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Nutrition and Disease

A Moderate-Protein Diet Produces Sustained Weight Loss and Long-Term Changes in Body Composition and Blood Lipids in Obese Adults^1,2

³ University of Illinois, Department of Food Science and Human Nutrition ⁴ Department of Kinesiology and Community Health, Urbana, IL 61801 ⁵ Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA 16802

Diets with increased protein and reduced carbohydrates (PRO) are effective for weight loss, but the long-term effect on maintenance is unknown. This study compared changes in body weight and composition and blood lipids after short-term weight loss (4 mo) followed by weight maintenance (8 mo) using moderate PRO or conventional high-carbohydrate (CHO) diets. Participants (age = 45.4 ± 1.2 y; BMI = 32.6 ± 0.8 kg/m²; n = 130) were randomized to 2 energy-restricted diets (–500 kcal/d or –2093 kJ/d): PRO with 1.6 g·kg^–1·d^–1 protein and <170 g/d carbohydrates or CHO with 0.8 g·kg^–1·d^–1 protein, >220 g/d carbohydrates. At 4 mo, the PRO group had lost 22% more fat mass (FM) (–5.6 ± 0.4 kg) than the CHO group (–4.6 ± 0.3 kg) but weight loss did not differ between groups (–8.2 ± 0.5 kg vs. –7.0 ± 0.5 kg; P = 0.10). At 12 mo, the PRO group had more participants complete the study (64 vs. 45%, P < 0.05) with greater improvement in body composition; however, weight loss did not differ between groups (–10.4 ± 1.2 kg vs. –8.4 ± 0.9 kg; P = 0.18). Using a compliance criterion of participants attaining >10% weight loss, the PRO group had more participants (31 vs. 21%) lose more weight (–16.5 ± 1.5 vs. –12.3 ± 0.9 kg; P < 0.01) and FM (–11.7 ± 1.0 vs. –7.9 ± 0.7 kg; P < 0.01) than the CHO group. The CHO diet reduced serum cholesterol and LDL cholesterol compared with PRO (P < 0.01) at 4 mo, but the effect did not remain at 12 mo. PRO had sustained favorable effects on serum triacylglycerol (TAG), HDL cholesterol (HDL-C), and TAG:HDL-C compared with CHO at 4 and 12 mo (P < 0.01). The PRO diet was more effective for FM loss and body composition improvement during initial weight loss and long-term maintenance and produced sustained reductions in TAG and increases in HDL-C compared with the CHO diet.

^* To whom correspondence should be addressed. E-mail: dlayman{at}illilabelis.edu.

Manuscript received 5 September 2008. Initial review completed 12 November 2008. Revision accepted 31 December 2008.