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Nondieting versus dieting treatment for overweight binge-eating women. For our branded diet analysis, we made a visual assessment of funnel plots for publication bias for direct comparisons that included 10 or more studies. Consuming a hypocaloric high fat low carbohydrate diet for 12 weeks lowers C-reactive protein, and raises serum adiponectin and high density lipoprotein-cholesterol in obese subjects. The characteristics of eligible branded dietary programs are reported in eTable 1 in the Supplement. Weight loss with a low-carbohydrate, Mediterranean, or low-fat diet. Screening for obesity in adults: recommendations and rationale. Improved psychological well-being, quality of life, and health practices in moderately overweight women participating in a 12-week structured weight loss program. The effect of a low-carbohydrate, ketogenic diet versus a low-glycemic index diet on glycemic control in type 2 diabetes mellitus. Want to suddenly feel excited and challenged by your next workout. Systematic review: an evaluation of major commercial weight loss programs in the United States. How to use an article reporting a multiple treatment comparison meta-analysis. The search strategy is available from the authors upon request. Difference in mean weight loss at 6 and 12 months across all diet classes with 95% credible intervals when restricted to low risk of bias studies eTable 5. Comparison of range of commercial or primary care led weight reduction programmes with minimal intervention control for weight loss in obesity: lighten up randomised controlled trial. The effects of a commercially available weight loss program among obese patients with type 2 diabetes: a randomized study. 7 In the absence of published head-to-head clinical trials of each diet against each other diet, network meta-analysis uses both direct and indirect clinical trial evidence to estimate their relative effects. 12. A randomized trial of a low-carbohydrate diet for obesity. Establishing which of the major named diets is most effective is important because overweight and obese patients often want to know which diet results in the most effective weight loss. A detailed description of the statistical analysis appears in the eMethods in the Supplement. 4. Exercise was defined as having explicit instructions for weekly physical activities and simply dichotomized when differences between varying degrees of exercise frequencies appeared to have negligible effects. 71 kg greater weight loss than the Zone diet at 6-month follow-up. Some physiological explanations regarding the merits of different macronutrient compositions, including variable genetic response to diets with different recommended dietary fat intake, make intuitive sense. Quiz Ref ID Network meta-analysis facilitates comparison of different diets using all available randomized clinical trial (RCT) data. Reviewers, in pairs, independently screened titles and abstracts of articles and reviewed the full text of any title or abstract deemed potentially eligible by either reviewer. GRADE overall confidence in estimates: 12-month weight loss eTable 13. We searched 6 electronic databases: AMED, CDSR, CENTRAL, CINAHL, EMBASE, and MEDLINE from inception of each database to April 2014. When available, we used P values for group differences to derive the standard deviation of change from baseline. Effects of dietary carbohydrate restriction versus low-fat diet on flow-mediated dilation. Carbohydrate restriction has a more favorable impact on the metabolic syndrome than a low fat diet. GRADE guidelines: 3, rating the quality of evidence. Weight and metabolic outcomes after 2 years on a low-carbohydrate versus low-fat diet: a randomized trial. Search terms included extensive controlled vocabulary and keyword searches for (RCTs) AND (diets) AND (adults) AND (weight loss). Influence of reported study design characteristics on intervention effect estimates from randomized, controlled trials. Random-effects pairwise meta-analyses (using the method by DerSimonian and Laird 19 ) were used to determine direct and indirect associated treatment effects for all network meta-analyses. 12. 9, 10. Network diagrams for randomized controlled trials investigating weight loss among branded diets eFigure 4. Only a few of the reviews of named diets have used rigorous meta-analytic techniques to provide quantitative estimates of how much better one diet is compared with another. Comparison of high-fat and high-protein diets with a high-carbohydrate diet in insulin-resistant obese women. Lifestyle intervention in overweight individuals with a family history of diabetes. Difference in mean weight loss at 6 and 12 months across all diet classes with 95% credible intervals when adjusting for proportion female (continuous measure) eTable 8. Long-term effects of a very low-carbohydrate diet and a low-fat diet on mood and cognitive function. Flip Your Shoulder Routine For Explosive Muscle Growth. A self-regulation program for maintenance of weight loss. Stern. Long-term effects of a high-protein, low-carbohydrate diet on weight control and cardiovascular risk markers in obese hyperinsulinemic subjects. Comparison of the Atkins, Ornish, Weight Watchers, and Zone diets for weight loss and heart disease risk reduction: a randomized trial. A Delicious, Refreshing Bcaa And Energy Formula Designed For Active Individuals. The gray literature search identified 213 additional articles. DeGroote Institute for Pain Research and Care, McMaster University, Hamilton, Ontario, Canada. 