A diet rich in dairy and calcium (Ca) has been variably associated with improvements in body composition and decreased risk of type 2 diabetes. Our objective was to determine if a dietary pattern high in dairy and Ca improves weight loss and subjective appetite to a greater extent than a low dairy/Ca diet during energy restriction in overweight and obese adults with metabolic syndrome.
A total of 49 participants were randomized to one of two treatment groups: Control (low dairy, ∼700 mg/day Ca, −500 kcal/day) or Dairy/Ca (high dairy, ∼1400 mg/day Ca, −500 kcal/day) for 12 weeks. Body composition, subjective ratings of appetite, food intake, plasma satiety hormones, glycemic response and inflammatory cytokines were measured.
Control (−2.2±0.5 kg) and Dairy/Ca (−3.3±0.6 kg) had similar weight loss. Based on self-reported energy intake, the percentage of expected weight loss achieved was higher with Dairy/Ca (82.1±19.4%) than Control (32.2±7.7%; P=0.03). Subjects in the Dairy/Ca group reported feeling more satisfied (P=0.01) and had lower dietary fat intake (P=0.02) over 12 weeks compared with Control. Compared with Control, Dairy/Ca had higher plasma levels of peptide tyrosine tyrosine (PYY, P=0.01) during the meal tolerance test at week 12. Monocyte chemoattractant protein-1 was reduced at 30 min with Dairy/Ca compared with Control (P=0.04).
In conclusion, a dairy- and Ca-rich diet was not associated with greater weight loss than control. Modest increases in plasma PYY concentrations with increased dairy/Ca intake, however, may contribute to enhanced sensations of satisfaction and reduced dietary fat intake during energy restriction.
This is a preview of subscription content, access via your institution
Subscribe to Journal
Get full journal access for 1 year
only $9.92 per issue
All prices are NET prices.
VAT will be added later in the checkout.
Tax calculation will be finalised during checkout.
Get time limited or full article access on ReadCube.
All prices are NET prices.
Dougkas A, Reynolds CK, Givens ID, Elwood PC, Minihane AM . Associations between dairy consumption and body weight: a review of the evidence and underlying mechanims. Nutr Res Rev 2011; 15: 1–24.
Teegarden D, Gunther CW . Can the controversial relationship between dietary calcium and body weight be mechanistically explained by alterations in appetite and food intake? Nutr Rev 2008; 66: 601–605.
Chen M, Pan A, Malik VS, Hu FB . Effects of dairy intake on body weight and fat: a meta-analysis of randomized controlled trials. Am J Clin Nutr 2012; 96: 735–747.
Abargouei AS, Janghorbani M, Salehi-Marzijarani M, Esmaillzadeh A . Effect of dairy consumption on weight and body composition in adults: a systematic review and meta-analysis of randomized controlled clinical trials. Int J Obes (Lond) 2012; 36: 1485–1493.
Hall WL, Millward DJ, Long SJ, Morgan LM . Casein and whey exert different effects on plasma amino acid profiles, gastrointestinal homrone secretion and appetite. Br J Nutr 2003; 89: 239–248.
Veldhorst MA, Nieuwenhuizen AG, Hochstenbach-Waelen A, van Vught AJ, Westerterp KR, Engelen MP et al. Dose-dependent satiating effect of whey relative to casein or soy. Physiol Behav 2009; 96: 675–682.
Gilbert JA, Joanisse DR, Chaput JP, Miegueu P, Cianflone K, Almeras N et al. Milk supplementation facilitates appetite control in obese women during weight loss: a randomised, single-blind, placebo-controlled trial. Br J Nutr 2011; 105: 133–143.
Lorenzen JK, Nielsen S, Holst JJ, Tetens I, Rehfeld JF, Astrup A . Effect of dairy calcium or supplementary calcium intake on postprandial fat metabolism, appetite, and subsequent energy intake. Am J Clin Nutr 2007; 85: 678–687.
Major GC, Alarie FP, Dore J, Tremblay A . Calcium plus vitamin D supplementation and fat mass loss in female very low-calcium consumers: potential link with a calcium-specific appetite control. Br J Nutr 2009; 101: 659–663.
Sun X, Zemel MB . Calcium and dairy products inhibit weight and fat regain during ad libitum consumption following energy restriction in Ap2-agouti transgenic mice. J Nutr 2004; 134: 3054–3060.
Jacobsen R, Lorenzen JK, Toubro S, Krog-Mikkelsen I, Astrup A . Effect of short-term high dietary calcium inake on 24-h energy expenditure, fat oxidation, and fecal fat excretion. Int J Obes (Lond) 2005; 29: 292–301.
