Dietary strategy to manipulate ad libitum macronutrient intake, and glycaemic index, across eight European countries in the Diogenes Study

Abstract

SummaryThe aim of this study was to describe the development and implementation of a multifaceted, low-fat, weight-loss strategy for a Pan-European randomized controlled dietary intervention study, Diogenes. There were 891 families with at least one overweight/obese parent who underwent screening. Eligible, overweight/ obese adults followed an 8-week weight-loss phase with a fixed low-energy diet (800 kcal). On attaining weight loss of Ն8%, families were randomized to a 6-or 12-month low-fat (25-30%E) diet either based on national dietary guidelines or one of four interventions: low protein (LP)/low glycaemic index (LGI), LP/high GI (HGI), high protein (HP)/LGI and HP/HGI. The impact of each diet in preventing weight (re)gain was tested. A points-based system was used to manipulate dietary protein and carbohydrate. Manipulating carbohydrate composition involved substituting foods with a relatively high or low GI. A questionnaire was designed and completed by study investigators, providing feedback on the dietary intervention methods used to inform future interventions. The points system allowed macronutrient manipulations without compromising dietary flexibility or enforcing energy restrictions. Reported centre/participant differences in the ease of implementing the intervention may reflect dietary diversity and personal preferences for specific weight-management strategies. The points system provides a useful starting point for designing improved experimental paradigms for the manipulation of dietary intake in future trials.

Application of the Theory of Planned Behaviour to weight control in an overweight cohort. Results from a pan-European dietary intervention trial (DiOGenes)

“…A detailed description of the Diogenes intervention trial can be found elsewhere (Larsen et al, 2010a;Moore et al, 2010;Saris & Harper, 2005).…”

“…Specific details on the diets and the dietary counselling are given in a separate publication (Moore et al, 2010).…”

Initial weight loss on an 800-kcal diet as a predictor of weight loss success after 8 weeks: the Diogenes study

“…Details of the methodology of the project are given in papers by Larsen et al (2009) and Moore et al (2009).…”

Assessment of dietary exposure related to dietary GI and fibre intake in a nutritional metabolomic study of human urine

“…The main aspects of the research conducted in the comprehensive, long-term, randomised, controlled dietary intervention study were to address the impact of dietary protein and glycaemic index (GI) on weight (re)gain in a large number of families in which parents and children suffer from obesity or overweight. A detailed description of the study and further information on the study recruitment, exclusion criteria and the investigations carried out at the clinical investigation days have been described in two methodological papers (Larsen et al 2010b;Moore et al 2010). The study population in the present study consisted of the adult members of the families participating in the intervention study carried out in the Danish centre.…”

“…The latter implies that both the LGI and the HGI diets had quite a substantial range in GL. A detailed description of the diets and the dietary strategy is described elsewhere (Aston et al 2010b;Moore et al 2010). Alcohol consumption was allowed in accordance with the current guidelines issued by the Danish National Board of Health, i.e., \14 units/week and \21 units/week (1 unit = 12 g alcohol) for women and men, respectively.…”