Predictors of successful weight loss with relative maintenance of fat-free mass in individuals with overweight and obesity on an 8-week low-energy diet

AbstractA low-energy diet (LED) is an effective approach to induce a rapid weight loss in individuals with overweight. However, reported disproportionally large losses of fat-free mass (FFM) after an LED trigger the question of adequate protein content. Additionally, not all individuals have the same degree of weight loss success. After an 8-week LED providing 5020 kJ/d for men and 4184 kJ/d for women (84/70 g protein/d) among overweight and obese adults, we aimed to investigate the relationship between protein intake relative to initial FFM and proportion of weight lost as FFM as well as the individual characteristics associated with weight loss success. We assessed all outcomes baseline and after the LED. A total of 286 participants (sixty-four men and 222 women) initiated the LED of which 82 % completed and 70 % achieved a substantial weight loss (defined as ≥8 %). Protein intake in the range 1·0–1·6 g protein/d per kg FFM at baseline for men and 1·1–2·2 g protein/d per kg FFM at baseline for women was not associated with loss of FFM (P = 0·632). Higher Three-Factor Eating Questionnaire (TFEQ) hunger at baseline and reductions in TFEQ disinhibition and hunger during the LED were associated with larger weight loss (all P ≤ 0·020); whereas lower sleep quality at baseline predicted less successful weight loss using intention to treat analysis (P = 0·021), possibly driven by those dropping out (n 81, P = 0·067 v. completers: n 198, P = 0·659). Thus, the protein intakes relative to initial FFM were sufficient for maintenance of FFM and specific eating behaviour characteristics were associated with weight loss success.

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Men and women respond differently to rapid weight loss: Metabolic outcomes of a multi-centre intervention study after a low-energy diet in 2500 overweight, individuals with pre-diabetes (PREVIEW)

Diabetes Obesity and Metabolism ◽

10.1111/dom.13466 ◽

2018 ◽

Vol 20 (12) ◽

pp. 2840-2851 ◽

Cited By ~ 34

Author(s):

Pia Christensen ◽

Thomas Meinert Larsen ◽

Margriet Westerterp-Plantenga ◽

Ian Macdonald ◽

J. Alfredo Martinez ◽

...

Keyword(s):

Weight Loss ◽

Intervention Study ◽

Low Energy ◽

Rapid Weight Loss ◽

Men And Women ◽

Metabolic Outcomes ◽

Low Energy Diet

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Rapid Weight Loss with a High-Protein Low-Energy Diet Allows the Recovery of Ideal Body Composition and Insulin Sensitivity in Obese Dogs

Journal of Nutrition ◽

10.1093/jn/134.8.2148s ◽

2004 ◽

Vol 134 (8) ◽

pp. 2148S-2150S ◽

Cited By ~ 29

Author(s):

Géraldine Blanchard ◽

Patrick Nguyen ◽

Constance Gayet ◽

Isabelle Leriche ◽

Brigitte Siliart ◽

...

Keyword(s):

Weight Loss ◽

Body Composition ◽

Insulin Sensitivity ◽

Low Energy ◽

High Protein ◽

Rapid Weight Loss ◽

Ideal Body ◽

Low Energy Diet

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Additional protein intake limits weight regain after weight loss in humans

British Journal Of Nutrition ◽

10.1079/bjn20041305 ◽

2005 ◽

Vol 93 (2) ◽

pp. 281-289 ◽

Cited By ~ 142

Author(s):

Manuela P. G. M. Lejeune ◽

Eva M. R. Kovacs ◽

Margriet S. Westerterp-Plantenga

Keyword(s):

Weight Loss ◽

Protein Intake ◽

Weight Regain ◽

Low Energy ◽

Control Group ◽

Significant Group ◽

Very Low Energy Diet ◽

Protein Group ◽

Overweight Subjects ◽

Low Energy Diet

Since long-term weight maintenance (WM) is a major problem, interventions to improve WM are needed. The aim of the study was to investigate whether the addition of protein to the diet might limit weight regain after a weight loss of 5–10 % in overweight subjects. In a randomised parallel study design, 113 overweight subjects (BMI 29·3 (SD 2·5) kg/m2); age 45·1 (SD 10·4) years) followed a very-low-energy diet for 4 weeks, after which there was a 6-month period of WM. During WM, subjects were randomised into either a protein group or a control group. The protein group received 30 g/d protein in addition to their own usual diet. During the very-low-energy diet, no differences were observed between the groups. During WM, the protein group showed a higher protein intake (18 %v.15 %;P<0·05), a lower weight regain (0·8v.3·0 kg;P<0·05), a decreased waist circumference (−1·2 (SD 0·7)v.0·5 (SD 0·5 ) cm;P<0·05) and a smaller increase in respiratory quotient (0·03 (SD 0·01)v.0·07 0·01; (SD/)P<0·05) compared with the control group. Weight regain in the protein group consisted of only fat-free mass, whereas the control group gained fat mass as well. Satiety in the fasted state before breakfast increased significantly more in the protein group than in the control group. After 6 months follow-up, body weight showed a significant group × time interaction. A protein intake of 18 % compared with 15 % resulted in improved WM in overweight subjects after a weight loss of 7·5 %. This improved WM implied several factors, i.e. improved body composition, fat distribution, substrate oxidation and satiety.

