• Sabine Frisch, Armin Zittermann, Heiner K Berthold, Christian Götting, Joachim Kuhn, Knut Kleesiek, Peter Stehle, and Heinrich Körtke.
• Klinik für Thorax- und Kardiovaskularchirurgie, Herzzentrum NRW, Ruhr Universität Bochum, Bad Oeynhausen, Germany. sfrisch@hdz-nrw.de
• Cardiovasc Diabetol. 2009 Jan 1;8:36.

BackgroundWe investigated whether macronutrient composition of energy-restricted diets influences the efficacy of a telemedically guided weight loss program.MethodsTwo hundred overweight subjects were randomly assigned to a conventional low-fat diet and a low-carbohydrate diet group (target carbohydrate content: >55% energy and <40% energy, respectively). Both groups attended a weekly nutrition education program and dietary counselling by telephone, and had to transfer actual body weight data to our clinic weekly with added Bluetooth technology by mobile phone. Various fatness and fat distribution parameters, energy and macronutrient intake, and various biochemical risk markers were measured at baseline and after 6, and 12 months.ResultsIn both groups, energy intake decreased by 400 kcal/d compared to baseline values within the first 6 months and slightly increased again within the second 6 months. Macronutrient composition differed significantly between the groups from the beginning to month 12. At study termination, weight loss was 5.8 kg (SD: 6.1 kg) in the low-carbohydrate group and 4.3 kg (SD: 5.1 kg) in the low-fat group (p = 0.065). In the low-carbohydrate group, triglyceride and HDL-cholesterol levels were lower at month 6 and waist circumference and systolic blood pressure were lower at month 12 compared with the low-fat group (P = 0.005-0.037). Other risk markers improved to a similar extent in both groups.ConclusionDespite favourable effects of both diets on weight loss, the carbohydrate-reduced diet was more beneficial with respect to cardiovascular risk factors compared to the fat-reduced diet. Nevertheless, compliance with a weight loss program appears to be even a more important factor for success in prevention and treatment of obesity than the composition of the diet.Trial RegistrationClinicaltrials.gov as NCT00868387.

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