Energy balance
Long-term weight loss (2 years) is equivalent across diets emphasizing different macronutrients (low/high fat, average/high protein, low/high carbohydrate) when caloric intake is reduced and adherence is supported.
To lose weight, focus on creating a consistent caloric deficit rather than obsessing over whether your diet is high-protein, low-carb, or low-fat. This study shows that if you can adhere to a reduced-calorie diet (approx. 750 kcal deficit/day) for two years, you will lose a similar amount of weight regardless of the macronutrient breakdown. Use behavioral tools like food diaries and regular check-ins to maintain adherence, as attendance and consistency were the strongest predictors of success.
Reduced-calorie diets result in clinically meaningful weight loss regardless of which macronutrients they emphasize.
Why this rating
Large randomized clinical trial (n=811), 2-year duration, factorial design, intention-to-treat analysis, published in NEJM.
Source
Comparison of Weight-Loss Diets with Different Compositions of Fat, Protein, and Carbohydrates
Frank M. Sacks et al. · New England Journal of Medicine · 2009
DOI 10.1056/nejmoa0804748
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