312, No. Named or branded (trade-marked) weight loss programs are broadly available to the general public, providing structured dietary and lifestyle recommendations via popular books and in-person or online behavioral support. A randomized trial comparing a very low carbohydrate diet and a calorie-restricted low fat diet on body weight and cardiovascular risk factors in healthy women. Continuous outcomes were most often reported as mean change, but sometimes were reported as preintervention and postintervention measures or percentage change. Quiz Ref ID Despite potential biological mechanisms explaining why some popular diets should be better than others, recent reviews suggest that most diets are equally effective, 2, 5, 6 a message very different from what the public hears in advertisements or expert pronouncements. They also relied on aggregating studies comparing one diet with another and did not have the ability to determine the relative performance of diets when they were not directly compared with one another in clinical trials. Two reviewers independently extracted data on populations, interventions, outcomes, risk of bias, and quality of evidence. Comparative study of the effects of a 1-year dietary intervention of a low-carbohydrate diet versus a low-fat diet on weight and glycemic control in type 2 diabetes. Dietary energy density in the treatment of obesity: a year-long trial comparing 2 weight-loss diets. The Lifting Dead: 4 Surefire Ways To Kill Your Weak Points. Risk of bias versus quality assessment of randomised controlled trials: cross sectional study. Diet classes were established by macronutrient content ( Table 1 ). A 12-week commercial web-based weight-loss program for overweight and obese adults: randomized controlled trial comparing basic versus enhanced features. We contacted the named diet companies and individuals working in the field of obesity and weight management to identify additional or unpublished trials. Exercise and weight loss reduce blood pressure in men and women with mild hypertension: effects on cardiovascular, metabolic, and hemodynamic functioning. Effects of hypocaloric diet, low-intensity resistance exercise with slow movement, or both on aortic hemodynamics and muscle mass in obese postmenopausal women. 9, 10, 17, 18, 22 -. Johnston BC, Kanters S, Bandayrel K, Wu P, Naji F, Siemieniuk RA, Ball GDC, Busse JW, Thorlund K, Guyatt G, Jansen JP, Mills EJ. A moderate-protein diet produces sustained weight loss and long-term changes in body composition and blood lipids in obese adults. We reviewed bibliographies of review articles and eligible trials, and searched the registries of ClinicalTrials. A randomized controlled trial of a commercial Internet weight loss program. Supplement. eTable 1. In the case of percentage change, we assumed independence. Once you leave the gym, your body shifts to muscle recovery and growth. To determine weight loss outcomes for popular diets based on diet class (macronutrient composition) and named diet. Effect of a high-protein, energy-restricted diet on body composition, glycemic control, and lipid concentrations in overweight and obese hyperinsulinemic men and women. gov and the metaRegister of Controlled Trials. Named diets were identified through the explicit naming of the brand, the referencing of branded literature, or the naming of a brand as funders of an article reporting weight loss outcomes from the diet. Difference in mean weight loss at 6 and 12 months across all diet brands with 95% credible intervals when restricted to low risk of bias studies eTable 10. Comparison of the effects of four commercially available weight-loss programmes on lipid-based cardiovascular risk factors. Long-term effects of advice to consume a high-protein, low-fat diet, rather than a conventional weight-loss diet, in obese adults with type 2 diabetes: one-year follow-up of a randomised trial. The effect of a low-carbohydrate, high-protein diet on post laparoscopic gastric bypass weight loss: a prospective randomized trial. Dieting and the development of eating disorders in obese women: results of a randomized controlled trial. Accessed July 30, 2014. Network diagrams for randomized controlled trials investigating change in BMI among branded and common diets. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada. 312, No. A low-carbohydrate as compared with a low-fat diet in severe obesity. Using a network meta-analytic approach, we assessed the relative effectiveness of different popular diets in improving weight loss. Changes in body weight and metabolic indexes in overweight breast cancer survivors enrolled in a randomized trial of low-fat vs reduced carbohydrate diets. The effects of low-carbohydrate versus conventional weight loss diets in severely obese adults: one-year follow-up of a randomized trial. The connectivity of each network meta-analysis was described using density, which was calculated as the ratio of the number of treatment pairs with head-to-head evidence over the total number of treatment pairs.
