High Protein Medium CHO Promotes Lean Mass Gains and Stable Metabolic Rates Compared to Two Different Macros

High Protein Medium CHO Promotes Lean Mass Gains and Stable Metabolic Rates Compared to Two Different Macros

dieting gain muscle high protein lose fat lose weight macronutrient composition macronutrients medium protein obesity weight loss

This could not be a meal from the study too few carbohydrates... even for the medium CHO group.

As a SuppVersity reader you're not going to be surprised to hear about beneficial effects of increased (dairy) protein intakes on weight loss.

What may be surprising, though, is that the statistics based conclusion of a recent study that determined the effects of 16-week high[er]-dairy-protein, variable-carbohydrate diets and exercise training on body composition in men and women with overweight/obesity says: "Compared to a healthy control diet, energy-restricted high-protein diets containing different proportions of fat and CHO confer no advantage to weight loss or change in body composition in the presence of an appropriate exercise stimulus" (Parr. 2016).

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If this is not your first visit to www.suppversity.com, you will probably be here, because you know that I never settle for a 1-2 sentence conclusion from an abstract - and guess what: If you take a look at the actual study outcomes, it turns out that there is a noteworthy difference between the three diet groups, in which the participants, one hundred and eleven participants (age 47 6 6 years, body mass 90.9 +/- 11.7 kg, BMI 33 +/- 4 kg/m², values mean +/- SD) were randomly stratified to one of the following (isocaloric) three diets:

• High dairy protein, high CHO (HDPHC; 30% protein, 55% CHO, 15% fat; 41 dairy servings/day of sweetened, low-fat products)  
• High dairy protein, moderate CHO (HDPMC; 30% protein, 40% CHO, 30% fat; 41 dairy servings/day of unsweetened/artificially sweetened, full-fat products)  
• Low dairy protein, high CHO (CON; 15% protein, 55% CHO, 30% fat: 1-2 dairy servings/day) 

All three dietary interventions were implemented as a free-living energy restricted eating plan where energy intake was based on a mild restriction (2250 kcal/day) from estimated maintenance energy
requirements (Frankenfield. 2005).

Table 1: Sample of a 1-day meal plan for each of the diets (1,600 kcal version) - aBold items correspond to a “Basket” of foods that could be consumed as a post-exercise recovery snack or added to the meal structure. For the first 8 weeks, participants consumed a prescribed meal plan consisting of a meal structure 1one “Basket” per day. From weeks 8 to 16, participants were encouraged to develop their own meal structure (using a points system to achieve a desired energy and macronutrient intake) and add one of 5-7 “Basket” combinations to the day’s intake (Parr. 2016).

Over the course of the study, the subjects got more leeway (no wonder they didn't lost that much fat during the 2nd phase of the study). While week 1-8 required the subjects to consume a prescribed menu that met the desired energy restriction and macronutrient composition, week 9-16 involved a more flexible self-chosen plan (week 9-16) that was based on a points system. The points system was yet only one of the things that was supposed to increase the subjects' adherence. In addition ...

"[...p]articipants met fortnightly with a dietitian and were provided with edu cation resources. Menus for each diet provided for three meals/day and a “Dairy/Snack Basket” (food choices that achieved most of the nutrient manipulation for each diet; Table 1). For the higher protein diets, the Baskets contained foods equivalent to four to five dairy servings (NHMRC. 2011) where two servings were to be consumed as soon as practical post-EXT. In the moderate-protein CON diet, “Baskets” provided CHO-rich choices (e.g., non-dairy) for post-EXT recovery snacks and meal additions" (Parr. 2016).

To optimize fat and minimize muscle loss, all participants had to follow the same combined resistance (REX) plus aerobic exercise (EXT) training:

• REX - 3 sessions per week (total 48 sessions in 16 weeks) of an individualized training program; a range of exercises were employed to train the same muscle groups (chest, back, legs and core) for 3-4 sets of 8-15 reps at 40-70% of 1RM. Exercise diaries kept by the study trainers were used to ensure the appropriate weight and number of sets was completed.
• EXT - 4 sessions on days without REX equating to 250 kcal/day energy expenditure; more specifically, the subjects performed exercises such as a 4 km walk, 16 km cycle or 1 km swimming, or equivalent combinations

The effects on body composition were monitored by pre-/inter-/post-DXA scans. The results, which are also the reason why I previously said that the statistics-based conclusion may be misleading are plotted in Figure 1, which shows no sign. difference in fat, but a meaningful difference in lean mass loss (in the CON group), respectively gains (in the protein groups, HDPHPC, HDMPC).

