Effect of low-fat diet interventions versus other diet interventions on long-term weight change in adults: a systematic review and meta-analysis.

[꽉이]

Lancet Diabetes Endocrinol. 2015 Dec;3(12):968-79. doi: 10.1016/S2213-8587(15)00367-8. Epub 2015 Oct 30.

Effect of low-fat diet interventions versus other diet interventions on long-term weight
change in adults: a systematic review and meta-analysis.

Tobias DK¹, Chen M², Manson JE³, Ludwig DS⁴, Willett W⁵, Hu FB⁵.

Author information

Abstract

BACKGROUND:

The effectiveness of low-fat diets for long-term weight loss has been debated for decades,
with many randomised controlled trials (RCTs) and recent reviews giving mixed results. We aimed to summarise
the large body of evidence from RCTs to determine whether low-fat diets contribute to greater weight loss than
participants' usual diet, low-carbohydrate diets, and other higher-fat dietary interventions.

METHODS:

We did a systematic review and random effects meta-analysis of RCTs comparing the long-term
effect (≥1 year) of low-fat and higher-fat dietary interventions on weight loss by searching MEDLINE, Embase,
Cochrane Central Register of Controlled Trials (CENTRAL), and Cochrane Database of Systematic Reviews to
identify eligible trials published from database inception up until July 31, 2014. We excluded trials if one intervention

group included a non-dietary weight loss component but the other did not, and trials of dietary supplements or meal

replacement drink interventions. Data including the main outcome measure of mean difference in weight change

between interventions, and whether interventions were intended to lead to weight loss, weight maintenance, or
neither, were extracted from published reports. We estimated the pooled weighted mean difference (WMD) with
a DerSimonian and Laird random effects method.

FINDINGS:

3517 citations were identified by the search and 53 studies met our inclusion criteria, including 68 128
participants (69 comparisons). In weight loss trials, low-carbohydrate interventions led to significantly greater
weight loss than did low-fat interventions (18 comparisons; WMD 1·15 kg [95% CI 0·52 to 1·79]; I(2)=10%).
Low-fat interventions did not lead to differences in weight change compared with other higher-fat weight loss
interventions (19 comparisons; WMD 0·36 kg [-0·66 to 1·37; I(2)=82%), and led to a greater weight decrease only
when compared with a usual diet (eight comparisons; -5·41 kg [-7·29 to -3·54]; I(2)=68%). Similarly, results of
non-weight-loss trials and weight maintenance trials, for which no low-carbohydrate comparisons were made,
showed that low-fat versus higher-fat interventions have a similar effect on weight loss, and that low-fat interventions
led to greater weight loss only when compared with usual diet. In weight loss trials, higher-fat weight loss interventions
led to significantly greater weight loss than low-fat interventions when groups differed by more than 5% of calories
obtained from fat at follow-up (18 comparisons; WMD 1·04 kg [95% CI 0·06 to 2·03]; I(2)=78%), and when the
difference in serum triglycerides between the two interventions at follow-up was at least 0·06 mmol/L
(17 comparisons; 1·38 kg [0·50 to 2·25]; I(2)=62%).

INTERPRETATION:

These findings suggest that the long-term effect of low-fat diet intervention on bodyweight
depends on the intensity of the intervention in the comparison group. When compared with dietary interventions
of similar intensity, evidence from RCTs does not support low-fat diets over other dietary interventions for long-term
weight loss.

FUNDING:

National Institutes of Health and American Diabetes Association.

Copyright © 2015 Elsevier Ltd. All rights reserved.

Comment in

• Prescribing low-fat diets: useless for long-term weight loss? [Lancet Diabetes Endocrinol. 2015]

PMID:

 

26527511

 

PMCID:

 

PMC4667723

 

DOI:

 

10.1016/S2213-8587(15)00367-8

[PubMed - indexed for MEDLINE] 

Free PMC Article

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