Skip to main content Accessibility help

Additional protein intake limits weight regain after weight loss in humans

  • Manuela P. G. M. Lejeune (a1), Eva M. R. Kovacs (a1) and Margriet S. Westerterp-Plantenga (a1)


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 (0·8 v. 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.

    • Send article to Kindle

      To send this article to your Kindle, first ensure is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the or variations. ‘’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Additional protein intake limits weight regain after weight loss in humans
      Available formats

      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Additional protein intake limits weight regain after weight loss in humans
      Available formats

      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Additional protein intake limits weight regain after weight loss in humans
      Available formats


Corresponding author

*Corresponding author: Ms M. P. G. M. Lejeune, fax +31 43 367 09 76, email M.Lejeune@HB.Unimaas.NL


Hide All
Allison, DB, Gadbury, G, Schwartz, LG, Murugesan, R, Kraker, JL, Heshka, S, Fontaine, KR & Heymsfield, SB (2003) A novel soy-based meal replacement formula for weight loss among obese individuals: a randomized controlled clinical trial. Eur J Clin Nutr 57, 514522.
Anderson, GH (1994) Regulation of food intake.In Modern Nutrition in Health and Disease 8th ed.524536 [Shils, MOlson, JShike, M, editors]. Malvern: Lea & Febiger.
Ashley, JM, St., Jeor, ST, Perumean-Chaney, S, Schrage, J Bovee, V (2001) Meal replacements in weight intervention. Obes Res 9, 312S320S.
Astrup, A (2001) Healthy lifestyles in Europe: prevention of obesity and type II diabetes by diet and physical activity. Public Health Nutr 2, 499515.
Barkeling, B, Rossner, S & Bjorvell, H (1990) Effects of a high-protein meal (meat) and a high-carbohydrate meal (vegetarian) on satiety measured by automated computerized monitoring of subsequent food intake, motivation to eat and food preferences. Int J Obes Relat Metab Disord 14, 743751.
Blundell, JE (2000) What foods do people habitually eat? A dilemma for nutrition, an enigma for psychology. Am J Clin Nutr 71, 35.
Boirie, Y, Dangin, M, Gachon, P, Vasson, MP, Maubois, JL & Beaufrere, B (1997) Slow and fast dietary proteins differently modulate postprandial protein accretion. Proc Nat Acad Sci USA 94, 1493014935.
Booth, DA, Chase, A & Campbell, AT (1970) Relative effectiveness of protein in the late stages of appetite suppression in man. Physiol Behav 5, 12991302.
Burton-Freeman, B, Davis, PA & Schneeman, BO (2002) Plasma cholecystokinin is associated with subjective measures of satiety in women. Am J Clin Nutr 76, 659667.
Crovetti, R, Porrini, M, Santangelo, A & Testolin, G (1998) The influence of thermic effect of food on satiety. Eur J Clin Nutr 52, 482488.
Ditschuneit, HH, Flechtner-Mors, M, Johnson, TD & Adler, G (1999) Metabolic and weight-loss effects of a long-term dietary intervention in obese patients. Am J Clin Nutr 69, 198204.
Dulloo, AG & Jacquet, J (1999) Low-protein overfeeding: a tool to unmask susceptibility to obesity in humans. Int J Obes Relat Metab Disord 23, 11181121.
Dumesnil, JG, Turgeon, J & Tremblay, A (2001) Effect of a low-glycaemic index-low-fat-high protein diet on the atherogenic metabolic risk profile of abdominally obese men. Br J Nutr 86, 557568.
