Protein versus carbohydrates, weight loss and calories

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Hi All,

How effective is increased protein versus carbohydrates for weight loss and what

is

the role of intake of calories?

See the pdf-available below paper.

Westerterp-Plantenga MS, Lejeune MP.

Protein intake and body-weight regulation.

Appetite. 2005 Oct;45(2):187-90.

PMID: 15950318

Abstract

Body-weight management requires a multi-factorial approach. Recent findings

suggest

that an elevated protein intake seems to play such a key role in body-weight

management, through (i) increased satiety related to increased diet-induced

thermogenesis, (ii) its effect on thermogenesis, (iii) body composition, and

(iv)

decreased energy-efficiency. Supported by these mechanisms a relatively larger

weight loss and stronger body-weight maintenance thereafter have been observed.

.... protein intake ... its increased satiety effect despite similar energy

intake

(Westerterp-Plantenga, Rolland, , & Westerterp, 1999), its contribution to

storage of fat free mass ( Rome, Mathe, & Tome, 2001) its low energy

efficiency

during overfeeding (Dulloo and Jacquet, 1999 and Stock, 1999). The low energy

efficiency may be partly due to the increased thermogenesis; partly to the

composition of the body-mass gained, since fat free mass makes the cost of

energy

storage relatively high (Pullar & Webster, 1977). ...

Protein intake, satiety and diet-induced thermogenesis

Considering different satiating efficacies of the macronutrients protein,

carbohydrate and fat, a hierarchy has been observed with protein as most

satiating

and fat as least satiating, and, at the same time, a priority is shown with

respect

to the magnitude of the rate at which these macronutrients are metabolised

(Eisenstein et al., 2002, Latner and Schwartz, 1999 and Westerterp-Plantenga et

al.,

1999). ... The subjects ingested pre-determined, identical amounts of energy and

volume from foods comparable with respect to organoleptic characteristics, at

identical times, in a fully controlled situation: a high protein/high

carbohydrate

diet (protein/carbohydrate/fat: 30/60/10 percentage of energy) and a high fat

diet

(protein/carbohydrate/fat: 10/30/60 percentage of energy). Throughout the day,

in

between meals, satiety and fullness were significantly higher on the high

protein/high carbohydrate diet, than on the high fat diet, while hunger,

appetite,

desire to eat, and estimated quantity to eat, were significantly lower. Satiety

was

not only higher in the post-prandial state during the high protein/high

carbohydrate

diet, it was also higher during the high protein/high carbohydrate meals, and

hunger

was lower, compared to the high fat meal. Moreover, a higher diet-induced

thermogenesis (DIT) with a high protein/high carbohydrate diet, compared to the

DIT

with a high fat diet was observed. Satiety was positively related to 24 h DIT.

The

theoretical basis of this relationship between satiety and DIT may be that

increased

energy expenditure at rest implies an increased oxygen consumption and an

increase

in body temperature which may be lead to feeling deprived of oxygen and

translated

into satiety feelings (Westerterp-Plantenga et al., 1999). This idea is derived

from

observations of higher satiety scores under limited oxygen availability

conditions,

as observed at high altitude and in COPD patients, who also very quickly feel

deprived of oxygen when feeding ...

.... Higher satiety on a high protein diet, under similar energy intake

conditions

was also shown in the longer term, during a weight maintenance/weight regain

period

(Westerterp-Plantenga, Lejeune, Nijs, van Ooijen, & Kovacs, 2004). This

supported

the stronger weight maintenance in overweight to moderately obese men and women

who

consumed 18% of energy intake as protein, after 7.5±2.0% body weight loss over 4

weeks, compared to their counterparts who consumed 15% of energy intake as

protein

(Westerterp-Plantenga et al., 2004).

.... in the short-term, evidence for differences in short-term satiety between

protein from different sources e.g. whey and casein, has been shown (Hall,

Millward,

Long, & , 2003). The digestion and absorption of whey and casein differ in

that casein, unlike whey, coagulates in the stomach due to its precipitation by

gastric acid (Billeaud, Guillet, & Sandler, 1990). As a result, overall gastric

emptying time for casein appeared to be longer and a smaller post-prandial

increase

in plasma amino acids (AA) compared with the non-coagulating whey protein was

observed.

