Paper

International Journal of Obesity (2004) 28, 57–64. doi:10.1038/sj.ijo.0802461

High protein intake sustains weight maintenance after body weight loss in humans

M S Westerterp-Plantenga1, M P G M Lejeune1, I Nijs1, M van Ooijen1 and E M R Kovacs1

1Department of Human Biology, Maastricht University, Maastricht, The Netherlands

Correspondence: Dr MS Westerterp-Plantenga, Department of Human Biology, Maastricht University, PO Box 616, NL-6200 MD Maastricht, The Netherlands. E-mail: M.Westerterp@HB.UNIMAAS.NL

Received 8 October 2002; Revised 3 June 2003; Accepted 13 July 2003.

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Abstract

BACKGROUND: A relatively high percentage of energy intake as protein has been shown to increase satiety and decrease energy efficiency during overfeeding.

AIM: To investigate whether addition of protein may improve weight maintenance by preventing or limiting weight regain after weight loss of 5–10% in moderately obese subjects.

DESIGN OF THE STUDY: In a randomized parallel design, 148 male and female subjects (age 44.2plusminus10.1 y; body mass index (BMI) 29.5plusminus2.5 kg/m2; body fat 37.2plusminus5.0%) followed a very low-energy diet (2.1 MJ/day) during 4 weeks. For subsequent 3 months weight-maintenance assessment, they were stratified according to age, BMI, body weight, restrained eating, and resting energy expenditure (REE), and randomized over two groups. Both groups visited the University with the same frequency, receiving the same counseling on demand by the dietitian. One group (n=73) received 48.2 g/day additional protein to their diet. Measurements at baseline, after weight loss, and after 3 months weight maintenance were body weight, body composition, metabolic measurements, appetite profile, eating attitude, and relevant blood parameters.

RESULTS: Changes in body mass, waist circumference, REE, respiratory quotient (RQ), total energy expenditure (TEE), dietary restraint, fasting blood-glucose, insulin, triacylglycerol, leptin, beta-hydroxybutyrate, glycerol, and free fatty acids were significant during weight loss and did not differ between groups. During weight maintenance, the 'additional-protein group' showed in comparison to the nonadditional-protein group 18 vs 15 en% protein intake, a 50% lower body weight regain only consisting of fat-free mass, a 50% decreased energy efficiency, increased satiety while energy intake did not differ, and a lower increase in triacylglycerol and in leptin; REE, RQ, TEE, and increases in other blood parameters measured did not differ.

CONCLUSION: A 20% higher protein intake, that is, 18% of energy vs 15% of energy during weight maintenance after weight loss, resulted in a 50% lower body weight regain, only consisting of fat-free mass, and related to increased satiety and decreased energy efficiency.

Keywords:

appetite, satiety, energy expenditure, substrate oxidation, metabolic syndrome, leptin, body composition, body temperature

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