Effect of reducing total fat intake on body weight: Systematic review and meta-analysis of randomised controlled trials and cohort studies

BMJ (Online)

Volumn 345, Issue 7891, 2013, Pages

  Hooper, Lee ^a   Abdelhamid, Asmaa ^a   Moore, Helen J ^b   Douthwaite, Wayne ^b   Skeaff, C Murray ^c   Summerbell, Carolyn D ^b  

^a UNIVERSITY OF EAST ANGLIA   (United Kingdom)

^b Wolfson Research Institute   (United Kingdom)

^c UNIVERSITY OF OTAGO   (New Zealand)

Author keywords

[No Author keywords available]

Indexed keywords

ALCOHOL; CARBOHYDRATE; LIPID; PROTEIN; SUGAR;

BLOOD PRESSURE; BODY FAT; BODY MASS; BODY WEIGHT; COHORT ANALYSIS; ENERGY; FAT INTAKE; FEMALE; HUMAN; LIPID BLOOD LEVEL; LOW FAT DIET; MALE; META ANALYSIS; PRIORITY JOURNAL; RANDOMIZED CONTROLLED TRIAL (TOPIC); REVIEW; SENSITIVITY ANALYSIS; SYSTEMATIC REVIEW; VALIDITY; WAIST CIRCUMFERENCE; WEIGHT GAIN; WEIGHT REDUCTION;

ADULT; ALCOHOL DRINKING; BLOOD PRESSURE; BODY MASS INDEX; CHILD; COHORT STUDIES; DIET, FAT-RESTRICTED; DIETARY CARBOHYDRATES; DIETARY FATS; ENERGY INTAKE; FEMALE; HUMANS; LIPIDS; MALE; RANDOMIZED CONTROLLED TRIALS AS TOPIC; RISK FACTORS; WAIST CIRCUMFERENCE; WEIGHT LOSS;

EID: 84872695447     PISSN: None     EISSN: 17561833     Source Type: Journal    
DOI: 10.1136/bmj.e7666     Document Type: Review

References (85)

