Flexibility and personalization can boost long-term adherence to diet, and weight-loss success/outcome depends on eating more protein, and fiber while limiting calories, according to a study recently published in Obesity Science and Practice.
During this study, participants in a self-directed dietary education program who had the greatest weight loss success across a 25 month period were found to have consumed more protein and fiber. Additionally, personalization and flexibility were imperative to the creation of dietary plans that the participants were able to adhere to over time.
Individualized Diet Improvement Program
Participants were enrolled in the Individualized Diet Improvement Program (iDip), which uses visualization tools and dietary education sessions to increase knowledge of key nutrients, enabling them to create a personalized, safe, and effective weight-loss plan, explained Manabu T. Nakamura, professor of nutrition at the University of Illinois Urbana-Champaign and the leader of the research.
“Flexibility and personalization are key in creating programs that optimize dieters’ success at losing weight and keeping it off,” Nakamura said. “Sustainable dietary change, which varies from person to person, must be achieved to maintain a healthy weight. The iDip approach allows participants to experiment with various dietary iterations, and the knowledge and skills they develop while losing weight serve as the foundation for sustainable maintenance.”
The iDip focuses on increasing protein and fiber consumption while keeping calorie intake to 1,500 calories or less each day. Using the dietary guidelines issued by the Institutes of Medicine, the iDip team created a quantitative data visualization tool that plots protein and fiber densities per calorie, as well as provides a target range for each meal. Starting with foods the participants habitually ate, the dieters used this tool to create an individualized plan, increasing their protein intake to about 80 grams and their fiber intake to about 20 grams daily.
Results
While tracking participant eating habits and weights it was found that there were strong inverse correlations between the percentages of fiber and protein eaten and dieters’ weight loss. According to the researchers, after one year 41% of the most successful participants had lost 12.9% of their starting body weight compared to the remainder of the participants who were less successful and only lost just over 2% of their starting body weight.
22 people between the ages of 30 to 64 years old who enrolled in the program completed it. At enrollment, participants reported having made at least two or more unsuccessful attempts to lose weight. The participants also had a variety of comorbidities: 54% had high cholesterol, 50% had skeletal problems, and 36% had hypertension and/or sleep apnea. The participants also had diagnoses of diabetes, non-alcoholic fatty liver disease, depression, and cancer.
Those with depression lost 2.4% of their starting weight compared to those without depression who lost 8.39% of their starting weight. However, weight loss did not differ significantly among those with other comorbidities, ages, or sexes.
Sustainable Changes
“The research strongly suggests that increasing protein and fiber intake while simultaneously reducing calories is required to optimize the safety and efficacy of weight loss diets,” said first author and U. of I. alumna Mindy H. Lee, a then-graduate student and registered dietitian-nutritionist for the iDip program.
Analysis of body composition revealed that the participants did not lose lean body mass, losing an average of 7.1 kilograms of fat mass and minimal muscle mass at 6 months. The results showed that among those who lost more than 5% of their initial weight, 78% of that loss was fat. Overall, fat mass loss from an average of 42.6 kilograms at enrollment decreased to 35.7 at 15 months; with waist diameters decreasing by 7 centimeters at 6 months to 9 centimeters at 15 months. Additionally, tracking participant protein and fiber intake revealed a strong correlation between protein and fiber consumption and weight loss at the 3 and 12-month markers.
“The strong correlation suggests that participants who were able to develop sustainable dietary changes within the first three months kept losing weight in the subsequent months, whereas those who had difficulty implementing sustainable dietary patterns early on rarely succeeded in changing their diet in the later months,” Nakamura said.
“Recently, the popularity of injectable weight loss medications has been increasing,” Nakamura said. “However, using these medications when food intake is strongly limited will cause serious side effects of muscle and bone loss unless protein intake is increased during weight loss.”
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