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To the Editor: In 1968, Grande¹ critically reviewed purported weight and body composition effects of 3 weight reduction diets by invoking the laws of thermodynamics. Grande showed inconsistencies that rendered the publications inconclusive. Four decades later, serious data inconsistencies are still appearing in studies of diet intervention, such as the A TO Z Weight Loss Study by Dr Gardner and colleagues.²

The self-reported dietary intake and energy expenditure results by diet group are presented in Table 2 in the article. Participants reported a baseline energy intake of about 1800 kcal/d to 2000 kcal/d, and with weight-loss treatments, intake levels were reduced by approximately 300 kcal/d to between 1500 kcal/d and 1700 kcal/d. Small increases in self-reported total energy expenditure were also observed over time in all 4 study groups.

The values presented in Table 2 suggest major patient misreporting that raises questions about their validity. Participants would have been expected . . . [Full Text of this Article]

Steven B. Heymsfield, MD
steven_heymsfield@merck.com
Merck & Co
Rahway, New Jersey

George L. Blackburn, MD, PhD
Harvard Medical School
Boston, Massachusetts

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