Weight Management: Review of the Dietary Guidelines for Americans and Institute of Medicine Report Recommendations
Julie L. Roth, MD, Courtney A. Noble, MD, and Bethany M. Doerfler, MS, RD
This article reviews two currently available evidence-based guidelines pertaining to diet and nutrition: the US Department of Health and Human Services and US Department of Agriculture’s 2005 dietary guidelines and the Institute of Medicine,
report on dietary reference intakes. These publications provide the most reliable evidence for the treatment of overweight and obesity. Key recommendations for weight loss include: expend energy in excess of caloric intake, accrue at least 60 minutes of daily physical activity, and maintain consistency in weight loss efforts. Maintaining a balanced diet of macronutrients as put forth in the Institute of Medicine’s report will also help prevent the development of chronic disease.
Nutr Clin Care. 2005;8:107–114
© 2005 International Life Sciences Institute
Low-fat Diets for Weight Management: Efficacy, Safety, and Applications
Sachiko T. St. Jeor, PhD, RD, Vicki H. Bovee, MS, RD, and Jolyn K. Wirshing, RD
Low-fat diets continue to be popular for weight management and health promotion. Weight loss during the reduction phase has been directly related to total energy (in kilocalories) consumed and appears to be independent of the fat content of the
diet. Weight maintenance, prevention of weight regain, and health promotion over the longer term have been associated with lower fat intakes overall. Consumers need to be aware of the limitations and applications of low-fat diets and how to
evaluate them for overall efficacy, safety, and palatability.
Nutr Clin Care. 2005;8:115–122
© 2005 International Life Sciences Institute
Carbohydrate-Controlled Diets: Are They Safe and Effective?
Holly R. Wyatt, MD, and James O. Hill, PhD
Low-carbohydrate diets have traditionally been regarded as non-evidence-based, fad diets. However, several research groups have now reported randomized trials of up to 1 year in duration in which weight loss with low-carbohydrate diets was
compared with conventional low-fat, calorie-restricted diets. In general, the trials have shown better weight reduction at 6 months in the low-carbohydrate compared with the low-fat groups, but very little if any difference in weight loss at 12 months between the diet groups. Favorable changes in triglycerides and high-density lipoprotein (HDL) cholesterol were also noted in the low-carbohydrate groups. While the available results are intriguing, there are still unanswered questions about the safety and long-term efficacy of low-carbohydrate diets that will require larger and longer-term studies. This research is needed before low-carbohydrate diets can be routinely recommended to the general overweight and obese population.
Nutr Clin Care. 2005;8:123–131
© 2005 International Life Sciences Institute
Major Commercial and Self-Help Weight Loss Programs in the United States
Adam Gilden Tsai, MD, MS and Thomas A. Wadden, PhD
We sought to describe the nutritional and behavioral components, costs, and efficacy of the major commercial and self-help weight loss programs in the United States. Company websites and telephone discussions with company representatives were used to gather information about components and costs, and a Medline search was conducted. We found that participants in Weight Watchers®, in a randomized trial, achieved a 3.2% weight loss after 2 years. Participants in two medically supervised programs, OPTIFAST® and Health Management Resources
(HMR®), achieved larger weight losses with low-calorie or very-low-calorie diets, but with large attrition rates and at high cost. No research supported Internet or self-help programs, but the latter might be useful because they cost little or nothing to patients. Thus, a range of options exists for patients, but the evidence to support them is generally lacking. Further research in this area is needed.
Nutr Clin Care. 2005;8:132–140
© 2005 International Life Sciences Institute