Protein-Rich Diets for Weight Loss Maintenance
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METABOLISM (M DALAMAGA, SECTION EDITOR)
Protein-Rich Diets for Weight Loss Maintenance Faidon Magkos 1
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose of Review High-protein diets in the management of obesity have been around for many years and have been rigorously tested for their ability to induce weight loss. Comparably less is known about their effects on the maintenance of lost weight. Recent Findings Several small and a few large randomized trials have evaluated the efficacy of high-protein diets (20–35% of calories from protein; 1.2–1.9 g/kg∙day) compared with normal-protein diets (10–20% of calories from protein; 0.8–1.3 g/kg∙day), consumed mostly ad libitum during weight loss maintenance, i.e., after clinically significant weight loss. Most of these studies indicate that weight regain in the short term (3–12 months) is lower by 1–2 kg with high-protein diets than low-protein diets. This effect is attenuated with longer periods of observation, likely because of decreasing dietary compliance. Summary In line with findings during the active weight loss phase, studies assessing the efficacy of protein-rich diets to improve weight loss maintenance report beneficial effects in the short term, which nevertheless dissipate over time. Keywords Weight loss . Weight maintenance . Diet composition . High-protein . Low-carbohydrate
Introduction Diets for weight loss have been around for thousands of years [1] but their clinical use for the treatment of obesity is a relatively “recent” application that emerged in the last 100– 150 years [2]. During the same period of time, however, the average body weight, body mass index, and the prevalence of overweight and obesity have been increasing steadily [3, 4], which suggests that none of the dietary approaches that have been tested so far have been particularly successful. There are many different diets with variable characteristics and macronutrient composition that can induce modest weight loss in the short term (5–9% after 6 months); however, this is typically followed by regain of lost weight over time so that maintenance of clinically significant (≥ 5%) weight loss in the longterm is unlikely [5, 6]. There is mounting evidence suggesting that compliance to the dietary intervention is far more important than diet itself. This article is part of the Topical Collection on Metabolism * Faidon Magkos [email protected] 1
Department of Nutrition, Exercise and Sports/Obesity Research, Faculty of Science, University of Copenhagen, Rolighedsvej 26, 1958 Frederiksberg C, Denmark
Progressively decreasing adherence is a common characteristic of any dietary intervention, no matter how modest or extreme. In the DIRECT study, a 2-year randomized controlled trial in which 322 subjects with obesity were assigned to a high-protein/low-carbohydrate diet, a low-fat diet, or a Mediterranean diet, self-reported adherence ratings dropped from 81% at the first month of the intervention to 57% at 24 months, with no significant differences among diet arms [
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