A multicenter weight loss study using a low-calorie diet over 8 weeks: Regional differences in efficacy across eight European cities

Principles: The efficacy of low-calorie diets (LCDs) has not been investigated in large-scale studies or among people from different regions, who are perhaps unaccustomed to such weight-loss methods. The aim of the present study was to investigate changes in obesity measures among overweight/obese adults from eight European cities (from Northern, Central and Southern Europe) during the 8-week LCD phase of the DiOGenes study (2006-2007), a family-based, randomized, controlled dietary intervention.
Methods: 938 overweight/obese adults completed baseline examinations and underwent an 8-week LCD, providing 3.3-4.2 MJ/day to replace all meals. Anthropometric measurements and body composition were assessed at baseline and post-LCD.
Results: 773 (82.4%) adults (mean age, 43.1 y) completed the LCD successfully. The highest drop-out was observed in the Southern (24.9%) and the lowest in the Northern (13.3%) European cities. Overall, the LCD induced favorable changes in all outcomes, including an approximate 11.0% reduction in body weight and body fat percentage. Changes in outcomes differed significantly between regions, with the North- and Central-European cities generally achieving higher percentage reductions in most anthropometric measurements assessed. Nonetheless, participants in Southern Europe reduced their body fat percentage significantly more than participants in Northern Europe (-11.8 vs. -9.5%, P=0.017).
Conclusions: The LCD significantly improved anthropometric and body composition measurements in all cities participating in DiOGenes. Objective acceptability measures should be examined in order to further explain regional differences in the effect of this diet on obesity.