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Journal of Parenteral and Enteral Nutrition
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2007 Clinical Nutrition Week Research Workshop Papers

Dietary Management of Obesity

Arne Astrup, MD

From the Department of Human Nutrition, Faculty of Life Sciences, University of Copenhagen, Frederiksberg, Denmark.

Address correspondence to: Arne Vernon Astrup, MD, Department of Human Nutrition, Faculty of Life Sciences, University of Copenhagen, Rolighedsvej 30, DK-1958 Frederiksberg C, Denmark; phone: +45-3533-2470; e-mail: ast{at}life.ku.dk.

Background: The optimal diet for prevention of weight gain, obesity, metabolic syndrome, and type 2 diabetes is fat-reduced, fiber-rich, high in low-energy density carbohydrates (fruit, vegetables, and whole grain products), and intake of energy-containing drinks is restricted. Results on dietary fat: The reduction of the total fat content of ad libitum diets produces weight loss in both the short term and over periods as long as 7 years. A fat-reduced diet, combined with physical activity, reduces almost all risk factors for cardiovascular disease and reduces the incidence of type 2 diabetes. The combination of reduction of dietary fat and energy, and increased physical activity has been shown to reduce the incidence of diabetes by 58% in 2 major trials. In post hoc analyses, the reduction in dietary fat (energy density) and increase in fiber were the strongest predictors of weight loss and diabetes-protective effects. Low-glycemic index and high-protein diets: It remains to be shown whether a low-glycemic index diet provides any benefit to weight control beyond this. Low-carbohydrate diets may be an option for inducing weight loss in obese patients, but a very low intake of carbohydrate-rich foods is not commensurate with a healthy and palatable diet in the long term. However, there is evidence that increasing the protein content of the diet from 15% up to 20%-30%, at the expense of carbohydrates, increases the satiating effect of the diet, and induces a spontaneous weight loss, and this could turn out to be a preferred option for patients with metabolic syndrome and type 2 diabetes.

Key Words: Obesity • weight control • optimal diet • metabolic syndrome • type 2 diabetes • protein

Journal of Parenteral and Enteral Nutrition, Vol. 32, No. 5, 575-577 (2008)
DOI: 10.1177/0148607108321707


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