The optimal balance of macronutrients to prevent weight gain is not known, and the chance that low-fat, high-carbohydrate diets may cause weight gain has been raised. Howard and
colleaguesArticle assessed this possibility using data on weight change from baseline among women in the Women's Health Initiative Dietary Modification Trial, in which postmenopausal participants were randomly assigned to either a diet plan low in fat (target 20% fat) and high in vegetable, fruit, and grain intake or a self-selected diet control group. The authors found that the low-fat, high-carbohydrate diet was not associated with weight gain during a mean 7.5 years of follow-up. In an editorial, Dansinger and SchaeferArticle discuss the importance of adherence to lifestyle modifications to achieve long-term weight loss.