What are the long‐term benefits of weight reducing diets in adults? A systematic review of randomized controlled trials

Avenell, Alison; Brown, Tamara; McGee, Magnus A.; Campbell, Marion K; Grant, Adrian; Broom, John; Jung, R. T.; Smith, W. C.

doi:10.1111/j.1365-277x.2004.00531.x

Cited by 150 publications

(117 citation statements)

References 76 publications

(161 reference statements)

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“…Treatment of obesity is connected with multiple health benefits, particularly the common risk factors as diabetes, chronic renal disease, hypertension and related to the decrease in total or cardiovascular mortality (17,29,30).…”

Section: Discussionmentioning

confidence: 99%

Obesity dilemma in the global burden of cardiovascular diseases

et al. 2013

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Aim: Obesity is a well-known risk factor in the cardiovascular disease continuum. However, its clinical effects are multimodal, perplexed and non-unanimously understood. Our aim was to assess the prevalence and effects of obesity on the cardiometabolic risk factors and systolic function of left ventricle ejection fraction (LVEF) in patients scheduled for cardiovascular rehabilitation. Methods: A cohort of 302 consecutive patients recently treated for ischaemic or valvular heart disease was matched according to the existence of obesity, defined with body mass index (BMI ≥ 30 kg/m 2 ; n = 90 vs. 212), and the advanced grade of obesity (BMI ≥ 35 kg/m 2 ; n = 19 vs. 283). Nutritional risk screening was performed using the standardised NRS-2002 tool. Results: The mean age of patients was 62.4 AE 11.2 (range 23-86) years; there were more men than women 244 (80.8%) : 58 (19.2%). Group of obese conveyed higher prevalence of ischaemic heart disease than non-obese (OR = 2.69; 95% CI: 1.01-7.20; p = 0.048); while the difference was insignificant for the advanced grade of obesity (n = 17; 89.5%) vs. controls (n = 233; 82.3%; p > 0.05). There was no significant difference in prevalence of other comorbidities (diabetes, glucose intolerance, hypercholesterolaemia, chronic renal and chronic obstructive pulmonary disease) between studied groups (p > 0.05). Utilisation of lipid-lowering drugs was of similar range between the studied groups (p > 0.05), respectively. LVEF (%) was 50.5 AE 8.2 vs. 50.7 AE 7.7 (p > 0.05) and 50.6 AE 7.8 vs. 49.6 AE 10.9 (p > 0.05; Rho = 0.001; p > 0.05), respectively. Conclusion: In studied set of patients, BMI positively correlated with left ventricle dimension and thickness. No significant connection of obesity was found with the prevalence of chronic comorbidities, increased nutritional risk, laboratory diagnostics or systolic function of left ventricle. Existence of obesity paradox in clinical practice was in part reaffirmed with our study. What's known• Obesity is a well-established risk factor and an important chronic comorbidity in cardiovascular diseases continuum.• However, obese individuals time and again have more fortunate prognosis than normal weighted individuals, known as the obesity paradox.• Obesity paradox is repeatedly found in reports from observational trials.• Modifications in lifestyle, healthy diet and treatment of obesity represent beneficial evidence-based medical interventions.

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Section: Discussionmentioning

confidence: 99%

Obesity dilemma in the global burden of cardiovascular diseases

et al. 2013

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“…Although a number of studies have evaluated adult diet modification for the treatment of obesity, there are fewer published paediatric studies. Longitudinal data from adult randomized controlled trials have documented improvement in BMi as well as comorbidities including blood pressure, lipids and fasting glucose with longterm use of low fat diets (Avenell et al, 2004). Other adult studies suggest greater weight loss and improvement in metabolic parameters with use of low carbohydrate diets (Hession et al, 2009).…”

Section: Dietary Treatmentmentioning

confidence: 99%

“…An increase in intra-abdominal pressure due to carriage of excessive weight predisposes to the relaxation of the lower oesophageal sphincter and development of reflux-associated symptoms. Obesity is responsible for the majority of gallstones in otherwise healthy children (Baker et al, 2005). Non-alcoholic fatty liver disease is the most frequent cause of paediatric liver disease.…”

Section: Gastrointestinal Disordersmentioning

confidence: 99%

Overview of paediatric obesity for the paediatric mental health provider

Scheimann

2012

International Review of Psychiatry

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“…In fact, commenting on a recent review of weight-loss treatments for obesity, Professor Annie Anderson notes that 'often it seems we have policy looking for an evidence base' (Anderson, 2005). There is a recurring pattern in the medical/ dietetic literature around evidence searches for weight loss, a description of morbidity and mortality deemed to arise from obesity, the intake/output equation energetically defended, an impressive list of search engines and strategies, and a conclusion along the lines of 'controlled trails of interventions for weight loss with adequate duration and power to detect differences in mortality are lacking' combined with observations that there is 'substantial evidence documenting the difficulty of sustaining weight loss over time' (Noël and Pugh, 2002) or 'the high attrition rate (69%) suggests that these dietary programmes were of little value to many patients who were referred to the dietetic department' (Taylor et al, 2003), and 'We found that the evidence from long-term RCTs on which to base dietary recommendations -aimed at weight loss -for obese adults was limited' (Avenell et al, 2004). That the conclusions should then unanimously call for better trials, better behaviour change skills, betternot-rewrite the question is flabbergasting.…”

Section: Where Does Science Fit Fat?mentioning

confidence: 99%

Is A Weight-Centred Health Framework Salutogenic? Some Thoughts on Unhinging Certain Dietary Ideologies

Aphramor

2005

Soc Theory Health

125

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Does promoting weight loss improve health? This paper draws on diverse writings in empowerment, social justice, critical obesity literature, feminism and stress biology to challenge the appropriateness of the continued reliance on a reductionist metaphor of 'energy balance' in understanding fatness. It examines some of the scientific and philosophical premises underlying mainstream UK dietary antiobesity guidelines and argues that the evidence supporting a link between promoting weight-loss and improving health is, at best, contentious. A central theme is that the current weight-loss schema helps to naturalise a fatness discourse that not only represents large people in offensively stereotyped ways but also fails to integrate people's lived experience as gendered, situated bodies in an inequitable world.

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What are the long‐term benefits of weight reducing diets in adults? A systematic review of randomized controlled trials

Abstract: Little evidence supports the use of diets other than LFDs for weight reduction. With the increasing prevalence of morbid obesity, long-term follow-up in RCTs is needed to evaluate the effect of LCDs, VLCDs and PSMFs more fully.

Cited by 150 publications

References 76 publications

Obesity dilemma in the global burden of cardiovascular diseases

Obesity dilemma in the global burden of cardiovascular diseases

Overview of paediatric obesity for the paediatric mental health provider

Is A Weight-Centred Health Framework Salutogenic? Some Thoughts on Unhinging Certain Dietary Ideologies

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