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

Andrea R Josse, Stephanie A Atkinson, Mark A Tarnopolsky, Stuart M Phillips, Andrea R Josse, Stephanie A Atkinson, Mark A Tarnopolsky, Stuart M Phillips

Abstract

Weight loss can have substantial health benefits for overweight or obese persons; however, the ratio of fat:lean tissue loss may be more important. We aimed to determine how daily exercise (resistance and/or aerobic) and a hypoenergetic diet varying in protein and calcium content from dairy foods would affect the composition of weight lost in otherwise healthy, premenopausal, overweight, and obese women. Ninety participants were randomized to 3 groups (n = 30/group): high protein, high dairy (HPHD), adequate protein, medium dairy (APMD), and adequate protein, low dairy (APLD) differing in the quantity of total dietary protein and dairy food-source protein consumed: 30 and 15%, 15 and 7.5%, or 15 and <2% of energy, respectively. Body composition was measured by DXA at 0, 8, and 16 wk and MRI (n = 39) to assess visceral adipose tissue (VAT) volume at 0 and 16 wk. All groups lost body weight (P < 0.05) and fat (P < 0.01); however, fat loss during wk 8-16 was greater in the HPHD group than in the APMD and APLD groups (P < 0.05). The HPHD group gained lean tissue with a greater increase during 8-16 wk than the APMD group, which maintained lean mass and the APLD group, which lost lean mass (P < 0.05). The HPHD group also lost more VAT as assessed by MRI (P < 0.05) and trunk fat as assessed by DXA (P < 0.005) than the APLD group. The reduction in VAT in all groups was correlated with intakes of calcium (r = 0.40; P < 0.05) and protein (r = 0.32; P < 0.05). Therefore, diet- and exercise-induced weight loss with higher protein and increased dairy product intakes promotes more favorable body composition changes in women characterized by greater total and visceral fat loss and lean mass gain.

Trial registration: ClinicalTrials.gov NCT00710398.

Conflict of interest statement

Author disclosures: A. R. Josse, S. A. Atkinson, M. A. Tarnopolsky, and S. M. Phillips, no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Absolute (A,C,E) and relative-to-baseline (B,D,F) changes in body fat mass (A,B), percent body fat (C,D), and lean mass (E,F) in overweight and obese premenopausal women who underwent a 16-wk intervention of diet- and exercise-induced weight loss. Values are means ± SE, n = 90 (30/group). Means at a time without a common letter differ, P < 0.05. *Different from the preceding time point, P < 0.05.APLD, adequate protein, low dairy; APMD, adequate protein, medium dairy; HPHD, high protein, high dairy.
FIGURE 2
FIGURE 2
Relative to baseline changes in trunk fat mass measured by DXA (A) and visceral fat volume measured by MRI (B) in overweight and obese premenopausal women who underwent a 16-wk intervention of diet- and exercise-induced weight loss, and the correlation between the 2 measures (C). Values are means ± SE, n = 39. Means without a common letter differ, P < 0.05. *Different from wk 0, P < 0.05. APLD, adequate protein, low dairy; APMD, adequate protein, medium dairy; HPHD, high protein, high dairy; VAT, visceral adipose tissue.

