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Low-fat dietary pattern and weight change over 7 years: the Women's Health Initiative Dietary Modification Trial.

Abstract

CONTEXT

Obesity in the United States has increased dramatically during the past several decades. There is debate about optimum calorie balance for prevention of weight gain, and proponents of some low-carbohydrate diet regimens have suggested that the increasing obesity may be attributed, in part, to low-fat, high-carbohydrate diets.

OBJECTIVES

To report data on body weight in a long-term, low-fat diet trial for which the primary end points were breast and colorectal cancer and to examine the relationships between weight changes and changes in dietary components.

DESIGN, SETTING, AND PARTICIPANTS

Randomized intervention trial of 48,835 postmenopausal women in the United States who were of diverse backgrounds and ethnicities and participated in the Women's Health Initiative Dietary Modification Trial; 40% (19,541) were randomized to the intervention and 60% (29,294) to a control group. Study enrollment was between 1993 and 1998, and this analysis includes a mean follow-up of 7.5 years (through August 31, 2004).

INTERVENTIONS

The intervention included group and individual sessions to promote a decrease in fat intake and increases in vegetable, fruit, and grain consumption and did not include weight loss or caloric restriction goals. The control group received diet-related education materials.

MAIN OUTCOME MEASURE

Change in body weight from baseline to follow-up.

RESULTS

Women in the intervention group lost weight in the first year (mean of 2.2 kg, P<.001) and maintained lower weight than control women during an average 7.5 years of follow-up (difference, 1.9 kg, P<.001 at 1 year and 0.4 kg, P = .01 at 7.5 years). No tendency toward weight gain was observed in intervention group women overall or when stratified by age, ethnicity, or body mass index. Weight loss was greatest among women in either group who decreased their percentage of energy from fat. A similar but lesser trend was observed with increases in vegetable and fruit servings, and a nonsignificant trend toward weight loss occurred with increasing intake of fiber.

CONCLUSION

A low-fat eating pattern does not result in weight gain in postmenopausal women. Clinical Trial Registration ClinicalTrials.gov, NCT00000611.

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  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    MedStar Research Institute, Washington, DC, USA. Barbara.V.Howard@MedStar.net

    , , , , , , , , , ,

    Source

    JAMA 295:1 2006 Jan 04 pg 39-49

    MeSH

    Aged
    Anthropometry
    Diet Records
    Diet, Fat-Restricted
    Female
    Follow-Up Studies
    Humans
    Middle Aged
    Postmenopause
    Weight Loss

    Pub Type(s)

    Journal Article
    Randomized Controlled Trial
    Research Support, N.I.H., Extramural

    Language

    eng

    PubMed ID

    16391215

    Citation

    TY - JOUR T1 - Low-fat dietary pattern and weight change over 7 years: the Women's Health Initiative Dietary Modification Trial. AU - Howard,Barbara V, AU - Manson,JoAnn E, AU - Stefanick,Marcia L, AU - Beresford,Shirley A, AU - Frank,Gail, AU - Jones,Bobette, AU - Rodabough,Rebecca J, AU - Snetselaar,Linda, AU - Thomson,Cynthia, AU - Tinker,Lesley, AU - Vitolins,Mara, AU - Prentice,Ross, PY - 2006/1/5/pubmed PY - 2006/1/10/medline PY - 2006/1/5/entrez SP - 39 EP - 49 JF - JAMA JO - JAMA VL - 295 IS - 1 N2 - CONTEXT: Obesity in the United States has increased dramatically during the past several decades. There is debate about optimum calorie balance for prevention of weight gain, and proponents of some low-carbohydrate diet regimens have suggested that the increasing obesity may be attributed, in part, to low-fat, high-carbohydrate diets. OBJECTIVES: To report data on body weight in a long-term, low-fat diet trial for which the primary end points were breast and colorectal cancer and to examine the relationships between weight changes and changes in dietary components. DESIGN, SETTING, AND PARTICIPANTS: Randomized intervention trial of 48,835 postmenopausal women in the United States who were of diverse backgrounds and ethnicities and participated in the Women's Health Initiative Dietary Modification Trial; 40% (19,541) were randomized to the intervention and 60% (29,294) to a control group. Study enrollment was between 1993 and 1998, and this analysis includes a mean follow-up of 7.5 years (through August 31, 2004). INTERVENTIONS: The intervention included group and individual sessions to promote a decrease in fat intake and increases in vegetable, fruit, and grain consumption and did not include weight loss or caloric restriction goals. The control group received diet-related education materials. MAIN OUTCOME MEASURE: Change in body weight from baseline to follow-up. RESULTS: Women in the intervention group lost weight in the first year (mean of 2.2 kg, P<.001) and maintained lower weight than control women during an average 7.5 years of follow-up (difference, 1.9 kg, P<.001 at 1 year and 0.4 kg, P = .01 at 7.5 years). No tendency toward weight gain was observed in intervention group women overall or when stratified by age, ethnicity, or body mass index. Weight loss was greatest among women in either group who decreased their percentage of energy from fat. A similar but lesser trend was observed with increases in vegetable and fruit servings, and a nonsignificant trend toward weight loss occurred with increasing intake of fiber. CONCLUSION: A low-fat eating pattern does not result in weight gain in postmenopausal women. Clinical Trial Registration ClinicalTrials.gov, NCT00000611. SN - 1538-3598 UR - https://www.unboundmedicine.com/medline/citation/16391215/full_citation L2 - https://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.295.1.39 ER -