OBJECTIVES: We investigated the effects of weight loss and maintenance with diets that varied with regard to protein content and glycemic index (GI) on metabolic syndrome (MetSyn) status. METHODS: Secondary analyses were performed within the Diet, Obesity and Genes (DiOGenes) study (2006-2008), a randomized controlled dietary intervention. Nine hundred and thirty-eight overweight and obese adults from eight European countries entered an 8-wk low-calorie-diet period. Seven hundred and seventy-three adults who lost at least 8% of their body weights were randomized to one of five ad libitum diets for 6 mo: 1) low-protein (LP)/low-GI (LGI); 2) LP/high-GI (HGI); 3) high-protein (HP)/LGI; 4) HP/HGI; and 5) control diet. MetSyn prevalence and a standardized MetSyn score were assessed at baseline, after the low-calorie diet, and after the intervention. RESULTS: Weight loss among participants while on the low-calorie diet significantly reduced MetSyn prevalence (33.9% versus 15.9%; P < 0.001) and MetSyn score (-1.48 versus -4.45; P < 0.001). During weight maintenance, significant changes in MetSyn score were observed between the groups, with the highest increase detected in the LP/HGI group (P = 0.039, partial η(2) = 0.023). Protein, GI, and their interaction did not have isolated effects on study outcomes. CONCLUSIONS: Neither protein nor GI affected MetSyn status in this sample of European overweight and obese adults. However, a diet with a combination of an increased protein-to-carbohydrate ratio with low-GI foods had beneficial effects on MetSyn factors.

Centre for Exercise Nutrition and Health Sciences School for Policy Studies University of Bristol Bristol UK; Department of Social Medicine Preventive Medicine and Nutrition Clinic University of Crete Heraklion Crete Greece

Department of Clinical Nutrition German Institute of Human Nutrition Potsdam Rehbruecke Nuthetal Germany and Charité Universitätsmedizin Berlin Department of Endocrinology Diabetes and Nutrition Berlin Germany

Department of Human Biology Nutrition and Toxicology Research Institute Maastricht Maastricht University Medical Centre The Netherlands

Department of Human Nutrition Dietetics and Metabolic Diseases National Multiprofile Transport Hospital Sofia Bulgaria

Department of Nutrition Exercise and Sports Faculty of Science University of Copenhagen Denmark

Department of Physiology and Nutrition CIBERobn University of Navarra Pamplona Spain

Department of Social Medicine Preventive Medicine and Nutrition Clinic University of Crete Heraklion Crete Greece

Institute of Preventive Medicine Copenhagen University Hospitals Copenhagen Denmark

MRC Human Nutrition Research Elsie Widdowson Laboratory Cambridge UK

Obesity Management Centre Institute of Endocrinology Prague Czech Republic

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