VA, Wyatt HR, Hill JO. Obesity: overview of an epidemic. Psychiatr Clin North Am. 2011;34:717–32.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Ramage S, Farmer A, Eccles KA, McCargar L. Healthy strategies for successful weight loss and weight maintenance: a systematic review. Appl Physiol Nutr Metab. 2014;39(1):1–20. This review examines the evidence for successful diet strategies for weight loss and weight maintenance among adults.

    Article  CAS  PubMed  Google Scholar 

  18. Klem ML, Wing RR, McGuire MT, Seagle HM, Hill JO. A descriptive study of individuals successful at long-term maintenance of substantial weight loss. Am J Clin Nutr. 1997;66(2):239–46.

    CAS  PubMed  Google Scholar 

  19. McGuire MT, Wing RR, Klem ML, Hill JO. Behavioral strategies of individuals who have maintained long-term weight losses. Obes Res. 1999;7(4):334–41.

    Article  CAS  PubMed  Google Scholar 

  20. Wing RR, Tate DF, Gorin AA, Raynor HA, Fava JL. A self-regulation program for maintenance of weight loss. N Engl J Med. 2006;355:1563–71.

    Article  CAS  PubMed  Google Scholar 

  21. Wing RR, Gorin AA, Raynor HA, Tate DF, Fava JL, Machan J. “STOP regain”: are there negative effects of daily weighing? J Consult Clin Psychol. 2007;75(4):652–6.

    Article  PubMed  Google Scholar 

  22. Wing RR, Papandonatos G, Fava JL, Gorin AA, Phelan S, McCaffery J, et al. Maintaining large weight losses: the role of behavioral and psychological factors. J Consult Clin Psychol. 2008;76(6):1015–21.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Cox TL, Malpede CZ, Desmond RA, Faulk LE, Myer RA, Henson CS, et al. Physical activity patterns during weight maintenance following a low-energy density dietary intervention. Obesity. 2007;15(5):1226–32.

    Article  PubMed  Google Scholar 

  24. Phelan S, Lang W, Jordan D, Wing RR. Use of artificial sweeteners and fat-modified foods in weight loss maintainers and always-normal weight individuals. Int J Obes (Lond). 2009;33(10):1183–90.

    Article  CAS  Google Scholar 

  25. Gorin AA, Phelan S, Wing RR, Hill JO. Promoting long-term weight control: does dieting consistency matter? Int J Obes Relat Metab Disord. 2004;28(2):278–81.

    CAS  PubMed  Google Scholar 

  26. Phelan S, Wyatt HR, Hill JO, Wing RR. Are the eating and exercise habits of successful weight losers changing? Obesity. 2006;14(4):710–6.

    Article  PubMed  Google Scholar 

  27. Rosenbaum M, Kissileff HR, Mayer LE, Hirsch J, Leibel RL. Energy intake in weight-reduced humans. Brain Res. 2010;1350:95–102.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Wing RR, Hill JO. Successful weight loss maintenance. Annu Rev Nutr. 2001;21:323–41.

    Article  CAS  PubMed  Google Scholar 

  29. Jakicic JM, Marcus BH, Lang W, Janney C. Effect of exercise on 24-month weight loss maintenance in overweight women. Arch Intern Med. 2008;168(14):1550–9.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Goldsmith R, Joanisse D, Gallagher D, Simoneau J, Pavlovich K, Leibel R, et al. Effects of experimental weight perturbation on skeletal muscle work efficiency, fuel utilization, and biochemistry in human subjects. Am J Physiol Regul Integr Comp Physiol. 2010;298:R79–88.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  31. Rosenbaum M, Vandenborne K, Leigh J, Goldsmith R, Simoneau J, Hirsch J, et al. Effects of experimental weight perturbation on skeletal muscle work efficiency in human subjects. Am J Physiol Regul Integr Comp Physiol. 2003;285:R183–92.

    Article  CAS  PubMed  Google Scholar 

  32. Rosenbaum M, Goldsmith R, Bloomfield D, Magnano A, Weimer L, Heymsfield S, et al. Low dose leptin reverses skeletal muscle, autonomic, and neuroendocrine adaptations to maintenance of reduced weight. J Clin Invest. 2005;115:3579–386.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  33. Heymsfield SB, Greenberg AS, Fujioka K, Dixon RM, Kushner R, Hunt T, et al. Recombinant leptin for weight loss in obese and lean adults: a randomized, controlled, dose-escalation trial. JAMA. 1999;282(16):1568–75.

    Article  CAS  PubMed  Google Scholar 

  34. Kissileff HR, Thornton JC, Torres MI, Pavlovich K, Mayer LS, Kalari V, et al. Leptin reverses declines in satiation in weight-reduced obese humans. Am J Clin Nutr. 2012;95(2):309–17.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Nutritional Sciences, The Pennsylvania State University, 110 Chandlee Lab, University Park, PA, 16802, USA

    Jennifer A. Fleming & Penny M. Kris-Etherton

Authors
  1. Jennifer A. Fleming
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Penny M. Kris-Etherton
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Penny M. Kris-Etherton.

Ethics declarations

Conflict of Interest

Jennifer A. Fleming and Penny M. Kris-Etherton declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

This article is part of the Topical Collection on Obesity Treatment

Rights and permissions

Reprints and Permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Fleming, J.A., Kris-Etherton, P.M. Macronutrient Content of the Diet: What Do We Know About Energy Balance and Weight Maintenance?. Curr Obes Rep 5, 208–213 (2016). https://doi.org/10.1007/s13679-016-0209-8

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13679-016-0209-8

Keywords

search

Navigation