1. World Cancer Research Fund/American Institute for Cancer Research. Preventability of cancer by food, nutrition, and physical activity: Appendix A. Policy and Action for Cancer Prevention. Food, Nutrition, and Physical Activity: a Global Perspective. AICR, 2009.
2. Manson JE, Colditz GA, Stampfer MJ, Willett WC, Rosner B, Monson RR, et al. A prospective study of obesity and risk of coronary heart disease in women. N Engl J Med 1990;322:882-9.
3. Song Y-M, Sung J, Davey Smith G, Ebrahim S. Body mass index and ischemic and hemorrhagic stroke: a prospective study in Korean men. Stroke 2004;35:831-6.
4. Kelly S, Hillier F, Whittaker V, Ells LJ, Edmunds LD, Smith S, et al. The associations between food, nutrition, physical activity and the risk of weight gain, overweight and obesity and underlying mechanisms. World Cancer Research Fund/American Institute for Cancer Research, 2006 www.dietandcancerreport.org/ cancer-resource-center/downloads/SLR/Obesity-SLR.pdf.
5. Yu-Poth S, Zhao G, Etherton T, Naglak M, Jonnalagadda S, Kris-Etherton PM. Effects of the National Cholesterol Education Program's Step I And Step II dietary intervention programs on cardiovascular disease risk factors: a meta-analysis. Am J Clin Nutr 1999;69:632-46.
6. Higgins JPT, Green S. Cochrane handbook for systematic reviews of interventions version 5.0.2 [updated September 2009]. Available from www.cochrane-handbook.org.
7. World Health Organization. WHO Handbook for guideline development. WHO, 2010. www.who.int/hiv/topics/mtct/grc-handbook-mar2010-1.pdfed. Geneva, Switzerland: World Health Organisation; 2010.
8. Hooper L, Summerbell CD, Thompson R, Sills D, Roberts FG, Moore HJ, et al. Reduced or modified dietary fat for preventing cardiovascular disease. Cochrane Database Syst Rev 2012;(5):CD002137.
9. Summerbell CD, Douthwaite W, Whittaker V, Ells LJ, Hillier F, Smith S, et al. The association between diet and physical activity and subsequent excess weight gain and obesity assessed at 5 years of age or older: a systematic review of the epidemiological evidence. Int J Obes 2009;33(Suppl 3):S1-92.
10. Astrup A, Ryan L, Grunwald GK, Storgaard M, Saris W, Melanson E, et al. The role of dietary fat in body fatness: evidence from a preliminary meta-analysis of ad libitum low-fat dietary intervention studies. Br J Nutr 2000;83(Supp 1):S25-32.
11. Wells GA, Shea B, O'Connell D, Peterson J, Welch V, Losos M, et al. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. 2011. www.ohri.ca/programs/clinical-epidemiology/oxford.htm.
12. Higgins JPT, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. BMJ 2003;327:557-60.
13. Egger M, Davey Smith G, Schneider M, Minder C. Bias in meta-analysis detected by a simple graphical test. BMJ 1997;315:629-34.
14. Sterne JAC, Sutton AJ, Ioannidis JP, Terrin N, Jones DR, Carpenter J, et al. Recommendations for examining and interpreting funnel plot asymmetry in meta-analyses of randomised controlled trials. BMJ 2011;343:d4002.
15. Guyatt GH, Oxman AD, Vist G, Kunz R, Falck-Ytter Y, Alonso-Coello P, et al. Rating quality of evidence and strength of recommendations GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ 2008;336:924-6.
16. Ley SJ, Metcalf PA, Scragg RKR, Swinburn BA. Long-term effects of a reduced fat diet intervention on cardiovascular disease risk factors in individuals with glucose intolerance. Diabetes Res Clin Pract 2004;63:103-12.
17. Boyd NF, Martin LJ, Beaton M, Cousins M, Kriukov V. Long-term effects of participation in a randomized trial of a low-fat, high-carbohydrate diet. Cancer Epidemiol Biomarkers Prev 1996;5:217-22.
18. Retzlaff BM, Walden CE, McNeney WB, Buck BL, McCann BS, Knopp RH. Nutritional intake of women and men on the NCEP Step I and Step II diets. J Am Coll Nutr 1997;16:52-61.
19. Walden CE, Retzlaff BM, Buck BL, McCann BS, Knopp RH. Lipoprotein lipid response to the National Cholesterol Education Program Step II diet by hypercholesterolemic and combined hyperlipidemic women and men. Arterioscler Thromb Vasc Biol 1997;17:375-82.
20. Walden CE, Retzlaff BM, Buck BL, Wallick S, McCann BS, Knopp RH. Differential effect of National Cholesterol Education Program (NCEP) Step II Diet on HDL cholesterol, its subfractions, and apoprotein A-1 levels in hypercholesterolemic women and men after 1 year: the beFIT study. Arterioscler Thromb Vasc Biol 2000;20:1580-7.