Figure 1: Effects of a 16-week diet and exercise intervention on the percentage change relative to baseline in (left) fat mass, and (right) lean mass (LM) for three different diets (Parr. 2016).

In that, the lean mass advantage of the high protein medium carbohydrate group (HDPMPC) is most meaningful in the first 8 weeks - meaningful enough to be practically relevant, albeit not statistically significant over the complete 16 week study period. Even if ...

• the body mass loss in the three groups was virtually identical (HDPMC: 27.2 +/- 3.3 kg; HDPHC: 27.0 +/- 3.3 kg; CON: 27.7 +/- 3.6 kg; P = 0.42), and 
• the loss of body fat in all groups was significant in both absolute and relative-to-baseline changes across, but not significantly different

The lean mass retention or rather increase in the high protein groups may later literally turn the scale, when the high protein, medium carbohydrate group (HDPMPC) don't experience the same weight rebound as the subjects in the CON and maybe even the HDPHPC group, where the resting energy expenditure started to plummet more steeply after 8 weeks of dieting (see Figure 2).

This is no "high protein diet" study as the ones by Jose Antonio the total protein intake in the so-called "high protein" groups averaged ~110-120g and was thus hardly more than 1.3g/kg body weight. In view of the fact that the only really tightly controlled study on the effects of protein intake on weight and fat loss shows optimal results with a similar protein intake (1.6g/kg) at albeit overall much lower total energy intakes, it is also questionable, whether the lack of significant differences in the study at hand has anything to do with the "low" protein intakes in the high protein groups.

Additional non-significant benefits of the HDPMPC diet compared to the CON diet that were reported only as supplementary data, yet not in the full-text, were:

• 

  Figure 2: Effects of the diet intervention on total energy expenditure er day (Parr. 2016).

  greater reductions in waist circumference and waist:hip ratio over the full study duration (-1.1 cm and -0.02 vs. CON),
• greater reductions in trunk fat and greater increases in trunk lean mass,
• greater reductions in leg fat and greater increases in leg lean mass, as well as
• greater reductions in glucose, insulin, HOMA-IR, and total cholesterol.

Yes, none of these changes was statistically significant, and still... they occurred over only 16 weeks and the way the energy expenditure (Figure 2) develops, the advantage of the HDPMPC  (open squares) over the MDPHDC (black triangles) and the HDPMDC (black circles) diet is going to increase, not decrease over time.

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Bottom line: Yes, from a statistic perspective, there's no difference between the three diet interventions. From a common-sense perspective, however, everything points towards the high-protein, medium carbohydrate diet as the most effective way to eat during combined weight loss and exercise interventions... well, unless you want to lose weight, not fat while building muscle, that is.

Speaking of building muscle, I hope you realize that the subjects did the latter with little protein (high pro only ~1.3g/kg body weight), but high effort (7 w/outs/week). Goes to show you: You can eat yourself lean, but not lean and muscular | Comment on Facebook!

References:

• Frankenfield, David, et al. "Comparison of predictive equations for resting metabolic rate in healthy nonobese and obese adults: a systematic review." Journal of the American Dietetic Association 105.5 (2005): 775-789.
• National Health and Medical Research Council (NHMRC). A modelling system to inform the revision of the Australian Guide to Healthy Eating. In: Australian Dietary Guidelines, Dietitans Association of Australia, K. Baghurst, L Cobiac, P Baghurts and A. Magarey, eds. Chapter 3, Table 4. Canberra: Commonwealth of Australia; 2011, pp 1-621.
• Parr, Evelyn B., et al. "A randomized trial of high‐dairy‐protein, variable‐carbohydrate diets and exercise on body composition in adults with obesity." Obesity (2016).

Minimal Amounts of Fish Peptide Hydrolysate Double Fat Loss Compared to Whey Isolate on Energy Restricted Diet

Minimal Amounts of Fish Peptide Hydrolysate Double Fat Loss Compared to Whey Isolate on Energy Restricted Diet

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I certainly recommend eating fish. Whether I will be recommending fish hydrolysate supplements in the future, however, will have to be determined when additional studies with different baseline diets will have been published.

