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.