Skip to main content Accessibility help

Blood profiling of proteins and steroids during weight maintenance with manipulation of dietary protein level and glycaemic index

  • Ping Wang (a1), Claus Holst (a2), Arne Astrup (a3), Freek G. Bouwman (a1), Sanne van Otterdijk (a1), Will K. W. H. Wodzig (a4), Malene R. Andersen (a5), Marleen A. van Baak (a1), Lone G. Rasmussen (a3), J. Alfredo Martinez (a6), Susan A. Jebb (a7), Andreas F. H. Pfeiffer (a8) (a9), Anthony Kafatos (a10), Teodora Handjieva-Darlenska (a11), Petr Hlavaty (a12), Wim H. M. Saris (a1) and Edwin C. M. Mariman (a1)...


Weight regain after weight loss is common. In the Diogenes dietary intervention study, a high-protein and low-glycaemic index (GI) diet improved weight maintenance. The objective of the present study was to identify (1) blood profiles associated with continued weight loss and weight regain (2) blood biomarkers of dietary protein and GI levels during the weight-maintenance phase. Blood samples were collected at baseline, after 8 weeks of low-energy diet-induced weight loss and after a 6-month dietary intervention period from female continued weight losers (n 48) and weight regainers (n 48), evenly selected from four dietary groups that varied in protein and GI levels. The blood concentrations of twenty-nine proteins and three steroid hormones were measured. The changes in analytes during weight maintenance largely correlated negatively with the changes during weight loss, with some differences between continued weight losers and weight regainers. Increases in leptin (LEP) and C-reactive protein (CRP) were significantly associated with weight regain (P < 0·001 and P = 0·005, respectively), and these relationships were influenced by the diet. Consuming a high-protein and high-GI diet dissociated the positive relationship between the change in LEP concentration and weight regain. CRP increased during the weight-maintenance period only in weight regainers with a high-protein diet (P < 0·001). In addition, testosterone, luteinising hormone, angiotensinogen, plasminogen activator inhibitor-1, resistin, retinol-binding protein 4, insulin, glucagon, haptoglobin and growth hormone were also affected by the dietary intervention. The blood profile reflects not only the weight change during the maintenance period, but also the macronutrient composition of the dietary intervention, especially the protein level.


Corresponding author

*Corresponding author: Professor Dr Edwin C. M. Mariman, fax +31 43 3670976; email