21. Bloemberg BPM, Kromhout D, Goddijn HE, Jansen A, Obermannde Boer GL. The impact for the guidelines for a healthy diet of the Netherlands Nutrition Council on total and high density lipoprotein cholesterol in hypercholesterolemic free living men. Am J Epidemiol 1991;134:39-48.
22. Hebert JR, Ebbeling CB, Olendzki BC, Hurley TG, Ma Y, Saal N, et al. Change in women's diet and body mass following intensive intervention for early-stage breast cancer. J Am Diet Assoc 2001;101:421-31.
23. Boyd NF, Lockwood GA, Greenberg CV, Martin LJ, Tritchler DL, Boyd NF, et al. Effects of a low-fat high-carbohydrate diet on plasma sex hormones in premenopausal women: results from a randomized controlled trial. Canadian Diet and Breast Cancer Prevention Study Group. Br J Cancer 1997;76:127-35.
24. Poppitt SD, Keogh GF, Prentice AM, Williams DEM, Sonnemans HMW, Valk EEJ, et al. Long-term effects of ad libitum low-fat, high-carbohydrate diets on body weight and serum lipids in overweight subjects with metabolic syndrome. Am J Clin Nutr 2002;75:11-20.
25. Saris WHM, Astrup A, Prentice AM, Zunft HJF, Formiguera X, Verboeket-van de Venne WPHG, et al. Randomized controlled trial of changes in dietary carbohydrate/fat ratio and simple vs complex carbohydrates on body weight and blood lipids: the CARMEN study. Int J Obes 2000;24:1310-8.
26. De Bont AJ, Baker IA, St, Sweetnam PM, Wragg KG, Stephens SM, et al. A randomised controlled trial of the effect of low fat diet advice on dietary response in insulin independent diabetic women. Diabetologia 1981;21:529-33.
27. Stefanick ML, Mackey S, Sheehan RD, Ellsworth N, Haskell WL, Wood PD. Effects of diet and exercise in men and postmenopausal women with low levels of HDL cholesterol and high levels of LDL cholesterol. N Engl J Med 1998;339:12-20.
28. Seppelt B, Weststrate JA, Reinert A, Johnson D, Luder W, Zunft HJ. Long-term effects of nutrition with fat-reduced foods on energy consumption and body weight. Z Ernahrungswiss 1996;35:369-77.
29. Anderson JW, Garrity TF, Smith BM, Whitis SE. Follow-up on a clinical trial comparing the effects of two lipid lowering diets. Arteriosclerosis 1990;10:882a.
30. Anderson JW, Garrity TF, Wood CL, Whitis SE, Smith BM, Oeltgen PR. Prospective, randomized, controlled comparison of the effects of low-fat and low-fat plus high-fiber diets on serum lipid concentrations. Am J Clin Nutr 1992;56:887-94.
31. Sarkkinen E. Long-term feasibility and effects of three different fat-modified diets in free-living hypercholesterolemic subjects. [Thesis]. University of Kuopio, 1995.
32. Boyd NF, McGuire V, Shannon P, Cousins M, Kriukov V, Mahoney L, et al. Effect of a low-fat high-carbohydrate diet on symptoms of cyclical mastopathy. Lancet 1988;2:128-32.
33. Castagnetta L, Granata OM, Cusimano R, Ravazzolo B, Liquori M, Polito L, et al. The Mediet Project. Ann N Y Acad Sci 2002;963:282-9.
34. Moy TF, Yanek LR, Raqueno JV, Bezirdjian PJ, Blumenthal RS, Wilder LB, et al. Dietary counseling for high blood cholesterol in families at risk of coronary disease. Prevent Cardiol 2001;4:158-64.
35. Van het Hof KH, Weststrate JA, van den Berg H, Velthuis-te Wierik EJ, de Graaf C, Zimmermanns NJ, et al. A long-term study on the effect of spontaneous consumption of reduced fat products as part of a normal diet on indicators of health. Int J Food Sci Nutr 1997;48:19-29.
36. NDHS. The national diet-heart study final report. Circulation 1968;37(II):1-428.
37. Djuric Z, Poore KM, Depper JB, Uhley VE, Lababidi S, Covington C, et al. Methods to increase fruit and vegetable intake with and without a decrease in fat intake: compliance and effects on body weight in the Nutrition and Breast Health Study. Nutr Cancer 2002;43:141-51.
38. Pilkington TRE, Stafford JL, Hankin VS, Simmonds FM, Koerselman HB. Practical diets for lowering serum lipids. BMJ 1960;1:23-5.
39. Lanza E, Schatzkin A, Ballard BR, Clifford DC, Paskett E, Hayes D, et al. The polyp prevention trial II: dietary intervention program and participant baseline dietary characteristics. Cancer Epidemiol Biomarkers Prev 1996;5:385-92.
40. Schatzkin A, Lanza E, Freedman LS, Tangrea J, Cooper MR, Marshall JR, et al. The polyp prevention trial I: rationale, design, recruitment, and baseline participant characteristics. Cancer Epidemiol Biomarkers Prev 1996;5:375-83.
41. Rivellese AA, Auletta P, Marotta G, Saldalamacchia G, Giacoo A, Mastrilli V, et al. Long term metabolic effects of two dietary methods of treating hyperlipidaemia. BMJ 1994;308:227-31.
