Weight Loss Maintenance in Overweight Subjects on Ad Libitum Diets with High or Low Protein Content and Glycemic Index: The DIOGENES Trial 12-Month Results
Open accessAbstract
Background A high dietary protein (P) content and low glycemic index (LGI) have been suggested to be beneficial for weight management, but long-term studies are scarce.Objective The DIOGENES randomized clinical trial investigated the effect of P and GI on weight loss maintenance in overweight or obese adults in eight centers across Europe. This study reports the 1-year results in two of the centers that extended the intervention to 1 year.Method After an 8-week low-calorie diet (LCD), 256 adults (body mass index >27 kg m(-)(2)) were randomized to five ad libitum diets for 12 months: high P/LGI (HP/LGI), HP/high GI (HP/HGI), low P/LGI (LP/LGI), LP/HGI and a control diet. During the first 6 months, foods were provided for free through a shop system and during the whole 12-month period, subjects received guidance by a dietician. Primary outcome variable was the change in body weight over the 12-month intervention period.Results During the LCD period, subjects lost 11.2 (10.8, 12.0) kg (mean (95% confidence interval (CI))). Average weight regain over the 12-month intervention period was 3.9 (95% CI 3.0-4.8) kg. Subjects on the HP diets regained less weight than subjects on the LP diets. The difference in weight regain after 1 year was 2.0 (0.4, 3.6) kg (P=0.017) (completers analysis, N=139) or 2.8 (1.4, 4.1) kg (P<0.001) (intention-to-treat analysis, N=256). No consistent effect of GI on weight regain was found. There were no clinically relevant differences in changes in cardiometabolic risk factors among diet groups.Conclusion A higher protein content of an ad libitum diet improves weight loss maintenance in overweight and obese adults over 12 months.
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References 27 · Cited by 121
- Authors
- Aller, E. E. J. G., Larsen, T. M., Claus, H., Lindroos, A. K., Kafatos, A., Pfeiffer, A., Martinez, J. A., Handjieva-Darlenska, T., Kunesova, M., Stender, S., Saris, W. H. M., Astrup, A., & van Baak, M. A.
- Affiliations
- Maastricht University Medical Centre (NL)
- University of Copenhagen (DK)
- MRC Elsie Widdowson Laboratory (GB)
- University of Crete (GR)
- German Institute of Human Nutrition (DE)
- Gentofte Hospital (DK)
- Venue
- International Journal of Obesity
- Published
- 2014-03-28
- Volume
- 38
- Issue
- 12
- Pages
- 1511-1517
- ISSN
- 0307-0565 (ISSN-L)
- 1476-5497
- OpenAlex
- W2025707255
- Cited by
- 121
- References
- 27
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 2 · 2023: 5 · 2022: 6 · 2021: 11 · 2020: 12 · 2019: 17 · 2018: 9 · 2017: 20 · 2016: 13 · 2015: 13 · 2014: 9
- FWCI
- 12.19
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- International Journal of Obesity (publishedVersion)
- PubMed (publishedVersion)
- Research Publications (Maastricht University) (submittedVersion)
- Research at the University of Copenhagen (University of Copenhagen) (submittedVersion)
- Funders
- European Commission (FP6-2005–513946)
- Topics
- Health Sciences › Medicine › Physiology › Diet and metabolism studies
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Regulation of Appetite and Obesity
- Keywords
- weight loss maintenance, glycemic index, ad libitum feeding, overweight, obesity, weight regain, hypocaloric diet, cardiometabolic risk factors
- MeSH terms
- Adult, Body Weight, Energy Intake, Diet, Reducing, Dietary Carbohydrates, Dietary Proteins, Europe, Family, Female, Glucose Tolerance Test, Humans, Male, Nutrition Surveys, Obesity, Patient Compliance, Time Factors, Weight Gain, Weight Loss, Body Mass Index, Diet, Protein-Restricted, Caloric Restriction, Glycemic Index, White People, Waist Circumference
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