Ekelund, U, Yngve, A, Sjöström, M & Westerterp, KR (2000) Field evaluation of the Computer Science and Application's inc. activity monitor during running and skating training in adolescent athletes. Int J Sports Med 21, 586592.
Flechtner-Mors, M, Ditschuneit, HH, Johnson, TD, Suchard, MA & Adler, G (2000) Metabolic and weight loss effects of long-term dietary intervention in obese patients: four-year results. Obes Res 8, 399402.
Flint, A, Raben, A, Astrup, A & Holst, J (1998) Glucagon-like peptide 1 promotes satiety and suppresses energy intake in humans. J Clin Invest 101, 515520.
Goldstein, DJ (1992) Beneficial effects of modest weight loss. Int J Obes Relat Metab Disord 16, 397415.
Goris, AHC, Meijer, EP, Kester, A & Westerterp, KR (2001) Use of a triaxial accelerometer to validate reported food intakes. Am J Clin Nutr 73, 549553.
Goris, AH & Westerterp, KR (1999) Underreporting of habitual food intake is explained by undereating in highly motivated lean women. J Nutr 129, 878882.
Goris, AH & Westerterp, KR (2000) Improved reporting of habitual food intake after confrontation with earlier results on food reporting. Br J Nutr 83, 363369.
Goris, AH, Westerterp-Plantenga, MS & Westerterp, KR (2000) Undereating and underreporting of habitual food intake in obese men: selective underreporting of fat intake. Am J Clin Nutr 71, 130134.
Gutzwiller, JP, Drewe, J, Goke, B, Schmidt, H, Rohrer, B, Lareid, V & Beglinger, C (1999) Glucagon-like peptide-1 promotes satiety and reduces food intake in patients with diabetes mellitus type 2. Am J Physiol 276, R1541R1544.
Herman, CP & Polivy, J (1980) Restrained eating Obesity 208 – 224 Stunkard AJ Philadelphia WB Saunders.
Hulshof, KFAM, Brussaard, JH, Kruizinga, AG, Telman, J, Löwik, MRH (2003) Socio-economic status, dietary intake and 10y trends: the Dutch National Food Consumption Survey. Eur J Clin Nutr 57, 128137.
Isaksson, B (1980) Urinary nitrogen output as a validity test in dietary surveys. Am J Clin Nutr 33, 45.
Jean, C, Rome, S, Mathé, V, Huneau, JF, Aattouri, N, Fromentin, G, Fromentin, G, Achagiotis, CL & Tome, D (2001) Metabolic evidence for adaptation to a high protein diet in rats. J Nutr 131, 9198.
Kissileff, HR, Carretta, JC, Geliebter, A, Pi-Sunyer, FX (2003) Cholecystokinin and stomach distension combine to reduce food intake in humans. Am J Physiol Regul Integr Comp Physiol 285, R992R998.
Kramer, FM, Jeffery, RW, Foster, JL & Snell, MK (1989) Long-term follow-up of behavioral treatment for obesity: patterns of weight regain among men and women. Int J Obes Relat Metab Disord 13, 123136.
Latner, JD & Schwartz, M (1999) The effects of a high-carbohydrate, high-protein or balanced lunch upon later food intake and hunger ratings. Appetite 33, 119128.
Layman, DK, Boileau, RA, Erickson, DJ, Painter, JE, Shine, H, Santher, C & Christon, DD (2003) A reduced ratio of dietary carbohydrate to protein improves body composition and blood lipid profiles during weight loss in adult women. J Nutr 133, 411417.
Mikkelsen, PB, Toubro, S & Astrup, A (2000) Effect of fat-reduced diets on 24-h energy expenditure: comparisons between animal protein, vegetable protein, and carbohydrate. Am J Clin Nutr 72, 11351141.
Naslund, E, Barkeling, B, King, N, Gutniak, M, Blundell, JE, Holst, JJ, Rossner, S & Hellstrom, PM (1999) Energy intake and appetite are suppressed by glucagon-like peptide-1 (GLP-1) in obese men. Int J Obes Relat Metab Disord 23, 304311.
Pasman, WJ, Saris, WHM, Muls, E, Vansant, G, Westerterp-Plantenga, MS (1999) The effect of exercise training on long-term weight maintenance in weight-reduced men. Metabolism 48, 1521.