42. Simon MS, Heilbrun LK, Boomer A, Kresge C, Depper J, Kim PN, et al. A randomised trial of a low-fat dietary intervention in women at high risk for breast cancer. Nutr Cancer 1997;27:136-42.
43. Sondergaard E, Moller JE, Egstrup K. Effect of dietary intervention and lipid-lowering treatment on brachial vasoreactivity in patients with ischemic heart disease and hypercholesterolemia. Am Heart J 2003;145:E19.
44. Strychar I, Cohn JS, Renier G, Rivard M, ris-Jilwan N, Beauregard H, et al. Effects of a diet higher in carbohydrate/lower in fat versus lower in carbohydrate/higher in monounsaturated fat on postmeal triglyceride concentrations and other cardiovascular risk factors in type 1 diabetes. Diabetes Care 2009;32:1597-9.
45. Holm LE, Nordevang E, Ikkala E, Hallstrom L, Callmer E. Dietary intervention as adjuvant therapy in breast cancer patients - a feasibility study. Breast Cancer Res Treat 1990;16:103-9.
46. Nordevang E, Callmer E, Marmur A, Holm LE. Dietary intervention in breast cancer patients: effects on food choice. Eur J Clin Nutr 1992;46:387-96.
47. Nordevang E, Ikkala E, Callmer E, Hallstrom L, Holm LE. Dietary intervention in breast cancer patients: effects on dietary habits and nutrient intake. Eur J Clin Nutr 1990;44:681-7.
48. Black HS, Herd JA, Goldberg LH, Wolf-JE J, Thornby JI, Rosen T, et al. Effect of a low-fat diet on the incidence of actinic keratosis. N Engl J Med 1994;330:1272-5.
49. Pierce JP, Natarajan L, Caan BJ, Parker BA, Greenberg ER, Flatt SW, et al. Influence of a diet very high in vegetables, fruit, and fiber and low in fat on prognosis following treatment for breast cancer: the Women's Healthy Eating and Living (WHEL) randomized trial. JAMA 2007;298:289-98.
50. Howard BV, Manson JE, Stefanick ML, Beresford SA, Frank G, Jones B, et al. Low-fat dietary pattern and weight change over 7 years: the Women's Health Initiative Dietary Modification Trial. JAMA 2006;295:39-49.
51. Hall WD, Feng Z, George VA, Lewis CE, Oberman A, Huber M, et al. Low-fat diet: effect on anthropometrics, blood pressure, glucose and insulin in older women. Ethn Dis 2003;13:337-43.
52. Chlebowski RT, Blackburn GL, Buzzard IM, Rose DP, Martino S, Khandekar JD, et al. Adherence to a dietary fat intake reduction program in postmenopausal women receiving therapy for early breast cancer. The Women's Intervention Nutrition Study. J Clin Oncol 1993;11:2072-80.
53. Curzio JL, Kennedy SS, Elliott HL, Farish E, Barnes JF, Howie CA, et al. Hypercholesterolaemia in treated hypertensives: a controlled trial of intensive dietary advice. J Hypertens Suppl 1989;7:S254-5.
54. Dullaart RP, Beusekamp BJ, Meijer S, Hoogenberg K, van Doormaal JJ, Sluiter WJ. Long-term effects of linoleic-acid-enriched diet on albuminuria and lipid levels in type 1 (insulin-dependent) diabetic patients with elevated urinary albumin excretion. Diabetologia 1992;35:165-72.
55. Frenkiel PG, Lee DW, Cohen H, Gilmore CJ, Resser K, Bonorris GG, et al. The effect of diet on bile acid kinetics and biliary lipid secretion in gallstone patients treated with ursodeoxycholic acid. Am J Clin Nutr 1986;43:239-50.
56. Houtsmuller AJ, Zahn KJ, Henkes HE. Unsaturated fats and progression of diabetic retinopathy. Doc Ophthalmol 1979;48:363-71.
57. Frantz ID J, Dawson EA, Ashman PL, Gatewood LC, Bartsch GE, Kuba K, et al. Test of effect of lipid lowering by diet on cardiovascular risk. The Minnesota Coronary Survey. Arteriosclerosis 1989;9:129-35.
58. Ederer F, Leren P, Turpeinen O, Frantz ID Jr. Cancer among men on cholesterol lowering diets: experience of five clinical trials. Lancet 1971;2:203-6.
59. MRC. Controlled trial of soya-bean oil in myocardial infarction. Lancet 1968;2:693-9.
60. Leren P. The effect of plasma cholesterol lowering diet in male survivors of myocardial infarction. A controlled clinical trial. Acta Med Scand Suppl 1966;466:1-92.
61. Rose GA, Thomson WB, Williams RT. Corn oil in treatment of ischaemic heart disease. BMJ 1965;1:1531-3.
62. Woodhill JM, Palmer AJ, Leelarthaepin B, McGilchrist C, Blacket RB. Low fat, low cholesterol diet in secondary prevention of coronary heart disease. Adv Exp Med Biol 1978;109:317-30.
63. Dayton S, Pearce ML, Hashimoto S, Dixon WJ, Tomayasu U. A controlled clinical trial of a diet high in unsaturated fat in preventing complications of atherosclerosis. Circulation 1969;15(1, Suppl 2):II-63.
