Markers of dietary protein intake are associated with successful weight loss in the POUNDS Lost trial.
To assess the association of markers for dietary protein intake, measures of dietary adherence and demographic variables with weight loss in the POUNDS Lost study over the first 6 months and again between 6 and 24 months using data from those who completed each period. This is a secondary analysis of pooled data on completers assigned to one of four diets: 65%C/15%P/20%F (AP/LF), 55%C/25%P/20%F (HP/LF), 45%C/15%P/40%F (AP/HF) or 35%C/25%P40%F (HP/HF) in the POUNDS Lost study. Urinary nitrogen excretion, dietary adherence measured by 24-h recall and attendance at sessions, age (above and below 50 years), gender, race/ethnicity and activity by pedometry were analysed. Increased spread between protein intake at baseline and protein at 6 or 24 months, assessed by urinary nitrogen excretion, was associated with greater weight loss from baseline to 2 years. At 6 and 24 months, older age, male gender, body mass index > 30 kg m-2and adherence to the fat and protein diets were associated with more weight loss. None of these variables was associated with a regain from 6 to 24 months. Weight regain for women in the highest carbohydrate (65%) group was significantly greater (-4.4 kg [95% CI: -5.9, -3.0]) than for women in the lowest carbohydrate group (-1.8 kg [95% CI: -3.2, -0.4 kg]) (P for interaction = 0.012). An increased spread in the difference between baseline and follow-up protein intake was associated with greater weight loss, consistent with the 'protein spread theory'. Women eating the highest carbohydrate diet regained more weight from 6 to 24 months.
Pennington Biomedical Research Center of the University State University System (PBRC), Baton Rouge, LA, USA.
G A
GA
Bray
Pennington Biomedical Research Center of the University State University System (PBRC), Baton Rouge, LA, USA.
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DH
Ryan
Pennington Biomedical Research Center of the University State University System (PBRC), Baton Rouge, LA, USA.
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W
Johnson
Pennington Biomedical Research Center of the University State University System (PBRC), Baton Rouge, LA, USA.
C M
CM
Champagne
Pennington Biomedical Research Center of the University State University System (PBRC), Baton Rouge, LA, USA.
C M
CM
Johnson
Pennington Biomedical Research Center of the University State University System (PBRC), Baton Rouge, LA, USA.
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J
Rood
Pennington Biomedical Research Center of the University State University System (PBRC), Baton Rouge, LA, USA.
D A
DA
Williamson
Department of Nutrition, Harvard T.H. Chan School of Public Health (HCSPH), Boston, MA, USA.|General Clinical Research Center, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
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Sacks
D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000378:metabolism; D015992:Body Mass Index; D004041:Dietary Fats / Q000032:analysis / Q000378:metabolism; D004044:Dietary Proteins / Q000032:analysis / Q000378:metabolism*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009765:Obesity / Q000178:diet therapy* / Q000378:metabolism / Q000503:physiopathology / Q000523:psychology; D010349:Patient Compliance; D015431:Weight Loss
D015415:Biomarkers; D004041:Dietary Fats; D004044:Dietary Proteins
High protein diet; low-carbohydrate diet; randomized clinical trial; urinary nitrogen excretion