OBJECTIVE To evaluate the effects of two low-fat hypocaloric diets differing in the carbohydrate-to-protein ratio, with and without resistance exercise training (RT), on weight loss, body composition, and cardiovascular disease (CVD) risk outcomes in overweight/obese patients with type 2 diabetes. RESEARCH DESIGN AND METHODS A total of 83 men and women with type 2 diabetes (aged 56.1 +/- 7.5 years, BMI 35.4 +/- 4.6 kg/m(2)) were randomly assigned to an isocaloric, energy-restricted diet (female subjects 6 MJ/day, male subjects 7 MJ/day) of either standard carbohydrate (CON; carbohydrate:protein:fat 53:19:26) or high protein (HP; 43:33:22), with or without supervised RT (3 days/week) for 16 weeks. Body weight and composition, waist circumference (WC), and cardiometabolic risk markers were assessed. RESULTS Fifty-nine participants completed the study. There was a significant group effect (P <or= 0.04) for body weight, fat mass, and WC with the greatest reductions occurring in HP+RT (weight [CON: -8.6 +/- 4.6 kg, HP: -9.0 +/- 4.8 kg, CON+RT: -10.5 +/- 5.1 kg, HP+RT: -13.8 +/- 6.0 kg], fat mass [CON: -6.4 +/- 3.4 kg, HP: -6.7 +/- 4.0 kg, CON+RT: -7.9 +/- 3.7 kg, HP+RT: -11.1 +/- 3.7 kg], and WC [CON: -8.2 +/- 4.6 cm, HP: -8.9 +/- 3.9 cm, CON+RT: -11.3 +/- 4.6 cm, HP+RT: -13.7 +/- 4.6 cm]). There was an overall reduction (P < 0.001) in fat-free mass (-2.0 +/- 2.3 kg), blood pressure (-15/8 +/- 10/6 mmHg), glucose (-2.1 +/- 2.2 mmol/l), insulin (-4.7 +/- 5.4 mU/l), A1C (-1.25 +/- 0.94%), triglycerides (-0.47 +/- 0.81 mmol/l), total cholesterol (-0.67 +/- 0.69 mmol/l), and LDL cholesterol (-0.37 +/- 0.53 mmol/l), with no difference between groups (P >or= 0.17). CONCLUSIONS An energy-restricted HP diet combined with RT achieved greater weight loss and more favorable changes in body composition. All treatments had similar improvements in glycemic control and CVD risk markers.