Match!

Effects of 4 weight-loss diets differing in fat, protein, and carbohydrate on fat mass, lean mass, visceral adipose tissue, and hepatic fat: results from the POUNDS LOST trial

Published on Mar 1, 2012in The American Journal of Clinical Nutrition6.568
· DOI :10.3945/ajcn.111.026328
Russell J. de Souza34
Estimated H-index: 34
,
George A. Bray117
Estimated H-index: 117
+ 6 AuthorsSteven R. Smith71
Estimated H-index: 71
Sources
Abstract
Background: Weight loss reduces body fat and lean mass, but whether these changes are influenced by macronutrient composition of the diet is unclear. Objective: We determined whether energy-reduced diets that emphasize fat, protein, or carbohydrate differentially reduce total, visceral, or hepatic fat or preserve lean mass. Design: In a subset of participants in a randomized trial of 4 weightloss diets, body fat and lean mass (n = 424; by using dual-energy X-ray absorptiometry) and abdominal and hepatic fat (n = 165; by using computed tomography) were measured after 6 mo and 2 y. Changes from baseline were compared between assigned amounts of protein (25% compared with 15%) and fat (40% compared with 20%) and across 4 carbohydrate amounts (35% through 65%). Results: At 6 mo, participants lost a mean (6SEM) of 4.2 6 0.3 kg (12.4%) fat and 2.1 6 0.3 kg (3.5%) lean mass (both P , 0.0001 compared with baseline values), with no differences between 25% and 15% protein (P 0.10), 40% and 20% fat (P 0.34), or 65% and 35% carbohydrate (P 0.27). Participants lost 2.3 6 0.2 kg (13.8%) abdominal fat: 1.5 6 0.2 kg (13.6%) subcutaneous fat and 0.9 6 0.1 kg (16.1%) visceral fat (all P , 0.0001 compared with baseline values), with no differences between the diets (P 0.29). Women lost more visceral fat than did men relative to total-body fat loss. Participants regained ;40% of these losses by 2 y, with no differences between diets (P 0.23). Weight loss reduced hepatic fat, but there were no differences between groups (P 0.28). Dietary goals were not fully met; self-reported contrasts were closer to 2% protein, 8% fat, and 14% carbohydrate at 6 mo and 1%, 7%, and 10%, respectively, at 2 y. Conclusion: Participants lost more fat than lean mass after consumption of all diets, with no differences in changes in body composition, abdominal fat, or hepatic fat between assigned macronutrient amounts. This trial was registered at clinicaltrials.gov as NCT00072995. Am J Clin Nutr 2012;95:614‐25.
  • References (60)
  • Citations (106)
📖 Papers frequently viewed together
1,249 Citations
317 Citations
200751.27JAMA
760 Citations
78% of Scinapse members use related papers. After signing in, all features are FREE.
References60
Newest
A 3-week high-fat diet increases intrahepatic fat content, which is already evident after 1 week, and decreases metabolic flexibility without affecting insulin sensitivity.
71 CitationsSource
#1Jaimie N. Davis (SC: University of Southern California)H-Index: 26
#2Kim-Anne Lê (SC: University of Southern California)H-Index: 4
Last. Michael I. Goran (SC: University of Southern California)H-Index: 86
view all 8 authors...
Background: Recently, a genetic variant (rs738409; C/G) of the PNPLA3 gene was identified to be associated with increased hepatic fat deposition, and the effect was more pronounced in Hispanics. Animal models have also shown that PNPLA3 expression can be regulated by dietary carbohydrate. Objective: The aim of this study was to examine whether the influence of PNPLA3 genotype on hepatic fat is modulated by dietary factors in Hispanic children. Design: PNPLA3 was genotyped in 153 Hispanic childre...
99 CitationsSource
#1Thomas M. Larsen (UCPH: University of Copenhagen)H-Index: 31
Last. A. AstrupH-Index: 96
view all 11 authors...
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 We enrolled overweight adults from eight European countries who had lost at least 8% of their initial body weight with a 3.3-MJ (800-kcal) low-calorie diet. 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-wee...
547 CitationsSource
#1Maria Cristina Elias (UNIFESP: Federal University of São Paulo)H-Index: 2
#2Edison Roberto Parise (UNIFESP: Federal University of São Paulo)H-Index: 14
Last. João Prola Netto (UNIFESP: Federal University of São Paulo)H-Index: 1
view all 5 authors...
Abstract Objective We evaluated the effect of diet therapy as exclusive treatment on insulin resistance, biochemical parameters of metabolic syndrome, and degree of hepatic steatosis in patients with non-alcoholic fatty liver disease. Methods Thirty-one patients with non-alcoholic fatty liver disease received a diet with a reduction of 500 to 1000 cal/d, containing 15% protein, 55% carbohydrates, and 30% fat, for 6 mo. At entry and 6 mo after dietary instructions, degrees of hepatic steatosis an...