References

    1. Oreopoulos A, Padwal R, McAlister FA, Ezekowitz J, Sharma AM, Kalantar-Zadeh K, Fonarow GC, Norris CM. Association between obesity and health-related quality of life in patients with coronary artery disease. Int J Obes (Lond). 2010;34:1434–41
    1. Sharma AM, Padwal R. Obesity is a sign over-eating is a symptom: an aetiological framework for the assessment and management of obesity. Obes Rev. 2010;11:362–70
    1. Campbell WW, Haub MD, Wolfe RR, Ferrando AA, Sullivan DH, Apolzan JW, Iglay HB. Resistance training preserves fat-free mass without impacting changes in protein metabolism after weight loss in older women. Obesity (Silver Spring). 2009;17:1332–9
    1. Hunter GR, Byrne NM, Sirikul B, Fernandez JR, Zuckerman PA, Darnell BE, Gower BA. Resistance training conserves fat-free mass and resting energy expenditure following weight loss. Obesity (Silver Spring). 2008;16:1045–51
    1. Weinheimer EM, Sands LP, Campbell WW. A systematic review of the separate and combined effects of energy restriction and exercise on fat-free mass in middle-aged and older adults: implications for sarcopenic obesity. Nutr Rev. 2010;68:375–88
    1. Hunter GR, Brock DW, Byrne NM, Chandler-Laney PC, Del Corral P, Gower BA. Exercise training prevents regain of visceral fat for 1 year following weight loss. Obesity (Silver Spring). 2010;18:690–5
    1. Strychar I, Lavoie ME, Messier L, Karelis AD, Doucet E, Prud'homme D, Fontaine J, Rabasa-Lhoret R. Anthropometric, metabolic, psychosocial, and dietary characteristics of overweight/obese postmenopausal women with a history of weight cycling: a MONET (Montreal Ottawa New Emerging Team) study. J Am Diet Assoc. 2009;109:718–24
    1. Samuel VT, Petersen KF, Shulman GI. Lipid-induced insulin resistance: unravelling the mechanism. Lancet. 2010;375:2267–77
    1. Lewis GF, Carpentier A, Adeli K, Giacca A. Disordered fat storage and mobilization in the pathogenesis of insulin resistance and type 2 diabetes. Endocr Rev. 2002;23:201–29
    1. Wolfe RR. The underappreciated role of muscle in health and disease. Am J Clin Nutr. 2006;84:475–82
    1. Dansinger ML, Gleason JA, Griffith JL, Selker HP, Schaefer EJ. Comparison of the Atkins, Ornish, Weight Watchers, and Zone diets for weight loss and heart disease risk reduction: a randomized trial. JAMA. 2005;293:43–53
    1. Gardner CD, Kiazand A, Alhassan S, Kim S, Stafford RS, Balise RR, Kraemer HC, King AC. Comparison of the Atkins, Zone, Ornish, and LEARN diets for change in weight and related risk factors among overweight premenopausal women: the A TO Z Weight Loss Study: a randomized trial. JAMA. 2007;297:969–77
    1. Sacks FM, Bray GA, Carey VJ, Smith SR, Ryan DH, Anton SD, McManus K, Champagne CM, Bishop LM, Laranjo N, et al. Comparison of weight-loss diets with different compositions of fat, protein, and carbohydrates. N Engl J Med. 2009;360:859–73
    1. Krieger JW, Sitren HS, Daniels MJ, Langkamp-Henken B. Effects of variation in protein and carbohydrate intake on body mass and composition during energy restriction: a meta-regression 1. Am J Clin Nutr. 2006;83:260–74
    1. Abete I, Astrup A, Martinez JA, Thorsdottir I, Zulet MA. Obesity and the metabolic syndrome: role of different dietary macronutrient distribution patterns and specific nutritional components on weight loss and maintenance. Nutr Rev. 2010;68:214–31
    1. Layman DK. Protein quantity and quality at levels above the RDA improves adult weight loss. J Am Coll Nutr. 2004;23:S631–6
    1. Layman DK, Evans E, Baum JI, Seyler J, Erickson DJ, Boileau RA. Dietary protein and exercise have additive effects on body composition during weight loss in adult women. J Nutr. 2005;135:1903–10
    1. Mettler S, Mitchell N, Tipton KD. Increased protein intake reduces lean body mass loss during weight loss in athletes. Med Sci Sports Exerc. 2010;42:326–37
    1. Meckling KA, Sherfey R. A randomized trial of a hypocaloric high-protein diet, with and without exercise, on weight loss, fitness, and markers of the metabolic syndrome in overweight and obese women. Appl Physiol Nutr Metab. 2007;32:743–52
    1. Larsen TM, Dalskov SM, van Baak M, Jebb SA, Papadaki A, Pfeiffer AF, Martinez JA, Handjieva-Darlenska T, Kunesova M, Pihlsgard M, et al. Diets with high or low protein content and glycemic index for weight-loss maintenance. N Engl J Med. 2010;363:2102–13