Zemel MB, Sun X . Dietary calcium and dairy products modulate oxidative and inflammatory stress in mice and humans. J Nutr 2008; 138: 1047–1052.
Gupta A, Gupta V . Metabolic syndrome: what are the risks for humans? Biosci Trends 2010; 4: 204–212.
Goldberg JH, Kiernan M . Innovative techniques to address retention in a behavioral weight loss trial. Health Education Res 2005; 20: 439–447.
Tremblay A, Sevigny J, Leblanc C, Bouchard C . The reproducibility of a three-day dietary record. Nutr Res 1983; 3: 819–830.
Frankenfield D, Roth-Yeusey L, Compher C . Comparison of predictive equations for resting metabolic rate in healthy nonobese and obese adults: a systematic review. J Am Diet Assoc 2005; 105: 775–789.
Godin G, Shephard RJ . A simple method to assess exercise behavior in the community. Can J Appl Sport Sci 1985; 10: 141–146.
Vilsboll T, Krarup T, Deacon CF, Madsbad S, Holst JJ . Reduced postprandial concentrations of intact biologically active glucagon-like peptide 1 in type 2 diabetic patients. Diabetes 2001; 50: 609–613.
Parnell JA, Reimer RA . Weight loss during oligofructose supplementation is associated with decreased ghrelin and increased peptide YY in overweight and obese adults. Am J Clin Nutr 2009; 89: 1751–1759.
Stubbs RJ, Hughes DA, Johnstone AM, Rowley E, Reid C, Elia M et al. The use of visual analogue scales to assess motivation to eat in human subjects: a review of their reliability and validity with an evaluation of new hand-held computerized systems for temporal tracking of appetite ratings. Br J Nutr 2000; 84: 405–415.
Thomas AP, Dunn TN, Drayton JB, Oort PJ, Adams SH . A high calcium diet containing nonfat dry milk reduces weight gain and associated adipose tissue inflammation in diet-induced obese mice when compared to high calcium alone. Nutr Metab 2012; 9: 3.
Van Loan MD, Keim NL, Adams SH, Souza E, Woodhouse LR, Thomas A et al. Dairy foods in a moderate energy restricted diet do not enhance central fat, weight, and intra-abdominal adipose tissue losses nor reduce adipocyte size or inflammatory markers in overweight and obese adults: a controlled feeding study. J Obes 2011; 2011: 989657.
Halford JC, Harrold JA . Satiety-enhancing products for appetite control: science and regulation of functional foods for weight management. Proc Nutr Soc 2012; 71: 350–362.
Zwirska-Korczala K, Konturek SJ, Sodowski M, Wylezol M, Kuka D, Sowa P et al. Basal and postprandial plasma levels of PYY, ghrelin, cholecystokinin, gastrin and insulin in women with moderate and morbid obesity and metabolic syndrome. J Physiol Pharmacol 2007; 58 (Suppl 1), 13–35.
Ghitza UE, Nair SG, Golden SA, Gray SM, Uejima JL, Bossert JM et al. Peptide YY3-36 decreases reinstatement of high-fat food seeking during dieting in a rat relapse model. J Neurosci 2007; 27: 11522–11532.
Korner J, Inabnet W, Conwell IM, Taveras C, Daud A, Olivero-Rivera L et al. Differential effects of gastric bypass and banding on circulating gut hormone and leptin levels. Obesity 2006; 14: 1553–1561.
Essah PA, Levy JR, Sistrun SN, Kelly SM, Nestler JE . Effect of weight loss by a low-fat and a low-carbohydrate diet on peptide YY levels. Int J Obes 2010; 34: 1239–1242.
Barr SI, McCarron DA, Heaney RP, Dawson-Hughes B, Berga SL, Stern JS et al. Effects of increased consumption of fluid milk on energy and nutrient intake, body weight, and cardiovascular risk factors in healthy older adults. J Am Diet Assoc 2000; 100: 810–817.
Christensen R, Lorenzen JK, Svith CR, Bartels EM, Melanson EL, Saris WH et al. Effect of calcium from dairy and dietary supplements on faecal fat excretion: a meta-analysis of randomized controlled trials. Obes Rev 2009; 10: 475–486.
Teegarden D, White KM, Lyle RM, Zemel MB, Van Loan MD, Mtakovic V et al. Calcium and dairy product modulation of lipid utilization and energy expenditure. Obesity 2008; 16: 1566–1572.