Pasman, WJ, Westerterp-Plantenga, MS, Muls, E, Vansant, G, Van Ree, J & Saris, WHM (1997a) The effectiveness of long-term fiber supplementation on weight maintenance in weight reduced women. Int J Obes Relat Metab Disord 21, 548555.
Pasman, WJ, Westerterp-Plantenga, MS & Saris, WHM (1997b) The effectiveness of long-term supplementation of carbohydrate, chromium, fiber and caffeine on weight maintenance. Int J Obes Relat Metab Disord 21, 11431151.
Pullar, JD & Webster, AJF (1977) The energy cost of fat and protein deposition in the rat. Br J Nutr 37, 355363.
Rothacker, DQ (2000) Five-year self-management of weight using meal replacements: comparison with matched controls in rural Wisconsin. Nutrition 16, 344348.
Schick, RR, Schusdziarra, V, Mossner, J, Neuberger, J, Schroder, B, Segmuller, R, Maier, V & Classen, M (1991) Effect of CCK on food intake in man: physiological or pharmacological effect?. Z Gastroenterol 29, 5358.
Schoeller, DA (1996) Hydrometry Human Body Composition, 2543 [Roche, AFHeymsfield, SBLohmans, TG, editors]. Champaign, IL: Human Kinetics.
Schoeller, DA, Van Santen, E, Peterson, DW, Diez, W, Jaspan, J & Klein, PD (1980) Total body water measurement in humans with 18 O and 2 H labeled water. Am J Clin Nutr 33, 26862693.
Schoffelen, PFM, Westerterp, KR, Saris, WHM, Ten, Hoor F (1997) A dual respiration chamber with automated calibration. J Appl Physiol 83, 20642072.
Skov, AR, Toubro, S, Ronn, B, Holm, L & Astrup, A (1999) Randomized trial on protein vs carbohydrate in ad libitum fat reduced diet for the treatment of obesity. Int J Obes Relat Metab Disord 23, 528536.
Stock, MJ (1999) Gluttony and thermogenesis revisited. Int J Obes Relat Metab Disord 23, 11051117.
Stunkard, AJ & Messick, S (1985) The three factor eating questionnaire to measure dietary restraint, disinhibition and hunger. J Psychosom Res 29, 7183.
Van Gaal, LF, Wauters, MA, De Leeuw, IH (1997) The beneficial effects of modest weight loss on cardiovascular risk factors. Int J Obes Relat Metab Disord 21, S5S9.
Van Marken, Lichtenbelt, WD, Westerterp, KR, Wouters L (1994) Deuterium dilution as a method for determining total body water: effect of test protocol and sampling time. Br J Nutr 72, 491497.
Wadden, TA, Foster, GD & Letizia, KA (1994) One-year behavioral treatment of obesity: comparison of moderate and severe caloric restriction and the effects of weight maintenance therapy. J Consult Clin Psychol 62, 165171.
Weir, JBDV (1949) New methods for calculating metabolic rate with special references to protein metabolism. J Physiol 109, 19.
Westerterp-Plantenga, MS, Kempen, KPG & Saris, WHM (1998) Determinants of weight maintenance in women after diet-induced weight reduction. Int J Obes Relat Metab Disord 22, 16.
Westerterp-Plantenga, MS, Lejeune, MPGM, Nijs, I, Van Ooijen, M & Kovacs, EMR (2004) High protein intake sustains weight maintenance after body weight loss in humans. Int J Obes Relat Metab Disord 28, 5764.
Westerterp-Plantenga, MS, Rolland, V, Wilson, SAJ & Westerterp, KR (1999) Satiety related to 24 h diet-induced thermogenesis during high protein/carbohydrate vs. high fat diets measured in a respiration chamber. Eur J Clin Nutr 53, 495502.
Wing, RR, Jeffery, RW, Burton, LR, Thorson, C, Kuller, LH & Folsom, AR (1992) Change in waist-hip ratio with weight loss and its association with change in cardiovascular risk factors. Am J Clin Nutr 55, 10861092.
Zemel, MB (2003) Mechanisms of dairy modulation of adiposity. J Nutr 133, 252S256S.



Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed