Randomized, multi-center trial of two hypo-energetic diets in obese subjects: high- versus low-fat content

Abstract

Objective: To investigate whether a hypo-energetic low-fat diet is superior to a hypo-energetic high-fat diet for the treatment of obesity. Design: Open-label, 10-week dietary intervention comparing two hypo-energetic (À600 kcal/day) diets with a fat energy percent of 20-25 or 40-45. Subjects: Obese (BMI X30 kg/m 2 ) adult subjects (n ¼ 771), from eight European centers. Measurements: Body weight loss, dropout rates, proportion of subjects who lost more than 10% of initial body weight, blood lipid profile, insulin and glucose. Results: The dietary fat energy percent was 25% in the low-fat group and 40% in the high-fat group (mean difference: 16 (95% confidence interval (CI) 15-17)%). Average weight loss was 6.9 kg in the low-fat group and 6.6 kg in the high-fat group (mean difference: 0.3 (95% CI À0.2 to 0.8) kg). Dropout was 13.6% (n ¼ 53) in the low-fat group and 18.3% (n ¼ 70) in the high-fat group (P ¼ 0.001). Among completers, more subjects lost 410% in the low-fat group than in the high-fat group ((20.8%, n ¼ 70) versus (14.7%, n ¼ 46), P ¼ 0.02). Fasting plasma total, low-density lipoprotein-and high-density lipoprotein-cholesterol decreased in both groups, but more so in the low-fat group than in the high-fat group. Fasting plasma insulin and glucose were lowered equally by both diets. Conclusions: The low-fat diet produced similar mean weight loss as the high-fat diet, but resulted in more subjects losing 410% of initial body weight and fewer dropouts. Both diets produced favorable changes in fasting blood lipids, insulin and glucose.

Macronutrient-specific effect of FTO rs9939609 in response to a 10-week randomized hypo-energetic diet among obese Europeans

“…24 Although we found no effect of FTO rs9939609 on weight loss, neither on its own nor in combination with the fat and CHO content of the hypo-energetic diet, the results in the present study suggest that for healthy obese carriers of the FTO rs9939609 risk A-allele the risk of dropping out from the intervention is lower on LF than HF hypo-energetic diet. For non-carriers completing the intervention the decrease in REE was smaller, and the decrease in HOMA-b and HOMA-IR was greater on LF than on a HF diet.…”

“…Although average weight loss was as expected indicating that participants on average complied with the 600 kcal day À1 energy deficit the inter-individual variation in weight loss suggests that not all individuals complied fully with the energy restrictionFsome individuals had a higher energy intake and others a lower energy intake than targeted. 24 Similarly, for compliance with fat and CHO content of HF and LF diet; the differences in changes in blood lipids between diets were as expected, but there were considerable inter-individual differences in reported fat and CHO composition within both diets. 23 However, using reported intake has its own problems with potential misreporting and would challenge the advantage of the study's randomized design.…”

“…24 Although there was only a significant difference in the risk of drop out between diets for AT genotype (greater on HF than LF) there was also a trend towards a greater drop out on HF diet than LF diet for AA genotype. It would seem more plausible to see an effect in all carriers of the A allele rather than just in heterozygous individuals, but clearly more AA individuals would need to be studied to confirm this.…”

“…NUGENOB was a multi-centre study including eight clinical centres in seven European countries (Sweden, Denmark, UK, The Netherlands, Czech Republic, France (two clinical centres), and Spain) and has been described in detail elsewhere (www.nugenob.org). 23,24 Participants were recruited from May 2001 until September 2002 through the media, from waiting lists or ongoing population studies and by self-referral or referral from a general practitioner or other clinical units and local obesity organizations. Inclusion criteria were: body mass index (BMI; kg m À2 ) X30, and age 20-50 years.…”

Dopamine gene methylation patterns are associated with obesity markers and carbohydrate intake

“…The MENA cohort is constituted by previous clinical trials analyzing genome‐environmental interactions concerning weight management and associated metabolic outcomes (Abete et al., 2015; Huerta, Navas‐Carretero, Prieto‐Hontoria, Martínez, & Moreno‐Aliaga, 2015; Larsen et al., 2010; Martínez‐González et al., 2014; Petersen et al., 2006; San‐Cristobal et al., 2015; Santos et al., 2016; Zulet et al., 2011). Each study received ethical approval from appropriate local Human Research Ethics Committees.…”