Weight-loss outcomes: a systematic review and meta-analysis of weight-loss clinical trials with a minimum 1-year follow-up. Weight loss with self-help compared with a structured commercial program: a randomized trial. A low-carbohydrate, ketogenic diet versus a low-fat diet to treat obesity and hyperlipidemia: a randomized, controlled trial. The hazards of scoring the quality of clinical trials for meta-analysis. Effects of a low carbohydrate weight loss diet on exercise capacity and tolerance in obese subjects. Publication bias assessed via funnel plots—Atkins versus moderate micronutrient diets: 6-month weight loss eFigure 5. Otherwise, we used the pre- and postintervention standard deviations along with a correlation estimated from studies that reported both change and pre- and postintervention results. Combining weight-loss counseling with the Weight Watchers plan for obese breast cancer survivors. Self-help weight loss versus a structured commercial program after 26 weeks: a randomized controlled study. Branded diets and weight loss in overweight or obese adults: a network meta-analysis. Description of dietary programs eTable 2. Pairs of reviewers independently, and in duplicate, extracted the following data items: study setting, type of trial (parallel or factorial), demographic information, experimental interventions, control interventions, exercise information, degree of calorie restriction, degree of behavioral support, and each of the outcomes of interest. Difference in mean decrease in BMI at 6 and 12 months across diet classes with 95% credible intervals eTable 14. JAMA 2014-09-02, Vol. Effect of a high-protein, energy-restricted diet on weight loss and energy expenditure after weight stabilization in hyperinsulinemic subjects. This supports the practice of recommending any diet that a patient will adhere to in order to lose weight. We categorized dietary treatment groups in 2 ways: using diet classes (moderate macronutrient distribution, low carbohydrate, and low fat) 15 and according to diet brands. Randomized trial of a multifaceted commercial weight loss program. A Bayesian framework was used to perform a series of random-effects network meta-analyses with meta-regression to estimate the relative effectiveness of diet classes and programs for change in weight and body mass index from baseline. Moderate carbohydrate, moderate protein weight loss diet reduces cardiovascular disease risk compared to high carbohydrate, low protein diet in obese adults: a randomized clinical trial. We included RCTs that reported weight loss or BMI reduction at 3-month follow-up or longer. Difference in mean weight loss at 6 and 12 months across all diet classes with 95% credible intervals when adjusting for percentage loss to follow-up (continuous measure) eTable 6. Weight loss differences between individual named diets were small. Our analyses adjusted for behavioral support and exercise. Search of 6 electronic databases: AMED, CDSR, CENTRAL, CINAHL, EMBASE, and MEDLINE from inception of each database to April 2014. Eligible programs included meal replacement products but had to consist primarily of whole foods and could not include pharmacological agents. GRADE confidence in indirect estimates: 12-month weight loss eTable 12. The 48 RCTs included 7286 individuals with a median age of 45. For example, the Atkins diet resulted in a 1. Dietary guidelines for Americans: 2010. In the latter cases, transformations were used to express weight loss and BMI as mean change. Up-and-coming competitor Hunter Labrada tells his story of progressing from shrimp to champ. Analyses were conducted using 6- and 12-month data, with a 3-month window (eg, if a study reported weight loss at 5 months, it was used in the 6-month analysis). Effects of two weight-loss diets on health-related quality of life. Weight loss differences between individual diets were minimal. Effects of a low-intensity intervention that prescribed a low-carbohydrate vs a low-fat diet in obese, diabetic participants. Many claims have been made regarding the superiority of one diet or another for inducing weight loss. Comparison of Weight Loss Among Named Diet Programs in Overweight and Obese Adults A Meta-analysis. View Large Download Diet Classes Based on Macronutrient Composition Table 2. Because it is impossible to provide a placebo diet in a clinical trial, eligible control diets included wait-listed controls, no specific assigned diet, or competing dietary programs. By not exploring the full range of potential comparisons in a statistically and methodologically rigorous fashion, these reviews could have missed important benefits of specific diets or their compositions. GRADE guidelines: 4, rating the quality of evidence—study limitations (risk of bias). Metabolic effects of weight loss on a very-low-carbohydrate diet compared with an isocaloric high-carbohydrate diet in abdominally obese subjects. Dietary protein and exercise have additive effects on body composition during weight loss in adult women. Lifestyle Behaviors Nutrition Obesity Shared Decision Making and Communication Treatment Adherence Diet. Primary care referral to a commercial provider for weight loss treatment versus standard care: a randomised controlled trial. Network diagrams for randomized controlled trials investigating change in BMI among diets, categorized by diet class eFigure 6. The effects of an intensive lifestyle modification program on carotid artery intima-media thickness: a randomized trial. 