Randomised controlled trial of four commercial weight loss programmes in the UK: initial findings from the BBC “diet trials”

Truby, Helen; Baic, Sue; deLooy, Anne; Fox, Keith R.; Livingstone, M Barbara E; Logan, Catherine M; Macdonald, I. A.; Morgan, Linda; Taylor, Moira A.; Millward, D. J.

doi:10.1136/bmj.38833.411204.80

Cited by 249 publications

(199 citation statements)

References 14 publications

(6 reference statements)

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“…Thus every effort was made to avoid investigator management of, or interference in, participants' food intakes. As discussed elsewhere (17) , there were no differences in diet, centre or gender in terms of the proportions of participants who completed or withdrew. The analysis of completers showed that, within each group, there was variable compliance resulting in a large range of weight loss for each of the four regimes, but all four diets tested were equally effective at promoting weight loss over 6 months.…”

Section: Discussionmentioning

confidence: 99%

“…There was no significant change in weight in the control group. A full examination of weight outcomes has been reported previously (17) . Markers of renal function were maintained within normal limits for all Atkins participants.…”

Section: Changes In Body Weightmentioning

confidence: 99%

“…Furthermore, with the notable exception of one recent study (15) , there have been few direct comparisons of the efficacy of commercially available weight-loss programmes in modifying blood lipids and lipoproteins. The present multi-centred study, the largest in the UK to date, was designed to examine the efficacy of four popular weightloss programmes, in a randomised controlled design, on a range of outcome variables related to weight loss, body composition and biochemical variables that have been reported elsewhere (16,17) . The current paper reports the effects of these diets on plasma lipid and lipoproteins as markers of CVD risk.…”

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confidence: 99%

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Comparison of the effects of four commercially available weight-loss programmes on lipid-based cardiovascular risk factors

Morgan

Griffin

Millward

et al. 2009

Public Health Nutr.

103

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Objective: To investigate the relative efficacy of four popular weight-loss programmes on plasma lipids and lipoproteins as measures of CVD risk. Design: A multi-centred, randomised, controlled trial of four diets -Dr Atkins' New Diet Revolution, The Slim-Fast Plan, Weight Watchers Pure Points programme and Rosemary Conley's 'Eat yourself Slim' Diet and Fitness Plan -against a control diet, in parallel for 6 months. Setting and subjects: The trial was conducted at five universities across the UK (Surrey, Nottingham, Ulster (Coleraine), Bristol and Edinburgh (Queen Margaret University College)) and involved the participation of 300 overweight and obese males and females aged 21-60 years in a community setting. Results: Significant weight loss was achieved by all dieting groups (5-9 kg at 6 months) but no significant difference was observed between diets at 6 months. The Weight Watchers and Rosemary Conley (low-fat) diets were followed by significant reductions in plasma LDL cholesterol (both 212?2 % after 6 months, P , 0?01), whereas the Atkins (low-carbohydrate) and Weight Watchers diets were followed by marked reductions in plasma TAG (-38?2 % and -22?6 % at 6 months respectively, P , 0?01). These latter two diets were associated with an increase in LDL particle size, a change that has been linked to reduced CVD risk. Conclusions: Overall, these results demonstrate the favourable effects of weight loss on lipid-mediated CVD risk factors that can be achieved through commercially available weight-loss programmes. No detrimental effects on lipid-based CVD risk factors were observed in participants consuming a low-carbohydrate diet. KeywordsLipids Lipoprotein sub-fractions Weight-loss programmes Cardiovascular diseaseThe prevalence of obesity in the UK is increasing, with 41 % of adult men and 33 % of women being overweight and an additional 25 % and 20 % respectively being obese (1) . As the health, economic and social costs of obesity have become increasingly apparent, the number and variety of weight-loss programmes has multiplied. Numerous dieting programmes are currently available that focus on different strategies for reducing energy intake, by restricting specific macronutrients (fat or carbohydrate), controlling portion size or replacing meals with substitutes.Obesity is one of the major modifiable risk factors for CVD. Weight loss per se results in favourable changes in blood lipid profiles, decreasing circulating LDL cholesterol (LDL-C) and TAG levels and increasing HDL cholesterol (HDL-C) if weight loss is maintained (2) .However, restriction of specific macronutrients can produce differential effects on lipid profiles. High-carbohydrate, low-fat diets, while decreasing LDL-C, have a tendency to increase plasma TAG concentrations and decrease HDL-C (3) , whereas low-carbohydrate diets, though effective in lowering plasma TAG concentrations, can be inherently high in saturated fat and cholesterol and show variable effects on LDL-C (4)(5)(6)(7)(8) . Obesity is frequently associated with raised plas...

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Section: Discussionmentioning

confidence: 99%

Section: Changes In Body Weightmentioning

confidence: 99%

mentioning

confidence: 99%

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Comparison of the effects of four commercially available weight-loss programmes on lipid-based cardiovascular risk factors

Morgan

Griffin

Millward

et al. 2009

Public Health Nutr.

