BACKGROUND:We have previously reported that a fat-reduced high-protein diet had more favourable effects on body weight loss over 6 months than a medium-protein diet. OBJECTIVE: To extend this observation by a further 6-12 months less stringent intervention and a 24 months follow-up. DESIGN: A randomised 6 months strictly controlled dietary intervention followed by 6-12 months dietary counselling period, and a subsequent 24 months follow-up, comparing an ad libitum, fat-reduced diet (30% of energy) either high in protein (25% of energy, HP) or medium in protein (12% of energy, MP). SUBJECTS: A total of 50 overweight and obese subjects (age: 19-55 y; BMI: 26-34 kg/m 2 ). MEASUREMENTS: Change in body weight, body composition and blood parameters. RESULTS: After 6 months, the HP group (n ¼ 23) achieved a greater weight loss than the MP group (n ¼ 23) (9.4 vs 5.9 kg) (Po0.01). After 12 months, 8% had dropped out in the HP vs 28% in the MP group (Po0.07). After 12 months, the weight loss was not significantly greater among the subjects in the HP group (6.2 and 4.3 kg), but they had a 10% greater reduction in intraabdominal adipose tissue and more in the HP group (17%) lost 410 kg than in the MP (Po0.09). At 24 months, both groups tended to maintain their 12 months weight loss, but more than 50% were lost to follow-up. CONCLUSION: A fat-reduced diet high in protein seems to enhance weight loss and provide a better long-term maintenance of reduced intra-abdominal fat stores.

An ad libitum NND produces weight loss and blood pressure reduction in centrally obese individuals. This trial was registered at www.clinicaltrials.gov as NCT01195610.

A diet high in monounsaturated fat has a more favorable effect on glucose homeostasis than does the typical Western diet in the short term and may also be more beneficial than the official recommended low-fat diet during a period of weight regain subsequent to weight loss.

Many dietary factors or substances exert effects on the three components of energy balance, and one strategy for tackling weight gain could be to use the inherent properties of these substances. Here, we will review the evidence regarding nutritional factors with a potential impact on energy balance, such as wholegrain foods, dietary fiber and protein content, calcium, and certain spices. There is ample evidence to suggest that dietary protein, wholegrain, and fiber promote satiety and either reduce energy absorption or stimulate energy expenditure. Dietary calcium reduces fat absorption, and a sufficient intake may also prevent excessive hunger during weight loss diets. Chili and mustard have beneficial effects on energy balance, although the quantitative importance of this may be modest. Manipulation of diet composition with an aim to prevent weight gain and weight regain is a promising avenue of research.

We aimed to test the effects of three different weight maintenance diets on appetite, glucose and fat metabolism following an initial low-energy diet (LED) induced body weight loss. Following an 8-week LED and a 2 -3-week refeeding period, 131 subjects were randomized to three diets for 6 months: MUFA, moderate-fat (35-45 energy percentage (E%) fat), high in MUFA with low glycaemic index; LF, low fat (20-30 E% fat) or CTR, control (35 E% fat). A meal test study was performed in a subgroup, before and after the 6-month dietary intervention, with forty-two subjects completing both meal tests. No difference in body weight, energy intake or appetite ratings were observed between diets. Both the LF and MUFA diets compared to CTR diet reduced postprandial glycaemia and insulinaemia and lowered fasting insulin from month 0 to month 6. Following the 8-week LED period lower levels of the appetite regulating peptides, pancreatic polypeptide, peptide YY, glucagon-like peptide-1 and glucagon-like peptide-2, along with increased appetite scores were seen in comparison to measurements performed after the 6-month dietary intervention. In conclusion, the two competing diets, MUFA and LF, were equally good with respect to glucose metabolism, whereas the CTR diet resembling the typical Western diet, high in SFA, sugar and high glycaemic carbohydrates, indicated associations to lowering of insulin sensitivity. Lower levels of appetite regulatory peptides along with increased appetite scores following an 8-week LED and 2-3-week refeeding period, suggest that strategies for physiological appetite control following a LED period are needed, in order to prevent weight regain.

Some infants experience excessive weight gain (EWG) during exclusive breastfeeding, but causes and consequences are unknown. The objective was to identify factors associated with early EWG. Infants with EWG (HW-group) were examined at 5, 9 and 18 mo and compared to a breastfed group with normal weight gain (NW-group). Anthropometry, body composition, milk and blood samples, and milk intake were measured. Mean body-mass-index-for-age z-scores (BAZ) increased 1.93 from birth to 5 mo in the HW-group (n = 13) while the NW-group (n = 17) was unchanged (−0.01). The HW-group had 70% more fat mass at 5 mo, and then showed marked catch-down in BAZ from 5 to 18 mo (−0.84). Milk intake at 5–6 mo did not differ between the groups. In the HW-group milk-leptin was lower at 5 mo and serum-leptin was considerably higher at 5 and 9 mo compared to the NW-group. Serum-leptin at 5 mo was positively associated with weight-for-age z-score (WAZ) and fat mass and negatively with WAZ change from 5 to 9 mo. In conclusion, breastfed infants with EWG had catch-down growth when other foods were introduced. Low milk-leptin in the HW-group may have stimulated appetite and milk intake when weight gain was high. High serum-leptin in the HW-group suggests early leptin resistance, which could impact cerebral regulation of energy intake. Larger studies are needed to confirm these results.

Dietary carbohydrate/protein ratio has no effect on inflammatory markers, but the study confirmed that body fatness is positively associated with levels of serum CRP.

These findings do not suggest that hyperinsulinaemia per se contributes to maintenance of the obese state, and insulin secretion inhibition seems not a promising drug target.