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Calorie for Calorie, Dietary Fat Restriction Results in More Body Fat Loss than Carbohydrate Restriction in People with Obesity
Open accessAbstract
Dietary carbohydrate restriction has been purported to cause endocrine adaptations that promote body fat loss more than dietary fat restriction. We selectively restricted dietary carbohydrate versus fat for 6 days following a 5-day baseline diet in 19 adults with obesity confined to a metabolic ward where they exercised daily. Subjects received both isocaloric diets in random order during each of two inpatient stays. Body fat loss was calculated as the difference between daily fat intake and net fat oxidation measured while residing in a metabolic chamber. Whereas carbohydrate restriction led to sustained increases in fat oxidation and loss of 53 ± 6 g/day of body fat, fat oxidation was unchanged by fat restriction, leading to 89 ± 6 g/day of fat loss, and was significantly greater than carbohydrate restriction (p = 0.002). Mathematical model simulations agreed with these data, but predicted that the body acts to minimize body fat differences with prolonged isocaloric diets varying in carbohydrate and fat.
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“In a controlled metabolic study conducted under isocaloric and tightly regulated dietary conditions, LC was associated with higher fat oxidation and lower insulin concentrations, whereas LF resulted in greater adipose tissue loss. Differences in total body mass loss were minimal [47].”
From Dietary and Behavioral Strategies for Weight Loss and Weight Loss Maintenance: A Narrative Review (2025) · cites this paper as [47]
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“In a very short but tightly controlled metabolic study with isocaloric diets with different macronutrient distributions, there were no differences in weight loss [47].”
From Dietary and Behavioral Strategies for Weight Loss and Weight Loss Maintenance: A Narrative Review (2025) · cites this paper as [47]
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“REE measurements were available for all 16 participants in a single season of “The Biggest Loser” at the precompetition baseline, 10 participants at week 6 of the competition, 16 participants at week 30 of the competition, and 14 participants 6 years after the end of the competition.”
BackgroundInfluentialNew insights in the mechanisms of weight‐loss maintenance: Summary from a Pennington symposium
Flanagan, E. W., Spann, R. A., Berry, S. E., Berthoud, H., Broyles, S. T., Foster, G. D., Krakoff, J. A., Loos, R. J. F., Lowe, M. R., Ostendorf, D. M., et al. (2023) · Obesity · doi:10.1002/oby.23905 · Cited by 42
“Such studies demonstrate that low-carbohydrate diets have a negligible advantage over low-fat/high-carbohydrate diets for short-term weight loss [67].”
BackgroundSelf-citationHjorth, M. F., Christensen, L. H., Kjølbæk, L., Larsen, L. H., Roager, H. M., Kiilerich, P., Kristiansen, K., & Astrup, A. V. (2019) · European Journal of Clinical Nutrition · doi:10.1038/s41430-019-0466-1 · Cited by 41
The regulation of healthspan and lifespan by dietary amino acids
Babygirija, R., & Lamming, D. W. (2021) · Translational Medicine of Aging · doi:10.1016/j.tma.2021.05.001 · Cited by 43
Hopkins, M., Gibbons, C., Caudwell, P., Blundell, J. E., & Finlayson, G. (2016) · British Journal Of Nutrition · doi:10.1017/s0007114516000775 · Cited by 39
“While this 63 view has been strongly debated (3) , it has long been established that dietary 64 macronutrients exert a hierarchical effect on appetite-related processes such as satiety 65 and short-term food intake (4) .”
Hamdy, O., Tasabehji, M. W., Elseaidy, T., Tomah, S., Ashrafzadeh, S., & Mottalib, A. (2018) · Current Diabetes Reports · doi:10.1007/s11892-018-1103-4 · Cited by 42
Do low-carbohydrate diets increase energy expenditure?
Hall, K. D., Guo, J., & Speakman, J. R. (2019) · International Journal of Obesity · doi:10.1038/s41366-019-0456-3 · Cited by 39
Self-citationSustainable Diets for Athletes
Meyer, N. L., Reguant-Closa, A., & Nemecek, T. (2020) · Current Nutrition Reports · doi:10.1007/s13668-020-00318-0 · Cited by 47
Low‐carbohydrate high‐fat weight reduction diet induces changes in human gut microbiota
Jaagura, M., Viiard, E., Karu-Lavits, K., & Adamberg, K. (2021) · MicrobiologyOpen · doi:10.1002/mbo3.1194 · Cited by 41
“LCHF is also very popular for the treatment of obesity due to its effectiveness when losing weight (Hall et al., 2015; Mansoor et al., 2016).”