You may remember that I've written about fish protein hydrolysates / peptides before. Unlike today's article, however, previous articles dealt with the effects of fish protein in rodents. Intrigued by in vitro and animal studies showing that fish-derived peptides demonstrated antihypertensive (Hatanaka. 2009; Kim. 2012; Li. 2012; Ngo. 2011), antioxidant (Nazeer. 2012; Najafian. 2012), immunomodulating effects (Duarte. 2006), reparative properties in the intestine (Fitzgerald. 2005; Marchbank. 2008), and effects in reducing plasma cholesterol and triglycerides levels (Möller. 2008), a group of Italian researchers decided to investigated the effect of Slimpro(R), a supplement containing commercially available fish protein hydrolysate from blue whiting (Micromesistius poutassou), on body composition and on stimulating cholecystokinin (CCK) and glucagon-like peptide-1 (GLP-1) secretion in 120, overweight, non-obese (25 kg/m² < BMI < 30 kg/m²), male (25%) and female (75%) subjects aged 18 - 55 year.

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Unlike the product that was used may suggest, the study was not sponsored by the supplement company. The authors received neither funding nor other external support and they also declare that they don't have a conflict of interest that may be related to patents or direct involvements in the industry. I guess it's important to point that out, even though fact that the scientists chose whey, i.e. an actually relevant control, instead of carbohydrates or just plain water, may have given away the lack of sponsorship, anyways.

Two weeks before the study started, subjects were asked to fill in an alimentary diary reporting their food preferences. A mild hypocaloric ( 300 kcal/day) diet was elaborated for each subject by a dietitian based on subject’s food preferences and habits as reported in the alimentary diary.

Figure 1: The low protein content of the diet is - as highlighted in the annotations to this graphical illustration of the macronutrient composition of the test diets - problematic, to say the least.

Approximately, 55% of energy intake was from carbohydrates, 25% from lipids, and the remaining 20% from proteins. Part of these 20% of protein were either 1.4g and 2.8g of fish protein or 1.4g of whey protein isolate as a control (I just assume that the dosage was 1.4g, because there was only one whey group), which were consumed in form of a flavored shake according to the following protocol:

"Both the active (one dose treatment arm) and the placebo products were taken as follows: ‘dilute the content of one sachet in a large glass of cool water (200 ml). Shake or stir with a spoon. Consume within 10 30 min before the main meal’. In the case of two-dose treatment arm, one sachet of the active product was taken 30 min before lunch and one sachet 30 min before dinner" (Nobile. 2016).

To be able to tell what could be responsible for advantages or disadvantages of the two treatments, the scientists assessed more than just body weight, fat mass (DXA scans), and safety of use as well as the secondary efficacy endpoints, extracellular water, and the circumference of waist, hips, and thighs. They also checked the CCK and GLP-1 levels in their subjects' blood. This is relevant, because this is how the fish hydrolysate is advertised on the manufacturers website:

"Taken daily before meals, Slimpro® increases the production of CCK and GLP-1 in the body, thus amplifying messages associated with a decrease of food intake. Promising results were reported from in vivo et in vitro trials of these molecules that may control food intake. Scientists have described this ingredient as a direct action on the hunger process" (Nobile. 2015).

As it is usually the case in studies like this, some patients were "lost". In this case, we're talking about a total count of eleven subjects who did not reappear for the follow-up check (One subject in the one-dose treatment arm, four subjects in the twodose treatment arm, and six subjects in the placebo treatment arm discontinued intervention because they were no longer interested to participate in the study). The results of the other subjects are plotted in Figure 2:

Figure 2: Changes in body composition after 45 and 90 days of dieting w/ the specific supplements (Nobile. 2016).

As you can see, double-dosing had astonishingly little effect on the subjects' ability to lose body fat. That's in contrast to switching from fish protein hydrolysate to whey protein isolate, which produced measurably, but not statistically reduced rates of fat loss and waist reductions.

Figure 3: Blood biomarker levels. (a) CCK blood levels and (b) GLP-1 blood levels. Intragroup (vs. D0) statistical analysis is reported upon the bars of the histogram. The lines report the intergroup (vs. placebo) statistical analysis. Statistical analysis is reported as follows: *p < 0.05, **p < 0.01, and ***p < 0.001. Data are mean +/- SE (Nobile. 2016).

