Low or Moderate Dietary Energy Restriction for Long-term Weight Loss: What Works Best?
Article first published online: 10 SEP 2012
2009 North American Association for the Study of Obesity (NAASO)
Volume 17, Issue 11, pages 2019–2024, November 2009
How to Cite
Das, S. K., Saltzman, E., Gilhooly, C. H., DeLany, J. P., Golden, J. K., Pittas, A. G., Dallal, G. E., Bhapkar, M. V., Fuss, P. J., Dutta, C., McCrory, M. A. and Roberts, S. B. (2009), Low or Moderate Dietary Energy Restriction for Long-term Weight Loss: What Works Best?. Obesity, 17: 2019–2024. doi: 10.1038/oby.2009.120
- Issue published online: 10 SEP 2012
- Article first published online: 10 SEP 2012
- Received 07 December, 2008; accepted 23 March, 2009
Theoretical calculations suggest that small daily reductions in energy intake can cumulatively lead to substantial weight loss, but experimental data to support these calculations are lacking. We conducted a 1-year randomized controlled pilot study of low (10%) or moderate (30%) energy restriction (ER) with diets differing in glycemic load in 38 overweight adults (mean ± s.d., age 35 ± 6 years; BMI 27.6 ± 1.4 kg/m2). Food was provided for 6 months and self-selected for 6 additional months. Measurements included body weight, resting metabolic rate (RMR), adherence to the ER prescription assessed using 2H218O, satiety, and eating behavior variables. The 10%ER group consumed significantly less energy (by 2H218O) than prescribed over 12 months (18.1 ± 9.8%ER, P = 0.04), while the 30%ER group consumed significantly more (23.1 ± 8.7%ER, P < 0.001). Changes in body weight, satiety, and other variables were not significantly different between groups. However, during self-selected eating (6–12 months) variability in % weight change was significantly greater in the 10%ER group (P < 0.001) and poorer weight outcome on 10%ER was predicted by higher baseline BMI and greater disinhibition (P < 0.0001; adj R2 = 0.71). Weight loss at 12 months was not significantly different between groups prescribed 10 or 30%ER, supporting the efficacy of low ER recommendations. However, long-term weight change was more variable on 10%ER and weight change in this group was predicted by body size and eating behavior. These preliminary results indicate beneficial effects of low-level ER for some but not all individuals in a weight control program, and suggest testable approaches for optimizing dieting success based on individualizing prescribed level of ER.