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High-Protein-Low-GI Diet Helps Keep Weight Off?

As anyone, who has ever tried to lose weight knows, the Holy Grail of weight management is not losing weight – it is preventing weight regain.

Today, the New England Journal of Medicine publishes the results of a large European multicentre trial called the Diet, Obesity, and Genes (DIOGENES) Project, showing that eating slightly more protein and slightly fewer high-glycemic-index foods may make it easier to keep weight off.

The DIOGENES trial randomised 773 overweight adults from eight European countries who had lost at least 8% of their initial body weight (~11 Kg) after several weeks on an 800-kcal low-calorie diet to one of five ad libitum diets (no caloric restrictions) to prevent weight regain over a 26-week period:

1) a low-protein and low-glycemic index diet,

2) a low-protein and high-glycemic-index diet,

3) a high-protein and low-glycemic-index diet,

4) a high-protein and high-glycemic-index diet,

5) a control diet.

The interventions aimed for a difference of 15 glycemic-index units between the high-glycemic-index and low-glycemic-index diets and a difference of 12% of total energy consumed from protein between the high-protein and the low-protein diets.

While only 548 (71%) participants completed the intervention, fewer participants in the high-protein (26.4%) and the low glycemic-index (25.6%) groups dropped out than in the low-protein–high-glycemic-index group (37.4%).

Among participants who completed the study, the high-protein low-glycemic-index group was by far the most successful in keeping the weight off. The low-protein high-glycemic-index group regained the most weight.

Thus, this large, randomized study, shows that a diet moderately high in protein content and slightly reduced in glycemic index not only is a diet that people are most likely to adhere to, but also the diet with the best odds of keeping weight off (at least over the 26 week observation period).

Obviously, all diets only work for people who stay on them – the fact that only 2 in 3 participants actually completed the trial (not counting additional dropouts during the initial weight loss phase), shows how difficult it may be even for motivated volunteers to adhere to such diets.

Nevertheless, for those wondering how to keep weight off, this study may provide some clear guidance that what you eat after losing weight may be even more important than what you eat to lose weight.

Toronto, Ontario

Larsen TM, Dalskov SM, van Baak M, Jebb SA, Papadaki A, Pfeiffer AF, Martinez JA, Handjieva-Darlenska T, Kunešová M, Pihlsgård M, Stender S, Holst C, Saris WH, Astrup A, & Diet, Obesity, and Genes (Diogenes) Project (2010). Diets with high or low protein content and glycemic index for weight-loss maintenance. The New England journal of medicine, 363 (22), 2102-13 PMID: 21105792


  1. Dr Sharma, I am a kidney stone sufferer and have been told to be careful of my protien intake. I am also obese and type 2 diabetic and have been instructed to increase my protien by a large amount and cut carbs by a large amount. Since starting this weight loss management the typical back pain that I experience when stones are forming or moving has returned so it is obvious to me that a high protien plan is not suitable for me. What on earth can I do about this? I did experience a tiny bit of weight loss but the thought of being hospitalized for another septic stone is enough of a deterrant to make me not continue with the program. Any thoughts on how to combine the two conditions and not aggravate one or the other? And it doesn’t matter what form the protien comes in, it’s all the same to my kidneys.

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  2. I want to know the advice you will give to Victoria

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  3. Victoria,
    Your kidney stone has nothing to do with your protein intake but with your diabetes-insulin resistance. You should prevent diabetes related kidney problem by avoinding carbs but more importantly the ACE-inhibitor effect of whey protein is very important to prevent renal problemas. Additionally whey is crucial to improve your insulin sensitivity and weight loss.
    Dr Salomon

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  4. Where is the high fat alternative?

    In my N=1 experiment, high natural fat, 70 gm protein, < 50 gm of slow carbs (low GI) was the best for me for maintaining weight loss and loosing weight, without hunger. By the way, any weight loss diet is high fat as far as what the body is living on.

    No sugars, no grains, no manufactured oils and only real foods produced a stable blood sugar and stable weight for the last 15 months. No drinking calories.

    Since insulin is the “boss” hormone for fat coming out of storage, insulin must be kept low. I cannot eat carbs and excess protein and keep insulin low. In fact, some proteins cause release of a lot of insulin, as assumed from blood sugar rise/decline. (caseins and nuts, peanuts)

    This diet also keeps the glycogen depleted, which must occur for weight loss.
    All the blood markers improved rapidly, and I was off blood pressure medication by the time I had lost 30% of body weight.

    Keep up the fine work.

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  5. Excellent blog – and frustrating at the same time. I am at the one-year mark on maintaining a 48 lb loss. Maintaining is indeed the Holy Grail – as you can imagine, getting accurate information is important to me. In the 1980s, fat was the bad food. In the first decade of the 2000s, fiber was added to all sorts of food. Lately, protein seems to be the newest holy grail. Gary Taubes book, “Good Calories, Bad Calories” certainly debunks many of the past popular weight loss beliefs.

    So much information out there and yet my knowledge of nutrition is really lacking.

    I am eating more veggies and fruit, generally decreasing the trans & sat fats / increasing the good fats, usually choosing whole foods over processed foods, and getting regular exercise. Yes, once in a while I eat french fries. Am I on the right track? Who knows, not me. I’m just an average consumer trying to be smart about nutrition.

    If I had reliable information about nutrition, I would follow it. That is what makes this whole subject so frustrating.

    I appreciate the accurate and timely information you provide in your blog.

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  6. 800 calories on the initial weight-loss diet? Isn’t that insanely low? Did I read that correctly?

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