Post-prandial satiety appeared to be larger after a whey-preload than after a

casein-preload, related to more elevated concentrations of amino-acids in the

blood

together with stronger elevation of both Cholecystokinin and Glucagon Like

Peptide-1

(Hall et al., 2003).

.... In conclusion, most of the papers show evidence for protein being more

satiating

than carbohydrate and fat, in the short term, over 24 h and in the long term.

Thermogenesis plays a role in the satiety effect ... Small short term

post-prandial

differences were shown due to the source of the protein: ‘fast’ proteins being

more

satiating than ‘slow’ proteins, and animal protein introducing a higher energy

expenditure than vegetable protein. ...

.... High protein diets for body-weight loss ... compared a high-protein diet

with a

control diet in order to evaluate weight loss over 6 months, when energy intake

was

ad libitum. The effects of ... (25% P (protein), 45% C (carbohydrate), 30% F

(fat)

vs 12% P, 58% C, 30% F) on weight loss in obese subject (BMI=30)... weight loss

(8.9

vs 5.1 kg) and fat loss (7.6 vs 4.3 kg) were significantly higher in the high

protein group, due to a lower energy intake (5.0 MJ/d vs 6.2 MJ/d) p<0.05. In a

follow-up study, Due, Toubro, Skov, and Astrup (2004) observed that after 12

months

the weight loss was not significantly greater among the subjects in the high

protein

group [(6.2 and 4.3 kg), PMID: 15303109], but they had a greater reduction in

intra-abdominal adipose tissue. Also Dumesnil, Turgeon, and Tremblay (2001)

found a

favourable effect of a high protein diet on body-weight during 6 days ad libitum

feeding. The low-glycemic index–low-fat-high protein diet consumed resulted in a

spontaneous decrease in energy intake of 25% compared to a high carbohydrate-low

fat

diet (8.8 MJ/d vs 11.7 MJ/d), in the ad lib situation, and the metabolic profile

had

considerably improved. Body-weight loss was 2.3 kg over 6 days compared to no

weight-loss on the high carbohydrate diet. However, in comparison to an

iso-energetic high-carbohydrate diet there was no significant difference in body

weight loss. Laymen, Boileau, and kson (2003) found an improved

body-composition

due to a reduced ratio of dietary carbohydrate to protein and improved blood

lipid

profiles during weight loss in adult women. However, weight loss on the high

protein

diet was not different from the control group, probably due to lack of

difference in

energy intake.

Taken together, body weight-loss on a high protein diet appears to be greater

under

ad lib energy intake conditions, leading to decreased energy intake ... Under

iso-energetic conditions no statistically significant difference between

body-weight

loss on a high protein or high carbohydrate diet was shown. ...

.... Taken together, evidence was shown in that increased protein intake

sustained

weight maintenance by (i) favoring regain of fat-free mass at the cost of fat

mass

at a similar physical activity level, (ii) reducing the energy efficiency with

respect to the body mass regained, and (iii) increasing satiety

(Westerterp-Plantenga et al., 2004).

Conclusions

The role of protein in body-weight regulation, in comparison to other

macronutrients, consists of different aspects, i.e. satiety, thermogenesis,

energy

efficiency and body composition. These aspects are partly related to each other.

First of all protein appears to increase satiety, and therefore sustains reduced

energy-intake diets, preferably in the ad libitum condition. Under ad libitum

conditions, in energy balance as well as in a negative energy balance protein

appears to reduce energy intake. The highly satiating effect of protein has been

observed post-prandially as well as post-absorptively. Post-prandially the type

and

source of protein may be of importance, but post-absorptively the satiating

effect

is still present with varying types and sources. The background of the satiating

effect still needs to be further elucidated. Thermogenesis as well as satiety

hormones appear to play a role.

Second, high protein diets appear to imply a high thermogenesis, with satiety

being

related to this. Animal protein showed a higher thermogenesis than vegetable

protein. In the longer term this high thermogenesis contributes to the low

energy-efficiency of protein.

Third, under conditions of body-weight regain (while aiming for

weight-maintenance)

a high protein diet shows a reduced energy efficiency related to a different

body

composition of the body-weight regained, in favor of fat free mass.

Fourth, during body-weight loss, as well as during weight regain, a high protein

diet preserves or increases fat free mass and reduces fat mass, and improves the

metabolic profile.

Acknowledgements

Harry R. Kissileff, Chairman, supported in part by Glaxosmithkline

Al Pater, PhD; email: old542000@...

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