ABSTRACT
Current scientific evidence indicates that dietary fat plays a role in weight loss
and maintenance. Meta-analyses of intervention trials find that fat-reduced diets
cause a 3-4-kg larger weight loss than normal-fat diets. A 10% reduction in dietary
fat can cause a 4-5-kg weight loss in individuals with initial body mass index of
30 kg m-2. Short-term trials show that nonfat dietary components are equally important. Sugar-sweetened
beverages promote weight gain, and replacement of energy from fat by sugar-sweetened
beverages is counterproductive in diets aimed at weight loss. Protein has been shown
to be more satiating than carbohydrate, and fat-reduced diets with a high protein
content (20-25% of energy) may increase weight loss significantly. There is little
evidence that low-glycemic index foods facilitate weight control. Evidence linking
certain fatty acids to body fatness is weak. Monounsaturated fatty acids may even
be more fattening than polyunsaturated and saturated fats. No ad libitum dietary intervention
study has shown that a normal-fat, high-monounsaturated fatty acid diet is comparable
to a low-fat diet in preventing weight gain. Current evidence indicates that the best
diet for prevention of weight gain, obesity, type 2 diabetes, and cardiovascular disease
is low in fat and sugar-rich beverages and high in carbohydrates, fiber, grains, and
protein.
KEYWORDS
Fat-reduced diets - food pyramid - glycemic index - low-fat diets - weight loss
REFERENCES
- 1 National Institutes of Health .The Practical Guide: Identification, Evaluation,
and Treatment of Overweight and Obesity in Adults. Publication 00-4084 Bethesda, MD;
National Institutes of Health 2000
- 2
Eurodiet core report. Nutrition and diet for healthy lifestyles in Europe: science
and policy implications.
Public Health Nutr.
2001;
4
265
- 3
Willett W C.
Is dietary fat a major determinant of body fat?.
Am J Clin Nutr.
1998;
67 (3 suppl)
556S-562S
- 4 Willett W C. Eat, Drink and be Healthy. A Harvard Medical School Book New York;
Simon and Schuster 2001
- 5
Eccles M, Freemantle N, Mason J.
North of England evidence based guidelines development project: methods of developing
for efficient drug use in primary care.
BMJ.
1998;
316
1232-1235
- 6
Rolls B J, Hammer V A.
Fat, carbohydrate, and the regulation of energy intake.
Am J Clin Nutr.
1995;
62(5 suppl)
1086S-1095S
- 7
Bray G A, Popkin B M.
Dietary fat intake does affect obesity.
Am J Clin Nutr.
1998;
68
1157-1173
- 8
Astrup A, Ryan L, Grunwald G K et al..
The role of dietary fat in body fatness: evidence from a preliminary meta-analysis
of ad libitum low fat dietary intervention studies.
Br J Nutr.
2000;
83(Suppl 1)
S25-S32
- 9
Yu-Poth S, Zhao G, Etherton T et al..
Effects of the National Cholesterol Education Programs step I and step II dietary
intervention programs on cardiovascular disease risk factors: a meta-analysis.
Am J Clin Nutr.
1999;
69
632-646
- 10
Astrup A, Grunwald G K, Melanson E L, Saris W H, Hill J O.
The role of low-fat diets in body weight control: a meta-analysis of ad libitum intervention
studies.
Int J Obes Relat Metab Disord.
2000;
24
1545-1552
- 11
Pirozzo S, Summerbell C, Cameron C, Galsziou P.
Should we recommend low-fat diets for obesity?.
Obes Rev.
2003;
4
83-90
- 12
Hill J O, Astrup A.
What diets should we be recommending for obesity?.
Obes Rev.
2003;
4
77-78
- 13
Singh R B, Rastogi S S, Verma R et al..
Randomised controlled trial of cardioprotective diet in patients with recent acute
myocardial infarction: result of one-year follow up.
BMJ.
1992;
304
1015-1019
- 14
Singh R B, Dubnov G, Niaz M A et al..
Effect of an Indo-Mediterranean diet on progression of coronary artery disease in
high risk patients (Indo-Mediterranean Diet Heart Study): a randomised single-blind
trial.
Lancet.
2002;
360
1455-1461
- 15
Tuomilehto J, Lindström J, Eriksson J G et al..
Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with
impaired glucose tolerance.
N Engl J Med.
2001;
344
1343-1350
- 16
Knowler W C, Barrett-Connor E, Fowler S E et al..
Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin.
N Engl J Med.
2002;
346
393-403
- 17 Sjöström L, Togerson J S, Hauptman J, Boldrin M. XENDOS-a landmark study: xenical
in the prevention of diabetes in obese subjects, in Abstracts from the Satellite Symposium
New Frontiers in Weight Management, 9th International Congress on Obesity, São Paulo,
Brazil 2002
- 18
Ornish D, Brown S E, Scherwitz L W et al..
Can lifestyle changes reverse coronary heart disease?.
Lancet.
1990;
336
129-133
- 19
Swinburn B A, Metcalf P A, Ley S J.
Long-term (5-year) effects of a reduced-fat diet intervention in individuals with
glucose intolerance.
Diabetes Care.
2001;
24
619-624
- 20
Pi-Sunyer F X.
Glycemic index and disease.
Am J Clin Nutr.
2002;
76
290S-298S
- 21
Raben A, Vasilaras T H, Møller A C, Astrup A.
Sucrose compared with artificial sweeteners: different effects on ad libitum food
intake and body weight after 10 wk of supplementation in overweight subjects.
Am J Clin Nutr.
2002;
76
721-729
- 22
Pawlak D B, Ebbeling C B, Ludwig D S.
Should obese patients be counselled to follow a low-glycaemic index diet? Yes.
Obes Rev.
2002;
3
235-243
- 23
Møller B K, Flint A, Pedersen D et al..