And guess what: Even though the bars don't look like it, the asterisks over the bars tell you that these differences may be caused by the same differential expression of the satiety hormones CCK and GLP-1 in the fish hydrolysate vs. whey protein group that has been observed with other control protein in previous studies and is boldly advertised on the producer's website.

Great! Let's eat more fish... It stands out of question that the former is actually a very good idea (assuming you make the right fish choices). I have to warn you, though: Firstly, the fish protein consumed in the study at hand came from fish, but just like whey protein and milk, fish and fish protein hydrolysates will also have different effects.

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What is probably way more important, however, is the relative protein deficiency of the subjects. With only 20% of the diet being protein, the study participants hovered around at the meager level of the RDA. Since the effects of 1.4g of fish protein hydrolysate you throw on top of a low protein diet are probably very different from those of the same amount of fish protein consumed alongside 2g/kg of dietary and supplemental protein, I wouldn't guarantee and in fact even doubt that you would see a similar almost 100% increase in fat loss while dieting - and still,  the CCK and GLP-1 boosting effects of fish protein hydrolysates are intriguing | Comment on Facebook!

References:

• Duarte, Jairo, et al. "Immunomodulating capacity of commercial fish protein hydrolysate for diet supplementation." Immunobiology 211.5 (2006): 341-350.
• Hatanaka, Akimasa, et al. "Isolation and identification of antihypertensive peptides from antarctic krill tail meat hydrolysate." Journal of food science 74.4 (2009): H116-H120.
• Kim, Se-Kwon, Dai-Hung Ngo, and Thanh-Sang Vo. "Marine fish-derived bioactive peptides as potential antihypertensive agents." Adv Food Nutr Res 65 (2012): 249-260.
• Li, Ying, et al. "Purification of a novel angiotensin I-converting enzyme (ACE) inhibitory peptide with an antihypertensive effect from loach (Misgurnus anguillicaudatus)." Journal of agricultural and food chemistry 60.5 (2012): 1320-1325.
• Marchbank, T., et al. "Clinical trial: protective effect of a commercial fish protein hydrolysate against indomethacin (NSAID)‐induced small intestinal injury." Alimentary pharmacology & therapeutics 28.6 (2008): 799-804.
• Möller, Niels Peter, et al. "Bioactive peptides and proteins from foods: indication for health effects." European journal of nutrition 47.4 (2008): 171-182.
• Nazeer, R. A., NS Sampath Kumar, and R. Jai Ganesh. "In vitro and in vivo studies on the antioxidant activity of fish peptide isolated from the croaker (Otolithes ruber) muscle protein hydrolysate." Peptides 35.2 (2012): 261-268.
• Najafian, L., and Abd Salam Babji. "A review of fish-derived antioxidant and antimicrobial peptides: their production, assessment, and applications." Peptides 33.1 (2012): 178-185.
• Ngo, Dai-Hung, et al. "Free radical scavenging and angiotensin-I converting enzyme inhibitory peptides from Pacific cod (Gadus macrocephalus) skin gelatin." International journal of biological macromolecules 49.5 (2011): 1110-1116.

Weight Loss, 'Metabolic Damage' and the Magic of Carbs? Human Study Probes Effects of Carbohydrate Content, GL & GI on Diet-Induced Suppression of Resting Metabolic Rate

Weight Loss, 'Metabolic Damage' and the Magic of Carbs? Human Study Probes Effects of Carbohydrate Content, GL & GI on Diet-Induced Suppression of Resting Metabolic Rate

dieting GI glycemic index glycemic load high carb high carbohydrate lose fat low carb low carbohydrate metabolic damage resting metablic rate RMR weight loss

Will slimming down from a 120 cm to a 60 cm waist always ruin your metabolic rate and set you up for weight regain or can high GI protect you from yoyoing?

Broscience tells us: "Carb up to preserve your resting metabolic rate." And in fact, there is some scientific evidence that suggests a link between high(er) carbohydrate intakes and increased thyroid function. The same amount of T3 will trigger a sign. higher stimulation of lipolysis and fat oxidation, for example, on high vs. low carb diets (Mariash. 1980). Low carb diets, on the other hand, lead to significant reductions of the active thyroid hormone and increases in the 'thyroid receptor inhibitor' rT3 - even in healthy individuals and if the energy intake is standardizes (Serog. 1982; Ullrich. 1985). So, is broscience right? Well, overfeeding studies show a similar increase in T3 in response to protein, fat and carbohydrates (Danforth Jr. 1979). So refeeds should work, irrespective of their carbohydrate content...

