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Effects of variation in protein and carbohydrate intake on body mass and composition during energy restriction: a meta-regression ^{1 ,2 ,3}

¹ From the Departments of Food Science and Human Nutrition (JWK, HSS, and BL-H) and of Statistics (MJD), University of Florida, Gainesville, FL.

Background: It is unclear whether low-carbohydrate, high-protein, weight-loss diets benefit body mass and composition beyond energy restriction alone.

Objective: The objective was to use meta-regression to determine the effects of variations in protein and carbohydrate intakes on body mass and composition during energy restriction.

Design: English-language studies with a dietary intervention of 4200 kJ/d (1000 kcal/d), with a duration of 4 wk, and conducted in subjects aged 19 y were considered eligible for inclusion. A self-reported intake in conjunction with a biological marker of macronutrient intake was required as a minimum level of dietary control. A total of 87 studies comprising 165 intervention groups met the inclusion criteria.

Results: After control for energy intake, diets consisting of 35–41.4% energy from carbohydrate were associated with a 1.74 kg greater loss of body mass, a 0.69 kg greater loss of fat-free mass, a 1.29% greater loss in percentage body fat, and a 2.05 kg greater loss of fat mass than were diets with a higher percentage of energy from carbohydrate. In studies that were conducted for >12 wk, these differences increased to 6.56 kg, 1.74 kg, 3.55%, and 5.57 kg, respectively. Protein intakes of >1.05 g/kg were associated with 0.60 kg additional fat-free mass retention compared with diets with protein intakes 1.05 g/kg. In studies conducted for >12 wk, this difference increased to 1.21 kg. No significant effects of protein intake on loss of either body mass or fat mass were observed.

Conclusion: Low-carbohydrate, high-protein diets favorably affect body mass and composition independent of energy intake, which in part supports the proposed metabolic advantage of these diets.

Key Words: Meta-analysis • body composition • high-protein diet • low-carbohydrate diet • weight loss

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