Prediction of glycemic index in mixed meals. Oral presentation. Proceedings of the
12th European Congress on Obesity, Helsinki, 29 May-1 June, 2003.
Int J Obes.
2003;
27(suppl 1)
S38
- 24
Saris W H, Astrup A, Prentice A M et al..
Randomized controlled trial of changes in dietary carbohydrate/fat ratio and simple
vs. complex carbohydrates on body weight and blood lipids: the CARMEN study.
Int J Obes Relat Metab Disord.
2000;
24
1310-1318
- 25
Miles C.
The metabolizable energy of diets differing in dietary fat and fiber measured in humans.
J Nutr.
1992;
122
306-311
- 26
Baer D J, Rumpler W V, Miles C W, Fahey Jr G C.
Dietary fiber decreases the metabolizable energy content and nutrient digestibility
of mixed diets fed to humans.
J Nutr.
1997;
127
579-586
- 27
Tordoff M G, Alleva M.
Effect of drinking soda sweetened with aspartame or high-fructose corn syrup on food
intake and body weight.
Am J Clin Nutr.
1990;
51
963-969
- 28
Porikos K P, Hesser M F, van Itallie T B.
Caloric regulation in normal-weight men maintained on a palatable diet of conventional
foods.
Physiol Behav.
1982;
29
293-300
- 29
Di Meglio D P, Mattes R D.
Liquid versus solid carbohydrate: effects on food intake and body weight.
Int J Obes Relat Metab Disord.
2000;
24
794-800
- 30
Ludwig D S, Peterson K E, Gortmaker S L.
Relation between consumption of sugar-sweetened drinks and childhood obesity: a prospective,
observational analysis.
Lancet.
2001;
357
505-508
- 31
Hoppe C, Mølgaard C, Juul A, Michaelsen K F.
Protein intake in infancy is related to body size but not to adiposity in 10-y old
children.
Int J Obes Relat Metab Disord.
2001;
25(suppl 2)
S64
- 32
Skov A R, Toubro S, Rønn B et al..
Randomized trial on protein versus carbohydrate in ad libitum fat reduced diet for
the treatment of obesity.
Int J Obes Relat Metab Disord.
1999;
23
528-536
- 33
Haulrik N, Toubro S, Dyerberg J et al..
Effect of protein and methionine intakes on plasma homocysteine concentrations: a
6-mo randomized controlled trial in overweight subjects.
Am J Clin Nutr.
2002;
76
1202-1206
- 34
Skov A R, Toubro S, Bülow J et al..
Changes in renal function during weight loss induced by high vs. low protein low-fat
diets in overweight subjects.
Int J Obes.
1999;
23
1170-1177
- 35
Skov A R, Haulrik N, Toubro S et al..
Effect of protein intake on bone mineralisation during weight loss: a 6-month trial.
Obes Res.
2002;
10
432-438
- 36
Shimomura Y, Tamura T, Suzuki M.
Less body fat accumulation in rats fed a safflower oil diet than in rats fed a beef
tallow diet.
J Nutr.
1990;
120
1291-1296
- 37
Dulloo A G, Mensi N, Seydoux J, Girardier L.
Differential effects of high-fat diets varying in fatty acid composition on the efficiency
of lean and fat tissue deposition during weight recovery after low food intake.
Metabolism.
1995;
44
273-279
- 38
Matsuo T, Shimomura Y, Saitoh S et al..
Sympathetic activity is lower in rats fed a beef tallow diet than rats fed a safflower
oil diet.
Metabolism.
1995;
44
934-939
- 39
Hill J O, Peters J C, Lin D et al..
Lipid accumulation and body fat distribution is influenced by type of dietary fat
fed to rats.
Int J Obes Relat Metab Disord.
1993;
17
223-236
- 40
Doucet N A, White M D, DespreŽs J-P et al..
Dietary fat composition and human adiposity.
Eur J Clin Nutr.
1998;
52
2-6
- 41
Colditz G A, Willett W C, Stampfer M J et al..
Patterns of weight change and their relation to diet in a cohort of healthy women.
Am J Clin Nutr.
1990;
51
100-105
- 42
van Dam R M, Stampfer M, Willett W C et al..
Dietary fat and meat intake in relation to risk of type 2 diabetes in men.
Diabetes Care.
2002;
25
417-424
- 43
Lawton C L, Delargy H J, Brockman J et al..
The degree of saturation of fatty acids influences post-ingestive satiety.
Br J Nutr.
2000;
83
473-482
- 44
Flint A, Jørgensen B H, Raben A et al..
No differences in appetite and energy expenditure after intake of polyunsaturated,
monounsaturated or trans-fatty acids.
Obes Res.
2003;
, In press
- 45
Wolever T MS, Jenkins D JA, Vuksan V et al..
Beneficial effect of low-glycemic index diet in overweight NIDDM subjects.
Diabetes Care.
1992;
15
562-564
- 46
Wolever T MS, Mehling C.
High-carbohydrate//low glycaemic index dietary advice improves glucose disposition
index in subjects with impaired glucose tolerance.
Br J Nutr.
2002;
87
477-487
- 47
Astrup A.
Dietary fat and obesity: still an important issue.
Scan J Nutr.
2003;
47
50-57
- 48
Wolever T MS, Mehling C.
Long-term effect of varying the source of dietary carbohydrate on postprandial plasma
glucose, insulin, triacylglycerol, and free fatty acid concentrations in subjects
with impaired glucose tolerance.
Am J Clin Nutr.
2003;
77
612-621
Arne AstrupM.D.
Department of Human Nutrition, Centre for Advanced Food Studies
The Royal Veterinary and Agricultural University
Rolighedsvej 30, DK-1958 Frederiksberg C, Denmark
