Diets with High or Low Protein Content and Glycemic Index for Weight-Loss Maintenance

By T. Larsen, S. Dalskov, M. van Baak, S. Jebb, A. Papadaki, A. Pfeiffer, J. A. Martínez, T. Handjieva-Darlenska, M. Kunesova, M. Pihlsgård and 4 more. New England Journal of Medicine, 2010

808 citations recorded by the source corpus.

Background Studies of weight-control diets that are high in protein or low in glycemic index have reached varied conclusions, probably owing to the fact that the studies had insufficient power. Methods We enrolled overweight adults from eight European countries who had lost at least 8% of their initial body weight with a 3.3-MJ (800-kcal) low-calorie diet. Participants were randomly assigned, in a two-by-two factorial design, to one of five ad libitum diets to prevent weight regain over a 26-week period: a low-protein and low-glycemic-index diet, a low-protein and high-glycemic-index diet, a high-protein and low-glycemic-index diet, a high-protein and high-glycemic-index diet, or a control diet. Results A total of 1209 adults were screened (mean age, 41 years; body-mass index [the weight in kilograms divided by the square of the height in meters], 34), of whom 938 entered the low-calorie-diet phase of the study. A total of 773 participants who completed that phase were randomly assigned to one of the five maintenance diets; 548 completed the intervention (71%). Fewer participants in the high-protein and the low-glycemic-index groups than in the low-protein–high-glycemic-index group dropped out of the study (26.4% and 25.6%, respectively, vs. 37.4%; P = 0.02 and P = 0.01 for the respective comparisons). The mean initial weight loss with the low-calorie diet was 11.0 kg. In the analysis of participants who completed the study, only the low-protein–high-glycemic-index diet was associated with subsequent significant weight regain (1.67 kg; 95% confidence interval [CI], 0.48 to 2.87). In an intention-to-treat analysis, the weight regain was 0.93 kg less (95% CI, 0.31 to 1.55) in the groups assigned to a high-protein diet than in those assigned to a low-protein diet (P = 0.003) and 0.95 kg less (95% CI, 0.33 to 1.57) in the groups assigned to a low-glycemic-index diet than in those assigned to a high-glycemic-index diet (P = 0.003). The analysis involving participants who completed the intervention produced similar results. The groups did not differ significantly with respect to diet-related adverse events. Conclusions In this large European study, a modest increase in protein content and a modest reduction in the glycemic index led to an improvement in study completion and maintenance of weight loss. (Funded by the European Commission; ClinicalTrials.gov number, NCT00390637.)

Subfields: Cell Biology, Nutrition and Dietetics, Physiology

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Citations in the corpus

• Glycemic index, glycemic load and glycemic response: An International Scientific Consensus Summit from the International Carbohydrate Quality Consortium (ICQC). (2015, positive): “Thus, a diet characterized by a slightly lower GI and a moderately higher protein content was more ef fi cient in counteracting weight gain after a period of energy restriction and weight loss [78].”
• Intestinal permeability – a new target for disease prevention and therapy (2014, background): “Among the diets, some sound promising such as dietary restriction of fat and sugars, or possibly also of poorly absorbed short-chain carbohydrates (FODMAPs) [261-263].”
• Maintenance of lost weight and long-term management of obesity (2018, background): “Diets with higher protein may also offer benefits for maintaining weight loss,(58) particularly when the overall diet has a low glycemic index.(59) Improved weight loss maintenance with higher protein diets might be partially mediated by protein’s greater effect on satiety compared with carbohydrate”
• Depression as a disease of modernity: explanations for increasing prevalence (2012, background): “There is increasing interest in high-protein, low-carbohydrate diets for weight-loss and weight maintenance (Hession et al., 2009; Larsen et al., 2010; Stern, 2004).”