Four-Year Follow-up after Two-Year Dietary Interventions

Abstract

To the Editor: Data from trials that compare the effectiveness of weight-loss diets are frequently limited to the intervention period. In our 2-year workplace-based study, called the Dietary Intervention Randomized Controlled Trial (DIRECT),1,2 we randomly assigned 322 moderately obese participants to one of three weight-loss plans: a low-fat, restricted-calorie diet; a Mediterranean, restricted-calorie diet; or a low-carbohydrate diet without calorie restriction. The mean age of the participants was 52 years, and the mean body-mass index (the weight in kilograms divided by the square of the height in meters) was 31; 86% of the participants were men. We provided nutrition . . .