BackgroundInduced and controlled dietary ketosis as a regulator of obesity and metabolic syndrome pathologies
Gibas, M. K., & Gibas, K. J. (2017) · Diabetes & Metabolic Syndrome Clinical Research & Reviews · doi:10.1016/j.dsx.2017.03.022 · Cited by 37
Kim, H., & Song, S.-W. (2019) · Nutrients · doi:10.3390/nu11030628 · Cited by 39
Hjorth, M. F., Bray, G. A., Zohar, Y., Urban, L. E., Miketinas, D. C., Williamson, D. A., Ryan, D. H., Rood, J. C., Champagne, C. M., Sacks, F. M., et al. (2019) · Nutrients · doi:10.3390/nu11030586 · Cited by 40
“Some have defended the more conventional low-fat/high-carbohydrate diet [1,2], whereas others point to a restriction in carbohydrates as being more effective [3].”
BackgroundThe role of dietary protein in obesity
Magkos, F. (2020) · Reviews in Endocrine and Metabolic Disorders · doi:10.1007/s11154-020-09576-3 · Cited by 37
“[36], who conducted an inpatient (metabolic ward) cross-over study in 19 participants receiving a 30% calorie restriction from either fat or carbohydrate, each for 6 days, this premise is not necessarily correct.”
BackgroundValsdottir, T. D., Øvrebø, B., Falck, T. M., Litleskare, S., Johansen, E. I., Henriksen, C., & Jensen, J. (2020) · Nutrients · doi:10.3390/nu13010110 · Cited by 35
“Our results are in line with results from a highly controlled weight-loss study, although that study was of much shorter duration [67].”
ResultChoi, A. H., Delgado, M., Chen, K. Y., Chung, S. T., Courville, A. B., Turner, S. A., Yang, S. B., Airaghi, K. J., Dustin, I. M., McGurrin, P. M., et al. (2024) · BMC Neurology · doi:10.1186/s12883-024-03603-5 · Cited by 37
“…gas exchange was performed at screening and week 3 visits in the morning fasting state to derive resting energy expenditure, minute ventilations of oxygen and carbon dioxide in milliliters (V ̇ O 2 , V ̇ CO 2 ) and respiratory quotient (RQ, V ̇ CO 2 /V ̇ O 2 ), as previously described [41].”
MethodSelf-citationSasaki, T. (2017) · Nutrients · doi:10.3390/nu9101151 · Cited by 35
“Fat restriction was reported to reduce adiposity over the long term, but not body weight, compared to carbohydrate restriction [96].”
BackgroundVijayaraj, P., Nakagawa, H., & Yamaki, K. (2019) · Journal of food biochemistry · doi:10.1111/jfbc.12774 · Cited by 34
Gut Microbiota Represent a Major Thermogenic Biomass
Riedl, R. A., Burnett, C. M.-L., Pearson, N. A., Reho, J. J., Mokadem, M., Edwards, R. A., Kindel, T. L., Kirby, J. R., & Grobe, J. L. (2021) · Function · doi:10.1093/function/zqab019 · Cited by 32
Zhang, X., Zhang, J., Du, W., Su, C., Ouyang, Y., Huang, F., Jia, X., Li, L., Bai, J., Zhang, B., et al. (2021) · Nutrients · doi:10.3390/nu14010013 · Cited by 32
“In their studies, the extra energy expenditure associated with an LC diet was much lower than the diet’s proponents claimed, and the effect waned over time [39,40].”
BackgroundRegulation of metabolic health by dietary histidine in mice
Flores, V., Spicer, A. B., Sonsalla, M. M., Richardson, N. E., Yu, D., Sheridan, G. E., Trautman, M. E., Babygirija, R., Cheng, E. P., Rojas, J. M., et al. (2022) · The Journal of Physiology · doi:10.1113/jp283261 · Cited by 29
“Multiple studies have found that calories from carbohydrates, fat, and protein all have unique effects on human metabolism (Hall et al., 2015; Fontana et al., 2016).”
