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A randomized study of dietary composition during weight-loss maintenance: Rationale, study design, intervention, and assessment

Published on Feb 1, 2018in Contemporary Clinical Trials2.28
· DOI :10.1016/j.cct.2017.12.004
Cara B. Ebbeling35
Estimated H-index: 35
(Boston Children's Hospital),
Gloria Klein2
Estimated H-index: 2
(Boston Children's Hospital)
+ 13 AuthorsDavid S. Ludwig66
Estimated H-index: 66
(Boston Children's Hospital)
Abstract
Abstract Background While many people with overweight or obesity can lose weight temporarily, most have difficulty maintaining weight loss over the long term. Studies of dietary composition typically focus on weight loss, rather than weight-loss maintenance, and rely on nutrition education and dietary counseling, rather than controlled feeding protocols. Variation in initial weight loss and insufficient differentiation among treatments confound interpretation of results and compromise conclusions regarding the weight-independent effects of dietary composition. The aim of the present study was to evaluate three test diets differing in carbohydrate-to-fat ratio during weight-loss maintenance. Design and dietary interventions Following weight loss corresponding to 12 ± 2% of baseline body weight on a standard run-in diet, 164 participants aged 18 to 65 years were randomly assigned to one of three test diets for weight-loss maintenance through 20 weeks (test phase). We fed them high-carbohydrate (60% of energy from carbohydrate, 20% fat), moderate-carbohydrate (40% carbohydrate, 40% fat), and low-carbohydrate (20% carbohydrate, 60% fat) diets, controlled for protein content (20% of energy). During a 2-week ad libitum feeding phase following the test phase, we assessed the effect of the test diets on body weight. Outcomes The primary outcome was total energy expenditure, assessed by doubly-labeled water methodology. Secondary outcomes included resting energy expenditure and physical activity, chronic disease risk factors, and variables to inform an understanding of physiological mechanisms by which dietary carbohydrate-to-fat ratio might influence metabolism. Weight change during the ad libitum feeding phase was conceptualized as a proxy measure of hunger.
  • References (73)
  • Citations (2)
References73
Newest
#1Stephen P. Juraschek (Johns Hopkins University)H-Index: 24
#2Edgar R. Miller (Johns Hopkins University)H-Index: 55
Last.Elizabeth Selvin (Johns Hopkins University)H-Index: 54
view all 6 authors...
#1Ci Song (NIH: National Institutes of Health)H-Index: 10
#2Stephen Burgess (University of Cambridge)H-Index: 41
Last.Andrew D. Johnson (NIH: National Institutes of Health)H-Index: 61
view all 5 authors...
#1Tõnu Esko (UT: University of Tartu)H-Index: 83
#2Joel N. Hirschhorn (Broad Institute)H-Index: 104
Last.David S. Ludwig (Boston Children's Hospital)H-Index: 66
view all 8 authors...
#1Kevin D. Hall (NIH: National Institutes of Health)H-Index: 37
#2Kong Y. Chen (NIH: National Institutes of Health)H-Index: 31
Last.B. Timothy Walsh (Columbia University)H-Index: 57
view all 11 authors...
#1Karen B. DeSalvo (HHS: United States Department of Health and Human Services)H-Index: 3
#2Richard Olson (HHS: United States Department of Health and Human Services)H-Index: 2
Last.Kellie O Casavale (HHS: United States Department of Health and Human Services)H-Index: 3
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Cited By2
Newest
#1Cara B. Ebbeling (Harvard University)H-Index: 35
#2Henry A. Feldman (Harvard University)H-Index: 74
Last.David S. Ludwig (Harvard University)H-Index: 66
view all 10 authors...
#1Julia M. W. Wong (Boston Children's Hospital)H-Index: 18
#2Lisa Bielak (Boston Children's Hospital)H-Index: 2
Last.Patricia Luoto (Framingham State University)H-Index: 2
view all 13 authors...
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