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Obesity is a risk factor for cardiovascular disease, but in women, abdominal obesity, defined by a large waist circumference or high waist to hip ratio, is a stronger risk factor for heart disease, stroke, and type 2 diabetes than BMI. Dietary macronutrient composition can potentiate the improvement in cardiovascular risk factors achieved with weight loss. Dietary macronutrient composition may also influence body composition. In 2 previously published studies, one in energy balance and one that was energy restricted, subjects with type 2 diabetes experienced an adverse effect on the ratio of upper body to lower body fat after consumption of a high-carbohydrate/low-fat diet compared with a high monounsaturated fat diet, which produced no change in this ratio. The aim of the current study was to establish whether these changes could be reproduced in a weight loss study in nondiabetic women, in which significant losses in total fat mass were achieved.
The subjects included 70 nondiabetic women with BMI > 27 kg/[m.sup.2]. The subjects were matched for BMI and self-reported menopause status. The women were blocked into two groups and randomly assigned to consume a diet either high in monounsaturated fat (HIMO) with 35% of energy from fat, 20% energy from monounsaturated fat, and 6% energy from saturated fat or a very low-fat (VLF) diet with 12% energy from fat, 4% energy as monounsaturated fat, and 4% energy from saturated fat for 12 wk. Protein intake provided 21% of energy.
Eight subjects (four from each dietary intervention) withdrew because of inability to maintain compliance or because of work or travel commitments. Total fat, carbohydrate, saturated fat, monounsaturated fat, and polyunsaturated fat intakes differed between the groups. Energy intake did not differ. Weight loss did not differ between the groups nor did total fat loss. Total fat mass fell 14% in both groups. There was a significant effect of menopausal status on the amount of trunk fat such that postmenopausal women lost more trunk fat when consuming VLF. Serum lipids declined during the course of the study.
In this study, a very low-fat weight loss diet compared with a high monounsaturated weight loss diet did not have differential effects on fat distribution. The researchers confirmed previous findings that weight loss was the same when either HIMO or VLF diets were consumed under energy-restricted conditions. However, in contrast to previous findings, the amount of fat and lean tissue lost and the distribution of the loss did not differ between groups.
P Clifton, M Noakes, J Keogh. Very low-fat (12%) and high monounsaturated fat (35%) diets do not differentially affect abdominal fat loss in overweight, nondiabetic women. d Nutr 134:1741-1745 (July 2004) [Correspondence: Peter Clifton. Email: peter.clifton@hsn.csiro.au]
