{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T06:36:17Z","timestamp":1790922977125,"version":"4.1.0"},"reference-count":84,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,4,5]],"date-time":"2022-04-05T00:00:00Z","timestamp":1649116800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Nutr."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Scientists have been investigating efficient interventions to prevent and manage obesity. This network meta-analysis (NMA) compared the effect of different diets [moderate macronutrients (MMs), low fat\/high carbohydrate (LFHC), high fat\/low carbohydrate (HFLC), and usual diet (UD)] on weight, body mass index (BMI), and waist circumference (WC) changes at \u226512 months.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We searched Medline, Embase, PubMed databases, and the Cochrane Library. We systematically assessed randomized controlled trials (RCTs) evaluating dietary interventions on adults (mean BMI \u2265 25 kg\/m<jats:sup>2<\/jats:sup>) receiving active dietary counseling for \u226512 months. We pooled the data using a random-effect NMA. We assessed the quality of the included RCTs using the Cochrane risk of bias (ROB) tool.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We included 36 trials, 14 of which compared HFLC with MM diets. Compared with UD, all diets were associated with a significant weight loss (WL) at \u226512 months, HFLC [mean difference in kg (95% <jats:italic>CI<\/jats:italic>): \u22125.5 (\u22127.6; \u22123.4)], LFHC [\u22125.0 (\u22127.1; \u22122.9)] and MM [\u22124.7 (\u22126.8; \u22122.7)]. HFLC, compared with MM diet, was associated with a slightly higher WL (of \u22120.77 kg) and drop in BMI (of \u22120.36 kg\/m<jats:sup>2<\/jats:sup>), while no significant difference was detected in other dietary comparisons. WC was lower with all diets compared to UD, with no significant difference across specific diets. There was no significant interaction of the results with the pre-specified sub-groups. The ROB was moderate to high, mostly related to unclear allocation concealment, high dropout rate and unclear or lack of blinding of participants, providers, and outcome assessors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Dietary interventions extending over \u226512 months are superior to UD in inducing weight, BMI and WC loss. HFLC might be associated with a slightly higher WL compared with MM diets.<\/jats:p><\/jats:sec><jats:sec><jats:title>Systematic Trial Registration<\/jats:title><jats:p><jats:ext-link>https:\/\/www.crd.york.ac.uk\/prospero\/display_record.php?RecordID=103116<\/jats:ext-link>, PROSPERO (CRD42018103116).<\/jats:p><\/jats:sec>","DOI":"10.3389\/fnut.2022.821096","type":"journal-article","created":{"date-parts":[[2022,4,11]],"date-time":"2022-04-11T11:14:01Z","timestamp":1649675641000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":12,"title":["Long Term Weight Loss Diets and Obesity Indices: Results of a Network Meta-Analysis"],"prefix":"10.3389","volume":"9","author":[{"given":"Jana","family":"Jabbour","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasmin","family":"Rihawi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Assem M.","family":"Khamis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Layal","family":"Ghamlouche","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bayan","family":"Tabban","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gloria","family":"Safadi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nour","family":"Hammad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruba","family":"Hadla","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marwa","family":"Zeidan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dana","family":"Andari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riwa Nour","family":"Azar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadine","family":"Nasser","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marlene","family":"Chakhtoura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,4,5]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"288","DOI":"10.1038\/s41574-019-0176-8","article-title":"Obesity: global epidemiology and pathogenesis","volume":"15","author":"Bl\u00fcher","year":"2019","journal-title":"Nat Rev Endocrinol."},{"key":"B2","doi-asserted-by":"publisher","first-page":"1083","DOI":"10.1016\/S0140-6736(09)60318-4","article-title":"Body-mass index and cause-specific mortality in 900 000 adults: collaborative analyses of 57 prospective studies","volume":"373","author":"Collaboration","year":"2009","journal-title":"Lancet."},{"key":"B3","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1001\/jama.289.2.187","article-title":"Years of life lost due to obesity","volume":"289","author":"Fontaine","year":"2003","journal-title":"JAMA."},{"key":"B4","doi-asserted-by":"publisher","first-page":"2211","DOI":"10.1056\/NEJMoa1000367","article-title":"Body-mass index and mortality among 146 million white adults New England","volume":"363","author":"Berrington de Gonzalez","year":"2010","journal-title":"J Med."},{"key":"B5","unstructured":"Obesity and overweight 2021 [updated June 9, 2021]"},{"key":"B6","doi-asserted-by":"publisher","first-page":"833","DOI":"10.1016\/j.fertnstert.2017.02.104","article-title":"Obesity pandemic: causes, consequences, and solutions\u2014but do we have the will?","volume":"107","author":"Meldrum","year":"2017","journal-title":"Fertil Steril."},{"key":"B7","doi-asserted-by":"publisher","first-page":"84","DOI":"10.4158\/EP151126.CS","article-title":"Consensus statement by the american association of clinical endocrinologists and american college of endocrinology on the comprehensive type 2 diabetes management algorithm \u2013 2016 executive summary","volume":"22","author":"Garber","year":"2016","journal-title":"Endocr Pract."},{"key":"B8","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1002\/9781119536604.ch11","article-title":"Undertaking network meta-analyses","volume-title":"Cochrane Handbook for Systematic Reviews of Interventions","author":"Chaimani","year":"2019"},{"key":"B9","first-page":"1","article-title":"Network meta-analysis reaches nutrition research","volume-title":"Eur. 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