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WOMEN’S HEALTH INITIATIVE UPDATE: Low-Fat Diets Not Associated with Weight Gain

Postmenopausal women randomized to a low-fat diet showed no tendency for weight gain over almost 8 years of follow-up.

Obesity in the U.S. has reached epidemic proportions. Many lay publications have promoted the belief that low-fat, high-carbohydrate diets are to blame. Now, a recent study has challenged that belief.

In the Women’s Health Initiative Dietary Modification Trial, researchers randomized 48,835 postmenopausal U.S. women of diverse backgrounds to either an intervention or control group. In the intervention group, dieticians met with women in individual and small group sessions that focused on reducing fat intake to approximately 20% of total calories and increasing consumption of vegetables, fruits, and grains, while maintaining usual caloric intake. Group sessions occurred 18 times in the first year and 4 times per year thereafter. The control group received diet- and health-related educational materials.

During a mean follow-up of 7.5 years, women in the intervention group showed no tendency for weight gain. In fact, these women had significant weight loss in the first year (mean, 2.2 kg), and they maintained lower weight than control women throughout follow-up. Weight loss was greatest among women who decreased their percentage of calories from fat: Those in the intervention and control groups who decreased their fat intake by more than 11% lost an average of 1.50 kg and 1.25 kg, respectively, over the course of the study. Similar, but smaller, weight-loss trends were seen with increased intake of vegetables and fruits.

Comment: The researchers conclude that a low-fat eating pattern does not result in weight gain in postmenopausal women; because the intervention group was not asked to restrict calories, lack of major weight loss is not surprising. Earlier research on four popular diets demonstrated that adherence correlated more with weight loss than did diet type (Journal Watch Women’s Health Apr 6 2005). Most of our patients will benefit from modifying their lifestyles, and some will prefer low-fat diets. We can safely incorporate this preference into our recommendations.

— Jane E. Corboy, MD

Published in Journal Watch Women's Health March 7, 2006

Citation(s):

Howard BV et al. Low-fat dietary pattern and weight change over 7 years: The Women's Health Initiative Dietary Modification Trial. JAMA 2006 Jan 4; 295:39-49.

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