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Huge Study Reveals the Secret of Keeping Lost Weight Off

14 May

In the past, 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.

Because of this, a team of researchers enrolled overweight adults from eight European countries who had lost at least 8% of their initial body weight with a low-calorie diet. Participants were randomly assigned, in a two-by-two factorial design, to one of five diets to prevent weight regain over a 26-week period. These were: 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.

A total of 1209 adults were screened (mean age, 41 years, 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%).

Significantly 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 (over 24 pounds).

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.

The investigators in this large European study conclude that 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.

Citation:  Larsen TM, Dalskov SM, van Baak M, Jebb SA, Papadaki A, Pfeiffer AF, Martinez JA, Handjieva-Darlenska T, Kunešová M, Pihlsgård M, Stender S, Holst C, Saris WH, Astrup A; Diet, Obesity, and Genes (Diogenes) Project. Diet, Obesity, and Genes (Diogenes) Project. Diets with high or low protein content and glycemic index for weight-loss maintenance. New England Journal of Medicine. 2010 Nov 25;363(22): pp.2102-13.

Belleruth Naparstek

Psychotherapist, author and guided imagery pioneer Belleruth Naparstek is the creator of the popular Health Journeys guided imagery audio series. Her latest book on imagery and posttraumatic stress, Invisible Heroes: Survivors of Trauma and How They Heal (Bantam Dell), won the Spirituality & Health Top 50 Books Award