# Women appear to be particularly prone to # metabolic damage - more on # female fat loss:

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As you can see, it is hardly possible to confirm or reject the "carb up to prevent metabolic damage" (=prevent the diet induced over-proportional reduction in resting energy expenditure) hypothesis based on the existing evidence. A recent study by J. Philip Karl and colleagues who tried to determine "the effects of diets varying in carbohydrate and glycemic index (GI) on changes in body composition, resting metabolic rate (RMR), and metabolic adaptation during and after weight
loss" (Karl. 2015), however, may yet take us one step further towards rejecting or confirming this commonly heard of idea.

Figure 1: Overview of the key parameters of the study design and dietary composition (Karl. 2015).

In said study, Karl et al. randomly assigned adults with obesity (n = 91) to one of four diet groups for 17 weeks. As you can see in Figure 1, the diets all subjects were provided with differed in percentage energy from carbohydrate (55% or 70% | Figure 1, top-right) and GI (low or high, Figure 1, bottom-right) but were matched for protein, fiber, and energy. The study design itself comprised 5 phases:

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"Phase 1 was a 5-week weight maintenance phase in which weight maintenance energy needs were determined by adjusting provided energy intake to maintain stable weight. Mean Phase 1 energy intake was 12.2 MJ/day with 48% energy provided as carbohydrate, 16% as protein, and 36% as fat. Following Phase 1, participants were randomized by the study statistician to their Phase 2 dietary assignment using computer-generated randomization. The four diets differed in carbohydrate content (55%, ModCarb or 70%, HighCarb of total energy) and dietary GI (less than 60, LowGI or 80, HighGI), and were provided for 12 weeks at 67% of the weight maintenance energy intake determined in Phase 1. 

Participants were allowed to increase their energy intake during Phase 2 by requesting additional, randomization-appropriate foods from the metabolic kitchen if too hungry to be adherent. Phase 3 was a 5-week weight maintenance phase during which food was provided according to randomization. Energy intake during Phase 3 was prescribed to support weight maintenance at the new, lower body weight, and was predicted from body weight and energy intake measured at the end of Phase 2, with adjustment for self-reported physical activity. Phase 4 was a 12- month follow-up period during which participants selected and pre pared their own meals after being provided with instructions on fol lowing the diet to which they were randomized" (Karl. 2015)

To assess the effects of this sequence of induction (weight maintenance), and weight stabilization phases, the body weight, body composition, RMR, and metabolic adaptation (measured RMR vs. predicted resting metabolic rate = RMR) of the middle aged study participants (49-64 years) were measured before and after all phases of the study.

Figure 2: (A) Weight loss and (B) percentage of total weight loss attributable to fat mass and fat free mass while consuming provided-food diets differing in glycemic index (GI) and percent energy from carbohydrate (55%, ModCarb and 70%, HighCarb) for 17 weeks (n = 79). Values are mean 6 SEM. Weight loss analyzed by repeated measures ANCOVA, body composition by two-factor ANOVA. a,bMain effect of time; asignificant decrease from baseline (P < 0.001), bsignificant difference from Phase 2 end (P < 0.001). No diet effects (main effects or interactions) for any comparisons. GI, glycemic index; HighCarb, 70% energy from carbohydrate; ModCarb, 55% energy from carbohydrate (Karl. 2015).

Interestingly, the analysis of this data revealed no significant inter-group differences in terms of any of the relevant study outcomes. Yes, you read me right: This means that neither the GI, nor the GL, nor the carbohydrate content of the diet had statistically significant effects on weight loss, body composition, RMR, or the metabolic adaptation aka "metabolic damage" due to weight loss.

Figure 3: Measured resting metabolic rate as a function of predicted metabolic rate (Karl. 2015). Note: If there was no "metabolic damage", the solid line which represents the ideal body-weight dependent decline of energy expenditure and the dashed line which represents the actual ratio of the measured to the predicted RMR should be congruent.

