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Effect of a high-protein, energy-restricted diet on weight loss and energy expenditure after weight stabilization in hyperinsulinemic subjects

International Journal of Obesity volume 27, pages 582–590 (2003)Cite this article

Abstract

OBJECTIVE: To determine the effect of replacing some dietary carbohydrate with protein, during energy restriction, on weight loss, total energy expenditure (TEE), resting energy expenditure (REE), respiratory quotient (RQ), and the thermic effect of feeding (TEF) in subjects with hyperinsulinemia.

DESIGN: Parallel, clinical intervention study of 12 weeks energy restriction (6.5?MJ/day) and 4 weeks energy balance (8.2?MJ/day) in two groups of subjects randomly assigned to either a high-protein (HP) diet (27% of energy (%E) as protein, 45%E as carbohydrate) or a lower-protein (LP) diet (16%E as protein, 57%E as carbohydrate).

SUBJECTS: A total of 36 obese nondiabetic volunteers with hyperinsulinemia (10 males/26 females, aged 34–65?y, BMI 28–43?kg/m2, fasting insulin 12–45?mU/l).

MEASUREMENTS: Body weight and composition, TEE, REE, and RQ were measured at baseline and at week 16. In addition, the TEF to an HP or LP meal was determined for 3?h, at baseline and at week 16.

RESULTS: After 16 weeks, weight loss was similar in response to each diet; the overall decrease was 7.9±0.6?kg (P<0.001), of which 6.8±0.5?kg was fat (P<0.001). REE fell similarly with each diet; the overall decrease was 719±106?kJ/day (P<0.001). The TEF was 2% greater after the HP than after the LP meal at baseline (P<0.01) and 0.8% greater at week 16 (P=0.35). After 16 weeks, the TEF was not reduced in either dietary group. There was no change in TEE after 16 weeks.

CONCLUSION: In subjects with hyperinsulinemia an energy-restrictive diet containing an increased protein-to-carbohydrate ratio does not enhance weight loss or significantly affect energy expenditure. Caloric restriction, rather than the macronutrient composition of the diet, is the most important determinant of weight loss.

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Acknowledgements

This study was supported by a National Health and Medical Research Grant #158012 and the Diary Research and Development Corporation of Australia. We also gratefully acknowledge Rosemary McArthur, Anne McGuffin, Jodie Avery, and Eleni Argyriou for assistance in performing these studies

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Authors and Affiliations

  1. Department of Physiology, University of Adelaide, South Australia

    N D Luscombe

  2. CSIRO Health Science and Nutrition, Adelaide, South Australia

    P M Clifton, M Noakes & E Farnsworth

  3. Department of Medicine, University of Adelaide, South Australia

    G Wittert

Authors
  1. N D Luscombe
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  2. P M Clifton
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  3. M Noakes
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  4. E Farnsworth
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  5. G Wittert
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Corresponding author

Correspondence to G Wittert.

Appendix

Appendix

This contains an itemized composition of the LP and HP test meals used in the assessment of the meal tolerance and TEF tests (see Table 4).

Table 4 Itemized composition of the LP and HP test meals
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Luscombe, N., Clifton, P., Noakes, M. et al. Effect of a high-protein, energy-restricted diet on weight loss and energy expenditure after weight stabilization in hyperinsulinemic subjects. Int J Obes 27, 582–590 (2003). https://doi.org/10.1038/sj.ijo.0802270

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