BackgroundZhang, W., Tian, Z., Qi, X., Chen, P., Yang, Q., Guan, Q., Ye, J., & Yu, C. (2023) · Scientific Reports · doi:10.1038/s41598-023-41291-2 · Cited by 34
Diet Change Improves Obesity and Lipid Deposition in High-Fat Diet-Induced Mice
Ji, T., Fang, B., Wu, F., Liu, Y., Cheng, L., Li, Y., Wang, R., & Zhu, L. (2023) · Nutrients · doi:10.3390/nu15234978 · Cited by 38
“A previous study in obese patients revealed that a low-fat diet resulted in weight loss of 8 kg in 6 months [8] and significantly restored obesity-related metabolic dysfunctions, including reduced visceral fat mass [9], improved glucose homeostasis, and hepatic ectopic fat deposition [10–12].”
BackgroundEffects of ketone bodies on energy expenditure, substrate utilization, and energy intake in humans
Fernández‐Verdejo, R., Mey, J. T., & Ravussin, É. (2023) · Journal of Lipid Research · doi:10.1016/j.jlr.2023.100442 · Cited by 31
“Thus, the majority of outpatient studies are deemed to be testing the effectiveness of diet prescriptions and behavioral interventions instead of the physiologic effect of altering dietary intake per se (58).”
BackgroundMethodInfluentialDeviations in energy sensing predict long-term weight change in overweight Native Americans
Basolo, A., Votruba, S. B., Heinitz, S., Krakoff, J. A., & Piaggi, P. (2018) · Metabolism · doi:10.1016/j.metabol.2017.12.013 · Cited by 30
“[32] showed a greater body fat loss after restricting dietary fat as compared to carbohydrate, although total weight loss was higher with the carbohydrate restriction diet.”
BackgroundHjorth, M. F., Astrup, A. V., Zohar, Y., Urban, L. E., Sayer, R. D., Patterson, B. W., Herring, S. J., Klein, S., Zemel, B. S., Foster, G. D., et al. (2018) · International Journal of Obesity · doi:10.1038/s41366-018-0298-4 · Cited by 29
Intermittent fasting for obesity and related disorders: unveiling myths, facts, and presumptions
Halpern, B., & Mendes, T. B. (2021) · Archives of Endocrinology and Metabolism · doi:10.20945/2359-3997000000322 · Cited by 31
“Also, isocaloric studies performed in metabolic chambers demonstrate that the differences in weight loss and energy expenditure among different macronutrients are clinically negligible (26-28).”
BackgroundHoshino, D., Kitaoka, Y., & Hatta, H. (2016) · The Journal of Physical Fitness and Sports Medicine · doi:10.7600/jpfsm.5.13 · Cited by 31
Yang, S., Lin, S., Chang, J., & Chien, Y. (2017) · Nutrients · doi:10.3390/nu9101148 · Cited by 29
“reported that fat restriction led to greater body fat loss than carbohydrate restriction in obese men [38].”
BackgroundDyńka, D., Kowalcze, K., Charuta, A., & Paziewska, A. (2023) · Nutrients · doi:10.3390/nu15204312 · Cited by 28
“The claim that body weight can be reduced to a greater extent with fat restriction, citing a short-term study [14] is a misstatement.”
BackgroundRecommendations for Designing, Conducting, and Reporting Feeding Trials in Nutrition Research
Tien, D. S. Y., Hockey, M., So, D., Stanford, J., Clarke, E. D., Collins, C. E., & Staudacher, H. M. (2024) · Advances in Nutrition · doi:10.1016/j.advnut.2024.100283 · Cited by 39
“…whether access to kitchen facilities or minimum cooking skill requirements Effect of restricted carbohydrate vs. restricted fat on bodyweight [5] Effect of diet high in ultraprocessed foods on energy intake [6] Partial-domiciled Participants consume some or all meals at the research facility…”
BackgroundBreaking Bad and Breaking Good: β-Cell Autophagy Pathways in Diabetes
Vivot, K., Pasquier, A., Goginashvili, A., & Ricci, R. (2019) · Journal of Molecular Biology · doi:10.1016/j.jmb.2019.07.030 · Cited by 29
Lima, L. M. T. R. (2017) · Anais da Academia Brasileira de Ciências · doi:10.1590/0001-3765201720160394 · Cited by 27
Mandøe, M. J., Hansen, K. B., Windeløv, J. A., Knop, F. K., Rehfeld, J. F., ROSENKILDE, M. M., Holst, J. J., & Hansen, H. S. (2018) · Nutrition and Diabetes · doi:10.1038/s41387-017-0011-z · Cited by 26
Dischinger, U., Corteville, C., Otto, C., Faßnacht, M., Seyfried, F., & Hankir, M. K. (2019) · Surgery for Obesity and Related Diseases · doi:10.1016/j.soard.2019.04.008 · Cited by 27
Wang, Y., Guan, Y., Xue, L., Liu, J., Yang, Z., Nie, C., Yan, Y., Liu, S., Sun, J., Fan, M., et al. (2020) · Food & Function · doi:10.1039/d0fo02163f · Cited by 25
Ghrelin Plasma Levels After 1 Year of Ketogenic Diet in Children With Refractory Epilepsy
Marchiò, M., Roli, L., Lucchi, C., Costa, A., Borghi, M., Iughetti, L., Trenti, T., Guerra, A., & Biagini, G. (2019) · Frontiers in Nutrition · doi:10.3389/fnut.2019.00112 · Cited by 25
“However, it has to be mentioned that also low carbohydrate high fat diets used for treatment of obesity have been found to modify ghrelin levels (23, 24).”
