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Reply to F Contaldo and F Pasanisi

General Clinical Research Center
University of Washington
Seattle, WA 98195
E-mail: hcal{at}u.washington.edu

Dear Sir:

Contaldo and Pasanisi offer thoughtful insights into the current global obesity epidemic in regard to food sustainability and the efficacy and health effects of diets high in protein. We acknowledge the complexity of the environmental issues related to the depletion of resources and population growth as well as the social and cultural implications driving food intake and physical activity.

A goal of our study design (1) was to examine the role of protein in body weight regulation. The study diets were created to measure a difference between a moderate-protein diet (15% of energy) and a high-protein diet (30% of energy). The protein foods used in the diets were obtained from both animal and vegetable sources to offer variety and appeal to a diverse population; our experience with study subjects indicates that a diet containing a wide variety of foods is essential for compliance. Our biggest challenge was to keep the fat content of the diet at 20% of energy while we increased the protein content and kept the carbohydrate content constant. To this end we used fat-free and low-fat dairy foods, egg whites, soy protein, and lean meats.

We appreciate the concerns of Contaldo and Pasanisi about the health effects of high-protein diets in regard to calcium and bone metabolism. We concluded in our article that it is essential to study the effects of protein-rich diets on renal function and calcium balance before recommending a high-protein diet for weight loss for the population at large (1). Perhaps the DiOGenes (Diet, Obesity, and Genes) trial described in Astrup's editorial (2) will begin to provide these answers.

ACKNOWLEDGMENTS

We hereby affirm that none of the authors had a financial, employment, or promotional conflict of interest relevant to the submission of this letter.

REFERENCES

1. Weigle DS, Breen PA, Matthys CC, et al. A high-protein diet induces sustained reductions in appetite, ad libitum caloric intake, and body weight despite compensatory changes in diurnal plasma leptin and ghrelin concentrations. Am J Clin Nutr 2005; 82: 41–8.[Abstract/Free Full Text]
2. Astrup A. The satiating power of protein—a key to obesity prevention? Am J Clin Nutr 2005; 82: 1–2.[Free Full Text]

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