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Cited by 140Diet and metabolism studiesObesity, Physical Activity, DietRegulation of Appetite and Obesity

The role of dietary fat in the prevention and treatment of obesity. Efficacy and safety of low-fat diets

Astrup, A·2001·International Journal of Obesity
DOI 10.1038/sj.ijo.0801698
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Abstract

Background Does dietary fat play a central role in weight gain and development of obesity? Do low-fat diets have adverse effects on blood lipids?Objective and design To answer these questions we have reviewed the evidence linking the dietary fat content to energy balance and obesity, and examined the efficacy and safety of ad libitum low fat, high carbohydrate/protein diets in the prevention and management of obesity.Results Physiological studies have provided insight into the mechanisms by which the macronutrients differ in their effect on energy balance: (1) energy from fat is less satiating than energy from carbohydrate, and a high fat/carbohydrate ratio in the diet promotes passive overconsumption, a positive energy balance and weight gain in susceptible individuals; (2) fat is more readily absorbed from the intestine and fecal energy loss is much lower with a high dietary fat/carbohydrate ratio; (3) carbohydrate is more thermogenic than fat and energy expenditure is lower during positive energy balance produced by a diet with a high fat/carbohydrate ratio than during positive energy balance produced by a diet with a low fat/carbohydrate ratio. Randomized intervention studies comparing low fat diets to normal fat diets show that low fat diets prevent weight gain in normal weight subjects and produce weight loss in overweight individuals. In our meta-analysis of ad libitum low fat interventions we included 16 trials involving 1728 individuals. The difference in weight loss between intervention and control groups was 2.5 kg (95% CI, 1.5-3.5; P<0.0001). Weight loss was positively related to pre-treatment body weight (r=0.52, P<0.05) and to reduction in percentage energy as fat (0.37 kg/%, P<0.005). Extrapolated to a body mass index (BMI) approximately 30 kg/m(2), and assuming a 10% reduction in dietary fat, the predicted weight loss would be 4.4 kg (95% CI, 2.0-6.8 kg), which has been confirmed in subsequent studies. Newer studies have shown that replacing some carbohydrate with protein may enhance weight loss.Conclusion The American Paradox, the observation that obesity prevalence is increasing despite a slight decrease in population dietary fat consumption, is easily explained by the concomitantly decreasing physical activity, which reduces fat requirements and counteracts the beneficial effect of a slight reduction in dietary fat. Low fat diets with a high content of complex carbohydrates and protein do not produce any adverse effect on cardiovascular risk factors when weight loss is allowed to occur, and they have been shown to decrease mortality among high risk subjects.

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Authors
Astrup, A.
Corresponding author
Astrup, A
ORCID
Astrup, A
Venue
International Journal of Obesity
Publisher
Springer Science and Business Media LLC
Published
2001-05
Volume
25
Issue
S1
Pages
S46-S50
ISSN
  • 0307-0565 (ISSN-L)
  • 1476-5497
DOI
10.1038/sj.ijo.0801698
OpenAlex
W2128651956
Cited by
140
References
19
Citations by year
2026: 1 · 2025: 1 · 2024: 1 · 2023: 4 · 2022: 3 · 2021: 6 · 2020: 4 · 2019: 2 · 2018: 1 · 2017: 1 · 2016: 3 · 2015: 6 · 2014: 7 · 2013: 7 · 2012: 7
FWCI
5.98
Type
journal article
Language
en
Open access
closed
Licence
www.springer.com/tdm (tdm)
Locations
  • International Journal of Obesity (publishedVersion)
  • PubMed (publishedVersion)
  • Research at the University of Copenhagen (University of Copenhagen) (submittedVersion)
Funders
Sundhed og Sygdom, Det Frie Forskningsråd
Topics
  • Health Sciences › Medicine › Physiology › Diet and metabolism studies
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
  • Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Regulation of Appetite and Obesity
Keywords
dietary fat, obesity prevention, obesity treatment, low-fat diet, energy balance, satiety, energy expenditure, weight loss, ad libitum feeding, serum lipids, physical inactivity, overweight individuals, complex carbohydrates
MeSH terms
Dietary Fats, Dietary Proteins, Humans, Lipids, Obesity, Safety, Exercise, Treatment Outcome, Diet, Fat-Restricted

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