Gunther CW, Lyle RM, Legowski PA, James JM, McCabe GP, McCabe LD et al. Fat oxidation and its relation to serum parathyroid hormone in young women enrolled in a 1-y dairy calcium intervention. Am J Clin Nutr 2005; 82: 1228–1234.
Zemel MB, Shi H, Greer B, Dirienzo D, Zemel PC . Regulation of adiposity by dietary calcium. FASEB J 2000; 14: 1132–1138.
Pittner RA, Moore CX, Bhavsar SP, Gedulin BR, Smith PA, Jodka CM et al. Effects of PYY[3-36] in rodent models of diabetes and obesity. Int J Obes Relat Metab Disord 2004; 28: 963–971.
Sloth B, Davidsen L, Holst JJ, Flint A, Astrup A . Effect of subcutaneous injections of PYY1-36 and PYY3-36 on appetite, ad libitum energy intake, and plasma free fatty acid concentration in obese males. Am J Physiol Endocrinol Metab 2007; 293: E604–E609.
Guo Y, Ma L, Enriori PJ, Koska J, Franks PW, Brookshire T et al. Physiological evidence for the involvement of peptide YY in the regulation of energy homeostasis in humans. Obesity 2006; 14: 1562–1570.
Zemel MB, Richards J, Milstead A, Campbell P . Effects of calcium and dairy on body composition and weight loss in African-American adults. Obes Res 2005; 13: 1218–1225.
Zemel MB, Richards J, Mathis S, Mildstead A, Gebhardt L, Silva E . Dairy augmentation of total and central weight loss in obese subjects. Int J Obes 2005; 29: 391–397.
Layman DK . The role of leucine in weight loss diets and glucose homeostasis. J Nutr 2003; 133: 261S–267SS.
Villareal DT, Fontana L, Weiss EP, Racette SB, Steger-May K, Schechtman KB et al. Bone mineral density response to caloric restriction-induced weight loss or exercise-induced weight loss: a randomized controlled trial. Arch Intern Med 2006; 166: 2502–2510.
Stancliffe RA, Thorpe T, Zemel MB . Dairy attentuates oxidative and inflammatory stress in metabolic syndrome. Am J Clin Nutr 2011; 94: 422–430.
Sun X, Zemel MB . Calcium and 1,25-dihydroxyvitamin D3 regulation of adipokine expression. Obesity 2007; 15: 340–348.
Jenkins DJ, Josse AR, Wong JM, Nguyen TH, Kendall CW . The portfolio diet for cardiovascular risk reduction. Curr Atheroscler Rep 2007; 9: 501–507.
Statistics Canada. Nutrition findings from the Canadian Community Health Survey 2004. Overview of Canadians’ eating habits. 2004. Report No.: Goverment of Canada 2006.
Gao X, Wilde PE, Lichtenstein AH, Tucker KL . Meeting adequate intake for dietary calcium without dairy foods in adolescents aged 9 to 18 years (National Health and Nutrition Examination Survey 2001-2002). J Am Diet Assoc 2006; 106: 1759–1765.
We thank the participants for their role in this study and MC Hallam, DT Reid and J Tunnicliffe for assistance on test days. Special thanks to the dietitians at the Diabetes, Hypertension and Cholesterol Center for help with recruitment. This project has been funded in part by research grants from the Canadian Foundation for Dietetic Research and Canadian Institutes of Health Research (MOP 86460). KWJ was supported by an Obesity Training Grant from the University of Calgary. LKE was supported by NSERC and Canadian Diabetes Association graduate scholarships.
RAR previously held research funding from the Dairy Farmers of Canada for work distinct from this study. The remaining authors declare no conflict of interest.
Contributors: RAR, ALE and PKDB designed research; KWJ and JAP conducted research; RAR and LKE analyzed data and wrote the paper; RAR had primary responsibility for final content. All authors read and approved the final manuscript.
Supplementary Information accompanies this paper on European Journal of Clinical Nutrition website
About this article
Cite this article
Jones, K., Eller, L., Parnell, J. et al. Effect of a dairy- and calcium-rich diet on weight loss and appetite during energy restriction in overweight and obese adults: a randomized trial. Eur J Clin Nutr 67, 371–376 (2013). https://doi.org/10.1038/ejcn.2013.52
- peptide YY
- clinical trial
This article is cited by
European Journal of Nutrition (2015)
The influence of calcium supplementation on substrate metabolism during exercise in humans: a randomized controlled trial
European Journal of Clinical Nutrition (2014)
Reviews in Endocrine and Metabolic Disorders (2013)