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. Author manuscript; available in PMC: 2012 Sep 6.
Published in final edited form as: Circulation. 2012 Mar 6;125(9):1157–1170. doi: 10.1161/CIRCULATIONAHA.111.039453

Table 1.

Weight Losses From Selected Randomized, Controlled Trials That Compared Diets With Varying Macronutrient Compositions

Study N No. Lifestyle
Sessions
Provided
Dietary Intervention Weight
Change
Month Comment/Other Results
Dansinger et al14 160 (51% F) 4 Atkins −2.1 kga 12 All participants had hypertension, dyslipidemia, and/or fasting hyperglycemia.
58% completed Zone −3.2 kga There were no significant differences between groups in reductions in CVD risk factors.
Weight Watchers −3.0 kga
Ornish −3.3 kga
Das et al15* 34 (% F unknown) 52 Low-glycemic load −7.8%a 12 No differences were observed between groups in change in CVD risk factors.
85% completed High-glycemic load −8.0%a
Ditschuneit et al16* 100 (79% F) 27 MR −10.4 kgb 27 There were significantly greater reductions in total cholesterol and fasting insulin in the group that received meal replacements.
63% completed Conventional diet for 3 mo, followed by addition of MR −7.7 kga
Fabricatore et al17 79 (80% F) 30 Low-glycemic load −4.5%a 9 All participants had type 2 diabetes.
63% completed Low-fat −6.4%a Larger reductions in HbA1c in the low-glycemic load group.
Foster et al18 63 (68% F) 3 Low-carbohydrate (high protein, high fat) −4.4%a 12 HDL cholesterol increased more and triglycerides decreased more in the low-carbohydrate group.
59% completed Conventional (high-carbohydrate, low-fat) −2.5%a Greater reductions in LDL and total cholesterol in the low-fat group at 3 mo.
Foster et al19 307 (68% F) 38 Low-carbohydrate −6.3 kga 24 Greater increase in HDL cholesterol in the low-carbohydrate group. Greater decrease in triglycerides at 3 and 6 mo in the low-carbohydrate group. Greater decrease in VLDL at 3, 6, and 12 mo in the low-carbohydrate group and in LDL at 3 and 6 mo in the low-fat group.
63% completed Low-fat −7.4 kga
Gardner et al20 311 (100% F) 8 Atkins (low-carbohydrate) −4.7 kga 12 Greater increase in HDL cholesterol in Atkins than Ornish group and greater decrease in triglyceride levels in Atkins than Zone group.
80% completed Zone (even distribution) −1.6 kgb Systolic blood pressure decreased more in Atkins than in all other groups. Diastolic blood pressure decreased more in Atkins than in Ornish group.
LEARN (calorie-restricted) −2.2 kga,b
Ornish (low-fat) −2.6 kga,b
Iqbal et al21 144 (10% F) 27 Low-carbohydrate −1.5 kga 24 All participants had diabetes.
47% completed Low-fat −0.2 kga No differences within or between groups for lipids or glycemic indexes.
Klemsdal et al22 202 (58% F) 9 Low-glycemic load −4.0 kga 12 62% participants with metabolic syndrome.
81% completed Low-fat −4.3 kga Waist circumference decreased more in low-fat diet group.
Diastolic blood pressure decreased more in the low glycemic load group.
Li et al23* 104 (% F unknown) 15 Individualized diet −2.4 kga 12
73% completed Individualized diet+MR −4.4 kga HbA1c was significantly lower in MR group with use of repeated measurement analysis.
Sacks et al24 811 (64% F) 66 Low-fat, average-protein (highest carbohydrate) −2.9 kga 24 LDL cholesterol decreased significantly more in lowest-fat/highest carbohydrate than in highest-fat/lowest carbohydrate groups. HDL cholesterol increased more with lowest carbohydrate than with the highest carbohydrate diet.
80% completed Low-fat, high-protein −3.8 kga All diets, except the highest carbohydrate, decreased fasting insulin (greater decrease in the high protein vs average protein diets).
High-fat, average-protein −3.1 kga
High-fat, high-protein (lowest carbohydrate) −3.5 kga
Samaha et al25 132 (17% F) 9 Low-carbohydrate −5.8 kga 6 Triglyceride levels decreased more in the low-carbohydrate group than in the low-fat group.
60% completed Conventional (low-fat) −1.9 kgb Among diabetic participants, mean fasting glucose level decreased more in the low-carbohydrate group than in the low-fat group.
Shai et al26 322 (14% F) 24 Low-fat −2.9 kga 24 HDL cholesterol increased in all groups, significantly more in the low-carbohydrate than low-fat group.
85% completed Mediterranean −4.4 kgb Triglyceride levels decreased more in the low-carbohydrate than in the low-fat group.
Low-carbohydrate −4.7 kgb In diabetic participants, only the Mediterranean diet group had a decrease in fasting glucose.
Stern et al27 132 (17% F) 15 Low-carbohydrate −5.1 kga 12 Triglyceride levels decreased more in the low-carbohydrate group than in the low-fat group.
66% completed Conventional (low-fat) −3.1 kga HDL cholesterol decreased less in the low-carbohydrate group than in the low-fat group.
Greater improvements in HbA1c in type 2 diabetics in the low-carbohydrate group.
Yancy et al28 120 (76% F) 9 Low-fat diet −6.5 kga 6 Low-carbohydrate group showed greater decreases in triglycerides and greater increases in HDL.
66% completed Low-carbohydrate, ketogenic diet with nutritional supplements −12.0 kgb

All studies were analyzed by use of an intention-to-treat population, with the exception as indicated by an asterisk (*).

Different letters (in superscript) indicate statistically significant differences in weight loss between groups.

F indicates female; LDL, low-density lipoprotein; HDL, high-density lipoprotein; VLDL, very low density lipoprotein; HbA1c, hemoglobin A1c; MR, meal replacements; CVD, cardiovascular disease.

*

A completer’s population was examined.

Results reported as “greater,” “larger,” “increased more,” etc represent statistically significant differences between treatment conditions.