Cited by 1,968Diet and metabolism studiesDietary Effects on HealthNutritional Studies and Diet

The DOI matches its Crossref record; 45 of the 45 references it cites were found in a registry or an index; 23 of the 62 sources its claims cite were checked for support.

Comparison of Weight-Loss Diets with Different Compositions of Fat, Protein, and Carbohydrates

Open access

Abstract

BACKGROUND: The possible advantage for weight loss of a diet that emphasizes protein, fat, or carbohydrates has not been established, and there are few studies that extend beyond 1 year. METHODS: We randomly assigned 811 overweight adults to one of four diets; the targeted percentages of energy derived from fat, protein, and carbohydrates in the four diets were 20, 15, and 65%; 20, 25, and 55%; 40, 15, and 45%; and 40, 25, and 35%. The diets consisted of similar foods and met guidelines for cardiovascular health. The participants were offered group and individual instructional sessions for 2 years. The primary outcome was the change in body weight after 2 years in two-by-two factorial comparisons of low fat versus high fat and average protein versus high protein and in the comparison of highest and lowest carbohydrate content. RESULTS: At 6 months, participants assigned to each diet had lost an average of 6 kg, which represented 7% of their initial weight; they began to regain weight after 12 months. By 2 years, weight loss remained similar in those who were assigned to a diet with 15% protein and those assigned to a diet with 25% protein (3.0 and 3.6 kg, respectively); in those assigned to a diet with 20% fat and those assigned to a diet with 40% fat (3.3 kg for both groups); and in those assigned to a diet with 65% carbohydrates and those assigned to a diet with 35% carbohydrates (2.9 and 3.4 kg, respectively) (P>0.20 for all comparisons). Among the 80% of participants who completed the trial, the average weight loss was 4 kg; 14 to 15% of the participants had a reduction of at least 10% of their initial body weight. Satiety, hunger, satisfaction with the diet, and attendance at group sessions were similar for all diets; attendance was strongly associated with weight loss (0.2 kg per session attended). The diets improved lipid-related risk factors and fasting insulin levels. CONCLUSIONS: Reduced-calorie diets result in clinically meaningful weight loss regardless of which macronutrients they emphasize. (ClinicalTrials.gov number, NCT00072995.)

Overview

Integrity signals

Registry

Crossref · 10.1056/nejmoa0804748

Cites

45 of 45 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Verification

Claims the paper makes

23 of 62 cited sources checked · 11 supported · 1 flagged · accuracy not yet measured

Show all 31 claims

  • It may state two separate claims as one. 28
  • Probably not a substantial claim. 7
31 of 31
  • The paper relies on this without support.

    Nonnutritional factors such as cultural norms, scientific novelty, and media attention can influence the success of a specific diet.

    “Conformity to cultural norms, scientific novelty, and media attention are nonbiologic reasons for the success of specific diets.”
  • The paper relies on this without support.

    The novelty of a diet, media attention, and researcher enthusiasm can affect how well participants adhere to any diet.

    “The novelty of the diet, media attention, and the enthusiasm of the researchers could affect the adherence of participants to any type of diet.”
2 of 2

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Metadata

Authors
Sacks, F. M., Bray, G. A., Carey, V. J., Smith, S. R., Ryan, D. H., Anton, S. D., McManus, K., Champagne, C. M., Bishop, L. M., Laranjo, N., Leboff, M. S., Rood, J. C., de Jonge, L., Greenway, F. L., Loria, C. M., Obarzanek, E., & Williamson, D. A.
Affiliations
  • Pennington Biomedical Research Center (US)
  • From the Department of Nutrition, Harvard School of Public Health (F.M.S., L.M.B.); the Channing Laboratory (F.M.S., V.J.C., N.L.) and the Endocrine Division (M.S.L.), Department of Medicine, Brigham and Women's Hospital and Harvard Medical School; and the Department of Nutrition, Brigham and Women's Hospital (K.M.) — all in Boston; Pennington Biomedical Research Center of the Louisiana State University System, Baton Rouge (G.A.B., S.R.S., D.H.R., S.D.A., C.M.C., J.C.R., L.J., F.L.G., D.A.W.); and the...
Venue
New England Journal of Medicine
Published
2009-02-26
Volume
360
Issue
9
Pages
859-873
ISSN
  • 0028-4793 (ISSN-L)
  • 1533-4406
OpenAlex
W2144376568
Cited by
1,966
References
45
Citations by year
2026: 37 · 2025: 69 · 2024: 78 · 2023: 96 · 2022: 79 · 2021: 96 · 2020: 160 · 2019: 87 · 2018: 104 · 2017: 103 · 2016: 120 · 2015: 123 · 2014: 130 · 2013: 156 · 2012: 159
FWCI
116.20
Type
journal article
Language
en
Open access
Locations
  • New England Journal of Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
  • Digital Access to Scholarship at Harvard (DASH) (Harvard University) (submittedVersion, cc-by)
Funders
  • National Institute on Aging (P30AG028740)
  • National Heart, Lung, and Blood Institute (HL073286, U01HL073286)
  • National Institute of Diabetes and Digestive and Kidney Diseases (P30DK072476, P30DK040561)
  • National Center for Research Resources (RR02635, M01RR002635)
Topics
  • Health Sciences › Medicine › Physiology (medical) › Diet and metabolism studies
  • Health Sciences › Medicine › Physiology (medical) › Dietary Effects on Health
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
Keywords
weight loss diet, macronutrient composition, high-protein diet, low-fat diet, carbohydrate restriction, overweight adults, long-term weight loss, weight regain, dietary adherence, group instruction, lipid risk factors, fasting insulin
MeSH terms
Blood Pressure, Body Weight, Energy Intake, Cardiovascular Diseases, Cholesterol, Counseling, Diabetes Mellitus, Diet, Reducing, Dietary Fats, Female, Humans, Male, Middle Aged, Obesity, Patient Compliance, Risk Factors, Satiation, Weight Loss, Diet, Fat-Restricted, Diet, Carbohydrate-Restricted, Waist Circumference

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