Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

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

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 44.2±10.1 y; body mass index (BMI) 29.5±2.5 kg/m2; body fat 37.2±5.0%) 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, β-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.

This is a preview of subscription content, access via your institution

Access options

Rent or buy this article

Prices vary by article type

from$1.95

to$39.95

Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2
Figure 3

References

  1. Seidell JC . Obesity in Europe. Obes Res 1995; 3: 249s–259s.

    Article  Google Scholar 

  2. Noppa H . Body weight change in relation to incidence of ischemic heart disease and change in risk factors for ischemic heart disease. Am J Epidemiol 1980; 111: 693–704.

    Article  CAS  PubMed  Google Scholar 

  3. Hubert HB, Feinleib M, McNamara PM, Castelli WP . Obesity as an independent risk factor for cardiovascular disease: a 26-year follow-up of participants in the Framingham Heart Study. Circulation 1983; 67: 968–977.

    Article  CAS  PubMed  Google Scholar 

  4. Kromhout D . Body weight, diet, and serum cholesterol in 871 middle-aged men during 10 years of follow-up (the Zutphen Study). Am J Clin Nutr 1983; 38: 591–598.

    Article  CAS  PubMed  Google Scholar 

  5. Goldstein DJ . Beneficial effects of modest weight loss. Int J Obes Relat Metab Disord 1992; 16: 397–415.

    CAS  PubMed  Google Scholar 

  6. Wing RR, Jeffery RW, Burton LR, Thorson C, Kuller LH, Folsom AR . Change in waist-hip ration with weight loss and its association with change in cardiovascular risk factors. Am J Clin Nutr 1992; 55: 1086–1092.

    Article  CAS  PubMed  Google Scholar 

  7. Gaal LF van, Wauters MA, Leeuw de IH . The beneficial effects of modest weight loss on cardiovascular risk factors. Int J Obes Relat Metab Disord 1997; 21: S5–S9.

    PubMed  Google Scholar 

  8. Westerterp-Plantenga MS, Kempen KPG, Saris WHM . Determinants of weight maintenance in women after diet-induced weight reduction. Int J Obes Relat Metab Disord 1998; 22: 1–6.

    Article  CAS  PubMed  Google Scholar 

  9. Wadden TA, Stunkard AJ, Liebschutz J . Three-year follow-up of the treatment of obesity by very low calorie diet, behavior therapy, and their combination. J Consult Clin Psycol 1998; 56: 925–928.

    Article  Google Scholar 

  10. Kramer FM, Jeffery RW, Forster JL, Snell MK . Long-term follow-up of behavioral treatment for obesity: patterns of weight regain among men and women. Int J Obes Relat Metab Disord 1989; 13: 123–136.

    CAS  Google Scholar 

  11. Pasman WJ, Westerterp-Plantenga MS, Muls E, Vansant G, Van Ree J, Saris WHM . The effectiveness of long-term fiber supplementation on weight maintenance in weight reduced women. Int J Obes Relat Metab Disord 1997; 21: 548–555.

    Article  CAS  PubMed  Google Scholar 

  12. Pasman WJ, Westerterp-Plantenga MS, Saris WHM . The effectiveness of long-term supplementation of carbohydrate, chromium, fiber and caffeine on weight maintenance. Int J Obes Relat Metab Disord 1997; 21: 1143–1151.

    Article  CAS  PubMed  Google Scholar 

  13. Pasman WJ, Saris WHM, Muls E, Vansant G, Westerterp-Plantenga MS . The effect of exercise training on long-term weight maintenance in weight-reduced men. Metabolism 1999; 48: 15–21.

    Article  CAS  PubMed  Google Scholar 

  14. Jean C, Rome S, Mathe Y, Huneay JF, Aattouri N, Fromentin G, Achagiotis CL, Tome D . Metabolic evidence for adaptation to a high protein diet in rats. J Nutr 2001; 131: 91–98.

    Article  CAS  PubMed  Google Scholar 

  15. Stock MJ . Gluttony and thermogenesis revisited. Int J Obes Relat Metab Disord 1999; 23: 1105–1117.

    Article  CAS  PubMed  Google Scholar 

  16. Dulloo AG, Jacquet J . Low-protein overfeeding: a tool to unmask susceptibility to obesity in humans. Int J Obes Relat Metab Disord 1999; 23: 1118–1121.

    Article  CAS  PubMed  Google Scholar 

  17. Westerterp-Plantenga MS, Rolland V, Wilson SAJ, Westerterp KR . Satiety related to 24 h diet-induced thermogenesis during high protein/carbohydrate vs high fat diets measured in a respiration chamber. Eur J Clin Nutr 1999; 53: 495–502.

