What are the long-term benefits of weight reducing diets in adults? A systematic review of randomized controlled trials

  • Avenell A
  • Brown T
  • McGee M
 et al. 
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BACKGROUND: Evidence is needed for the best long-term diet for weight loss, and improvement in cardiac risk and disease in obese adults. METHODS: We systematically reviewed randomized controlled trials (RCTs) in any language. We searched 13 databases and handsearched journals. Trials lasted 1 year or more. One investigator extracted the data and a second checked data extraction. Trial quality was assessed. RESULTS: Low fat diets (LFDs) produced significant weight losses up to 36 months (-3.55 kg; 95% CI, -4.54 to -2.55 kg). Blood pressure, lipids and fasting plasma glucose improved with these diets after 12 months. Four studies found that LFDs may prevent type 2 diabetes and reduce antihypertensive medication for up to 3 years. A very low calorie diet (VLCD, < 4.2 MJ day(-1)) was associated with the most weight loss after 12 months (-13.40 kg; 95% CI, -18.43 to -8.37 kg) in one small study with beneficial effects on asthma. There was no evidence that low carbohydrate protein sparing modified fasts (PSMFs) were associated with greater long-term weight loss than low calorie diets (LCDs, 4.2-6.7 MJ day(-1)) or VLCDs. PSMFs were, however, associated with greater lowering of fasting plasma glucose and HbA1c than LCDs. CONCLUSIONS: Little evidence supports the use of diets other than LFDs for weight reduction. With the increasing prevalence of morbid obesity, long-term follow-up in RCTs is needed to evaluate the effect of LCDs, VLCDs and PSMFs more fully.

Author-supplied keywords

  • Adult
  • Antihypertensive Agents -- Therapeutic Use
  • Asthma -- Prevention and Control
  • Blood Glucose
  • Blood Pressure
  • Body Mass Index
  • Cardiovascular Diseases -- Prevention and Control
  • Cardiovascular Risk Factors -- Prevention and Cont
  • Chi Square Test
  • Cholesterol -- Blood
  • Cochrane Library
  • Confidence Intervals
  • Descriptive Statistics
  • Diabetes Mellitus, Type 2 -- Prevention and Contro
  • Diet, Fat-Restricted
  • Diet, Reducing
  • Dietary Carbohydrates
  • Dietary Proteins
  • Embase
  • Energy Intake
  • Female
  • Funding Source
  • Hemoglobin A, Glycosylated -- Blood
  • Human
  • Linear Regression
  • Male
  • Medline
  • Meta Analysis
  • Obesity -- Diet Therapy
  • Professional Practice, Evidence-Based
  • Psycinfo
  • Public Health
  • Restricted Diet
  • Weight Loss

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  • A Avenell

  • T J Brown

  • M A McGee

  • M K Campbell

  • A M Grant

  • J Broom

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