OBJECTIVE: To study the effect on weight loss in obese subjects by replacement of carbohydrate by protein in ad libitum consumed fat-reduced diets. DESIGN: Randomized dietary intervention study over six months comparing two ad libitum fat reduced diets (30% of total energy) strictly controlled in composition: High-carbohydrate (HC, protein 12% of total energy) or high-protein (HP, protein 25% of total energy). SETTING AND PARTICIPANTS: Subjects were 65 healthy, overweight and obese subjects (50 women, 15 men, aged 18 ± 55 y) randomly assigned to HC (n 25), HP (n 25) or a control group (C, n 15). All food was provided by selfselection in a shop at the department, and compliance to the diet composition was evaluated by urinary nitrogen excretion. MAIN OUTCOME MEASURE: Change in body weight, body composition and blood lipids. RESULTS: More than 90% completed the trial. Weight loss after six months was 5.1 kg in the HC group and 8.9 kg in the HP group (difference 3.7 kg, 95% con®dence interval (CI)(1.3 ± 6.2 kg) P`0.001), and fat loss was 4.3 kg and 7.6 kg, respectively (difference 3.3 kg (1.1 ± 5.5 kg) P`0.0001), whereas no changes occurred in the control group. More subjects lost b10 kg in the HP group (35 %) than in the HC group (9 %). The HP diet only decreased fasting plasma triglycerides and free fatty acids signi®cantly. CONCLUSIONS: Replacement of some dietary carbohydrate by protein in an ad libitum fat-reduced diet, improves weight loss and increases the proportion of subjects achieving a clinically relevant weight loss. More freedom to choose between protein-rich and complex carbohydrate-rich foods may allow obese subjects to choose more lean meat and dairy products, and hence improve adherence to low-fat diets in weight reduction programs.

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Objective: To explore motivation and perceived barriers towards weight loss among Danish men. Design: The study was of an explorative nature, using qualitative focus group interviews as a method. Setting: Copenhagen, Denmark. Subjects: Twenty-two overweight men, at the age of 25-44 years and motivated for weight loss, were recruited and distributed into four focus groups. The men were primarily unskilled workers. Overall 13 men participated and each group contained three or four participants. Intervention: The interview guide was partly structured, partly unstructured and the themes of the interviews were motives and perceived barriers towards weight loss. Results: Main barriers for losing weight appeared to be lack of motivation and the perception of the slimming diet. The men had a desire to have a lean appearance and avoid illness, but in all the interviews it appeared that the strongest motive for losing weight was a strong desire to become more effective and a greater asset for one's workplace. Overweight subjects were considered less effective and attractive for the labour market. Conclusion: This study indicates that if men from lower socioeconomic backgrounds are to be motivated to weight loss the focus should not be on leanness and good health but rather on increased effectiveness and performance, and the arena should include the working place. Sponsorship: The Royal Veterinary and Agricultural University supplied the necessary equipment and conference rooms. (Kjøller and Rasmussen, 2002). Overweight and obese men are more likely than women to carry excess body fat around their waist and upper abdomen, which is associated with an increased risk of many health problems and men may benefit more from weight loss than women, because of the change in fat distribution following weight loss (Wirth and Steinmetz, 1998).Nevertheless, multiple studies have shown that men to a lesser extent than women try to lose weight, and significant fewer men than women participate in organized weight reduction programmes (French and Jeffery, 1994;Bendixen et al., 2002). Several reasons for this could be hypothesized: men are perhaps not motivated for weight loss, or they may perceive too many barriers towards weight reduction. A third reason could be that current weight reduction programmes and public health campaigns do not appeal to men. These issues are important to investigate in order to help design a more targeted endeavour to prevent obesity among men.Studies clarifying the motivation of men toward a lean body and weight loss are very sparse. Egger and Mowbray (1993) conducted focus group interviews among working class Australian men. They found that the main reason for wanting to lose weight was to feel better, whereas health was never mentioned spontaneously as a motive for wanting to lose weight. Contrary, Hankey et al. (2002) found that the main reason for seeking weight loss among a group of British overweight and obese male workers was that this would be beneficial to health.Only the study of Egger and Mowbray (...

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