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Loss of total body potassium during rapid weight loss does not depend on the decrease of potassium concentration in muscles. Different methods to evaluate body composition during a low energy diet

International Journal of Obesity ◽

10.1038/sj.ijo.0801092 ◽

2000 ◽

Vol 24 (1) ◽

pp. 101-107 ◽

Cited By ~ 7

Author(s):

M Krotkiewski ◽

K Landin ◽

D Mellström ◽

J Tölli

Keyword(s):

Weight Loss ◽

Body Composition ◽

Potassium Concentration ◽

Low Energy ◽

Rapid Weight Loss ◽

Total Body Potassium ◽

Total Body ◽

Low Energy Diet

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Factors associated with engagement and adherence to a low-energy diet to promote 10% weight loss in patients with clinically significant non-alcoholic fatty liver disease

BMJ Open Gastroenterology ◽

10.1136/bmjgast-2021-000678 ◽

2021 ◽

Vol 8 (1) ◽

pp. e000678

Author(s):

Jadine Scragg ◽

Kate Hallsworth ◽

Guy Taylor ◽

Sophie Cassidy ◽

Laura Haigh ◽

...

Keyword(s):

Weight Loss ◽

Fatty Liver Disease ◽

Positive Reinforcement ◽

Low Energy ◽

Rapid Weight Loss ◽

Alcoholic Fatty Liver ◽

Factors Associated ◽

Personalised Feedback ◽

Alcoholic Fatty Liver Disease ◽

Low Energy Diet

ObjectiveClinical guidelines recommend weight loss to manage non-alcoholic fatty liver disease (NAFLD). However, the majority of patients find weight loss a significant challenge. We identified factors associated with engagement and adherence to a low-energy diet (LED) as a treatment option for NAFLD.Design23 patients with NAFLD enrolled in a LED (~800 kcal/day) were individually interviewed. Transcripts were thematically analysed.Results14/23 patients achieved ≥10% weight loss, 18/23 achieved ≥7% weight loss and 19/23 achieved ≥5% weight loss. Six themes were generated from the data. A desire to achieve rapid weight loss to improve liver health and prevent disease progression was the most salient facilitator to engagement. Early and significant weight loss, accountability to clinicians and regular appointments with personalised feedback were facilitators to engagement and adherence. The desire to receive positive reinforcement from a consultant was a frequently reported facilitator to adherence. Practical and emotional support from friends and family members was critically important outside of the clinical setting. Irregular working patterns preventing attendance at appointments was a barrier to adherence and completion of the intervention.ConclusionsEngagement and adherence to a LED in patients with NAFLD were encouraged by early and rapid weight loss, personalised feedback and positive reinforcement in the clinical setting combined with ongoing support from friends and family members. Findings support those identified in patients who completed a LED to achieve type 2 diabetes remission and highlight the importance of behaviour change support during the early stages of a LED to promote adherence.

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Effect of 12-week dark chocolate intake combined with low-energy diet and exercise on weight loss in obese adults: a phase II randomized controlled trial protocol

Principles and Practice of Clinical Research Journal ◽

10.21801/ppcrj.2016.22.3 ◽

2016 ◽

Vol 2 (2) ◽

Author(s):

Roberta Diaz Savoldelli ◽

◽

Catherine Yin Mok ◽

Wilson Costa Junior ◽

Andreia Sapienza ◽

...

Keyword(s):

Weight Loss ◽

Randomized Controlled Trial ◽

Phase Ii ◽

Controlled Trial ◽

Low Energy ◽

Trial Protocol ◽

Obese Adults ◽

Randomized Controlled ◽

Diet And Exercise ◽

Low Energy Diet

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Assessment of Protein Intake in the First Three Months after Sleeve Gastrectomy in Patients with Severe Obesity

Nutrients ◽

10.3390/nu13030771 ◽

2021 ◽

Vol 13 (3) ◽

pp. 771

Author(s):

Lucrezia Bertoni ◽

Romina Valentini ◽

Alessandra Zattarin ◽

Anna Belligoli ◽

Silvia Bettini ◽

...

