High(er) Dose Fish Oil (3g EPA+DHA per Day), an Effective Thermogenic for Older Women - 187 kcal/Day Higher RMR

High(er) Dose Fish Oil (3g EPA+DHA per Day), an Effective Thermogenic for Older Women - 187 kcal/Day Higher RMR

basal metabolic rate DHA elderly energy expenditure EPA fat oxidation fish oil lose fat metabolic rate older women RMR women

This study is different from the average "fish oil is good for you" study and that's both refreshing and revealing. Speaking of "fresh" you got a 50/50 chance you buy fresh, not rancid fish oil.

I am not exactly a fan of fish oil supplementation, but I am neither ignoring the few gems among the bazillion of "fish oil is good for you" papers. Samantha L. Logan's and Lawrence L. Spriet's latest paper in the open access journal PLOS|ONE looks as if it was one of those gems. A gem that suggests that 3g of DHA + EPA per day (2 g/d EPA, 1 g/d DHA, to be precise) will not just lower the triglyceride levels of community dwelling older, healthy women by 29%, but also (a) increase their lean mass by 4%, (b) boost their functional capacity by 7% and (c) bump up their resting metabolic rate by 14%, their energy expenditure during exercise by 10%, and the rate of fat oxidation during rest and low-intensity cycling by 19% and 27%, respectively.

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What? Yep, now I got your attention, right? Well, the objective of the study was to evaluate the effect of fish oil (FO) supplementation in a cohort of healthy, community-dwelling older females. Now, in contrast to your average fish oil study, the scientists did not restrict themselves to measuring the effects on blood measures of insulin, glucose, c-reactive protein, and triglycerides, though. Their primary study outcomes included the effects on the subjects' metabolic rate and substrate oxidation at rest and during exercise as well as on body composition, strength and physical function.

For the study, twenty-four healthy females (66 ± 1 yr) were recruited and randomly assigned to receive either 3g/d of EPA and DHA or a placebo (PL, olive oil) for 12 wk. Exercise measurements
were taken before and after 12 wk of supplementation and resting metabolic measures were made before and at 6 and 12 wk of supplementation.

Figure 1: Relative changes in metabolic parameters at rest and during 30 min of exercise (Logan. 2015).

As you already know and can now see in Figure 1, the fish oil supplementation significantly increased the subjects' resting metabolic rates, energy expenditure during exercise and the rate of fat oxidation at rest and during exercise. What is kind of funny, though, is that the scientists either misreported the actual values or miscalculated the changes, because I used the data from their study to calculate the relative differences in Figure 1 and as you can easily see those are significantly different from the values reported in the introduction - values I copied directly from the abstract.

So, how did this work? As of now we don't really know that. It is most likely that EPA and DHA modulate energy metabolism by activating one or several PPAR receptors, which may then trigger increases in the levels several protein (FAT/CD36, FABPc, UPC3) and enzymes (acyl-CoA oxidase, CPTI) which control the mitochondrial fatty acid oxidation. Additional effects on PGC-1α, which is involved in regulating the genes involved in energy metabolism, as well as in mitochondrial biogenesis and function may augment the metabolic effects of the long-chain omega-3s. Effects of which we do yet not know how they are affected by and whether they require the incorporation of DHA and EPA into the cell membrane - obviously significantly more research is necessary.

Now the reason I am not going to spend time to find out, whether I or the researchers have made a mistake is that the statistically significant increase in resting metabolic rate for example amounts to 7kcal per hour, if the actual value is 2-5% lower or higher that's absolutely irrelevant. Since the same can be said for the other values, I think we all should be able to cope with any potential deviation from the actual data in the following overview I've compiled based on the (hopefully accurate) data from the tables in the full text of the study graphically in Figure 2.

Figure 2: Graphical overview of the absolute increase in energy expenditure and fat oxidation (Logan. 2015).

In conjunction with the marginal, but significant increase in lean mass, which does by the way only partially explain the increase in energy expenditure, these changes are not just statistically, but practically relevant - that's something even I, as a fish oil critic, have to admit ;-)

So, fish oil is a metbalic activator? Well, at least in this particular group of subjects, there's no debating that the 3g of combined EPA + DHA per day triggered statistically significant and as the data in Figure 2 shows even potentially practically relevant increases in energy expenditure at rest and during exercise.

Suggested Read: "TTA + Fish Oil Revisited - Increased Muscular N-3 Levels Compromise Heart & Skeletal Muscle Performance: 40% Reduced Endurance & 54% Lower Work Capacity in 9 Weeks" | more

As the authors highlight, though, "[f]uture research should also aim to test a greater number of participants and include a longer period of supplementation (ie. 1 yr) to determine whether the increase in metabolic rate results in changes in more robust changes in body composition" (Logan. 2015). In view of the complaints of their subjects who had difficulties stomaching the 5g of total fish oil that were required to achieve the desired dose of EPA + DHA, the scientists also argue that future studies have to investigate solutions that reduce the digestive issues (gastrointestinal discomfort) and whether you even need 3g of EPA + DHA or lower dosages would have the same effect... well, and obviously, it would be interesting to see if similar results could be observed in younger and / or male subjects | Comment on Facebook!