103

View full text Add to dashboard Cite

show abstract

“…Participants completed a questionnaire and a 7-day estimated food and activity diary (previously used in published studies (Truby et al, 2006)). The questionnaire was designed specifically for this study and included questions relating to diagnosis, self-reported symptoms (What conditions/symptoms do you have as a result of your PCOS?…”

Section: Methodsmentioning

confidence: 99%

Habitual dietary intake, eating pattern and physical activity of women with polycystic ovary syndrome

et al. 2011

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Background/Objective: Diet and lifestyle modifications may be of benefit in the management of polycystic ovary syndrome (PCOS), but there is a paucity of data on these behaviours in women with PCOS. This study aims to address this through a comprehensive investigation of the habitual diet and activity patterns of UK women with PCOS and their alignment with dietary recommendations for health. Subjects/Methods: A 7-day-estimated food and activity diary and questionnaire was completed by 210 women with PCOS for calculation of activity levels, energy and nutrient intakes and dietary glycaemic index (GI). Results: Mean (s.d.) body mass index (BMI) was 27.4 (7.3) kg/m 2 (n ¼ 183), with 53% of women with PCOS having a BMI425 kg/m 2 . Of the overweight women, approximately half were not achieving sufficient physical activity to promote weight loss. More frequent eating episodes and a lower BMI were weakly associated (r ¼ À0.158, P ¼ 0.034). Mean percentage energy from fat was 38 (7)% (12% energy from saturated fat), with 68% of women with PCOS consuming 4 35% energy from fat. Mean dietary GI was higher in obese women with PCOS, compared with healthy weight women with PCOS (55.7 (3.4) and 53.8 (4.0), respectively; P ¼ 0.043). Conclusion: Many women with PCOS are not achieving dietary intakes and levels of physical activity that optimise symptom management and disease prevention. Advice should focus on fat quality and quantity and carbohydrate modification. There is a need for further robust research into the role of dietary GI in the PCOS population.

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“…Many of these diets emphasize reduction of carbohydrate intake and thereby encourage high protein intake, given that, in Western countries, highfat diets are also generally avoided (Astrup et al, 2004). There is evidence that low carbohydrate-high protein (LC/HP) diets do indeed lead to better weight control or even weight loss in the short term (Foster et al, 2003;Samaha et al, 2003;Willett, 2004;Truby et al, 2006). In contrast, according to a randomized trial that examined for a year the effectiveness of four popular diets (Atkins, Zone, Weight Watchers, Ornish), the amount of weight loss and the changes in biochemical parameters were not significantly different among diets and were only evident among committed dieters (Dansinger et al, 2005).…”

Section: Introductionmentioning

confidence: 99%

Low-carbohydrate–high-protein diet and long-term survival in a general population cohort

et al. 2006

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Objective: We have evaluated the effects on mortality of habitual low carbohydrate-high-protein diets that are thought to contribute to weight control. Design: Cohort investigation. Setting: Adult Greek population. Subjects methods: Follow-up was performed from 1993 to 2003 in the context of the Greek component of the European Prospective Investigation into Cancer and nutrition. Participants were 22 944 healthy adults, whose diet was assessed through a validated questionnaire. Participants were distributed by increasing deciles according to protein intake or carbohydrate intake, as well as by an additive score generated by increasing decile intake of protein and decreasing decile intake of carbohydrates. Proportional hazards regression was used to assess the relation between high protein, high carbohydrate and the low carbohydrate-high protein score on the one hand and mortality on the other. Results: During 113 230 persons years of follow-up, there were 455 deaths. In models with energy adjustment, higher intake of carbohydrates was associated with significant reduction of total mortality, whereas higher intake of protein was associated with nonsignificant increase of total mortality (per decile, mortality ratios 0.94 with 95% CI 0.89 -0.99, and 1.02 with 95% CI 0.98 -1.07 respectively). Even more predictive of higher mortality were high values of the additive low carbohydrate-high protein score (per 5 units, mortality ratio 1.22 with 95% CI 1.09 -to 1.36). Positive associations of this score were noted with respect to both cardiovascular and cancer mortality. Conclusion: Prolonged consumption of diets low in carbohydrates and high in protein is associated with an increase in total mortality.

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Randomised controlled trial of four commercial weight loss programmes in the UK: initial findings from the BBC “diet trials”

Cited by 249 publications

References 14 publications

Comparison of the effects of four commercially available weight-loss programmes on lipid-based cardiovascular risk factors

Comparison of the effects of four commercially available weight-loss programmes on lipid-based cardiovascular risk factors

Habitual dietary intake, eating pattern and physical activity of women with polycystic ovary syndrome

Low-carbohydrate–high-protein diet and long-term survival in a general population cohort

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