While there were no inter-group differences and neither the amount or the type of carbohydrates had an effect on the reduction of the metabolic rate, there is still one interesting result you can see in the right graph in Figure 3. Said graph depicts the ratio of the measured to the predicted metabolic rate during the 5-week weight maintenance phase. If you look closely, you will realize that it suggests that having a high predicted RMR, i.e. being heavier, being taller and being more muscular, is associated with a non-significant decline of the non-predicted reduction of the energy expenditure (=metabolic damage) and thus a narrowing of the gap between the solid and dashed line.

"Solid and dashed? I don't get it!"

You're asking how I can support this hypothesis? Well, the dashed line that represents the true ratio of the actual to the predicted RMR approaches the theoretical one (the solid line) for higher RMR values. If this was more than a trend, it would suggest that two things: (a) Losing less weight and thus maintaining a higher predicted metabolic rate protects against metabolic damage (that would be useless). And (b) being tall and muscular and thus having a naturally high(er) predicted RMR can protect you from suffering metabolic damage when you lose weight.

Unfortunately, it's not possible to tell which (if any) of the two options is correct. If I had to make an educated guess, though, I would say it's a combination of both: The weight change of an average 5.5 kg did not wary too much and was withing 95% confidence intervals of [-7.1 kg, -4.6 kg]. In conjunction with individual physiological qualities of people with higher baseline RMRs, it could still explain the narrowing of the gap between predicted and true RMR after dieting.

Figure 4: Changes in body composition (absolute value in kg) after 20 weeks and after weight loss phase 2 (Karl. 2015).

Bottom line: As Karl et al. point out, "neither low-GI relative to high-GI diets nor moderate-carbohydrate relative to high-carbohydrate diets showed differences with respect to effects on changes in body composition or resting metabolism during weight loss when confounding dietary factors were tightly controlled in a study providing all food for 22 weeks" (Karl. 2015).

This does not just go against the mainstream assumption that low GI and/or low(er) carbohydrate diets facilitate weight loss, fat loss and weight maintenance (see data in Figure 4 for an overview of these parameters, it also contradicts the initially mentioned broscientific assumption that carbohydrates, in general, and high GI carbs, in particular, have a protective effect against the unexpected diet-induced reduction of basal energy expenditure many people know as "metabolic damage". If there's anything of which the study at hand suggests that it could protect you from such unexpectedly large decrease in RMR, it's not high GI carby, but rather an already high(er) baseline RMR (see Figure 3).

And what does that tell us? Right! Since a high predicted RMR is a function of (a) being male, (b) being tall, and (c) being muscular, all three attributes may protect you from diet-induced "metabolic damage" | Let me know your thoughts and comment on Facebook!

References:

• Danforth Jr, Elliot, et al. "Dietary-induced alterations in thyroid hormone metabolism during overnutrition." Journal of Clinical Investigation 64.5 (1979): 1336.
• Karl, J. Philip, et al. "Effects of carbohydrate quantity and glycemic index on resting metabolic rate and body composition during weight loss." Obesity 23.11 (2015): 2190-2198.
• Mariash, C. N., et al. "Synergism of thyroid hormone and high carbohydrate diet in the induction of lipogenic enzymes in the rat. Mechanisms and implications." Journal of Clinical Investigation 65.5 (1980): 1126.
• Serog, P., et al. "Effects of slimming and composition of diets on VO2 and thyroid hormones in healthy subjects." The American journal of clinical nutrition 35.1 (1982): 24-35.
• Ullrich, Irma H., Philip J. Peters, and M. J. Albrink. "Effect of low-carbohydrate diets high in either fat or protein on thyroid function, plasma insulin, glucose, and triglycerides in healthy young adults." Journal of the American College of Nutrition 4.4 (1985): 451-459.

Non-Adherence and Design Problems: Two Reasons Why Recent Diet Study May Fail to Show Benefits of High(er) Protein + Dairy Intakes in Overfat (>37%) Women

Non-Adherence and Design Problems: Two Reasons Why Recent Diet Study May Fail to Show Benefits of High(er) Protein + Dairy Intakes in Overfat (>37%) Women

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Don't expect weight loss wonders from high(er) protein and dairy intakes, but especially when the energy intake is not controlled both can have benefits the study at hand could not detect.