References:

• Logan, Samantha Louise. Physical Activity and Nutrition as Modifiable Lifestyle Factors for Healthy Aging in Older Adults. Diss. The University of Guelph, 2013.

Hormonal Response to Exercise, Revisited: A Consequence, not a Determinant of Your Mood, Effort & Performance

Hormonal Response to Exercise, Revisited: A Consequence, not a Determinant of Your Mood, Effort & Performance

build muscle DHT female GH growth hormone HIIT hormones performance resistance training testosterone women women strength

Studies in men suggest no effect of the hormonal response on training outcome - What about women? A news study provides insights that may be relevant for both female and male gymrats.

It has been a few years that I last wrote about the "hormonal ghost". Back in the day, Stuart M. Phillips published an excellent paper that debunked the myth of a mechanistic link of post-exercise increases in testosterone, growth hormone, IGF-1 and co., on the one hand, and exercise-induced strength and size gains, on the other hand. And for those for whom Phillip's review of the literature was not convincing enough, Daniel WD West's 2012, which showed none of the expected associations between exercise-induced hormone profiles (first and foremost higher post-workout testosterone levels) and the rate or significance of muscle strength and size gains in a large cohort of young men after weight training, should have been evidence enough to stop believing in "hormonal ghosts", but alas... you will probably know that "training for testosterone increases" is still en vogue.

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That's stupid stubbornness, nothing else, right? Well, even though I don't believe in ghosts, I have to admit that a closer look at West's data will have you reject the hypothesis that the post-workout testosterone response would augment size gains, it does yet also show other hormonal changes do correlate with the changes in the study's subjects' lean mass (Figure 1, left) as well as type I (middle) and type II fiber size increases (Figure 1, middle & right).

Figure 1: Sign. associations between PWO hormone levels and lean mass, as well as fiber size increases (West. 2012).

As you can see in Figure 1, this was the case for the cortisol response and the lean mass gains and the growth hormone (GH) response and the increases in type I ('endurance') and type II ('strength') fiber size. Even though I don't believe that more than 1% of the gymrats world-wide who still believe that maximizing the post-workout "anabolic response" would help them to maximize their gains even know about these results, you could argue that these correlations fuel their beliefs - even if that's paradoxical, because - in bro-scientific terms - you'd have to maximize the catabolic response, i.e. the increase in cortisol (which could by the way simply be a measure of training intensity) in order to maximize the overall gains in muscle size, but alas...

Figure 2: Changes in anabolic and catabolic hormones in response to AM and PM HIIT and RT training (Toon. 2015).

In a series of experiments Rebecca Toone conducted for her thesis, she re-addressed the issue of the acute hormonal effects on performance with female study participants (yes, a long-term study was not part of her thesis, but I promise, the results are still noteworthy).

Higher sprint cadence (RPM) during HIIT, higher increase in DHT in the female study participants (Toon. 2015).

DHT another acute phase reactant? Even though the overall results of the study suggest that increased pre- vs. post workout changes in DHT as Toone observed the with higher RPM-numbers during HIIT sprints are not the reason, but rather the consequences of training at higher intensities, it is worth mentioning that this is the first study to observe the existence of an association between DHT and HIIT performance in women and that the results are in line with the results of previous research suggesting that DHT, not its precursor, testosterone, has a direct influence on skeletal muscle force production in vitro. 

After some preliminary testing, Toone began with another of the infamous "AM vs. PM" workout studies in which she unsurprisingly confirmed that...

"[...] it could be beneficial to perform resistance training in the afternoon preceded by interval exercise in the morning in order to stimulate a hormonal milieu that may be more conducive to stimulating muscle protein turnover" (Toon. 2015). 

If you scrutinize the data in Figure 2, you can see that this hypothesis is warranted, because of the differential response of the anabolic hormones, testosterone and IGF-1, and the stress / catabolic hormones, cortisol and prolactin, she observed in her young female subjects. Against that background it is quite interesting that Toone's last and most important experiment, in which she investigating the potential acute effects of hormones on performance, failed to demonstrate a direct correlation between changes in testosterone or other "anabolic" hormones and her subjects' performance.

"The trial consisted of a 20 min effort at a target power of 80% of the average power obtained during the maximal 20 min TT, followed by a 5 min break, before completion of a bout of repeated sprint interval cycle exercise consisting of 10 x 30 s sprinting, with 90 s recovery. The session was self-paced with real-time numerical feedback provided on elapsed time, cadence and power. Participants were given verbal encouragement at specific time-points throughout the trial. The same protocol was repeated for the second main trial one week later. Participants were permitted to drink water ad libitum throughout the trials. Trials were completed in a group setting as a group of six and a group of eight. A trial timeline schematic is displayed [in Figure 3]" (Toon. 2015).