BackgroundQualls‐Creekmore, E., Marlatt, K. L., Aarts, E., Bruce‐Keller, A. J., Church, T., Clément, K., Fisher, J. O., Gordon‐Larsen, P., Morrison, C. D., Raybould, H. E., et al. (2020) · Obesity · doi:10.1002/oby.22806 · Cited by 25
“Another well-controlled, isocaloric diet further revealed that a diet low in dietary fat (high-carbohydrate) results in more fat loss (93).”
BackgroundYang, H., Li, C., Che, M., Li, Y., Feng, R., & Sun, C. (2023) · The Journal of Nutritional Biochemistry · doi:10.1016/j.jnutbio.2023.109318 · Cited by 23
Metadata
- Authors
- Hall, K. D., Bemis, T., Brychta, R., Chen, K. Y., Courville, A., Crayner, E. J., Goodwin, S., Guo, J., Howard, L., Knuth, N. D., Miller, B. V., Prado, C. M., Siervo, M., Skarulis, M. C., Walter, M., Walter, P. J., & Yannai, L.
- Affiliations
- National Institutes of Health (US)
- Towson University (US)
- University of Alberta (CA)
- Newcastle University (GB)
- Corresponding author
- Hall, Kevin D.
- ORCID
- Venue
- Cell Metabolism
- Publisher
- Elsevier BV
- Published
- 2015-09
- Volume
- 22
- Issue
- 3
- Pages
- 427-436
- ISSN
- 1550-4131 (ISSN-L)
- PMC
- PMC4603544
- OpenAlex
- W1934358478
- Cited by
- 280
- References
- 41
- Citations by year
- 2026: 20 · 2025: 14 · 2024: 17 · 2023: 29 · 2022: 24 · 2021: 37 · 2020: 25 · 2019: 45 · 2018: 21 · 2017: 23 · 2016: 20 · 2015: 4
- FWCI
- 16.69
- Type
- journal article
- Language
- en
- Update notices
- erratum (2015-09-01)
- Open access
- bronze
- doi.org
- Licence
- Locations
- Cell Metabolism (publishedVersion)
- PubMed (publishedVersion)
- Repository@Nottingham (University of Nottingham) (publishedVersion, other-oa)
- PubMed Central (acceptedVersion)
- Repository@Nottingham (University of Nottingham) (submittedVersion, cc-by)
- Newcastle University ePrints (Newcastle Univesity)
- Funders
- National Institutes of Health
- National Institute of Diabetes and Digestive and Kidney Diseases (ZIADK013036, ZIADK013037)
- Topics
- Health Sciences › Medicine › Physiology (medical) › Diet and metabolism studies
- Health Sciences › Medicine › Physiology (medical) › Dietary Effects on Health
- Health Sciences › Nursing › Nutrition and Dietetics › Muscle metabolism and nutrition
- Keywords
- obesity, dietary fat restriction, carbohydrate restriction, fat loss, fat oxidation, isocaloric diet, endocrine adaptation, energy balance
- MeSH terms
- Adipose Tissue, Adult, Energy Intake, Diet, Reducing, Dietary Carbohydrates, Dietary Fats, Female, Humans, Male, Models, Biological, Obesity, Oxidation-Reduction, Diet, Fat-Restricted, Diet, Carbohydrate-Restricted
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