In a study by Larsen et al., overweight adults who had lost weight on a low-calorie diet were randomly assigned to a maintenance diet and followed for 26 weeks. Diets with a higher protein content, a lower glycemic index, or both appeared to improve the diet-completion rate and weight-loss maintenance.
The importance of the composition of a diet for the prevention and management of obesity is debated. Ad libitum consumption of low-fat diets results in short-term weight loss, and low-carbohydrate, high-protein, and high-fat diets (e.g., the Atkins diet) may result in substantial weight loss as compared with that achieved with other types of diets. However, the weight loss is generally not sustained beyond 1 year.
Clinical Pearls
• What factor has the greater weight loss associated with low-carbohydrate diets been attributed to?
Greater weight loss with low-carbohydrate diets may be ascribed to the satiating effects of high protein content.
• Which diet was the least effective at preventing weight regain?
According to the results of this 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).
Morning Report Questions
Q: What average weight loss was achieved when participants received a low-calorie diet that provided 800 kcal per day over 8 weeks?
A: During the 8-week weight-loss phase, participants received a low-calorie diet that provided 3.3 MJ (800 kcal) per day. Participants could also eat up to 400 g of vegetables, providing 3.3 to 4.2 MJ (800 to 1000 kcal) per day. The mean initial weight loss with the low-calorie diet was 11.0 kg.
Q: What do the authors conclude is the optimal strategy to minimize weight regain?
A: The authors suggest that even a modest increase in dietary protein and a modest reduction in glycemic-index values were sufficient to minimize weight regain and promote further weight loss in obese patients after a successful weight-loss diet.