    1. Major GC, Chaput JP, Ledoux M, St-Pierre S, Anderson GH, Zemel MB, Tremblay A. Recent developments in calcium-related obesity research. Obes Rev. 2008;9:428–45
    1. Zemel MB, Miller SL. Dietary calcium and dairy modulation of adiposity and obesity risk. Nutr Rev. 2004;62:125–31
    1. Zemel MB, Richards J, Mathis S, Milstead A, Gebhardt L, Silva E. Dairy augmentation of total and central fat loss in obese subjects. Int J Obes (Lond). 2005;29:391–7
    1. Shahar DR, Schwarzfuchs D, Fraser D, Vardi H, Thiery J, Fiedler GM, Bluher M, Stumvoll M, Stampfer MJ, Shai I. Dairy calcium intake, serum vitamin D, and successful weight loss. Am J Clin Nutr. 2010;92:1017–22
    1. Onakpoya IJ, Perry R, Zhang J, Ernst E. Efficacy of calcium supplementation for management of overweight and obesity: systematic review of randomized clinical trials. Nutr Rev. 2011;69:335–43
    1. Parikh SJ, Yanovski JA. Calcium intake and adiposity. Am J Clin Nutr. 2003;77:281–7
    1. Zemel MB. The role of dairy foods in weight management. J Am Coll Nutr. 2005;24:S537–46
    1. Zemel MB. Mechanisms of dairy modulation of adiposity. J Nutr. 2003;133:S252–6
    1. Wilkinson SB, Tarnopolsky MA, Macdonald MJ, Macdonald JR, Armstrong D, Phillips SM. Consumption of fluid skim milk promotes greater muscle protein accretion after resistance exercise than does consumption of an isonitrogenous and isoenergetic soy-protein beverage. Am J Clin Nutr. 2007;85:1031–40
    1. Hartman JW, Tang JE, Wilkinson SB, Tarnopolsky MA, Lawrence RL, Fullerton AV, Phillips SM. Consumption of fat-free fluid milk after resistance exercise promotes greater lean mass accretion than does consumption of soy or carbohydrate in young, novice, male weightlifters. Am J Clin Nutr. 2007;86:373–81
    1. Josse AR, Tang JE, Tarnopolsky MA, Phillips SM. Body composition and strength changes in women with milk and resistance exercise. Med Sci Sports Exerc. 2010;42:1122–30
    1. Garthe I, Raastad T, Refsnes PE, Koivisto A, Sundgot-Borgen J. Effect of two different weight-loss rates on body composition and strength and power-related performance in elite athletes. Int J Sport Nutr Exerc Metab. 2011;21:97–104
    1. Government of Canada Tri-council policy statement: ethical conduct for research involving humans [cited January, 15, 2011]. Available from:
    1. Health Canada Eating Well with Canada's Food Guide [cited June 1, 2011]. Available from:
    1. USDA Food Guide Pyramid [cited June 1, 2011]. Available from:
    1. Frankenfield D, Roth-Yousey L, Compher C. Comparison of predictive equations for resting metabolic rate in healthy nonobese and obese adults: a systematic review. J Am Diet Assoc. 2005;105:775–89
    1. Bazzano LA, He J, Ogden LG, Loria CM, Vupputuri S, Myers L, Whelton PK. Agreement on nutrient intake between the databases of the First National Health and Nutrition Examination Survey and the ESHA Food Processor. Am J Epidemiol. 2002;156:78–85
    1. Astrand PO, Ryhming I. A nomogram for calculation of aerobic capacity (physical fitness) from pulse rate during sub-maximal work. J Appl Physiol. 1954;7:218–21
    1. Elobeid MA, Padilla MA, McVie T, Thomas O, Brock DW, Musser B, Lu K, Coffey CS, Desmond RA, St-Onge MP, et al. Missing data in randomized clinical trials for weight loss: scope of the problem, state of the field, and performance of statistical methods. PLoS ONE. 2009;4:e6624.
    1. Glickman SG, Marn CS, Supiano MA, Dengel DR. Validity and reliability of dual-energy X-ray absorptiometry for the assessment of abdominal adiposity. J Appl Physiol. 2004;97:509–14
    1. Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation. 2002;106:3143–421
    1. American Diabetes Association Executive summary: standards of medical care in diabetes–2011. Diabetes Care. 2011;34 Suppl 1:S4–10
    1. Dietary Reference Intakes for calcium, phosphorus, magnesium, vitamin D, and fluoride. Washington, DC: Institute of Medicine. National Academies Press; 1997
    1. Dietary Reference Intakes for energy, carbohydrate, fiber, fat, fatty acids, cholesterol, protein, and amino acids. Washington, DC: Institute of Medicine. National Academies Press; 2005
