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) Full Text of Discussion. The groups did not differ significantly with respect to diet-related adverse events. The crucial question is whether overweight people have a better response in the long term to diets that emphasize a specific macronutrient composition. Abstract Background The possible advantage for weight loss of a diet that emphasizes protein, fat, or carbohydrates has not been established, and there are few studies that extend beyond 1 year. 11 The study was conducted in eight European countries: Denmark, the Netherlands, the United Kingdom, Greece (Crete), Germany, Spain, Bulgaria, and the Czech Republic. 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. Media in This Article Poll Results Contributors Figure 1 Mean Change in Body Weight and Waist Circumference from Baseline to 2 Years According to Dietary Macronutrient Content. gov number, NCT00072995. Conclusions Reduced-calorie diets result in clinically meaningful weight loss regardless of which macronutrients they emphasize. Thus, we recognized the need for a large trial that would be designed to overcome the limitations of previous trials and that would compare the effects of three principal dietary macronutrients. The overall study leaders, together with the principal investigator at each study center, designed the study. The principal investigator at each study center collected the local data, which were entered into a data-registration system (EpiData) 12 and transferred to a central data hub. The participants were offered group and individual instructional sessions for 2 years. 3-MJ (800-kcal) low-calorie diet.
The diets improved lipid-related risk factors and fasting insulin levels. The project staff of the National Heart, Lung, and Blood Institute also participated in the development of the protocol, monitoring of progress, interpretation of results, and critical review of the manuscript. Figure 2 Mean Changes in Body Weight and Waist Circumference at Various Time Points. Media in This Article Figure 1 Screening, Randomization, and Follow-up of Study Participants. We report here the results of the 26-week weight-maintenance intervention phase of the study. The European Commission Food Quality and Safety Priority of the Sixth Framework Programme (the main sponsor of the study) had no role in the design of the study or in the analysis or interpretation of the data. Participants Our goal was to recruit 800 overweight and obese subjects (400 at each site), of whom about 40% would be men. Participants were randomly assigned, in a two-by-two factorial design, to one of five ad libitum diets to prevent weight regain over a 26-week period: a low-protein and low-glycemic-index diet, a low-protein and high-glycemic-index diet, a high-protein and low-glycemic-index diet, a high-protein and high-glycemic-index diet, or a control diet. Participants had to be 30 to 70 years of age and have a body-mass index (the weight in kilograms divided by the square of the height in meters) of 25 to 40. Article Activity 272 articles have cited this article Article The importance of the composition of a diet for the prevention and management of obesity is debated. Methods We enrolled overweight adults from eight European countries who had lost at least 8% of their initial body weight with a 3. Figure 2 Total 24-Hour Urinary Nitrogen Excretion and Changes in Body Weight. The diets consisted of similar foods and met guidelines for cardiovascular health. (ClinicalTrials. Abstract Background Studies of weight-control diets that are high in protein or low in glycemic index have reached varied conclusions, probably owing to the fact that the studies had insufficient power. Methods Study Protocol The study design, methods, and procedures have been described in detail previously.
