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Medline ® Abstracts for References 2,6,7

of 'Patient education: Weight loss treatments (Beyond the Basics)'

2
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Expert Panel Report: Guidelines (2013) for the management of overweight and obesity in adults.
AU
American College of Cardiology/American Heart Association Task Force on Practice Guidelines, Obesity Expert Panel, 2013
SO
Obesity (Silver Spring). 2014 Jul;22 Suppl 2:S41-410.
 
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PMID
6
TI
Comparison of weight-loss diets with different compositions of fat, protein, and carbohydrates.
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Sacks FM, Bray GA, Carey VJ, Smith SR, Ryan DH, Anton SD, McManus K, Champagne CM, Bishop LM, Laranjo N, Leboff MS, Rood JC, de Jonge L, Greenway FL, Loria CM, Obarzanek E, Williamson DA
SO
N Engl J Med. 2009;360(9):859.
 
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.
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, weightloss 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.
CONCLUSIONS: Reduced-calorie diets result in clinically meaningful weight loss regardless of which macronutrients they emphasize. (ClinicalTrials.gov number, NCT00072995.)
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Department of Nutrition, Harvard School of Public Health, Boston, USA.
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7
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Comparison of weight loss among named diet programs in overweight and obese adults: a meta-analysis.
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Johnston BC, Kanters S, Bandayrel K, Wu P, Naji F, Siemieniuk RA, Ball GD, Busse JW, Thorlund K, Guyatt G, Jansen JP, Mills EJ
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JAMA. 2014 Sep;312(9):923-33.
 
IMPORTANCE: Many claims have been made regarding the superiority of one diet or another for inducing weight loss. Which diet is best remains unclear.
OBJECTIVE: To determine weight loss outcomes for popular diets based on diet class (macronutrient composition) and named diet.
DATA SOURCES: Search of 6 electronic databases: AMED, CDSR, CENTRAL, CINAHL, EMBASE, and MEDLINE from inception of each database to April 2014.
STUDY SELECTION: Overweight or obese adults (body mass index≥25) randomized to a popular self-administered named diet and reporting weight or body mass index data at 3-month follow-up or longer.
DATA EXTRACTION AND SYNTHESIS: Two reviewers independently extracted data on populations, interventions, outcomes, risk of bias, and quality of evidence. A Bayesian framework was used to perform a series of random-effects network meta-analyses with meta-regression to estimate the relative effectiveness of diet classes and programs for change in weight and body mass index from baseline. Our analyses adjusted for behavioral support and exercise.
MAIN OUTCOMES AND MEASURES: Weight loss and body mass index at 6- and 12-month follow-up (±3 months for both periods).
RESULTS: Among 59 eligible articles reporting 48 unique randomized trials (including 7286 individuals) and compared with no diet, the largest weight loss was associated with low-carbohydrate diets (8.73 kg [95% credible interval {CI}, 7.27 to 10.20 kg]at 6-month follow-up and 7.25 kg [95% CI, 5.33 to 9.25 kg]at 12-month follow-up) and low-fat diets (7.99 kg [95% CI, 6.01 to 9.92 kg]at 6-month follow-up and 7.27 kg [95% CI, 5.26 to 9.34 kg]at 12-month follow-up). Weight loss differences between individual diets were minimal. For example, the Atkins diet resulted in a 1.71 kg greater weight loss than the Zone diet at 6-month follow-up. Between 6- and 12-month follow-up, the influence of behavioral support (3.23 kg [95% CI, 2.23 to 4.23 kg]at 6-month follow-up vs 1.08 kg [95% CI, -1.82 to 3.96 kg]at 12-month follow-up) and exercise (0.64 kg [95% CI, -0.35 to 1.66 kg]vs 2.13 kg [95% CI, 0.43 to 3.85 kg], respectively) on weight loss differed.
CONCLUSIONS AND RELEVANCE: Significant weight loss was observed with any low-carbohydrate or low-fat diet. Weightloss differences between individual named diets were small. This supports the practice of recommending any diet that a patient will adhere to in order to lose weight.
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Hospital for Sick Children Research Institute, Toronto, Ontario, Canada2Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada3Department of Clinical Epidemiology and Biostatistics, McMaster University, Hami.
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