Hostname: page-component-78c5997874-xbtfd Total loading time: 0 Render date: 2024-11-08T01:23:28.316Z Has data issue: false hasContentIssue false
  • English
  • Français

The role of dietary fat in body fatness: evidence from a preliminary meta-analysis of ad libitum low-fat dietary intervention studies

Published online by Cambridge University Press:  09 March 2007

Arne Astrup ,
Louise Ryan ,
Gary K. Grunwald ,
Mette Storgaard ,
Wim Saris ,
Ed Melanson  and
James O. Hill
Arne Astrup*
Affiliation:
Research Department of Human Nutrition & LMC, The Royal Veterinary and Agricultural University, Frederiksberg, Denmark
Louise Ryan
Affiliation:
Research Department of Human Nutrition & LMC, The Royal Veterinary and Agricultural University, Frederiksberg, Denmark
Gary K. Grunwald
Affiliation:
Center for Human Nutrition, University of Colorado Health Sciences Center, Denver, CO, USA
Mette Storgaard
Affiliation:
Research Department of Human Nutrition & LMC, The Royal Veterinary and Agricultural University, Frederiksberg, Denmark
Wim Saris
Affiliation:
University of Maastricht, Maastricht, The Netherlands.
Ed Melanson
Affiliation:
Center for Human Nutrition, University of Colorado Health Sciences Center, Denver, CO, USA
James O. Hill
Affiliation:
Center for Human Nutrition, University of Colorado Health Sciences Center, Denver, CO, USA
*
*Corresponding author: A. Astrup, fax +45 35282483, email [email protected]
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

The role of high-fat diets in weight gain and obesity has been questioned because of inconsistent reports in the literature concerning the efficacy of ad libitum low-fat diets to reduce body weight. We conducted a meta-analysis of weight loss occurring on ad libitum low-fat diets in intervention trials, and analysed the relationship between initial body weight and weight loss. We selected controlled trials lasting more than 2 months comparing ad libitum low-fat diets with a control group consuming their habitual diet or a medium-fat diet ad libitum published from 1966 to 1998. Data were included from 16 trials with a duration of 2–12 months, involving 1728 individuals. No trials on obese subjects fulfilled the inclusion criteria. The weighted difference in weight loss between intervention and control groups was 2.55 kg (95 % CI, 1.5–3.5; P < 0.0001). Weight loss was positively and independently related to pre-treatment body weight (r = 0.52,P < 0.05) and to reduction in the percentage of energy as fat (0.37 kg / %, P < 0.005) in unweighted analysis. Extrapolated to a BMI of about 30 kg/m2 and assuming a 10 % reduction in dietary fat, the predicted weight loss would be 4.4 kg (95 % CI, 2.0 to -6.8 kg). Because weight loss was not the primary aim in 12 of the 16 studies, it is unlikely that voluntary energy restriction contributed to the weight loss. Although there is no evidence that a high intake of simple sugars contributes to passive overconsumption, carbohydrate foods with a low glycaemic index may be more satiating and exert more beneficial effects on insulin resistance and cardiovascular risk factors. Moreover, an increase in protein content up to 25 % of total energy may also contribute to reducing total energy intake. In conclusion, a low-fat diet, high in protein and fibre-rich carbohydrates, mainly from different vegetables, fruits and whole grains, is highly satiating for fewer calories than fatty foods. This diet composition provides good sources of vitamins, minerals, trace elements and fibre, and may have the most beneficial effect on blood lipids and blood-pressure levels. A reduction in dietary fat without restriction of total energy intake prevents weight gain in subjects of normal weight and produces a weight loss in overweight subjects, which is highly relevant for public health.

Keywords

Low-fat dietsWeight lossObesityHumansBody weight regulation
Type
Research Article
Information
British Journal of Nutrition , Volume 83 , Issue S1 , June 2000 , pp. S25 - S32
Copyright
Copyright © The Nutrition Society 2000

