Long-term effects of 4 popular diets on weight loss and cardiovascular risk factors: a systematic review of randomized controlled trials.


Journal Article (Review)

BACKGROUND: We conducted a systematic review to examine the efficacy of the Atkins, South Beach, Weight Watchers (WW), and Zone diets, with a particular focus on sustained weight loss at ≥12 months. METHODS AND RESULTS: We systematically searched MEDLINE, EMBASE, and the Cochrane Library of Clinical Trials to identify randomized controlled trials (RCTs) published in English with follow-up ≥4 weeks that examined the effects of these 4 popular diets on weight loss and cardiovascular risk factors. We identified 12 RCTs (n=2559) with follow-up ≥12 months: 10 versus usual care (5 Atkins, 4 WW, and 1 South Beach) and 2 head-to-head (1 of Atkins, WW, and Zone, and 1 of Atkins, Zone, and control). At 12 months, the 10 RCTs comparing popular diets to usual care revealed that only WW was consistently more efficacious at reducing weight (range of mean changes: -3.5 to -6.0 kg versus -0.8 to -5.4 kg; P<0.05 for 3/4 RCTs). However, the 2 head-to-head RCTs suggest that Atkins (range: -2.1 to -4.7 kg), WW (-3.0 kg), Zone (-1.6 to -3.2 kg), and control (-2.2 kg) all achieved modest long-term weight loss. Twenty-four-month data suggest that weight lost with Atkins or WW is partially regained over time. CONCLUSIONS: Head-to-head RCTs, providing the most robust evidence available, demonstrated that Atkins, WW, and Zone achieved modest and similar long-term weight loss. Despite millions of dollars spent on popular commercial diets, data are conflicting and insufficient to identify one popular diet as being more beneficial than the others.

Full Text

Cited Authors

  • Atallah, R; Filion, KB; Wakil, SM; Genest, J; Joseph, L; Poirier, P; Rinfret, S; Schiffrin, EL; Eisenberg, MJ

Published Date

  • November 2014

Published In

Volume / Issue

  • 7 / 6

Start / End Page

  • 815 - 827

PubMed ID

  • 25387778

Pubmed Central ID

  • 25387778

Electronic International Standard Serial Number (EISSN)

  • 1941-7705

Digital Object Identifier (DOI)

  • 10.1161/CIRCOUTCOMES.113.000723


  • eng

Conference Location

  • United States