Diets with high or low protein content and glycemic index for weight-loss maintenance

Thomas Meinert Larsen; Stine-Mathilde Dalskov; Marleen van Baak; Susan A. Jebb; Angeliki Papadaki; Andreas F.H. Pfeiffer; J. Alfredo Martinez; Teodora Handjieva-Darlenska; Marie Kunesová; Mats Pihlsgård; Steen Stender; Claus Holst; Wim H.M. Saris; Arne Astrup

doi:10.1056/NEJMoa1007137

Diets with high or low protein content and glycemic index for weight-loss maintenance

Thomas Meinert Larsen, Stine-Mathilde Dalskov, Marleen van Baak, Susan A. Jebb, Angeliki Papadaki, Andreas F.H. Pfeiffer, J. Alfredo Martinez, Teodora Handjieva-Darlenska, Marie Kunesová, Mats Pihlsgård, Steen Stender, Claus Holst, Wim H.M. Saris, Arne Astrup

553 Citations (Scopus)

Abstract

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.)

Original language	English
Journal	New England Journal of Medicine
Volume	363
Issue number	22
Pages (from-to)	2102-2113
Number of pages	12
ISSN	0028-4793
DOIs	https://doi.org/10.1056/NEJMoa1007137
Publication status	Published - 25 Nov 2010

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Larsen, T. M., Dalskov, S-M., Baak, M. V., Jebb, S. A., Papadaki, A., Pfeiffer, A. F. H., Martinez, J. A., Handjieva-Darlenska, T., Kunesová, M., Pihlsgård, M., Stender, S., Holst, C., Saris, W. H. M., & Astrup, A. (2010). Diets with high or low protein content and glycemic index for weight-loss maintenance. New England Journal of Medicine, 363(22), 2102-2113. https://doi.org/10.1056/NEJMoa1007137

Larsen, TM, Dalskov, S-M, Baak, MV, Jebb, SA, Papadaki, A, Pfeiffer, AFH, Martinez, JA, Handjieva-Darlenska, T, Kunesová, M, Pihlsgård, M, Stender, S, Holst, C, Saris, WHM & Astrup, A 2010, 'Diets with high or low protein content and glycemic index for weight-loss maintenance', New England Journal of Medicine, vol. 363, no. 22, pp. 2102-2113. https://doi.org/10.1056/NEJMoa1007137

@article{5bfb6340f3c611dfb6d2000ea68e967b,

title = "Diets with high or low protein content and glycemic index for weight-loss maintenance",

abstract = "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.)",

author = "Larsen, {Thomas Meinert} and Stine-Mathilde Dalskov and Baak, {Marleen van} and Jebb, {Susan A.} and Angeliki Papadaki and Pfeiffer, {Andreas F.H.} and Martinez, {J. Alfredo} and Teodora Handjieva-Darlenska and Marie Kunesov{\'a} and Mats Pihlsg{\aa}rd and Steen Stender and Claus Holst and Saris, {Wim H.M.} and Arne Astrup",

year = "2010",

month = nov,

day = "25",

doi = "10.1056/NEJMoa1007137",

language = "English",

volume = "363",

pages = "2102--2113",

journal = "New England Journal of Medicine",

issn = "0028-4793",

publisher = "Massachusetts Medical Society",

number = "22",

}

TY - JOUR

T1 - Diets with high or low protein content and glycemic index for weight-loss maintenance

AU - Larsen, Thomas Meinert

AU - Dalskov, Stine-Mathilde

AU - Baak, Marleen van

AU - Jebb, Susan A.

AU - Papadaki, Angeliki

AU - Pfeiffer, Andreas F.H.

AU - Martinez, J. Alfredo

AU - Handjieva-Darlenska, Teodora

AU - Kunesová, Marie

AU - Pihlsgård, Mats

AU - Stender, Steen

AU - Holst, Claus

AU - Saris, Wim H.M.

AU - Astrup, Arne

PY - 2010/11/25

Y1 - 2010/11/25

N2 - 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.)

AB - 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.)

U2 - 10.1056/NEJMoa1007137

DO - 10.1056/NEJMoa1007137

M3 - Journal article

C2 - 21105792

SN - 0028-4793

VL - 363

SP - 2102

EP - 2113

JO - New England Journal of Medicine

JF - New England Journal of Medicine

IS - 22

ER -

Diets with high or low protein content and glycemic index for weight-loss maintenance

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