Carbohydrate-restricted diets high in either monounsaturated fat or protein are equally effective at promoting fat loss and improving blood lipids.

BACKGROUND: When substituted for carbohydrate in an energy-reduced diet, dietary protein enhances fat loss in women. It is unknown whether the effect is due to increased protein or reduced carbohydrate.

OBJECTIVE: We compared the effects of 2 isocaloric diets that differed in protein and fat content on weight loss, lipids, appetite regulation, and energy expenditure after test meals.

DESIGN: This was a parallel, randomized study in which subjects received either a low-fat, high-protein (LF-HP) diet (29 +/- 1% fat, 34 +/- 0.8% protein) or a high-fat, standard-protein (HF-SP) diet (45 +/- 0.6% fat, 18 +/- 0.3% protein) during 12 wk of energy restriction (6 +/- 0.1 MJ/d) and 4 wk of energy balance (7.4 +/- 0.3 MJ/d). Fifty-seven overweight and obese [mean body mass index (in kg/m(2)): 33.8 +/- 0.9] volunteers with insulin concentrations >12 mU/L completed the study.

RESULTS: Weight loss (LF-HP group, 9.7 +/- 1.1 kg; HF-SP group, 10.2 +/- 1.4 kg; P = 0.78) and fat loss were not significantly different between diet groups even though the subjects desired less to eat after the LF-HP meal (P = 0.02). The decrease in resting energy expenditure was not significantly different between diet groups (LF-HP, -342 +/- 185 kJ/d; HF-SP, -349 +/- 220 kJ/d). The decrease in the thermic effect of feeding with weight loss was smaller in the LF-HP group than in the HF-SP group (-0.3 +/- 1.0% compared with -3.6 +/- 0.7%; P = 0.014). Glucose and insulin responses to test meals improved after weight loss (P < 0.001) with no significant diet effect. Bone turnover, inflammation, and calcium excretion did not change significantly.

CONCLUSION: The magnitude of weight loss and the improvements in insulin resistance and cardiovascular disease risk factors did not differ significantly between the 2 diets, and neither diet had any detrimental effects on bone turnover or renal function.