Diet adherence, not diet type is the key to success.(Clinical Rounds)

SAN FRANCISCO -- The right diet for your patient is the one she can stick to, Dr. Corey H. Evans said at the annual meeting of the American Academy of Family Physicians.

"Adherence is the key to success in losing weight," Dr. Evans, a family physician in St. Petersburg, Fla., said at a session supported in part by a grant from Abbott Laboratories.

Physicians are often asked whether they favor a low-fat or low-carbohydrate approach, he said, but the evidence is still inconclusive on what works over the long term.

Cultural and epidemiologic investigations show that societies with a diet low in processed food--one that is low in fat and high in whole grains, fruits, and vegetables--have a low incidence of heart disease.

Physicians can also look to the National Weight Control Registry for what has worked for successful dieters in the United States.

The National Weight Control Registry is a study looking at successful weight-loss strategies, and includes information from about 4,500 people who have lost at least 30 pounds and have kept it off for at least 1 year. The registry was jointly developed by Rena Wing, Ph.D., of the University of Pittsburgh and Brown University, and by James Hill, Ph.D., of the University of Colorado, and is available online at www.nwcr.ws.

The average weight loss in the registry is about 60 pounds, and the average duration of loss is 5 years. Most people in the registry reported using a low-fat, low caloric density diet, combined with exercise. The average fat content consumed by registry participants was 23%, and one in three participants ate less than 20% fat, according to Dr. Evans.