55 CitationsSource
#1William S. YancyH-Index: 42
#2Eric C. WestmanH-Index: 44
Last. Eugene Z. OddoneH-Index: 55
view all 8 authors...
Background Two potent weight loss therapies, a low-carbohydrate, ketogenic diet (LCKD) and orlistat therapy combined with a low-fat diet (O + LFD), are available to the public but, to our knowledge, have never been compared. Methods Overweight or obese outpatients (n = 146) from the Department of Veterans Affairs primary care clinics in Durham, North Carolina, were randomized to either LCKD instruction (initially, Results The mean age was 52 years and mean body mass index was 39.3 (calculated as...
80 CitationsSource
#1U. BradleyH-Index: 2
#2Michelle SpenceH-Index: 13
Last. Steven J. HunterH-Index: 24
view all 10 authors...
OBJECTIVE Low-fat hypocaloric diets reduce insulin resistance and prevent type 2 diabetes in those at risk. Low-carbohydrate, high-fat diets are advocated as an alternative, but reciprocal increases in dietary fat may have detrimental effects on insulin resistance and offset the benefits of weight reduction. RESEARCH DESIGN AND METHODS We investigated a low-fat (20% fat, 60% carbohydrate) versus a low-carbohydrate (60% fat, 20% carbohydrate) weight reduction diet in 24 overweight/obese subjects ...
73 CitationsSource
#1David J.A. JenkinsH-Index: 88
#2Julia M. W. WongH-Index: 21
Last. William SingerH-Index: 23
view all 11 authors...
Background Low-carbohydrate, high–animal protein diets, which are advocated for weight loss, may not promote the desired reduction in low-density lipoprotein cholesterol (LDL-C) concentration. The effect of exchanging the animal proteins and fats for those of vegetable origin has not been tested. Our objective was to determine the effect on weight loss and LDL-C concentration of a low-carbohydrate diet high in vegetable proteins from gluten, soy, nuts, fruits, vegetables, cereals, and vegetable ...
105 CitationsSource
#1Chad M. Kerksick (OU: University of Oklahoma)H-Index: 26
#2A. Thomas (Baylor University)H-Index: 3
Last. Richard B. Kreider (A&M: Texas A&M University)H-Index: 39
view all 14 authors...
Objective To determine the safety and efficacy of altering the ratio of carbohydrate and protein in low-energy diets in conjunction with a popular exercise program in obese women.
69 CitationsSource
#1Donald K. Layman (UIUC: University of Illinois at Urbana–Champaign)H-Index: 30
#2Ellen M. Evans (Urbana University)H-Index: 35
Last. Penny M. Kris-Etherton (PSU: Pennsylvania State University)H-Index: 89
view all 9 authors...
Diets with increased protein and reduced carbohydrates (PRO) are effective for weight loss, but the long-term effect on maintenance is unknown. This study compared changes in body weight and composition and blood lipids after short-term weight loss (4 mo) followed by weight maintenance (8 mo) using moderate PRO or conventional high-carbohydrate (CHO) diets. Participants (age = 45.4 ± 1.2 y; BMI = 32.6 ± 0.8 kg/m 2 ; n = 130) were randomized to 2 energy-restricted diets (-500 kcal/d or -2093 kJ/d...
151 CitationsSource
BackgroundThe 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. MethodsWe 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 cardiova...
1,249 CitationsSource
Cited By106
Newest
#1Tohru Yamaguchi (Kao Corporation)H-Index: 10
#2Naoki Ozato (Hirosaki University)H-Index: 1
Last. Shigeyuki Nakaji (Hirosaki University)H-Index: 29
view all 7 authors...
The accumulation of visceral fat is considered a potential cause of a clustering of metabolic disorders including hypertension, hyperglycemia, and dyslipidemia. These disorders are some of the upstream determinants of serious diseases such as coronary heart disease, cerebrovascular disease, and dementia. In particular, the accumulation of visceral fat is considered to have a causal relationship with dietary habits. To clarify this relationship, we characterize dietary habits with dietary macronu...
Source
#1Yang Hu (Harvard University)H-Index: 11
#2Gang Liu (HUST: Huazhong University of Science and Technology)H-Index: 18
Last. Qi Sun (Harvard University)H-Index: 62
view all 11 authors...
Abstract Background Recent studies suggested an inverse association between exposures to perfluoroalkyl substances (PFASs) and bone mineral density (BMD). Whether exposures to PFASs are also associated with changes in BMD has not been examined. Methods Five major PFASs (perfluorooctanesulfonic acid, PFOS; perfluorooctanoic acid, PFOA; perfluorohexanesulfonic acid, PFHxS; perfluorononanoic acid, PFNA; perfluorodecanoic acid, PFDA) and BMD (g/cm2) at six bone sites (spine, total hip, femoral neck,...