    Article  CAS  PubMed  Google Scholar 

  18. Pullar JD, Webster AJF . The energy cost of fat and protein disposition in the rat. Br J Nutr 1977; 37: 355–363.

    Article  CAS  PubMed  Google Scholar 

  19. Schoeller DA, Santen E van, Peterson DW, Diez W, Jaspan J, Klein PD . Total body water measurement in humans with 18O and 2H labeled water. Am J Clin Nutr 1980; 33: 2686–2693.

    Article  CAS  PubMed  Google Scholar 

  20. Marken Lichtenbelt WD van, Westerterp KR, Wouters L . Deuterium dilution as a method for determining total body water: effect of test protocol and sampling time. Br J Nutr 1994; 72: 491–497.

    Article  PubMed  Google Scholar 

  21. Stunkard AJ, Messick S . The three factor eating questionnaire to measure dietary restraint, disinhibition and hunger. J Psychol Res 1985; 29: 71–83.

    CAS  Google Scholar 

  22. Herman CP, Polivy J . Restrained eating. In: Stunkard AJ (ed). Obesity. WB Saunders: Philadelphia; 1980; pp 208–224.

    Google Scholar 

  23. Schoffelen PFM, Westerterp KR, Saris WHM, ten Hoor F . A dual respiration chamber with automated calibration. J Appl Physiol 1997; 83: 2064–2072.

    Article  CAS  PubMed  Google Scholar 

  24. Weir JBDV . New methods for calculating metabolic rate with special references to protein metabolism. J Physiol 1949; 109: 1–9.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Ekelund U, Yngve A, Sjöström M, Westerterp KR . Field evaluation of the computer science and application's inc. activity monitor during running and skating training in adolescent athletes. Int J Sports Med 2000; 21: 586–592.

    Article  CAS  PubMed  Google Scholar 

  26. Goris AHC, Meijer EP, Kester A, Westerterp KR . Use of a triaxial accelerometer to validate reported food intakes. Am J Clin Nutr 2001; 73: 549–553.

    Article  CAS  PubMed  Google Scholar 

  27. Isaksson B . Urinary nitrogen output as a validity test in dietary surveys. Am J Clin Nutr 1980; 33: 4–5.

    Article  CAS  PubMed  Google Scholar 

  28. Ashley JM . Meal replacements in weight intervention. Obes Res 2001; 9: 312S.

    Article  CAS  PubMed  Google Scholar 

  29. Boden G, Chen X, Mozzoli M, Ryan I . Effect of fasting on serum leptin in normal human subjects. J Clin Endocrinol Metab 1996; 81: 3419–3423.

    CAS  PubMed  Google Scholar 

  30. Kolaczynski JW, Ohannesian JP, Considine RV, Marco CC, Caro JF . Response of leptin to short term and prolonged overfeeding in humans. J Clin Endocrinol Metab 1996; 81: 4162–4165.

    CAS  PubMed  Google Scholar 

  31. Keim NL, Stern JS, Havel PJ . Relation between circulating leptin concentrations and appetite during a prolonged moderate energy deficit in women. Am J Clin Nutr 1998; 68: 794–801.

    Article  CAS  PubMed  Google Scholar 

  32. Levine JA, Eberhardt NL, Jensen MD . Leptin responses to overfeeding: relationship with body fat and nonexercise activity thermogenesis. J Clin Endocrinol Metab 1999; 84: 2751–2754.

    CAS  PubMed  Google Scholar 

  33. Chin-Chance C, Polonsky KS, Schoeller DA . Twenty four hour leptin levels respond to cumulative short term energy imbalance and predict subsequent intake. J Clin Endocrinol Metab 2000; 85: 2685–2691.

    CAS  PubMed  Google Scholar 

  34. Karhunen L . Serum leptin and short term regulation of eating in obese women. Clin Sci (Cloch) 1997; 92: 573–578.

    Article  CAS  Google Scholar 

  35. Flier JS . Clinical review 94: what's in a name? In search of leptin's physiological role. J Clin Endocrinol Metab 1998; 83: 1407–1413.

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to M S Westerterp-Plantenga.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Westerterp-Plantenga, M., Lejeune, M., Nijs, I. et al. High protein intake sustains weight maintenance after body weight loss in humans. Int J Obes 28, 57–64 (2004). https://doi.org/10.1038/sj.ijo.0802461

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.ijo.0802461

Keywords

This article is cited by

Search

Quick links