64. Azadbakht L, Mirmiran P, Esmaillzadeh A, Azizi F. Better dietary adherence and weight maintenance achieved by a long-term moderate fat diet. Br J Nutr 2007;97:399-404.
65. Ball KP, Hanington E, McAllen PM, Pilkington TRE, Richards JM, Sharland DE, et al. Low-fat diet in myocardial infarction: a controlled trial. Lancet 1965;2:501-4.
66. Burr ML, Fehily AM, Gilbert JF, Rogers S, Holliday RM, Sweetnam PM, et al. Effects of changes in fat, fish, and fibre intakes on death and myocardial reinfarction: diet and reinfarction trial (DART). Lancet 1989;2:757-61.
67. Hjerkinn EM, Seljeflot I, Ellingsen I, Berstad P, Hjermann I, Sandvik L, et al. Influence of long-term intervention with dietary counselling, long-chain n-3 fatty acid supplements, or both on circulating markers of endothelial activation in men with long-standing hyperlipidemia. Am J Clin Nutr 2005;81:583-9.
68. Due A, Larsen TM, Mu H, Hermansen K, Stender S, Astrup A. Comparison of 3 ad libitum diets for weight-loss maintenance, risk of cardiovascular disease, and diabetes: a 6-mo randomized, controlled trial. Am J Clin Nutr 2008;88:1232-41.
69. Lean MEJ, Han TS, Prvan T, Richmond PR, Avenell A. Weight loss with high and low carbohydrate 1200 kcal diets in free living women. Eur J Clin Nutr 1997;51:243-8.
70. McAuley KA, Hopkins CM, Smith KJ, McLay RT, Williams SM, Taylor RW, et al. Comparison of a high-fat and high-protein diets with a high-carbohydrate diet in insulin-resistant obese women. Diabetologia 2005;48:8-16.
71. Bray GA, Lovejoy JC, Most-Windhauser M, Smith SR, Volaufova J, Denkins Y, et al. A 9-mo randomized clinical trial comparing fat-substituted and fat-reduced diets in healthy obese men: the Ole Study. Am J Clin Nutr 2002;76:928-34.
72. Hockaday TD, Hockaday JM, Mann JI, Turner RC. Prospective comparison of modified fat-high-carbohydrate with standard low-carbohydrate dietary advice in the treatment of diabetes: one year follow-up study. Br J Nutr 1978;39:357-62.
73. Appel LJ, Champagne CM, Harsha DW, Cooper LS, Obarzanek E, Elmer PJ, et al. Effects of comprehensive lifestyle modification on blood pressure control: main results of the PREMIER clinical trial. JAMA 2003;289:2083-93.
74. Sacks FM, Bray GA, Carey VJ, Smith SR, Ryan DH, Anton SD, et al. Comparison of weight-loss diets with different compositions of fat, protein, and carbohydrates. N Engl J Med 2009;360:859-73.
75. Watts GF, Lewis B, Brunt JN, Lewis ES, Coltart DJ, Smith LD, et al. Effects on coronary artery disease of lipid-lowering diet, or diet plus cholestyramine, in the St Thomas' Atherosclerosis Regression Study (STARS). Lancet 1992;339:563-9.
76. Tuttle KR, Shuler LA, Packard DP, Milton JE, Daratha KB, Bibus DM, et al. Comparison of low-fat versus Mediterranean-style dietary intervention after first myocardial infarction (from The Heart Institute of Spokane Diet Intervention and Evaluation Trial). Am J Cardiol 2008;101:1523-30.
77. McKeown-Eyssen GE, Bright-See E, Bruce WR, Jazmaji V, Toronto Polyp Prevention Group. A randomized trial of a low fat high fibre diet in the recurrence of colorectal polyps. J Clin Epidemiol 1994;47:525-36.
78. Furukawa TA, Watanabe N, Montori VM, Guyatt GH. Association between unreported outcomes and effect size estimates in Cochrane meta-analyses. JAMA 2007;297:468-70.
79. Mihas C, Mariolis A, Manios Y, Naska A, Arapaki A, Mariolis-Sapsakos T, et al. Evaluation of a nutrition intervention in adolescents of an urban area in Greece: short- and long-term effects of the VYRONAS study. Public Health Nutr 2010;13:712-9.
80. Davison KK, Birch LL. Child and parent characteristics as predictors of change in girls' body mass index. Int J Obes 2001;25:1834-42.
81. Butte NF, Cai G, Cole SA, Wilson TA, Fisher JO, Zakeri IF, et al. Metabolic and behavioral predictors of weight gain in Hispanic children: the Viva la Familia Study. Am Jf Clin Nutr 2007;85:1478-85.
82. Klesges RC, Klesges LM, Eck LH, Shelton ML. A longitudinal analysis of accelerated weight gain in preschool children. Pediatrics 1995;95:126-30.
83. Willett WC. Dietary fat plays a major role in obesity: no. Obesity reviews 2002;3:59-68.
84. Bray GA, Popkin BM. Dietary fat intake does affect obesity! Am J Clin Nutr 1998;68:1157-73.
85. Prospective Studies Collaboration. Body-mass index and cause-specific mortality in 900,000 adults: collaborative analyses of 57 prospective studies. Lancet 2009;373:1083e96.