La réduction de l’apport énergétique est le facteur le plus important pour perdre du poids, plutôt que la nature des macronutriments

Effets de 4 régimes pour perdre du poids ayant une influence différente pour ce qui est des matières grasses, des protéines et des glucides sur la masse grasse, la masse maigre, le tissu adipeux viscéral et le gras hépatique : nombre de KILOGRAMMES PERDUS dans l’essai

Russell J de Souza, George A Bray, Vincent J Carey, Kevin D Hall, Meryl S LeBoff, Catherine M Loria, Nancy M Laranjo, Frank M Sacks, and Steven R Smith
Department of Nutrition, Harvard School of Public Health, Boston, MA and Endocrine Division, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.

Am J Clin Nutr. 2012 Mar;95(3):614-625.

Abstract

Background: Weight loss reduces body fat and lean mass, but whether these changes are influenced by macronutrient composition of the diet is unclear.

Objective: We determined whether energy-reduced diets that emphasize fat, protein, or carbohydrate differentially reduce total, visceral, or hepatic fat or preserve lean mass.

Design: In a subset of participants in a randomized trial of 4 weight-loss diets, body fat and lean mass (n = 424; by using dual-energy X-ray absorptiometry) and abdominal and hepatic fat (n = 165; by using computed tomography) were measured after 6 mo and 2 y. Changes from baseline were compared between assigned amounts of protein (25% compared with 15%) and fat (40% compared with 20%) and across 4 carbohydrate amounts (35% through 65%).

Results: At 6 mo, participants lost a mean (±SEM) of 4.2 ± 0.3 kg (12.4%) fat and 2.1 ± 0.3 kg (3.5%) lean mass (both P < 0.0001 compared with baseline values), with no differences between 25% and 15% protein (P ≥ 0.10), 40% and 20% fat (P ≥ 0.34), or 65% and 35% carbohydrate (P ≥ 0.27). Participants lost 2.3 ± 0.2 kg (13.8%) abdominal fat: 1.5 ± 0.2 kg (13.6%) subcutaneous fat and 0.9 ± 0.1 kg (16.1%) visceral fat (all P < 0.0001 compared with baseline values), with no differences between the diets (P ≥ 0.29). Women lost more visceral fat than did men relative to total-body fat loss. Participants regained ∼40% of these losses by 2 y, with no differences between diets (P ≥ 0.23). Weight loss reduced hepatic fat, but there were no differences between groups (P ≥ 0.28). Dietary goals were not fully met; self-reported contrasts were closer to 2% protein, 8% fat, and 14% carbohydrate at 6 mo and 1%, 7%, and 10%, respectively, at 2 y.

Conclusion: Participants lost more fat than lean mass after consumption of all diets, with no differences in changes in body composition, abdominal fat, or hepatic fat between assigned macronutrient amounts.

Link to abstract