title: Randomized trial on protein vs carbohydrate in ad libitum fat reduced diet for the treatment of obesity.
abstract: OBJECTIVE
  To study the effect on weight loss in obese subjects by replacement of carbohydrate by protein in ad libitum consumed fat-reduced diets.
  
  
  METHODS
  Randomized dietary intervention study over six months comparing two ad libitum fat reduced diets (30% of total energy) strictly controlled in composition: High-carbohydrate (HC, protein 12% of total energy) or high-protein (HP, protein 25% of total energy).
  
  
  METHODS
  Subjects were 65 healthy, overweight and obese subjects (50 women, 15 men, aged 18-55 y) randomly assigned to HC (n = 25), HP (n = 25) or a control group (C, n = 15). All food was provided by self-selection in a shop at the department, and compliance to the diet composition was evaluated by urinary nitrogen excretion.
  
  
  METHODS
  Change in body weight, body composition and blood lipids.
  
  
  RESULTS
  More than 90% completed the trial. Weight loss after six months was 5.1 kg in the HC group and 8.9 kg in the HP group (difference 3.7 kg, 95% confidence interval (CI)(1.3-6.2 kg) P < 0.001), and fat loss was 4.3 kg and 7.6 kg, respectively (difference 3.3 kg (1.1-5.5 kg) P < 0.0001), whereas no changes occurred in the control group. More subjects lost > 10 kg in the HP group (35%) than in the HC group (9%). The HP diet only decreased fasting plasma triglycerides and free fatty acids significantly.
  
  
  CONCLUSIONS
  Replacement of some dietary carbohydrate by protein in an ad libitum fat-reduced diet, improves weight loss and increases the proportion of subjects achieving a clinically relevant weight loss. More freedom to choose between protein-rich and complex carbohydrate-rich foods may allow obese subjects to choose more lean meat and dairy products, and hence improve adherence to low-fat diets in weight reduction programs.
authors.affiliation: Research Department of Human Nutrition, The Royal Veterinary and Agricultural University, Copenhagen, Denmark.
authors.forename: A R
authors.initials: AR
authors.lastname: Skov
authors.forename: S
authors.initials: S
authors.lastname: Toubro
authors.forename: B
authors.initials: B
authors.lastname: Rønn
authors.forename: L
authors.initials: L
authors.lastname: Holm
authors.forename: A
authors.initials: A
authors.lastname: Astrup
mesh_terms: D000293:Adolescent; D000328:Adult; D001823:Body Composition; D018752:Diet, Fat-Restricted; D004040:Dietary Carbohydrates / Q000008:administration & dosage*; D004044:Dietary Proteins / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000178:diet therapy* / Q000652:urine; D010342:Patient Acceptance of Health Care; D010349:Patient Compliance; D015431:Weight Loss
chemical_list: D004040:Dietary Carbohydrates; D004044:Dietary Proteins; D008055:Lipids