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DAA Best Practice Guidelines for the Treatment of
Overweight and Obesity in Adults
Report to inform the 2011 revision of the 2005 guidelines
25 January 2012
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Acknowledgements
It is important to acknowledge the members of the DAA consortium who have conducted the review of the
evidence. These are as follows:-
University of Newcastle (UoN) consortium team members
Professor Clare Collins, FDAA (Chair), Co-Director of The University of Newcastle Priority Research
Centre in Physical Activity and Nutrition, NHMRC Career Development Fellow
Dr Melinda Neve, APD, (Project Manager), Postdoctoral Research Fellow, School of Health Sciences,
Faculty of Health, The University of Newcastle.
Dr Michelle Palmer, APD, formerly the School of Public Health, Griffith University, Qld
Dr Lesley MacDonald-Wicks, APD, Lecturer in Nutrition and Dietetics, School of Health Sciences,
Faculty of Health, The University of Newcastle.
Professor Lauren Williams, AdvAPD, formerly UoN, currently The University of Canberra
Dr Surinder Baines, APD, Senior Lecturer in Nutrition and Dietetics, School of Health Sciences, Faculty
of Health, The University of Newcastle
Dr Tracy Burrows, AdvAPD, Lecturer in Nutrition and Dietetics, School of Health Sciences, Faculty of
Health, The University of Newcastle
Dr Alexis Hure, AdvAPD, Postdoctoral Research Fellow, Centre for Research Excellence in Women’s
Health in the 21st Century, Faculty of Health, The University of Newcastle
The assistance of the following dietitians is also acknowledged Kristine Pezdirc APD, Lana Mitchell APD,
Roberta Asher APD, Jenna Hollis APD and Caitlin West. Thanks also to Professor Sandra Capra, AM, FDAA.
We thank the Obesity Reference Group appointed by DAA to provide advice to the consortium review
team and who critiqued the survey and review. These are as follows:-
Dr Janet Franklin APD
Corinna Michael APD
Jacqueline Muller APD
Kay Gibbons FDAA
Melanie McGrice AdvAPD
Riana Pienaar APD
Anita Star APD
Melissa Barnes APD
Amy Lewis APD
Megan Alsford APD
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ISBN 978-0-9871143-6-5
DAA Canberra 2012
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Table of contents
List of tables ............................................................................................................................................................................................. 6
List of figures ........................................................................................................................................................................................... 8
Executive summary............................................................................................................................................................................ 12
1. Part One: Systematic review of the literature ......................................................................................................... 16
1.1 Background ............................................................................................................................................................................... 16
1.2 Methodology ............................................................................................................................................................................. 16
1.3 Results ......................................................................................................................................................................................... 18
1.3.1 Energy restriction systematic review ............................................................................................................... 18
1.3.1.1 Energy restriction ........................................................................................................................................................ 19
1.3.1.2 Meal replacements and VLCDs................................................................................................................................ 21
1.3.1.3 Macronutrient composition ..................................................................................................................................... 25
1.3.1.4 Popular diets....................................................................................................................................................................... 27
1.3.2 Modification of fat composition systematic review ..................................................................................... 28
1.3.2.1 Monounsaturated fatty acids .................................................................................................................................. 29
1.3.2.2 Omega-3 Fatty Acids .................................................................................................................................................. 30
1.3.3 Modification of carbohydrate composition systematic review ....................................................................... 32
1.3.3.1 Glycaemic index/glycaemic load ................................................................................................................................. 33
1.3.4 Modification of calcium or dairy composition systematic review ......................................................... 35
1.3.4.1 CLA supplementation ................................................................................................................................................. 36
1.3.4.2 Calcium and Vitamin D supplementation ........................................................................................................... 36
1.3.4.3 Calcium supplementation ......................................................................................................................................... 36
1.3.4.4 Amount of calcium ...................................................................................................................................................... 37
1.4.4.5 Source of calcium .............................................................................................................................................................. 38
1.3.5 Behavioural/psychological approaches to dietary interventions systematic review ............................ 39
1.3.6 Meal frequency literature review ........................................................................................................................ 43
1.3.7 Nutragenetics literature review ........................................................................................................................... 43
1.3.8 Drug therapy literature review ............................................................................................................................. 44
1.3.9 Comparisons between 2005 DAA weight management guidelines and current findings .................... 47
1.4 Discussion .................................................................................................................................................................................. 48
1.5 References ................................................................................................................................................................................. 50
1.6 Summary of evidence tables .............................................................................................................................................. 70
2. Part Two: Survey of dietetic intervention in overweight and obesity ....................................................... 141
2.1 Objectives................................................................................................................................................................................ 141
2.2 Methods ................................................................................................................................................................................... 141
2.2.1 Sample and recruitment................................................................................................................................................ 141
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