A. Astrup et al., THE ROLE OF LOW-FAT DIETS AND FAT SUBSTITUTES IN BODY-WEIGHT MANAGEMENT - WHAT HAVE WE LEARNED FROM CLINICAL-STUDIES, Journal of the American Dietetic Association, 97(7), 1997, pp. 82-87
The introduction of low-fat, high-complex carbohydrate diets for the p
revention and treatment of obesity was based on the causal link establ
ished between dietary fat and body fatness. Observational and mechanis
tic studies show that because fat possesses a lower satiating power th
an carbohydrate and protein, a diet rich in fat can increase energy in
take. The propensity to gain weight is enhanced in susceptible persons
, particularly sedentary people who have a genetic predisposition to o
besity. Low-fat diets cause weight loss proportional to pretreatment b
ody weight in a dose-dependent manner; that is, weight loss is correla
ted positively to the reduction in dietary fat content. A reduction of
10% fat energy produces an average 5-kg weight loss in obese persons.
As with traditional calorie counting diets, obese persons lose weight
only if they adhere to the prescribed low-fat diet. Failure to achiev
e a weight loss and to maintain it may be attributed in part to lack o
f adherence to the diet. After a major weight loss, an ad libitum low-
fat diet program appears to be superior to calorie counting in maintai
ning the weight loss 2 years later. Replacing some fat with protein in
stead of carbohydrate may increase the weight loss further. Moreover,
fat substitutes may make it easier to prevent and treat obesity by mak
ing the diet palatable. More randomized, controlled, long-term dietary
intervention studies are warranted to identify the optimal diet compo
sition for the treatment of obesity.