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Summary and Conclusions Dietary treatment of obesity A Systematic Review The full report contains tables in English that present included studies Swedish Council on Health Technology Assessment SBU Board of Directors and Scientific Advisory Committee Secretariat Måns Rosén Executive Director, SBU Board of Directors Nina Rehnqvist Sven Ohlman Håkan Sörman Karolinska Institutet, National Board of The Swedish Association Solna (Chair) Health and Welfare of Local Authorities and Regions Peter Friberg Jonas Rastad The Swedish Society Region Skåne Mats Ulfendahl of Medicine The Swedish Research Sineva Ribeiro Council Björn Klinge The Swedish Association Malmö University of Health Professionals Marie Wedin The Swedish Medical Måns Rosén Association SBU Scientific Advisory Committee Kjell Asplund Nils Feltelius Jörgen Nordenström Professor emeritus (Chair) The Medical Products Karolinska University Agency, Uppsala Hospital, Solna Kristina Bengtsson Boström Mats G Hansson Ulf Näslund Billingens Medical Center, Uppsala University Norrland University Skövde Hospital, Umeå Sten Landahl Christina Bergh Sahlgrenska University Joakim Ramsberg Sahlgrenska University Hospital, Göteborg The Swedish Agency for Hospital, Göteborg Health and Care Services Margareta Möller Analysis, Stockholm Anna Ehrenberg University Hospital, Högskolan Dalarna Örebro Bo Runeson Karolinska Institutet, Solna Summary and Conclusions of the SBU Report: Dietary treatment of obesity A Systematic Review September 2013 Project Group Nina Rehnqvist (Chair) Jonas Lindblom (Project Director, Kjell Asplund Information Specialist) Christian Berne Staffan Lindeberg Katarina Bälter Fredrik Nyström Thomas Davidson Anders Norlund (Health Economist) (Health Economist) Carl-Erik Flodmark Jenny Odeberg Emelie Heintz (Health Economist) (Assistant Project Director) Christel Larsson Ewalotte Ränzlöv Ingrid Larsson (Project Administrator) Scientific Reviewers Göran Berglund Kerstin Nilsson Mai-Lis Hellénius Ulf Risérus Claude Marcus Niklas Zethraeus Report: Dietary treatment of obesity (no 218/2013) ISBN: 978-91-85413-59-1 • ISSN: 1400-1403 3 SBU’s conclusions The purpose of this report was to systematically collate scientific literature on dietary advice for obese individuals, or the actual food intake among such people. The following conclusions are limited to links between food and weight, morbidity and mor tal ity among obese individuals (defined as people with a BMI of ≥30 kg/m2 or a waist size of ≥102 cm (men) or ≥88 cm (women). Links with other outcomes are described in the introductions to each subsection of this report. SBU has previously discussed diet for individuals with diabetes. The results for obese individuals and individuals with diabetes generally point in the same direction. This report does not evaluate implemention methods for passing on dietary advice. Nor have we reviewed the scientific literature for links between diet and ill-health among the population in general. Weight loss in adults. A range of advice on alteration of eating and drinking habits can result in obese individuals losing weight or reducing their waist size. In the short term (six months), advice on strict or moderate low carbohydrate diets is a more effective means of achieving weight loss than advice on low fat diets. In the long term, there are no differences in the effect on weight loss between advice on strict and moderate low carbohydrate diets, low fat diets, high protein diets, Mediterranean diets, diets aimed at achieving a low glycaemic load or diets containing a high per- centage of monounsaturated fats. Advice on increasing the intake of dairy products (primarily milk) or reducing the intake of sweet drinks may also lead to weight loss. Weight loss in children and young people. Advice on increasing the intake of dairy products (primarily milk) in the event of energy restriction may lead to weight loss among obese children and young people. There is insufficient scientific data to assess whether other dietary advice which is effective for obese adults is also effective for people under 18. sbu’s summary and conclusions 4
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