Low-fat (CR) diet

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Hi All,

The below may interest. It had a good introduction and review that are also

available as pdfs.

Low-Fat Dietary Pattern and Weight Change Over 7 Years: The Women's Health

Initiative Dietary Modification Trial

Barbara V. ; JoAnn E. Manson; Marcia L. Stefanick; Shirley A. Beresford;

Gail

; Bobette ; J. Rodabough; Snetselaar; Thomson;

Lesley Tinker; Mara Vitolins; Ross Prentice

JAMA. 2006;295:39-49.

ABSTRACT

Context 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.

Objectives 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.

Design, Setting, and Participants 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).

Interventions 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.

Main Outcome Measure Change in body weight from baseline to follow-up.

Results 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.

Conclusion A low-fat eating pattern does not result in weight gain in

postmenopausal women.

.... Table 2. Baseline and Final Nutrient Intakes in Intervention and Control

Groups*

==================================================

---Intervention Control----

----No. Mean (SD) No. Mean (SD)---Difference (SE) P Value†

==================================================

Total energy, kcal

Baseline 19 517 1788.1 (703.8) 29 273 1789.2 (703.3) 1.1 (6.5) .86

Follow-up 14 246 1445.9 (510.1) 22 083 1564.0 (594.9) 118.0 (6.1) <.001

Change 14 246 & #8722;361.4 (653.8) 22 083 & #8722;240.8 (643.6) 120.7 (7.0)

<.001

Energy from fat, %

Baseline 19 517 38.8 (5.0) 29 273 38.8 (5.0) 0.01 (0.05) .84

Follow-up 14 246 29.8 (8.3) 22 083 38.1 (7.2) 8.3 (0.1) <.001

Change 14 246 & #8722;8.8 (8.5) 22 083 & #8722;0.6 (7.2) 8.2 (0.1) <.001

Energy from saturated fat, %

Baseline 19 517 13.6 (2.6) 29 273 13.6 (2.5) 0.02 (0.02) .41

Follow-up 14 246 10.1 (3.3) 22 083 13.2 (3.2) 3.1 (0.04) <.001

Change 14 246 & #8722;3.4 (3.6) 22 083 & #8722;0.3 (3.2) 3.1 (0.04) <.001

Energy from carbohydrates, %

Baseline 19 517 44.5 (6.2) 29 273 44.5 (6.2) 0.02 (0.1) .73

Follow-up 14 246 52.7 (9.8) 22 083 44.7 (8.5) & #8722;8.0 (0.1) <.001

Change 14 246 8.2 (9.6) 22 083 0.2 (8.3) 8.0 (0.1) <.001

Fiber, g

Baseline 19 517 14.4 (6.0) 29 273 14.4 (6.0) 0.05 (0.1) .44

Follow-up 14 246 16.9 (7.1) 22 083 14.4 (6.1) & #8722;2.5 (0.1) <.001

Change 14 246 2.2 (7.0) 22 083 & #8722;0.2 (5.9) 2.4 (0.1) <.001

Fruits and vegetables, servings/d

Baseline 19 428 3.6 (1.8) 29 170 3.6 (1.8) 0.01 (0.02) .67

Follow-up 14 183 5.0 (2.4) 22 020 3.9 (2.0) & #8722;1.2 (0.02) <.001

Change 14 183 1.4 (2.3) 22 020 0.2 (1.9) & #8722;1.2 (0.02) <.001

Grains, servings/d

Baseline 19 428 4.7 (2.5) 29 170 4.8 (2.5) 0.02 (0.02) .45

Follow-up 14 183 4.1 (2.2) 22 020 3.8 (2.0) & #8722;0.4 (0.02) <.001

Change 14 183 & #8722;0.7 (2.7) 22 020 & #8722;1.1 (2.5) & #8722;0.4 (0.03)

<.001

Whole grains, servings/d

Baseline 19 428 1.1 (0.8) 29 170 1.1 (0.8) 0.002 (0.01) .88

Follow-up 14 183 1.2 (0.8) 22 020 1.0 (0.7) & #8722;0.2 (0.01) <.001

Change 14 183 0.1 (0.9) 22 020 & #8722;0.1 (0.8) & #8722;0.2 (0.01) <.001

Non–whole grains, servings/d

Baseline 19 428 3.6 (2.1) 29 170 3.6 (2.1) 0.02 (0.02) .33

Follow-up 14 183 2.9 (1.7) 22 020 2.7 (1.6) & #8722;0.17 (0.02) <.001

Change 14 183 & #8722;0.7 (2.2) 22 020 & #8722;0.9 (2.0) & #8722;0.2 (0.02)

<.001

Physical activity, METs/wk

Baseline 17 507 10.0 (11.7) 26 254 10.1 (12.0) 0.1 (0.1) .44

Year 1 9962 11.4 (12.8) 14 822 11.1 (12.7) & #8722;0.3 (0.2) .13

Change 9962 1.1 (10.4) 14 822 0.9 (10.5) & #8722;0.2 (0.1) .07

==================================================

Abbreviation: MET, metabolic equivalents.

*Change = follow-up & #8722; baseline. Follow-up values were computed from food

frequency questionnaires (FFQs) taken between years 5 and 7. Completion rates

for

FFQs for years 5 through 7 were 86.8%, 86.6%, and 70.5%, respectively.

†P values are from 2-sample t tests.

Al Pater, PhD; email: old542000@...

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