BACKGROUND: Weight regain often occurs after weight loss in overweight individuals. We aimed to compare the effectiveness of 2 support programs and 2 diets of different macronutrient compositions intended to facilitate long-term weight maintenance. METHODS: Using a 2 x 2 factorial design, we randomly assigned 200 women who had lost 5% or more of their initial body weight to an intensive support program (implemented by nutrition and activity specialists) or to aninexpensive nurse-led program (involving "weigh-ins" and encouragement) that included advice about high-carbohydrate diets or relatively high-monounsaturated-fat diets. RESULTS: In total, 174 (87%) participants were followed-up for 2 years. The average weight loss (about 2 kg) did not differ between those in the support programs (0.1 kg, 95% confidence interval [CI] -1.8 to 1.9, p = 0.95) or diets (0.7 kg, 95% CI -1.1 to 2.4, p = 0.46). Total and low-density lipoprotein (LDL) cholesterol levels were significantly higher among those on the high-monounsaturated-fat diet (total cholesterol: 0.17 mmol/L, 95% CI 0.01 to 0.33; p = 0.040; LDL cholesterol: 0.16 mmol/L, 95% CI 0.01 to 0.31; p = 0.039) than among those on the high-carbohydrate diet. Those on the high-monounsaturated-fat diet also had significantly higher intakes of total fat (5% total energy, 95% CI 3% to 6%, p < 0.001) and saturated fat (2% total energy, 95% CI 1% to 2%, p < 0.001). All of the other clinical and laboratory measures were similar among those in the support programs and diets. INTERPRETATION: A relatively inexpensive program involving nurse support is as effective as a more resource-intensive program for weight maintenance over a 2-year period. Diets of different macronutrient composition produced comparable beneficial effects in terms of weight loss maintenance.
RCT Entities:
BACKGROUND: Weight regain often occurs after weight loss in overweight individuals. We aimed to compare the effectiveness of 2 support programs and 2 diets of different macronutrient compositions intended to facilitate long-term weight maintenance. METHODS: Using a 2 x 2 factorial design, we randomly assigned 200 women who had lost 5% or more of their initial body weight to an intensive support program (implemented by nutrition and activity specialists) or to an inexpensive nurse-led program (involving "weigh-ins" and encouragement) that included advice about high-carbohydrate diets or relatively high-monounsaturated-fat diets. RESULTS: In total, 174 (87%) participants were followed-up for 2 years. The average weight loss (about 2 kg) did not differ between those in the support programs (0.1 kg, 95% confidence interval [CI] -1.8 to 1.9, p = 0.95) or diets (0.7 kg, 95% CI -1.1 to 2.4, p = 0.46). Total and low-density lipoprotein (LDL) cholesterol levels were significantly higher among those on the high-monounsaturated-fat diet (total cholesterol: 0.17 mmol/L, 95% CI 0.01 to 0.33; p = 0.040; LDL cholesterol: 0.16 mmol/L, 95% CI 0.01 to 0.31; p = 0.039) than among those on the high-carbohydrate diet. Those on the high-monounsaturated-fat diet also had significantly higher intakes of total fat (5% total energy, 95% CI 3% to 6%, p < 0.001) and saturated fat (2% total energy, 95% CI 1% to 2%, p < 0.001). All of the other clinical and laboratory measures were similar among those in the support programs and diets. INTERPRETATION: A relatively inexpensive program involving nurse support is as effective as a more resource-intensive program for weight maintenance over a 2-year period. Diets of different macronutrient composition produced comparable beneficial effects in terms of weight loss maintenance.
Authors: J I Mann; I De Leeuw; K Hermansen; B Karamanos; B Karlström; N Katsilambros; G Riccardi; A A Rivellese; S Rizkalla; G Slama; M Toeller; M Uusitupa; B Vessby Journal: Nutr Metab Cardiovasc Dis Date: 2004-12 Impact factor: 4.222
Authors: Kelly S Dale; Jim I Mann; Kirsten A McAuley; Sheila M Williams; Victoria L Farmer Journal: Asia Pac J Clin Nutr Date: 2009 Impact factor: 1.662
Authors: A Zambon; G Sartore; D Passera; F Francini-Pesenti; A Bassi; C Basso; S Zambon; E Manzato; G Crepaldi Journal: J Intern Med Date: 1999-08 Impact factor: 8.989
Authors: Susan L Norris; Xuanping Zhang; Alison Avenell; Edward Gregg; Barbara Bowman; Christopher H Schmid; Joseph Lau Journal: Am J Prev Med Date: 2005-01 Impact factor: 5.043
Authors: Rachael W Taylor; Deirdre Brown; Anna M Dawson; Jill Haszard; Adell Cox; Elaine A Rose; Barry J Taylor; Kim Meredith-Jones; Lee Treacy; Jim Ross; Sheila M William Journal: BMC Public Health Date: 2010-05-24 Impact factor: 3.295
Authors: Elizabeth H Evans; Vera Araújo-Soares; Ashley Adamson; Alan M Batterham; Heather Brown; Miglena Campbell; Stephan U Dombrowski; Alison Guest; Daniel Jackson; Dominika Kwasnicka; Karim Ladha; Elaine McColl; Patrick Olivier; Alexander J Rothman; Kirby Sainsbury; Alison J Steel; Ian Nicholas Steen; Luke Vale; Martin White; Peter Wright; Falko F Sniehotta Journal: Trials Date: 2015-09-22 Impact factor: 2.279
Authors: Rachael W Taylor; Melyssa Roy; Michelle R Jospe; Hamish R Osborne; Kim J Meredith-Jones; Sheila M Williams; Rachel C Brown Journal: BMC Public Health Date: 2015-09-04 Impact factor: 3.295