In Reply Even though they agree with our emphasis on behavioral adherence, Dr Yancy and colleagues advocate for additional diet comparison studies given the controversy regarding their effectiveness for improving health outcomes. Specifically, Yancy and colleagues describe scant high-quality evidence to support any diet’s beneficial effects on clinical events.
We agree with the importance of demonstrating effects of diet on clinical events (eg, incident diabetes, stroke) rather than on weight and cardiometabolic risk factors alone. However, to the extent that the dietary effects on clinical events are driven by weight loss, the 4 meta-analyses1- 4 cited in our Viewpoint, and a fifth published afterward,5 indicate that differences between individual diets are likely to be trivial.
Pagoto S, Appelhans BM. Adherence to Diets for Weight Loss—Reply. JAMA. 2013;310(24):2676-2677. doi:10.1001/jama.2013.282651