Background: Revised guidelines have been published on dietary approaches for weight management. The aim is to present current evidence for successful dietary approaches for weight loss and maintenance of lost weight and provide guidance in selecting appropriate dietary interventions for weight management.
Method: Recent evidence based clinical guidelines were reviewed in terms of the recommendations made for dietary advice in weight control.
Results: Systematic reviews indicate that a variety of dietary strategies can facilitate weight loss, so long as they achieve an energy restriction. Approaches include different ratios of protein, fat and carbohydrate; macronutrient type; or use of meal replacements monitored by health professionals. Combining dietary interventions with behavioural therapy and support can enhance short and medium term weight loss. Lower evidence levels support setting an energy restriction of ≥2.0MJ/day below maintenance energy requirements, use of low carbohydrate diets (≤20 to <30g/day with gradual increases) without a prescriptive energy restriction for 6-weeks to 6-months but not from 1-5 years. The use of low energy diets (~4.2-5.0MJ/d) with or without use of meal replacements is equally effective. At low energy intakes, monitoring of nutrient intakes is important as individuals may require multivitamins and/or minerals to optimise intake. Accredited Practising Dietitians are qualified to assess, diagnose and treat individual nutrition problems and support maintenance of dietary behaviour change.
Conclusion: Evidence based dietary advice for weight loss supports energy restriction as the key element of successful approaches. A variety of dietary strategies can be used based on individual preference, health status, past dieting history and reasons for attempting weight loss. To facilitate long-term weight loss maintenance specific strategies are needed. Further evidence is required to identify approaches to achieve long-term energy intake reduction and evaluation of approaches to support behaviour change during weight loss maintenance.