1 CitationsSource
#1Dong Ling Sun (PKU: Peking University)H-Index: 14
#2Tao Zhou (Tulane University)H-Index: 3
Last. Lu Qi (Tulane University)H-Index: 73
view all 8 authors...
High blood pressure (BP) is closely related to obesity, and weight loss lowers BP. Evidence has shown considerable interpersonal variation of changes in BP among people experiencing weight loss, and such variation might be partly determined by genetic factors. We assessed the changes in systolic and diastolic BP (SBP/DBP) among 692 participants randomly assigned to 1 of 4 diets varying in macronutrient content for 2 years. Two separate polygenic scores (SBP/DBP-PGS derived from 52/50 single nucl...
2 CitationsSource
#1Dong Ling Sun (PKU: Peking University)H-Index: 14
#2Tao Zhou (Tulane University)H-Index: 3
Last. Lu Qi (Tulane University)H-Index: 73
view all 8 authors...
High blood pressure (BP) is closely related to obesity, and weight loss lowers BP. Evidence has shown considerable interpersonal variation of changes in BP among people experiencing weight loss, and such variation might be partly determined by genetic factors. We assessed the changes in systolic and diastolic BP (SBP/DBP) among 692 participants randomly assigned to 1 of 4 diets varying in macronutrient content for 2 years. Two separate polygenic scores (SBP/DBP-PGS derived from 52/50 single nucl...
2 CitationsSource
The ketogenic diet (KD) has gained a resurgence in popularity due to its purported reputation for fighting obesity. The KD has also acquired attention as an alternative and/or supplemental method for producing energy in the form of ketone bodies. Recent scientific evidence highlights the KD as a promising strategy to treat obesity, diabetes, and cardiac dysfunction. In addition, studies support ketone body supplements as a potential method to induce ketosis and supply sustainable fuel sources to...
Source
#1Tanya Agurs-CollinsH-Index: 21
#2Sharon A. RossH-Index: 25
Last. Barbara K. DunnH-Index: 22
view all 3 authors...
Obesity is associated with increased risk of breast and other cancers. However, the complexity of the underlying mechanisms, together with the interplay of diet and physical activity - contributing to energy balance - and the role of adipose tissue, pose challenges to our understanding of the basis of this increased risk. Epidemiologic studies have documented a higher obesity prevalence in US African-American (AA) and Hispanic women compared to Caucasian women. Elucidation of the contribution of...
Source
#1Yftach Gepner (TAU: Tel Aviv University)H-Index: 1
#2Ilan ShelefH-Index: 25
Last. Iris Shai (BGU: Ben-Gurion University of the Negev)H-Index: 39
view all 23 authors...
Background & Aim It is unclear if a reduction in hepatic fat content (HFC) is a major mediator of the cardiometabolic benefit of lifestyle intervention, and whether it has prognostic significance beyond the loss of visceral adipose tissue (VAT). In the present sub-study, we hypothesized that HFC loss in response to dietary interventions induces specific beneficial effects independently of VAT changes. Methods In an 18-month weight-loss trial, 278 participants with abdominal obesity/dyslipidemia ...
5 CitationsSource
Last. Rocío Mateo-Gallego (University of Zaragoza)H-Index: 15
view all 8 authors...
Summary Background & Aims It has not been elucidated if an energy-restricted diet with high protein content could induce a benefit in insulin resistance in subjects with type 2 diabetes (T2DM); and if an adipose tissue functionality improvement could mediate this effect. We aimed to assess the effect of energy-restricted diets with standard (18% from total calories; SP) vs. high (35%) protein (HP), mainly coming from lean animal source, composition on glucose metabolism and adipokine concentrati...
Source
#1Dong Ling SunH-Index: 14
#2Tao ZhouH-Index: 3
Last. Lu QiH-Index: 73
view all 8 authors...
High blood pressure (BP) is closely related to obesity, and weight loss lowers BP. Evidence has shown considerable interpersonal variation of changes in BP among people experiencing weight loss, an...
2 CitationsSource
#1Leticia Goni (University of Navarra)H-Index: 7
#2Dong Ling Sun (Tulane University)H-Index: 14
Last. Lu Qi (Tulane University)H-Index: 73
view all 11 authors...
Purpose A common variant of the melatonin receptor 1B (MTNR1B) gene has been related to increased signaling of melatonin, a hormone previously associated with body fatness mainly through effects on energy metabolism. We examined whether the MTNR1B variant affects changes of body fatness and composition in response to a dietary weight loss intervention.
6 CitationsSource