“There is no good evidence for recommending low-fat diets,” said lead author Deirdre Tobias from Brigham and Women’s Hospital and Harvard Medical School in the US.
“Behind current dietary advice to cut out fat which contains more than twice the calories per gramme of carbohydrates and protein, the thinking is that simply reducing fat intake will naturally lead to weight loss. Our robust evidence clearly suggests otherwise,” said Tobias.
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They took into account the intensity of diets which ranged from only pamphlets or instructions at the beginning of the programme to intensive multi-component programmes, including counselling sessions, meetings with dieticians, food diaries, and cooking lessons.
Analysis of 53 studies involving 68,128 adults showed no difference in the average weight loss between reduced-fat diets and higher-fat diets.
Indeed, reduced-fat diets only led to greater weight loss when compared with no diet at all, and resulted in less weight loss compared with low-carbohydrate interventions, although differences in weight change were small (weighted mean difference 1.15 kg).
Similarly, when only considering trials without a weight loss goal (eg, those assessing lipids or cancer endpoints), participants following a reduced-fat diet lost similar amounts of weight on average compared to those on other diets.
“The science does not support low-fat diets as the optimal long-term weight loss strategy,” said Tobias.
“To effectively address the obesity epidemic, we will need more research to identify better approaches for long-term weight loss and weight maintenance, including the need to look beyond differences in macronutrient composition - the proportion of calories that come from fat, carbohydrate, and protein,” said Tobias.
“Long-term adherence is critical for the success of any dietary intervention, and one should also take into account other long-term health effects of their dietary choices,” Tobias added.
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