Keyword(s):

Weight Loss ◽

Sleeve Gastrectomy ◽

Protein Intake ◽

Severe Obesity ◽

Protein Supplementation ◽

Fat Free Mass ◽

The Third ◽

Total Protein Intake ◽

Dietary Record ◽

Protein Rich

An adequate protein intake prevents the loss of fat-free mass during weight loss. Laparoscopic sleeve gastrectomy (SG) jeopardizes protein intake due to post-operative dietary restriction and intolerance to protein-rich foods. The purpose of this study is to evaluate protein intake in the first three months after SG. We evaluated, 1 month and 3 months after surgery, 47 consecutive patients treated with SG. Protein intake, both from foods and from protein supplementation, was assessed through a weekly dietary record. Patients consumed 30.0 ± 10.2 g of protein/day on average from foods in the first month, with a significant increase to 34.9 ± 4.8 g of protein/day in the third month (p = 0.003). The use of protein supplementation significantly increased total protein intake to 42.3 ± 15.9 g protein/day (p < 0.001) in the first month and to 39.6 ± 14.2 g of protein/day (p = 0.002) in the third one. Compliance with supplement consumption was 63.8% in the first month and only 21.3% in the third month. In conclusion, both one and three months after SG, protein intake from foods was not sufficient. The use of modular supplements seems to have a significant impact on protein intake, but nevertheless it remains lower than recommended.

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Preoperative weight loss with a very-low-energy diet: quantitation of changes in liver and abdominal fat by serial imaging

American Journal of Clinical Nutrition ◽

10.1093/ajcn/84.2.304 ◽

2006 ◽

Vol 84 (2) ◽

pp. 304-311 ◽

Cited By ~ 216

Author(s):

Susan L Colles ◽

John B Dixon ◽

Paul Marks ◽

Boyd J Strauss ◽

Paul E O’Brien

Keyword(s):

Weight Loss ◽

Abdominal Fat ◽

Low Energy ◽

Preoperative Weight Loss ◽

Very Low Energy Diet ◽

Serial Imaging ◽

Preoperative Weight ◽

Low Energy Diet

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Low Energy Diet-induced and Bariatric Surgery-induced Weight Loss Decreases Branched-chain and Aromatic Amino Acids in Plasma and Tissue (P21-078-19)

Current Developments in Nutrition ◽

10.1093/cdn/nzz041.p21-078-19 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

Cited By ~ 1

Author(s):

Zhanxuan Wu ◽

Karl Fraser ◽

Marlena Kruger ◽

Garth Cooper ◽

Anne-Thea McGill ◽

...

Keyword(s):

Bariatric Surgery ◽

Amino Acids ◽

Weight Loss ◽

Aromatic Amino Acids ◽

Fold Change ◽

Low Energy ◽

Post Surgery ◽

T1 And T2 ◽

Branched Chain ◽

Low Energy Diet

Abstract Objectives Plasma levels of branched-chain amino acids (BCAA) and aromatic amino acids (AAA) phenylalanine (phe) and tyrosine (tyr) have been associated with obesity, insulin resistance and risk of type 2 diabetes. This study aimed to investigate the response of circulating plasma and tissue levels of BCAA and AAA to weight loss, and to correlate the level of these metabolites in plasma and tissue in obese women. Methods 28 obese (mean BMI 46.2 kg/m2) women underwent low energy diet (LED)-induced weight loss (−9.2 ± 4.2 kg) followed by bariatric surgery-induced weight loss (−23.6 ± 2.5 kg). Plasma at baseline (t0), post-LED/pre-surgery (t1) and 6-month post-surgery (t2) as well as biopsies of subcutaneous abdomen adipose tissue (SAfat), superficial thigh adipose tissue (Tfat) and vastus lateralis thigh muscle (Tmuscle) at both t1 and t2 were collected, and profiled using mass spectrometry-based metabolomics approach. Paired t-tests were applied to assess between-timepoint differences, and Pearson correlation used to calculate correlation coefficient of metabolite levels between plasma and tissue. Results Plasma BCAA and AAA were all significantly reduced post-LED at t1 (fold-change of 0.76–0.85 for val, leu, ile, tyr and phe, P < 0.05) and 6-month post-surgery at t2 (fold-change of 0.74–0.85 for val, leu, ile, tyr and phe, P < 0.05) as compared to baseline t0; but not significant between t1 and t2, although trends of decrease were observed. Among the 3 tissue biopsies, only SAfat showed significantly decreased levels of tyr, leu and ile at t2 compared to t1 (fold-change for tyr 0.63, leu 0.66, ile 0.68, P < 0.05). In addition, plasma levels of val and ile were correlated with Tfat levels at both t1 and t2 (r2 = 0.47–0.57), and that of val, ile and leu were correlated with Tmuscle at t1 only (r2 = 0.64–0.67). Conclusions Circulating levels of BCAA and AAA were decreased by weight loss interventions. The decrease following an LED program was sustained after bariatric surgery without further significant decrease. Bariatric surgery also decreased BCAA levels in SAfat; moreover, our data suggested that plasma BCAA levels correlated well with peripheral tissue Tfat and Tmuscle. Funding Sources The New Zealand National Science Challenge High-Value Nutrition program.

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