RCT with 307 participants:  Successful weight loss can be achieved with either a low-fat or low-carbohydrate diet when coupled with behavioral treatment. A low-carbohydrate diet is associated with favorable changes in cardiovascular disease risk factors at 2 years. Weight loss was approximately 11 kg (11%) at 1 year and 7 kg (7%) at 2 years. During the first 6 months, the low carbohydrate diet group had greater reductions in diastolic blood pressure, triglyceride levels, and very-low-density lipoprotein cholesterol levels, lesser reductions in low density lipoprotein cholesterol levels, and more adverse symptoms than did the low-fat diet group. The low carbohydrate diet group had greater increases in high-density lipoprotein cholesterol levels at all time points, approximating a 23% increase at 2 years.

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