    1. Burd NA, Tang JE, Moore DR, Phillips SM. Exercise training and protein metabolism: influences of contraction, protein intake, and sex-based differences. J Appl Physiol. 2009;106:1692–701
    1. Phillips SM, Tipton KD, Aarsland A, Wolf SE, Wolfe RR. Mixed muscle protein synthesis and breakdown after resistance exercise in humans. Am J Physiol. 1997;273:E99–107
    1. Caan B, Neuhouser M, Aragaki A, Lewis CB, Jackson R, LeBoff MS, Margolis KL, Powell L, Uwaifo G, Whitlock E, et al. Calcium plus vitamin D supplementation and the risk of postmenopausal weight gain. Arch Intern Med. 2007;167:893–902
    1. Liu S, Song Y, Ford ES, Manson JE, Buring JE, Ridker PM. Dietary calcium, vitamin D, and the prevalence of metabolic syndrome in middle-aged and older U.S. women. Diabetes Care. 2005;28:2926–32
    1. McCarron DA, Morris CD, Henry HJ, Stanton JL. Blood pressure and nutrient intake in the United States. Science. 1984;224:1392–8
    1. Wagner G, Kindrick S, Hertzler S, DiSilvestro RA. Effects of various forms of calcium on body weight and bone turnover markers in women participating in a weight loss program. J Am Coll Nutr. 2007;26:456–61
    1. Major GC, Alarie FP, Dore J, Tremblay A. Calcium plus vitamin D supplementation and fat mass loss in female very low-calcium consumers: potential link with a calcium-specific appetite control. Br J Nutr. 2009;101:659–63
    1. Ervin RB, Wang CY, Wright JD, Kennedy-Stephenson J. Dietary intake of selected minerals for the United States population: 1999–2000. NHANES Database. Advance data from vital and health statistics; no 341. Hyattsville (MD): National Center for Health Statistics; 2004
    1. Briefel RR, Johnson CL. Secular trends in dietary intake in the United States. Annu Rev Nutr. 2004;24:401–31
    1. Nutrient intakes from food. Canadian Community Health Survey, Cycle 2.2 (2004, published 2007). Health Canada [cited: January 15, 2011]. Available from:
    1. Flegal KM, Carroll MD, Ogden CL, Curtin LR. Prevalence and trends in obesity among US adults, 1999–2008. JAMA. 2010;303:235–41
    1. Faghih S, Abadi AR, Hedayati M, Kimiagar SM. Comparison of the effects of cows’ milk, fortified soy milk, and calcium supplement on weight and fat loss in premenopausal overweight and obese women. Nutr Metab Cardiovasc Dis. 2010;21:499–503
    1. Zemel MB, Thompson W, Milstead A, Morris K, Campbell P. Calcium and dairy acceleration of weight and fat loss during energy restriction in obese adults. Obes Res. 2004;12:582–90
    1. Layman DK, Walker DA. Potential importance of leucine in treatment of obesity and the metabolic syndrome. J Nutr. 2006;136:S319–23
    1. Jacobsen R, Lorenzen JK, Toubro S, Krog-Mikkelsen I, Astrup A. Effect of short-term high dietary calcium intake on 24-h energy expenditure, fat oxidation, and fecal fat excretion. Int J Obes (Lond). 2005;29:292–301
    1. Lorenzen JK, Nielsen S, Holst JJ, Tetens I, Rehfeld JF, Astrup A. Effect of dairy calcium or supplementary calcium intake on postprandial fat metabolism, appetite, and subsequent energy intake. Am J Clin Nutr. 2007;85:678–87
    1. Melanson EL, Donahoo WT, Dong F, Ida T, Zemel MB. Effect of low- and high-calcium dairy-based diets on macronutrient oxidation in humans. Obes Res. 2005;13:2102–12
    1. Shi H, Dirienzo D, Zemel MB. Effects of dietary calcium on adipocyte lipid metabolism and body weight regulation in energy-restricted aP2-agouti transgenic mice. FASEB J. 2001;15:291–3
    1. Sun X, Zemel MB. Leucine and calcium regulate fat metabolism and energy partitioning in murine adipocytes and muscle cells. Lipids. 2007;42:297–305
    1. Zemel MB, Shi H, Greer B, Dirienzo D, Zemel PC. Regulation of adiposity by dietary calcium. FASEB J. 2000;14:1132–8
    1. Sun X, Zemel MB. Calcium and dairy products inhibit weight and fat regain during ad libitum consumption following energy restriction in Ap2-agouti transgenic mice. J Nutr. 2004;134:3054–60
    1. Marsset-Baglieri A, Fromentin G, Tome D, Bensaid A, Makkarios L, Even PC. Increasing the protein content in a carbohydrate-free diet enhances fat loss during 35% but not 75% energy restriction in rats. J Nutr. 2004;134:2646–52
    1. Farrell SW, Fitzgerald SJ, McAuley PA, Barlow CE. Cardiorespiratory fitness, adiposity, and all-cause mortality in women. Med Sci Sports Exerc. 2010;42:2006–12

Source: PubMed

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