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Cited by 192Diet and metabolism studiesNutritional Studies and DietMuscle metabolism and nutrition

Effects of 4 weight-loss diets differing in fat, protein, and carbohydrate on fat mass, lean mass, visceral adipose tissue, and hepatic fat: results from the POUNDS LOST trial

Open access
de Souza, Russell J, Bray, George A, Carey, Vincent J, Hall, Kevin D, LeBoff, Meryl S, Loria, Catherine M, Laranjo, Nancy M, Sacks, Frank M +1 more·2012·The American Journal of Clinical Nutrition
DOI 10.3945/ajcn.111.026328PMC PMC3278241
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Abstract

Background Weight loss reduces body fat and lean mass, but whether these changes are influenced by macronutrient composition of the diet is unclear.Objective We determined whether energy-reduced diets that emphasize fat, protein, or carbohydrate differentially reduce total, visceral, or hepatic fat or preserve lean mass.Design In a subset of participants in a randomized trial of 4 weight-loss diets, body fat and lean mass (n = 424; by using dual-energy X-ray absorptiometry) and abdominal and hepatic fat (n = 165; by using computed tomography) were measured after 6 mo and 2 y. Changes from baseline were compared between assigned amounts of protein (25% compared with 15%) and fat (40% compared with 20%) and across 4 carbohydrate amounts (35% through 65%).Results At 6 mo, participants lost a mean (±SEM) of 4.2 ± 0.3 kg (12.4%) fat and 2.1 ± 0.3 kg (3.5%) lean mass (both P < 0.0001 compared with baseline values), with no differences between 25% and 15% protein (P ≥ 0.10), 40% and 20% fat (P ≥ 0.34), or 65% and 35% carbohydrate (P ≥ 0.27). Participants lost 2.3 ± 0.2 kg (13.8%) abdominal fat: 1.5 ± 0.2 kg (13.6%) subcutaneous fat and 0.9 ± 0.1 kg (16.1%) visceral fat (all P < 0.0001 compared with baseline values), with no differences between the diets (P ≥ 0.29). Women lost more visceral fat than did men relative to total-body fat loss. Participants regained ~40% of these losses by 2 y, with no differences between diets (P ≥ 0.23). Weight loss reduced hepatic fat, but there were no differences between groups (P ≥ 0.28). Dietary goals were not fully met; self-reported contrasts were closer to 2% protein, 8% fat, and 14% carbohydrate at 6 mo and 1%, 7%, and 10%, respectively, at 2 y.Conclusion Participants lost more fat than lean mass after consumption of all diets, with no differences in changes in body composition, abdominal fat, or hepatic fat between assigned macronutrient amounts. This trial was registered at clinicaltrials.gov as NCT00072995.

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Authors
de Souza, R. J., Bray, G. A., Carey, V. J., Hall, K. D., LeBoff, M. S., Loria, C. M., Laranjo, N. M., Sacks, F. M., & Smith, S. R.
ORCID
Venue
The American Journal of Clinical Nutrition
Publisher
Elsevier BV
Published
2012-03
Volume
95
Issue
3
Pages
614-625
ISSN
0002-9165 (ISSN-L)
DOI
10.3945/ajcn.111.026328
PMC
PMC3278241
OpenAlex
W2102602599
Cited by
192
References
60
Citations by year
2026: 7 · 2025: 5 · 2024: 8 · 2023: 12 · 2022: 12 · 2021: 11 · 2020: 12 · 2019: 14 · 2018: 12 · 2017: 20 · 2016: 18 · 2015: 17 · 2014: 15 · 2013: 17 · 2012: 11
FWCI
12.86
Type
journal article
Language
en
Open access
Licence
Locations
  • American Journal of Clinical Nutrition (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Heart, Lung, and Blood Institute (HL073286, U01HL073286)
  • National Institute of Diabetes and Digestive and Kidney Diseases (P30DK072476)
  • National Center for Research Resources (RR02635, M01RR002635)
Topics
  • Health Sciences › Medicine › Physiology › Diet and metabolism studies
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Cell Biology › Muscle metabolism and nutrition
Keywords
weight loss, macronutrient composition, high-protein diet, high-fat diet, high-carbohydrate diet, visceral adipose tissue, liver fat, fat mass, lean body mass, abdominal fat, weight regain, POUNDS Lost trial, hypocaloric diet, dietary adherence, obesity treatment
MeSH terms
Adult, Aged, Body Composition, Energy Intake, Diet, Reducing, Dietary Carbohydrates, Dietary Fats, Dietary Proteins, Female, Follow-Up Studies, Humans, Interviews as Topic, Male, Middle Aged, Patient Compliance, Surveys and Questionnaires, Weight Loss, Absorptiometry, Photon, Subcutaneous Fat, Intra-Abdominal Fat, Abdominal Fat

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