References

Astrup, A, Toubro, S, Raben, A & Skov, AR (1997) The role of low fat diets and fat substitutes in body weight management: what have we learned from clinical studies?. Journal of the American Dietetics Association 97, 82S-87S.Google Scholar
Baer, JT (1993) Improved plasma cholesterol levels in men after a nutrition education program at the worksite. Journal of the American Dietetics Association 93, 658–663.Google Scholar
Bennett, C, Reed, GW, Peters, JC, Abumrad, NN, Sun, M & Hill, JO (1992) Short-term effects of dietary-fat ingestion on energy expenditure and nutrient balance. American Journal of Clinical Nutrition 55, 1071–1077.CrossRefGoogle ScholarPubMed
Bingham, SA (1999) High-meat diets and cancer risk. Proceedings of the Nutrition Society 58, 243–248.CrossRefGoogle ScholarPubMed
Bloemberg, BPM, Kromhout, D, Goddijin, E, Jansen, A, Obermann-de Boer, GL (1991) The impact of the guidelines for a healthy diet of the Netherlands Nutrition Council on total and high density lipoprotein cholesterol in hypercholesterolemic free-living men. American Journal of Epidemiology 134, 39–48.CrossRefGoogle ScholarPubMed
Bolton-Smith, C & Woodward, M (1994) Dietary composition and fat to sugar ratios in relation to obesity. International Journal of Obesity 18, 820–828.Google Scholar
Boyd, NF, Cousins, M, Beaton, M, Kriukov, V, Lockwood, G & Tritchler, D (1990) Quantative changes in dietary fat intake and serum cholesterol in women: results from a randomized, controlled trial. American Journal of Clinical Nutrition 52, 470–476.CrossRefGoogle Scholar
Bray, GA & Popkin, BM (1998) Dietary fat intake does affect obesity. American Journal of Clinical Nutrition 68, 1157–1173.CrossRefGoogle ScholarPubMed
Buzzard, IM, Chlebowski, RT & Jeffery, RW (1990) Diet intervention methods to reduce fat intake: nutrient and food group composition of self-selected low-fat diets. Journal of the American Dietetics Association 53, 42–50.Google Scholar
Hill, MJ (1999) Meat and colo-rectal cancer. Proceedings of the Nutrition Society 58, 261–264.CrossRefGoogle ScholarPubMed
Hunninghake, DB, Stein, EA & Dujovne, CA (1993) The efficacy of intensive dietary therapy alone or combined with lovastatin in outpatients with hupercholesterolemia. New England Journal of Medicine 328, 1213–1219.Google Scholar
Frost, G, Leeds, AA, Doré, CJ, Madeiros, S, Brading, S & Dornhorst, A (1999) Glycaemic index as a determinant of serum HDL-cholesterol concentration. Lancet 353, 1045–1048.Google Scholar
Jarvi, AE, Karlstrom, BE, Granfeldt, YE, Bjorck, IE, Asp, NG & Vessby, B (1999) Improved glycemic control and lipid profile and normalized fibrinolytic activity on a low-glycemic index diet in type 2 diabetic patients. Diabetes Care 22, 10–18.Google Scholar
Kant, AK, Graubard, BI, Schatzkin, A, Ballard-Barbash, R (1995) Proportion of energy intake from fat and subsequent weight change in the NAHNES I Epidemiologic Follow-up Study. American Journal of Clinical Nutrition 61, 11–17.Google Scholar
Kasim, SE, Martino, S, Kim, P, Khilnani, S, Boomer, A, Depper, J, Reading, BA & Heilbrun, LK (1993) Dietary and anthropometric determinants of plasma lipoproteins during a long-term low-fat diet in healthy women. American Journal of Clinical Nutrition 57, 146–153.Google Scholar
Katan, MB, Grundy, SM & Willett, WC (1997) Beyond low-fat diets. New England Journal of Medicine 337, 563–566.Google ScholarPubMed
Lee-Han, H, Cousins, M, Beaton, M, McGuire, V, Kriukov, V, Chipman, M & Boyd, N (1988) Compliance in a randomized clinical trial of dietary fat reduction in patients with breast dysplasia. American Journal of Clinical Nutrition 48, 575–586.Google Scholar
Luscombe, ND, Noakes, M & Clifton, PM (1999) Diets high and low in glycemic index versus high monounsaturated fat diets: effects on glucose and lipid metabolism in NIDDM. European Journal of Clinical Nutrition 53, 473–478.CrossRefGoogle ScholarPubMed
Ornish, D, Brown, SE, Scherwitz, LW, Billings, JH, Armstrong, WT, Ports, TA, McLanahan, SM, Kirkeeide, RL, Brand, RJ & Gould, KL (1990) Can lifestyle changes reverse coronary heart disease?. Lancet 336, 129–133.CrossRefGoogle ScholarPubMed
