A large number of different dietary approaches have been studied in the attempt to achieve healthy, sustainable weight loss among individuals with overweight and obesity. Restriction of energy intake is the primary method of producing a negative energy balance leading to weight loss. However, owing to the different metabolic roles of proteins, carbohydrates and lipids in energy homeostasis, diets of similar overall energy content but with different macronutrient distribution can differentially affect metabolism, appetite and thermogenesis. Evidence increasingly suggests that the fuel values of calories provided by distinct macronutrients should be considered separately, as metabolism of specific molecular components generates differences in energy yield and. The causes of variation in individual responses to various diets are currently under debate, and some evidence suggests that differences are associated with specific genotypes. This narrative Review discusses all available systematic reviews and metaanalyses, and summarizes the results of relevant randomized controlled intervention trials assessing the influence of macronutrient composition on weight management. The initial findings of research into personalized nutrition, based on the interactions of macronutrient intake and genetic background and its potential influence on dietary intervention strategies, are also discussed.
Key points• The relative contributions of different aetiological factors to obesity remains to be fully defined, although the importance of different dietary macronutrients, physical activity patterns and genetics is acknowledged• Improved understanding of the mechanisms of weight gain and obesity might lead to comprehensive and efficient strategies to prevent and ameliorate this global epidemic• Studies of the roles of individual macronutrients in weight management are needed to define whether diets of similar calorific content but different composition differentially effect energy yield and utilization• Experts generally agree that weight-loss strategies should aim to not only reduce body fat in the short term, but also achieve long-term maintenance of healthy body weight• The study of gene-nutrient interactions and the differential effects of genotype on macronutrient utilization might identify personalized strategies for effective weight loss and maintenance of healthy body weight