This randomized trial generated long-term weight loss data (2 years) according to macronutrient composition. A sample of 811 overweight adults were randomized to 1) low-fat, average-protein (20% fat, 15% protein), 2) low-fat, high-protein (20% fat, 25% protein), 3) high-fat, average-protein (40% fat, 15% protein) and 4) high-fat, high-protein (40% fat, 25% protein). The average weight loss at 6 months was 6 kg. After 2 years, weight loss and reductions in waist circumference were essentially similar across subgroups. Moreover, satiety, hunger, satisfaction with the diet and attendance at group sessions were also similar for all diets. There were improvements in lipoprotein-lipid variables and fasting insulin levels with all diets. These results provide useful long-term data that giving regular support to patients in order to reduce caloric intake rather than the composition of the diet is critical to achieve meaningful long-term weight loss and maintenance. The major point made by Dr. Katan in his editorial is that behavioural factors rather than macronutrient composition largely influence weight loss, although he underlines that small differences in macronutrient intake were achieved across study groups. He also pointed out that obesity, as a multifactorial problem, cannot be solved solely through individual actions: it also requires community-based actions.
Documentation centre