Sacks et al., 2009

The new england journal of medicineA All Participants0.0Protein Fat CarbohydrateChange in Weight (kg)−0.5−1.0−1.5−2.0−2.5−3.0−3.5−4.0−4.5−5.0Difference, −0.6(95% CI, −1.6 to 0.4)P=0.22High protein, fat, or carbohydrateDifference, 0.04(95% CI, −0.9 to 1.0)P=0.94Difference, 0.6(95% CI, −0.8 to 1.9)P=0.42Low or average protein, fat, or carbohydrateB Participants Who Completed the StudyProtein Fat Carbohydrate0.0Change in Weight (kg)−0.5−1.0−1.5−2.0−2.5−3.0−3.5−4.0−4.5−5.0Difference, −0.9(95% CI, −2.1 to 0.2)P=0.11Difference, 0.2(95% CI, −1.0 to 1.3)P=0.76Difference, 0.7(95% CI, −0.9 to 2.3)P=0.37C All Participants0Protein Fat CarbohydrateChange in Waist Circumference (cm)−1−2−3−4−5−6−7Difference, −0.7(95% CI, −1.7 to 0.4)P=0.22Difference, 0.0(95% CI, −1.0 to 1.0)P=0.99Difference, 0.7(95% CI, −0.8 to 2.1)P=0.39D Participants Who Completed the StudyProtein Fat Carbohydrate0Change in Waist Circumference (cm)−1−2−3−4−5−6−7Difference, −1.1(95% CI, −2.3 to 0.2)P=0.10Difference, 0.0(95% CI, −1.3 to 1.2)P=0.95Difference, 1.0(95% CI, −0.7 to 2.8)P=0.24Figure 1. Mean Change in Body Weight and Waist Circumference from Baseline to 2 Years According to Dietary Macronutrient Content.Solid bars represent high-protein, high-fat, or highest-carbohydrate diets. Open bars represent average-protein, low-fat, or lowest-carbohydratediets. T bars indicate standard errors. ICMPanels A and C show the change in body weight and the change in waist circumference,AUTHOR: SacksRETAKE 1stREG F FIGURE: 1 of 42ndrespectively, for all participants who were randomly assigned to a diet (a total of 811); missing 3rddata were imputed. A total of 403 participantswere assigned to a high-protein diet and CASE 408 to an average-protein diet, 405 were Revised assigned to a high-fat diet and 406 to a low-fatdiet, and 204 were assigned to the highest-carbohydrate EMailLine 4-CSIZEARTIST:diettsand 201 to the lowest-carbohydrate diet. Panel B shows the change in bodyH/T H/Tweight for the 645 participants who provided Enon measurements at 2 years. 36p6ComboOf these participants, 325 were assigned to a high-protein dietand 320 to an average-protein diet, 319 were assigned to a high-fat diet and 326 to a low-fat diet, and 169 were assigned to the highestcarbohydratediet and 168 to the lowest-carbohydrate Figure diet. has been Panel redrawn D shows and type the has change been reset. in waist circumference for the 599 participantsAUTHOR, PLEASE NOTE:who provided measurements at 2 years. Of these participants, Please 303 check were carefully. assigned to a high-protein diet and 296 to an average-proteindiet, 292 were assigned to a high-fat diet and 307 to a low-fat diet, and 159 were assigned to the highest-carbohydrate diet and 155 tothe lowest-carbohydrate diet.JOB: 36009 ISSUE: 02-26-09signed to a diet and those who completed the study(Table 1).Weight LossThe amount of weight loss after 2 years was similarin participants assigned to a diet with 25%protein and those assigned to a diet with 15%protein (3.6 and 3.0 kg, respectively; P = 0.22) andamong those who completed each of those diets(4.5 and 3.6 kg, respectively; P = 0.11) (Fig. 1). Weightloss was the same in those assigned to a diet with40% fat and those assigned to a diet with 20% fat(3.3 kg, P = 0.94) and was similar among those whocompleted each of those diets (3.9 and 4.1 kg, respectively;P = 0.76). There was no effect on weightloss of carbohydrate level through the target rangeof 35 to 65% (Fig. 1 and 2). The change in waistcircumference did not differ significantly amongthe diet groups (Fig. 1 and 2).Most of the weight loss occurred in the first864n engl j med 360;9 nejm.org february 26, 2009Downloaded from www.nejm.org on March 14, 2009 . For personal use only. No other uses without permission.Copyright © 2009 Massachusetts Medical Society. All rights reserved.