Instead, the results of the previously described exercise test point towards affective variables, i.e. mood and effort, as the factors that mediate any link between hormonal changes and performance markers during an acute bout of high intensity cycling.

Figure 3: Design of the last and most important experiment of the study (Toone. 2015).

And guess what, the effort Toone's subjects invested into their workouts was not just a predictor of their performance, it was also positively associated with the percent change in testosterone concentration from post-sprint 4 to post-exercise (r = 0.449; P < 0.01).

Note: We are till talking about associations and correlations. That one of these, e.g. the one between the effort we put into our workouts and the preformance and hormonal response exists because of a causal link is thus in view of the results of the study at hand logical, but still hypothetical. As I am about to point out in the bottom line, future studies will have to investigate that - even though I have to admit that it will be difficult to develop an effective design for these studies.

In conjunction with the subjects' affect, which was inversely correlated with the rate of perceived exertion, which in turn showed positive correlations with cortisol, the results highlight a previously overlooked role of effort and affect when it comes to both, exercise performance and its effect on certain hormones.

Figure 4: The hormonal response is rather the consequence than the trigger of acute performance.

Or as Toone has it in her interpretation of these somewhat surprising results: The acute short-term effects of hormone concentrations on performance may be more related to mood and behaviour" than the actual type / time of exercise in the context of her study.

What does that mean? Practically speaking this would confirm what I have said about the initially cited West study in several previous SuppVersity articles. In said study, cortisol probably has no mechanistic effect on muscle size. Rather than that, the increase in cortisol could serve as a measure of how much effort the subjects put into their workouts; and this, in turn, determined their muscle gains (more effort = bigger growth stimulus = greater gains).

The meager and transient increase in testosterone after your workouts has none of the muscle building and fat shedding effects of exogenous testosterone. The latter however, can turn back the time and an aging pouch into a true best-ager | learn more.

In the study at hand, the situation appears to be similar. Mood and effort determine performance and hormonal response of the female study participants. Accordingly, there may be associations between exercise performance and certain hormones, but those are of corollary, not causative nature. In the absence of an additional experiment that would investigate the correlations and associations between mood, effort, RPE, hormones and the exercise-induced adaptation in the long run, we can still only speculate that making the workouts more fun and stimulating maximal effort would promote both, the adaptive response and the hormonal response and thus confirm that mood and effort are in fact the most relevant determinants of the outcome of your workouts | Comment!

References:

• Phillips, Stuart M. "Strength and hypertrophy with resistance training: chasing a hormonal ghost." European journal of applied physiology 112.5 (2012): 1981-1983.
• Toone, Rebecca. Assessing the Hormone Response to High Intensity Exercise and Identifying Associations with Performance. Diss. University of Bath, 2015.
• West, Daniel WD, and Stuart M. Phillips. "Associations of exercise-induced hormone profiles and gains in strength and hypertrophy in a large cohort after weight training." European journal of applied physiology 112.7 (2012): 2693-2702.

Training "On Cycle", Done Right - Women See Much Better Results When Periodization is in Line W/ Menstrual Cycle

Training "On Cycle", Done Right - Women See Much Better Results When Periodization is in Line W/ Menstrual Cycle

build muscle build strength female health menstrual cycle periodization training plan training programming woman women women strength workout programming workout routines

Yes, I could have exploited the ambiguity and called this article "Training 'On Cycle', Done Right - Women See Much Better Results When Periodization is in Line W/ Their Period", but let's be honest: This is a science website and that's neither scientific, nor actually funny, is it?

As a man, I have to admit to be at best well-read, yet not experienced in all things "menstrual cycle". So, while I do only know from the (very different things) I've heard from (ex-)girl friends about how they feel during the different phases, I do know that the hormonal differences in the luteal phase, with high levels of progesterone and estrogen, and the follicular phase with low progesterone and eventually increasing estrogen levels are pronounced enough to cause much more than just mood disturbances.

For many trainers, however, the estrous cycle is still a closed book. "Can you train, or not!?" Especially male trainers are not just insensitive when they ask their protégées this question, they may also be missing out on a chance to maximize their clients' training progress. That's at least what a recent 4-months study from the Umea University in Sweden (Wikström-Frisén. 2015) suggests.

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According to Wikström-Frisén and colleagues, "high frequency periodized leg resistance training during the first two weeks of the menstrual cycle is more beneficial to optimize training, than the last two weeks" (ibid. 2015). Now, "beneficial" is obviously a very loosely defined term. When I am telling you, though, that power, strength and lean body mass gains all benefited from the right timing of the workouts (in the first two weeks of the estrous cycle), I will hopefully have every women's and every trainers' attention (even though, I guess I will lose even more of the male bros, now).

