title: Impact of weight loss and maintenance with ad libitum diets varying in protein and glycemic index content on metabolic syndrome.
abstract: OBJECTIVE
  We investigated the effects of weight loss and maintenance with diets that varied with regard to protein content and glycemic index (GI) on metabolic syndrome (MetSyn) status.
  
  
  METHODS
  Secondary analyses were performed within the Diet, Obesity and Genes (DiOGenes) study (2006-2008), a randomized controlled dietary intervention. Nine hundred and thirty-eight overweight and obese adults from eight European countries entered an 8-wk low-calorie-diet period. Seven hundred and seventy-three adults who lost at least 8% of their body weights were randomized to one of five ad libitum diets for 6 mo: 1) low-protein (LP)/low-GI (LGI); 2) LP/high-GI (HGI); 3) high-protein (HP)/LGI; 4) HP/HGI; and 5) control diet. MetSyn prevalence and a standardized MetSyn score were assessed at baseline, after the low-calorie diet, and after the intervention.
  
  
  RESULTS
  Weight loss among participants while on the low-calorie diet significantly reduced MetSyn prevalence (33.9% versus 15.9%; P < 0.001) and MetSyn score (-1.48 versus -4.45; P < 0.001). During weight maintenance, significant changes in MetSyn score were observed between the groups, with the highest increase detected in the LP/HGI group (P = 0.039, partial η(2) = 0.023). Protein, GI, and their interaction did not have isolated effects on study outcomes.
  
  
  CONCLUSIONS
  Neither protein nor GI affected MetSyn status in this sample of European overweight and obese adults. However, a diet with a combination of an increased protein-to-carbohydrate ratio with low-GI foods had beneficial effects on MetSyn factors.
authors.affiliation: Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK; Department of Social Medicine, Preventive Medicine & Nutrition Clinic, University of Crete, Heraklion, Crete, Greece. Electronic address: angeliki.papadaki@bristol.ac.uk.
authors.forename: Angeliki
authors.initials: A
authors.lastname: Papadaki
authors.affiliation: Department of Social Medicine, Preventive Medicine & Nutrition Clinic, University of Crete, Heraklion, Crete, Greece.
authors.forename: Manolis
authors.initials: M
authors.lastname: Linardakis
authors.affiliation: Department of Social Medicine, Preventive Medicine & Nutrition Clinic, University of Crete, Heraklion, Crete, Greece.
authors.forename: Maria
authors.initials: M
authors.lastname: Plada
authors.affiliation: Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Denmark.
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Larsen
authors.affiliation: Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Denmark.
authors.forename: Camilla T
authors.initials: CT
authors.lastname: Damsgaard
authors.affiliation: Department of Human Biology, Nutrition and Toxicology Research Institute Maastricht, Maastricht University Medical Centre, The Netherlands.
authors.forename: Marleen A
authors.initials: MA
authors.lastname: van Baak
authors.affiliation: MRC Human Nutrition Research, Elsie Widdowson Laboratory, Cambridge, UK.
authors.forename: Susan
authors.initials: S
authors.lastname: Jebb
authors.affiliation: Department of Clinical Nutrition, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany, and Charité Universitätsmedizin Berlin, Department of Endocrinology, Diabetes and Nutrition, Berlin, Germany.
authors.forename: Andreas F H
authors.initials: AF
authors.lastname: Pfeiffer
authors.affiliation: Department of Physiology and Nutrition, CIBERobn, University of Navarra, Pamplona, Spain.
authors.forename: J Alfredo
authors.initials: JA
authors.lastname: Martinez
authors.affiliation: Department of Human Nutrition, Dietetics and Metabolic Diseases, National Multiprofile Transport Hospital, Sofia, Bulgaria.
authors.forename: Teodora
authors.initials: T
authors.lastname: Handjieva-Darlenska
authors.affiliation: Obesity Management Centre, Institute of Endocrinology, Prague, Czech Republic.
authors.forename: Marie
authors.initials: M
authors.lastname: Kunešová
authors.affiliation: Institute of Preventive Medicine, Copenhagen University Hospitals, Copenhagen, Denmark.
authors.forename: Claus
authors.initials: C
authors.lastname: Holst
authors.affiliation: Department of Human Biology, Nutrition and Toxicology Research Institute Maastricht, Maastricht University Medical Centre, The Netherlands.
authors.forename: Wim H M
authors.initials: WH
authors.lastname: Saris
authors.affiliation: Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Denmark.
authors.forename: Arne
authors.initials: A
authors.lastname: Astrup
authors.affiliation: Department of Social Medicine, Preventive Medicine & Nutrition Clinic, University of Crete, Heraklion, Crete, Greece.
authors.forename: Anthony
authors.initials: A
authors.lastname: Kafatos
mesh_terms: D000328:Adult; D031204:Caloric Restriction; D004032:Diet; D004040:Dietary Carbohydrates / Q000008:administration & dosage*; D004044:Dietary Proteins / Q000008:administration & dosage*; D002149:Energy Intake; D005260:Female; D038321:Glycemic Index; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000517:prevention & control*; D009765:Obesity / Q000178:diet therapy*; D050177:Overweight; D015431:Weight Loss
chemical_list: D004040:Dietary Carbohydrates; D004044:Dietary Proteins
keywords: DiOGenes; Dietary intervention; Glycemic index; Metabolic syndrome; Obesity; Protein