title: The effect of three different ad libitum diets for weight loss maintenance: a randomized 18-month trial.
abstract: OBJECTIVE
  To test the effect of three diets in their ability to sustain weight loss and improve type 2 diabetes (T2D) and cardiovascular disease (CVD) risk markers after 18-month intervention.
  
  
  METHODS
  Following a ≥8 % weight loss, 131 healthy, overweight/obese (BMI ± SD 31.5 ± 2.6 kg/m2) men (n = 55) and women (n = 76) aged 28.2 ± 4.8 years were randomized to either 1. Moderate fat (40 E%) with 20 E% MUFA and low in glycemic index (GI) (MUFA, n = 54), 2. Low fat (25 E%) and medium in GI (LF, n = 51) or 3. Control (35 E% fat) and high in GI (CTR, n = 26) all with similar protein content, and all provided ad libitum. First 6-month intervention with 100 % food provision (previously reported) following 12 months of moderately intensive intervention with 20 % food provision now reported.
  
  
  RESULTS
  Attrition rate was higher in MUFA (63 %) than in LF (37 %, P = 0.019) and CTR (42 %, P = 0.09) group. Weight regain in completers was not different between groups (mean ± SEM), MUFA 7.1 ± 2.1 % versus LF 5.6 ± 1.3 % versus CTR 7.2 ± 1.5 %, nor was body fat regain, MUFA 4.8 ± 1.0 % versus LF 4.7 ± 0.8 % versus CTR 5.7 ± 0.6 %. The MUFA group reduced LDL/HDL ratio by -0.47 ± 0.09 compared with -0.23 ± 0.11 in LF (P < 0.05) and 0.06 ± 0.14 (P < 0.005) in CTR groups.
  
  
  CONCLUSIONS
  Weight regain or body composition did not differ between diets over 18 months. No effects on risk markers for T2D or CVD were found, with the exception of an improvement in the LDL/HDL ratio by the MUFA diet compared to the CTR diet. The LF diet was generally more satisfactory and the MUFA diet seemed more difficult to follow.
authors.affiliation: Department of Nutrition, Exercise and Sports, University of Copenhagen, Rolighedsvej 30, 1958, Frederiksberg C, Denmark. adue@phmetropol.dk.|Department of Nutrition and Midwifery, Faculty of Health and Technology, Metropolitan University College, Pustervig 8, 1126, Copenhagen, Denmark. adue@phmetropol.dk.
authors.forename: Anette
authors.initials: A
authors.lastname: Due
authors.affiliation: Department of Nutrition, Exercise and Sports, University of Copenhagen, Rolighedsvej 30, 1958, Frederiksberg C, Denmark.
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Larsen
authors.affiliation: Department of Pharmaceutics and Analytical Chemistry, University of Copenhagen and Biocentrum, Technical University of Denmark, Copenhagen, Denmark.
authors.forename: Huiling
authors.initials: H
authors.lastname: Mu
authors.affiliation: Department of Endocrinology and Internal Medicine MEA, Aarhus University Hospital, 8000, Aarhus C, Denmark.
authors.forename: Kjeld
authors.initials: K
authors.lastname: Hermansen
authors.affiliation: Department of Clinical Biochemistry, Copenhagen University Hospital, Gentofte, Denmark.
authors.forename: Steen
authors.initials: S
authors.lastname: Stender
authors.affiliation: Research Unit, Universitetsparken 2, 4000, Roskilde, Denmark.|Novo Nordisk, Depart 4177 GLP-1 & Obesity, 2860, Søborg, Denmark.
authors.forename: Søren
authors.initials: S
authors.lastname: Toubro
authors.affiliation: Department of Biostatistics, Nutrition Obesity Research Center, University of Alabama, Birmingham, AL, USA.
authors.forename: David B
authors.initials: DB
authors.lastname: Allison
authors.affiliation: Department of Nutrition, Exercise and Sports, University of Copenhagen, Rolighedsvej 30, 1958, Frederiksberg C, Denmark.
authors.forename: Arne
authors.initials: A
authors.lastname: Astrup
mesh_terms: D015415:Biomarkers / Q000097:blood; D001823:Body Composition; D015992:Body Mass Index; D000068959:Body Weight Maintenance; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D003718:Denmark / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D050528:Diet, Carbohydrate-Restricted / Q000009:adverse effects; D018752:Diet, Fat-Restricted / Q000009:adverse effects; D038441:Diet, Mediterranean / Q000009:adverse effects; D004038:Diet, Reducing / Q000009:adverse effects; D005229:Fatty Acids, Monounsaturated / Q000627:therapeutic use*; D005260:Female; D038321:Glycemic Index; D006801:Humans; D057194:Intention to Treat Analysis; D008297:Male; D009765:Obesity / Q000097:blood / Q000178:diet therapy / Q000503:physiopathology / Q000517:prevention & control*; D050177:Overweight / Q000097:blood / Q000178:diet therapy / Q000503:physiopathology / Q000517:prevention & control*; D010352:Patient Dropouts; D012307:Risk Factors; D055502:Secondary Prevention
chemical_list: D015415:Biomarkers; D005229:Fatty Acids, Monounsaturated
keywords: Cardiovascular disease; Dietary intervention; Mediterranean diet; Weight loss; Weight maintenance