9, Author Audio Interview. These programs represent a multibillion dollar industry. A reduced ratio of dietary carbohydrate to protein improves body composition and blood lipid profiles during weight loss in adult women. Network diagrams for randomized controlled trials investigating weight loss among diets, categorized by diet class eFigure 3. Effects of energy-restricted diets containing increased protein on weight loss, resting energy expenditure, and the thermic effect of feeding in type 2 diabetes. Hunter Labrada: The Son Of Bodybuilding Royalty Comes Of Age. For example, dietary programs that did not refer to Atkins but consisted of less than 40% of kilocalories from carbohydrates per day for the duration of study or were funded by Atkins were considered Atkins-like. Effect of a low-carbohydrate, ketogenic diet program compared to a low-fat diet on fasting lipoprotein subclasses. Of the total, 889 proved potentially relevant for full-text review and 59 articles that reported 48 RCTs of 11 branded diets proved eligible (eFigure 1 in the Supplement ). 9, Author Audio Interview. JAMA 2014-09-02, Vol. eMethods. Diets with at least 2 group or individual sessions per month for the first 3 months were considered as providing behavioral support. Long-term weight loss after diet and exercise: a systematic review. Weight-loss diets modify glucose-dependent insulinotropic polypeptide receptor rs2287019 genotype effects on changes in body weight, fasting glucose, and insulin resistance: the Preventing Overweight Using Novel Dietary Strategies trial. 1 Debate regarding the relative merit of the diets is accompanied by advertising claiming which macronutrient composition is superior, such as a low-carbohydrate diet being better than a low-fat diet, and the benefits of accompanying lifestyle interventions. Just pay attention to these simple but challenging ways to reinvigorate your training. 9. Accessibility verified August 4, 2014. Effect of a high-protein, high-monounsaturated fat weight loss diet on glycemic control and lipid levels in type 2 diabetes. Comparison of the Atkins, Zone, Ornish, and LEARN diets for change in weight and related risk factors among overweight premenopausal women: the A to Z Weight Loss Study: a randomized trial. Long-term effects of 2 energy-restricted diets differing in glycemic load on dietary adherence, body composition, and metabolism in CALERIE: a 1-y randomized controlled trial. Difference in mean weight loss at 6 and 12 months across all diet classes with 95% credible intervals when adjusting for baseline weight (overweight to obese vs morbidly obese) eTable 7. US Preventive Services Task Force. How To Stick To The Last Few Weeks Of Your Diet. Key differences between this analysis and recent joint guidelines from the American Heart Association (AHA), American College of Cardiology (ACC), and The Obesity Society (TOS) eFigure 1. Short-term effects of severe dietary carbohydrate-restriction advice in type 2 diabetes—a randomized controlled trial. Significant weight loss was observed with any low-carbohydrate or low-fat diet. Difference in mean decrease in BMI at 6 and 12 months across diet brands with 95% credible intervals eTable 15. Weight, protein, fat, and timing of preloads affect food intake. GRADE confidence in direct estimates: 12-month weight loss eTable 11. The diet was labeled as brand-like when the diet met the definition of a branded diet, but failed to name or reference the brand in the article. The last few weeks of a diet are make or break. The role of energy expenditure in the differential weight loss in obese women on low-fat and low-carbohydrate diets. Summary of risk of bias by diet class and brand eTable 3. Effect of a free prepared meal and incentivized weight loss program on weight loss and weight loss maintenance in obese and overweight women: a randomized controlled trial. Effects of a low-glycemic load vs low-fat diet in obese young adults: a randomized trial. Take 4 common leg exercises and tweak each one to make it as challenging as humanly possible. Pairs of reviewers independently assessed the risk of bias associated with individual trials using the Cochrane Collaboration instrument. Psychological benefits of a high-protein, low-carbohydrate diet in obese women with polycystic ovary syndrome—a pilot study. Combining behavioral weight loss treatment and a commercial program: a randomized clinical trial. 14. 13 We assigned 1 of 2 summary assessments for each included study: low risk of bias for key domains, allocation concealment, and missing participant data or high risk of bias for key domains. 2, 3 Low-carbohydrate diets may drive weight loss due to a higher intake of protein, which may induce a stronger satiating effect than fats and carbohydrates. 7 years (median SD, 9 years), median weight of 94. We considered 3 weight loss effect modifiers that were modeled as present or absent if they were included in an overall dietary program: calorie restriction, exercise, and behavioral support.
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