Low-Fat Dietary Pattern and Weight Change Over 7 Years: The Women's Health Initiative Dietary Modification Trial
ABSTRACT Obesity in the United States has increased dramatically during the past several decades. There is debate about optimum calorie balance for prevention of weight gain, and proponents of some low-carbohydrate diet regimens have suggested that the increasing obesity may be attributed, in part, to low-fat, high-carbohydrate diets.
To report data on body weight in a long-term, low-fat diet trial for which the primary end points were breast and colorectal cancer and to examine the relationships between weight changes and changes in dietary components.
Randomized intervention trial of 48,835 postmenopausal women in the United States who were of diverse backgrounds and ethnicities and participated in the Women's Health Initiative Dietary Modification Trial; 40% (19,541) were randomized to the intervention and 60% (29,294) to a control group. Study enrollment was between 1993 and 1998, and this analysis includes a mean follow-up of 7.5 years (through August 31, 2004).
The intervention included group and individual sessions to promote a decrease in fat intake and increases in vegetable, fruit, and grain consumption and did not include weight loss or caloric restriction goals. The control group received diet-related education materials.
Change in body weight from baseline to follow-up.
Women in the intervention group lost weight in the first year (mean of 2.2 kg, P<.001) and maintained lower weight than control women during an average 7.5 years of follow-up (difference, 1.9 kg, P<.001 at 1 year and 0.4 kg, P = .01 at 7.5 years). No tendency toward weight gain was observed in intervention group women overall or when stratified by age, ethnicity, or body mass index. Weight loss was greatest among women in either group who decreased their percentage of energy from fat. A similar but lesser trend was observed with increases in vegetable and fruit servings, and a nonsignificant trend toward weight loss occurred with increasing intake of fiber.
A low-fat eating pattern does not result in weight gain in postmenopausal women. Clinical Trial Registration ClinicalTrials.gov, NCT00000611.
- SourceAvailable from: Suzanne C Ho[Show abstract] [Hide abstract]
ABSTRACT: To examine dietary factors predisposing to overweight and obesity, taking into account age, gender, education level and physical activity.Design:Longitudinal population study. Community living subjects in Hong Kong. One thousand and ten Chinese subjects participating in a territory wide dietary and cardiovascular risk factor prevalence survey in 1995-1996 were followed up for 5-9 years. Body mass index (BMI) was measured. Information was collected on factors predisposing to development of overweight and obesity (age, gender, education level, physical activity, macronutrient intake, Mediterranean diet score and food variety), and the predisposing dietary factors examined, adjusted for other confounding factors, using logistic regression. The 5-9-year incidence of overweight is 22.6% (BMI > or =23 kg/m2, 95% confidence interval (CI)=15.0-30.1%) or 11.5% (BMI > or =25 kg/m2, 95% CI=7.3-15.7%), and for obesity (BMI >/=30 kg/m2) is 0.6% (95% CI=-0.2-1.4%). The corresponding figures for women were 14.1% (95% CI=8.8-19.5%), 9.7% (95% CI=6.0-13.4%) and 3% (95% CI=1.3-4.8%). After adjusting for confounding factors (age, sex, education and physical activity), increased variety of snack consumption was associated with increased risk of developing overweight (BMI > or =23 kg/m2) in the Hong Kong Chinese population over a 5-9-year period. Increased variety of snack consumption may predispose to weight gain over a 5-9-year period.European Journal of Clinical Nutrition 04/2008; 62(4):480-7. DOI:10.1038/sj.ejcn.1602702 · 2.95 Impact Factor
Article: Carbohydrate intake and obesity.[Show abstract] [Hide abstract]
ABSTRACT: The prevalence of obesity has increased rapidly worldwide and the importance of considering the role of diet in the prevention and treatment of obesity is widely acknowledged. This paper reviews data on the effects of dietary carbohydrates on body fatness. Does the composition of the diet as related to carbohydrates affect the likelihood of passive over-consumption and long-term weight change? In addition, methodological limitations of both observational and experimental studies of dietary composition and body weight are discussed. Carbohydrates are among the macronutrients that provide energy and can thus contribute to excess energy intake and subsequent weight gain. There is no clear evidence that altering the proportion of total carbohydrate in the diet is an important determinant of energy intake. However, there is evidence that sugar-sweetened beverages do not induce satiety to the same extent as solid forms of carbohydrate, and that increases in sugar-sweetened soft drink consumption are associated with weight gain. Findings from studies on the effect of the dietary glycemic index on body weight have not been consistent. Dietary fiber is associated with a lesser degree of weight gain in observational studies. Although it is difficult to establish with certainty that fiber rather than other dietary attributes are responsible, whole-grain cereals, vegetables, legumes and fruits seem to be the most appropriate sources of dietary carbohydrate.European Journal of Clinical Nutrition 01/2008; 61 Suppl 1:S75-99. DOI:10.1038/sj.ejcn.1602939 · 2.95 Impact Factor
- Preventive Medicine 05/2006; 42(4):251-3. DOI:10.1016/j.ypmed.2006.02.011 · 2.93 Impact Factor