What's better a calorie reduced diet with the suggested amount of protein or one with a slightly higher amount of protein and extra low-fat dairy in it, when it comes to shedding the exuberant body fat off the hips, abs and buttocks of 104 overweight / obese (or with a body fat content of 37%+ "overfat") premenopausal women?

That's probably not exactly the way the scientists from the Utah State University, the Pennsylvania State University, the University of Illinois and the FB Technical Center (Shlisky. 2015) would phrase their research question, but in the end, their 24-week three-phase randomized weight loss intervention comes tried to answer exactly this question.

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To learn more about the impact of higher protein intakes (30% vs. 20% of total energy intakes) and the purported "magic" of diets that are high in low fat dairy (in particular yogurt), Julie D. Shlisky and her colleagues had their subjects go through a three-phase weight loss intervention with

• the JumpStart phase (weeks 0–2), being intended to kickstart the subjects' weight loss on a ~35% energy deficit, phase (2), 
• the Weightloss phase (weeks 3–12; total of 12 weeks), during which the subjects were supposed to adhere to a 1,500-1,700kcal diet which came close to a 25-30% energy deficit compared to their baseline energy intakes, and
• the Weightloss Maintenance phase, (weeks 13–24; total of 12 weeks), over the course of which the subjects had to stick to a dietitian designed "energy-balanced" diet which had still ~20% less energy than the subjects baseline diet (see Figure 4, right)

If you look at the tabular overview of what the subjects eat (I won't reprint 4 pages from the full text here) you can easily get confused and think that there were five different groups, eventually it does yet all come down to two groups, the intervention (INT) and comparison (COM) groups and their different diets during the previously explained phases of the study.

Figure 1: Macronutrient compositions of the prescribed diets in the intervention and comparison group (Shlisky. 2015).

In that, the most significant inter-group difference were (a) the macronutrient composition with 30% PRO, 25% FAT, 45% CHO in the intervention group (INT) and 16-17% PRO, 24-25% FAT, 59% CHO in the comparison group (COM).

Figure 2: Total intake (g) of carbohydrates, proteins and fats during the 12 week weight loss and maintenance phases (Shlisky. 2015)

"[w]eekly educational sessions were held for both INT and COM groups throughout the 6- month study and included lessons on basic nutrition knowledge, exchange patterns of eating, portion size and control, purchasing and preparing food and modifying recipes as well as motivational lessons on outcome expectations, selfregulation and monitoring, problem- solving, lifestyle modification, emotion eating and motivation for walking" (Shlisky. 2015) 

In addition, the subjects were told to consume 5 servings per day (with a focus on low fat yogurt) in the intervention and 3 servings of dairy (excluding yogurt) in the comparison group, as well as to finally get their behind off the couch for a total of ~8,000-10,000 steps per day (that was ~30-40 minutes of walking per day).

Thorpe et al. were able to show that high(er) protein intakes from dairy will decrease calcium loss and preserve bone mass (WB = whole body; LS = lumbar spine) while dieting. Don't fall for the "protein is bad for your bones" lie!

What does previous research tell us? If you look at previous research by Bowen (2004 & 2005), Josse (2011), Thorpe (2008) and Zemel (2004), there is significant evidence that high(er) protein intakes will augment fat loss and lean mass retention while increased dairy intakes may benefit bone mass and metabolic markers in men, women, young and old. In particular, when they are consumed alongside true exercise regimen, high(er) protein intakes have been proven have additive effects on body comp. during weight loss (8.8kg vs. 5.5kg fat loss in 16wks | Layman. 2005).

Against that background I would be very hesitant to take use the study at hand to argue that you can shed body fat just as effectively on the bogus "recommended diet" (=15-20% protein, 60% carbohydrates and 20-25% fat).

Needless to say that the novelty of the physical activity, of which I'd like to remind you that it had the same volume for both groups, must be taken into consideration when we take a look at the results of the 24-wk study:

Figure 3: Relative changes in markers of body composition after the weight loss and weight maintenance phase; all values expressed as percent difference to the respective pre-values in both groups (Shilsky. 2015).

