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Adobe Flash Player is required to view this feature. If you are using an operating system that does not support Flash, we are working to bring you alternative formats. Original Article Comparison of Weight-Loss Diets with Different Compositions of Fat, Protein, and Carbohydrates Frank M. Sacks, M.D., George A. Bray, M.D., Vincent J. Carey, Ph.D., Steven R. Smith, M.D., Donna H.

Ryan, M.D., Stephen D. Anton, Ph.D., Katherine McManus, M.S., R.D., Catherine M. Champagne, Ph.D., Louise M. Bishop, M.S., R.D., Nancy Laranjo, B.A., Meryl S. Leboff, M.D., Jennifer C. Rood, Ph.D., Lilian de Jonge, Ph.D., Frank L. Greenway, M.D., Catherine M.

Loria, Ph.D., Eva Obarzanek, Ph.D., and Donald A. Williamson, Ph.D. N Engl J Med 2009; 360:859-873 DOI: 10.1056/NEJMoa0804748.

Methods We randomly assigned 811 overweight adults to one of four diets; the targeted percentages of energy derived from fat, protein, and carbohydrates in the four diets were 20, 15, and 65%; 20, 25, and 55%; 40, 15, and 45%; and 40, 25, and 35%. The diets consisted of similar foods and met guidelines for cardiovascular health. The participants were offered group and individual instructional sessions for 2 years. The primary outcome was the change in body weight after 2 years in two-by-two factorial comparisons of low fat versus high fat and average protein versus high protein and in the comparison of highest and lowest carbohydrate content. Results At 6 months, participants assigned to each diet had lost an average of 6 kg, which represented 7% of their initial weight; they began to regain weight after 12 months.

By 2 years, weight loss remained similar in those who were assigned to a diet with 15% protein and those assigned to a diet with 25% protein (3.0 and 3.6 kg, respectively); in those assigned to a diet with 20% fat and those assigned to a diet with 40% fat (3.3 kg for both groups); and in those assigned to a diet with 65% carbohydrates and those assigned to a diet with 35% carbohydrates (2.9 and 3.4 kg, respectively) (P>0.20 for all comparisons). Among the 80% of participants who completed the trial, the average weight loss was 4 kg; 14 to 15% of the participants had a reduction of at least 10% of their initial body weight. Satiety, hunger, satisfaction with the diet, and attendance at group sessions were similar for all diets; attendance was strongly associated with weight loss (0.2 kg per session attended). The diets improved lipid-related risk factors and fasting insulin levels. Figure 1 Mean Change in Body Weight and Waist Circumference from Baseline to 2 Years According to Dietary Macronutrient Content. Solid bars represent high-protein, high-fat, or highest-carbohydrate diets. Open bars represent average-protein, low-fat, or lowest-carbohydrate diets.

Keys Bin For Psx Games Iso. T bars indicate standard errors. Panels A and C show the change in body weight and the change in waist circumference, respectively, for all participants who were randomly assigned to a diet (a total of 811); missing data were imputed. A total of 403 participants were assigned to a high-protein diet and 408 to an average-protein diet, 405 were assigned to a high-fat diet and 406 to a low-fat diet, and 204 were assigned to the highest-carbohydrate diet and 201 to the lowest-carbohydrate diet.

Panel B shows the change in body weight for the 645 participants who provided measurements at 2 years. Of these participants, 325 were assigned to a high-protein diet and 320 to an average-protein diet, 319 were assigned to a high-fat diet and 326 to a low-fat diet, and 169 were assigned to the highest-carbohydrate diet and 168 to the lowest-carbohydrate diet. Panel D shows the change in waist circumference for the 599 participants who provided measurements at 2 years. Of these participants, 303 were assigned to a high-protein diet and 296 to an average-protein diet, 292 were assigned to a high-fat diet and 307 to a low-fat diet, and 159 were assigned to the highest-carbohydrate diet and 155 to the lowest-carbohydrate diet.