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Int J Obes (Lond). 2014 Dec;38(12):1511-7. doi: 10.1038/ijo.2014.52. Epub 2014 Mar 28.

Weight loss maintenance in overweight subjects on ad libitum diets with high or low protein content and glycemic index: the DIOGENES trial 12-month results.

Author information

1
Department of Human Biology, NUTRIM School for Nutrition, Toxicology and Metabolism, Maastricht University Medical Centre, Maastricht, The Netherlands.
2
Department of Nutrition, Exercise and Sports (NEXS), Faculty of Science, University of Copenhagen, Copenhagen, Denmark.
3
Institute of Preventive Medicine, Centre for Health and Society, Copenhagen, Denmark.
4
MRC Human Nutrition Research, Elsie Widdowson Laboratory, Cambridge, UK.
5
Department of Social Medicine, Preventive Medicine & Nutrition Clinic, University of Crete, Heraklion, Greece.
6
Department of Clinical Nutrition, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuhetal, Germany.
7
1] Department of Physiology and Nutrition, University of Navarra, Pamplona, Spain [2] CIBERObn, Instituto Carlos III, Madrid, Spain.
8
National Multiprofile Transport Hospital, Sofia, Bulgaria.
9
Obesity Management Centre, Institute of Endocrinology, Prague, Czech Republic.
10
Department of Clinical Biochemistry, Gentofte University Hospital, Hellerup, Denmark.

Abstract

BACKGROUND:

A high dietary protein (P) content and low glycemic index (LGI) have been suggested to be beneficial for weight management, but long-term studies are scarce.

OBJECTIVE:

The DIOGENES randomized clinical trial investigated the effect of P and GI on weight loss maintenance in overweight or obese adults in eight centers across Europe. This study reports the 1-year results in two of the centers that extended the intervention to 1 year.

METHOD:

After an 8-week low-calorie diet (LCD), 256 adults (body mass index >27 kg m(-)(2)) were randomized to five ad libitum diets for 12 months: high P/LGI (HP/LGI), HP/high GI (HP/HGI), low P/LGI (LP/LGI), LP/HGI and a control diet. During the first 6 months, foods were provided for free through a shop system and during the whole 12-month period, subjects received guidance by a dietician. Primary outcome variable was the change in body weight over the 12-month intervention period.

RESULTS:

During the LCD period, subjects lost 11.2 (10.8, 12.0) kg (mean (95% confidence interval (CI))). Average weight regain over the 12-month intervention period was 3.9 (95% CI 3.0-4.8) kg. Subjects on the HP diets regained less weight than subjects on the LP diets. The difference in weight regain after 1 year was 2.0 (0.4, 3.6) kg (P=0.017) (completers analysis, N=139) or 2.8 (1.4, 4.1) kg (P<0.001) (intention-to-treat analysis, N=256). No consistent effect of GI on weight regain was found. There were no clinically relevant differences in changes in cardiometabolic risk factors among diet groups.

CONCLUSION:

A higher protein content of an ad libitum diet improves weight loss maintenance in overweight and obese adults over 12 months.

PMID:
24675714
DOI:
10.1038/ijo.2014.52
[Indexed for MEDLINE]

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