Now, if you look at the overall effects and inter-group differences in Figure 3, three things are remarkable: Firstly, all subjects lost a significant amount of body weight and body fat without having to starve themselves or spending hours on the elliptical or treadmill. Secondly, there were no inter-group differences, which means that neither the overall increase in protein intake (see Figure 2), nor the increased intake of low-fat dairy and most prominently yogurt (effectively, the difference was only 1 serving per day, because the INT subjects failed to hit their target of five and ate only four servings per day) had beneficial effect on (a) the actual weight and more importantly fat / lean mass loss and (b) the subjects' general ability to keep the weight off during the follow up.

Figure 4: Reduction in energy expenditure (% of baseline) and total step count (activity level) of the subjects in the weight loss and weight maintenance phases of the study (Shlisky. 2015)

If we also take into account the data from Figure 3 which depicts the reduction in energy intake from baseline and the total number of steps participants in both groups took on a daily basis, we could yet conclude that the lower dairy (no yogurt) + lower protein group achieved very similar results with less efforts. There is thus no debating the scientists conclusion that

"[h]ealthy premenopausal women with excess adiposity effectively lost BW and fat mass and improved some metabolic risk factors following an ERD with approximately 20% protein and 3 svg/d of nonfat dairy intake." (Shlisky. 2015)

The increased protein or dairy (in this case mostly yogurt) intake did after all not offer significant benefits, as neither of the existing differences in Figure 3 was statistically significant.

The actual macronutrient ratio during the weight loss and maintenance phase (figure shows averages) was by no means what it was supposed to be. The women ate ~8% less protein than they were supposed to do.

So, there's no benefit to high(er) protein and dairy intakes? No, there isn't - at least in a study with such a questionable design. Did you recognize the culprit? Yes, you're right: What on earth do you expect to happen if you design a "weight maintenance phase" during which the subjects still have to consume an energy reduced diet... I mean, it is well possible that the dietitians equations said that the diet was "energy-balanced". If you compare their intake to the ad-libitum diets of the subjects (=their baseline diet), the women still consumed 18% (HP) and 27% (NP) less energy during the weight maintenance phase - this time with a significant inter-group difference in favor of the high(er) protein high(er) dairy (yogurt) group who consumed more energy during both the weight loss and maintenance phase with identical results.

I am not sure what you think, but I personally would refute any statement about the standard diet recommendation being as efficient as a high(er) protein + high(er) dairy variety based on the study at hand. The increased satiety effect, a potential increase in thermogenesis, etc. - all the purported benefits of high(er) protein intakes couldn't show due to (a) non-adherence (instead of 30%, the subjects in the intervention group consumed only 23% and 20% protein during the weight loss and maintenance phase, respectively, and were thus not far off of the 20% and 18% in the COM group) and (b) the stupid idea not to let the women eat an ad-libitum with a fixed macronutrient ratio during the weight maintenance phase. This is after all a more realistic scenario and one in which real benefits of high(er) protein can show | Comment on Facebook!

References:

• Bowen, Jane, Manny Noakes, and Peter M. Clifton. "A high dairy protein, high-calcium diet minimizes bone turnover in overweight adults during weight loss." The Journal of nutrition 134.3 (2004): 568-573.
• Bowen, J., M. Noakes, and P. M. Clifton. "Effect of calcium and dairy foods in high protein, energy-restricted diets on weight loss and metabolic parameters in overweight adults." International journal of obesity 29.8 (2005): 957-965.
• In particularly in conjunction with exercise, high(er) protein intakes have been proven have additive beneficial effects on body composition during weight loss (Layman. 2005)
• Josse, Andrea R., et al. "Increased consumption of dairy foods and protein during diet-and exercise-induced weight loss promotes fat mass loss and lean mass gain in overweight and obese premenopausal women." The Journal of nutrition 141.9 (2011): 1626-1634.
• Shlisky, Julie D., et al. "An energy‐reduced dietary pattern, including moderate protein and increased nonfat dairy intake combined with walking promotes beneficial body composition and metabolic changes in women with excess adiposity: a randomized comparative trial." Food Science & Nutrition (2015).
• Thorpe, Matthew P., et al. "A diet high in protein, dairy, and calcium attenuates bone loss over twelve months of weight loss and maintenance relative to a conventional high-carbohydrate diet in adults." The Journal of nutrition 138.6 (2008): 1096-1100.
• Zemel, Michael B., et al. "Calcium and dairy acceleration of weight and fat loss during energy restriction in obese adults." Obesity research 12.4 (2004): 582-590.