Figure 1: Relative changes in lean mass (DXA data), measures power and strength (torque) in 59 trained women in response two weeks of frequent leg-training in the first or second two weeks of their estrous cycle (Wikström-Frisén. 2015).

While all the aforementioned increases in the women who trained in the first two weeks of their estrous cycle were statistically significant (for all, but the quad torque test | +4.4% the statistical significance also survived the Benferroni corrections), the women in the group for whom the periodization scheme had a focus on the second two weeks of their menstrual cycle, saw no significant changes in lean mass and power and a significant reduction in quad strength (see Figure 1). Since the latter lost its statistical power, after Benferroni corrections, though, one could say that the changes the Swedish researchers observed in the 2nd weeks group were practically meaningless.

What about women on oral contraception? The scientists recruited 32 young women on oral contraceptives and 27 women who didn't use oral contraceptives and a re-analysis of the data in Figure 1 didn't show significant inter-group differences between the two groups. In other words, the data in Figure 1 and thus the main findings are relevant for "all" resistance training young women, irrespective of whether they're taking contraceptives, or not. The only difference is that you go by the contraceptive (CC), instead of the estrous cycle and place the high frequency training period in the first, not the last two weeks of the CC cycle.

"Meaningless changes", however, are not meaningless results. In fact, the exact opposite is the case. These results tell trainers and female trainees, alike, that abandoning their protégées / their own

• regular non-periodized training, i.e. three leg training workouts per week that consisted of leg presses and leg curls (3x sets @ 8-10RM, 1-2 minutes rest between sets; progressive increase of weight by 2-10% whenever the subjects could perform 3x10 reps with a given weight) 

for 4-months and switching to a periodized 2-week high- vs. 2-week low-frequency training, where they would perform the same 48 workouts in either

• high-frequency first cycles, i.e. 5 workouts per week in the first two weeks, 1 workout per week for the last two weeks of each menstrual / contraceptive cycle, or
• high-frequency last cycles, i.e. 1 workout per week in the first two weeks, 4 workouts per week for the last two weeks of each menstrual / contraceptive cycle,

would have beneficial effects on their progress only if they increase the frequency during the early phase of the cycle. 

Figure 2: Comparison of the relative changes in the periodization group (high frequency in the first two weeks of the menstrual / CC cycle) vs. control group (three workouts per week for 4 months | Wikström-Frisén. 2015).

Ok, if you compare the periodization group to the control group which kept the regular "three workouts per week"-frequency (see Figure 2, green bars) was maintained, the "advantages" of periodizing "correctly" are not as pronounced as they are in comparison to doing it the "wrong" way. Even though, only the hamstrings appear to benefit to a large extent from periodization, though, benefits exist.

What's even more important, though, is the simple, but really important revelation (or for the few of you who have read about this before e.g. in Reis et al. (1995) "confirmation") that a woman's menstrual and similarly her contraceptive cycle must be aligned to her training schedule. Obviously, the implications will have to be further explored in future studies. Studies, of which I hope, that they will be using smarter periodization schemes which acknowledge that training only once a week is simply not enough... ;-)

SuppVersity Classic: Train Like a Woman: Common Misconceptions About Training & Eating for A Cover-Model Physique - An Interview With Sports Nutritionist & Strength Coach Orit Tsaitli | learn more

Bottom line: Before I try to put things into perspective, I should mention that the participants of the study who were recruited at local gyms, were not jut healthy, non-smokers and had regular menses, they were also experienced trainees. All of them had been doing leg presses and leg-curls for several months - in fact, on average for 3.5 years. Against that background, even non-statistical significant inter-group differences as they were observed between the periodization (5 per week, 1 per week) and the control group (3 per week) may be practically relevant, because they may help experienced trainees to break through plateaus.

With that being said, I personally think of this study as one study in a series of studies that will hopefully elucidate how women can adapt their training regimen to the repetitive changes in the hormonal milieu of their bodies.

If we are honest with ourselves, the fact that Wikström-Frisén's results come as a surprise to most of us is only further evidence of how wantonly exercise scientists and trainers, alike, have hitherto neglected the peculiarities of the female physiology and endocrinology | Comment on Facebook!

References:

• Reis, E., U. Frick, and D. Schmidtbleicher. "Frequency variations of strength training sessions triggered by the phases of the menstrual cycle." International journal of sports medicine 16.8 (1995): 545-550.
• Wikström-Frisén, L., C. J. Boraxbekk, and K. Henriksson-Larsén. "Effects on power, strength and lean body mass of menstrual/oral contraceptive cycle based resistance training." The Journal of sports medicine and physical fitness (2015).

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.