Paeratakul, S, Popkin, BM, Keyou, G, Adair, LS & Stevens, J (1998) Changes in diet and physical activity affect the body mass index of Chinese adults. International Journal of Obesity and Related Metabolic Disorders 22, 424–431.CrossRefGoogle ScholarPubMed
Prentice, AM, Black, AE, Coward, WA, Davies, HL, Goldberg, GR, Murgatroyd, PR, Ashford, J, Sawyer, M & Whitehead, RG (1986) High levels of energy expenditure in obese women. British Medical Journal 292, 983–992.Google Scholar
Pritchard, JE, Nowson, CA & Wark, JD (1996) Bone loss accompanying diet-induced or exercise-induced weight loss: a randomised controlled study. International Journal of Obesity 20, 513–520.Google Scholar
Raben, A, Due Jensen, N, Marckmann, P, Sandstrom, B & Astrup, A (1995) Spontaneous weight loss during 11 weeks' ad libitum intake of a low fat/high fiber diet in young, normal weight subjects. International Journal of Obesity and Related Metabolic Disorders 19, 916–922.Google Scholar
Radimer, KL & Harvey, PWJ (1998) Comparison of self-report of reduced fat and salt foods with sales and supply data. European Journal of Clinical Nutrition 52, 380–382.CrossRefGoogle ScholarPubMed
Schaefer, EJ, Lichtenstein, AH, Lamon-Fava, S, McNamara, JR, Schaefer, MM, Rasmussen, H & Ordovas, JM (1995) Body weight and low-density lipoprotein cholesterol changes after consumption of a low-fat ad libitum diet. Journal of the American Medical Association 274, 1450–1455.CrossRefGoogle ScholarPubMed
Schoeller, DA (1990) How accurate is self reported dietary intake?. Nutrition Reviews 48, 373–379.Google Scholar
Sheppard, L, Kristal, AR & Kushi, LH (1991) Weight loss in women participating in a randomized trial of low-fat diets. American Journal of Clinical Nutrition 54, 821–828.Google Scholar
Siggaard, R, Raben, A & Astrup, A (1996) Weight loss during 12 weeks ad libitumcarbohydrate-rich diet in overweight and normal weight subjects at a Danish working site. Obesity Research 4, 347–356.CrossRefGoogle Scholar
Simon, MS, Heilbrun, LK, Boomer, A, Kresge, C, Depper, J, Kim, PN, Valeriote, F & Martino, S (1997) A randomized trial of a low-fat dietary intervention in women at high risk for breast cancer. Nutrition and Cancer 27, 136–142.CrossRefGoogle ScholarPubMed
Skov, AR, Toubro, S, Rønn, B, Holm, L & Astrup, A (1999) Randomized trial on protein versus carbohydrate in ad libitum fat reduced diet for the treatment of obesity. International Journal of Obesity 23, 528–536.Google Scholar
Stefanick, ML, Mackey, S, Sheehan, M, Ellsworth, N, Haskell, WL & Wood, PD (1998) Effects of diet and exercise in men and postmenopausal women with low levels of HDL cholesterol and high levels of LDL cholesterol. New England Journal of Medicine 339, 12–20.CrossRefGoogle ScholarPubMed
Stubbs, RJ, Harbron, CG, Murgatroyd, PR & Prentice, AM (1995) Covert manipulation of dietary fat and energy density: effect on substrate flux and food intake in men eating ad libitum. American Journal of Clinical Nutrition 62, 316–329.CrossRefGoogle ScholarPubMed
Weststrate, JA, van het Hof, KH, van den Berg, H, Velthuis-te-Wierik, EJ, de Graaf, C, Zimmermanns, NJ, Westerterp, KR, Westerterp-Plantenga, MS, Verboeket-van de Venne, WP (1998) A comparison of the effect of free access to reduced fat products or their full fat equivalents on food intake, body weight, blood lipids and fat-soluble antioxidants levels and haemostasis variables. European Journal of Clinical Nutrition 52, 389–395.Google Scholar
Willett, WC (1998) Is dietary fat a major determinant of body fat?. American Journal of Clinical Nutrition 67, 556S-562S.Google Scholar
Yu-Poth, S, Zhao, G, Etherton, T, Naglak, M, Jonnalagadda, S, Kris-Etherton, PM (1999) Effects of the National Cholesterol Education Program's step I and step II dietary intervention programs on cardiovascular disease risk factors: a meta-analysis. American Journal of Clinical Nutrition 69, 632–46.Google Scholar