Hide All
1 Flegal, KM, Carroll, MD, Ogden, CL, et al. (2010) Prevalence and trends in obesity among US adults, 1999–2008. JAMA 303, 235241.
2 International Association for the Study of Obesity, Adult overweight and obesity in the European Union (EU27), Switzerland. (accessed 29 June 2010).
3 Wing, RR & Phelan, S (2005) Long-term weight loss maintenance. Am J Clin Nutr 82, 222S225S.
4 Turk, MW, Yang, K, Hravnak, M, et al. (2009) Randomized clinical trials of weight loss maintenance: a review. J Cardiovasc Nurs 24, 5880.
5 Westerterp-Plantenga, MS, Nieuwenhuizen, A, Tome, D, et al. (2009) Dietary protein, weight loss, and weight maintenance. Annu Rev Nutr 29, 2141.
6 Du, H, Van der, AD & Feskens, EJ (2006) Dietary glycaemic index: a review of the physiological mechanisms and observed health impacts. Acta Cardiol 61, 383397.
7 Moore, CS, Lindroos, AK, Kreutzer, M, et al. (2010) Dietary strategy to manipulate ad libitum macronutrient intake, and glycaemic index, across eight European countries in the Diogenes Study. Obes Rev 11, 6775.
8 Larsen, TM, Dalskov, S, van Baak, M, et al. (2010) The Diet, Obesity and Genes (Diogenes) Dietary Study in eight European countries – a comprehensive design for long-term intervention. Obes Rev 11, 7691.
9 Larsen, TM, Dalskov, S, van Baak, MA, et al. (2010) Diets with high or low protein content and glycemic index for weight-loss maintenance. N Engl J Med 363, 21022113.
10 Liotta, LA, Ferrari, M & Petricoin, E (2003) Written in blood. Nature 425, 905905.
11 Wang, P, Holst, C, Andersen, MR, et al. (2011) Blood profile of proteins and steroid hormones predicts weight change after weight loss with interactions of dietary protein level and glycemic index. PLoS One 6, e16773.
12 Marquez-Quinones, A, Mutch, DM, Debard, C, et al. (2010) Adipose tissue transcriptome reflects variations between subjects with continued weight loss and subjects regaining weight 6 mo after caloric restriction independent of energy intake. Am J Clin Nutr 92, 975984.
13 Benjamini, Y & Hochberg, Y (1995) Controlling the false discovery rate: a practical and powerful approach to multiple testing. J R Stat Soc Series B Stat Methodol 57, 289300.
14 R Development Core Team (2009) R: A Language and Environment for Statistical Computing. Vienna: R Foundation for Statistical Computing.
15 Sjostrom, L, Rissanen, A, Andersen, T, et al. (1998) Randomised placebo-controlled trial of orlistat for weight loss and prevention of weight regain in obese patients. European Multicentre Orlistat Study Group. Lancet 352, 167172.
16 Sjostrom, CD, Lissner, L & Sjostrom, L (1997) Relationships between changes in body composition and changes in cardiovascular risk factors: the SOS Intervention Study. Swedish Obese Subjects. Obes Res 5, 519530.
17 Cummings, DE & Overduin, J (2007) Gastrointestinal regulation of food intake. J Clin Invest 117, 1323.
18 Scacchi, M, Pincelli, AL & Cavagnini, F (1999) Growth hormone in obesity. Int J Obes 23, 260271.
19 Kreitschmann-Andermahr, I, Suarez, P, Jennings, R, et al. (2010) GH/IGF-I regulation in obesity – mechanisms and practical consequences in children and adults. Horm Res Paediatr 73, 153160.
20 Rankinen, T, Zuberi, A, Chagnon, YC, et al. (2006) The human obesity gene map: the 2005 update. Obesity (Silver Spring) 14, 529644.
21 Moreno-Aliaga, MJ, Lorente-Cebrian, S & Martinez, JA (2010) Regulation of adipokine secretion by n-3 fatty acids. Proc Nutr Soc 69, 324332.
22 Vogels, N & Westerterp-Plantenga, MS (2007) Successful long-term weight maintenance: a 2-year follow-up. Obesity 15, 12581266.
23 Westerterp-Plantenga, MS, Lejeune, M, Nijs, I, et al. (2004) High protein intake sustains weight maintenance after body weight loss in humans. Int J Obes 28, 5764.
24 Weigle, DS, Breen, PA, Matthys, CC, et al. (2005) 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 82, 4148.
25 Claessens, M, van Baak, MA, Monsheimer, S, et al. (2009) The effect of a low-fat, high-protein or high-carbohydrate ad libitum diet on weight loss maintenance and metabolic risk factors. Int J Obes 33, 296304.
26 Cartier, A, Cote, M, Lemieux, I, et al. (2009) Sex differences in inflammatory markers: what is the contribution of visceral adiposity? Am J Clin Nutr 89, 13071314.
27 Rexrode, KM, Pradhan, A, Manson, JE, et al. (2003) Relationship of total and abdominal adiposity with CRP and IL-6 in women. Ann Epidemiol 13, 674682.
28 Due, A, Toubro, S, Stender, S, et al. (2005) The effect of diets high in protein or carbohydrate on inflammatory markers in overweight subjects. Diabetes Obes Metab 7, 223229.
29 Abete, I, Astrup, A, Martinez, JA, et al. (2010) Obesity and the metabolic syndrome: role of different dietary macronutrient distribution patterns and specific nutritional components on weight loss and maintenance. Nutr Rev 68, 214231.
30 Linn, T, Santosa, B, Gronemeyer, D, et al. (2000) Effect of long-term dietary protein intake on glucose metabolism in humans. Diabetologia 43, 12571265.
31 Gabay, C & Kushner, I (1999) Acute-phase proteins and other systemic responses to inflammation. N Engl J Med 340, 448454.
32 Patel, L, Buckels, AC, Kinghorn, IJ, et al. (2003) Resistin is expressed in human macrophages and directly regulated by PPAR gamma activators. Biochem Biophys Res Commun 300, 472476.
33 Oarada, M, Kamei, K, Gonoi, T, et al. (2009) Beneficial effects of a low-protein diet on host resistance to Paracoccidioides brasiliensis in mice. Nutrition 25, 954963.
34 Danesh, J, Wheeler, JG, Hirschfield, GM, et al. (2004) C-reactive protein and other circulating markers of inflammation in the prediction of coronary heart disease. N Engl J Med 350, 13871397.
35 Hulmi, JJ, Ahtiainen, JP, Selanne, H, et al. (2008) Androgen receptors and testosterone in men – effects of protein ingestion, resistance exercise and fiber type. J Steroid Biochem Mol Biol 110, 130137.
36 Chandler, RM, Byrne, HK, Patterson, JG, et al. (1994) Dietary supplements affect the anabolic hormones after weight-training exercise. J Appl Physiol 76, 839845.
37 Woodhouse, LJ, Gupta, N, Bhasin, M, et al. (2004) Dose-dependent effects of testosterone on regional adipose tissue distribution in healthy young men. J Clin Endocrinol Metab 89, 718726.
38 Promintzer, M & Krebs, M (2006) Effects of dietary protein on glucose homeostasis. Curr Opin Clin Nutr Metab Care 9, 463468.
39 Jensen, L, Sloth, B, Krog-Mikkelsen, I, et al. (2008) A low-glycemic-index diet reduces plasma plasminogen activator inhibitor-1 activity, but not tissue inhibitor of proteinases-1 or plasminogen activator inhibitor-1 protein, in overweight women. Am J Clin Nutr 87, 97105.
40 Mariman, EC & Wang, P (2010) Adipocyte extracellular matrix composition, dynamics and role in obesity. Cell Mol Life Sci 67, 12771292.


Type Description Title
Supplementary Data

Mariman Supplementary Data 1
Mariman Supplementary Data 1

 PDF (77 KB)
77 KB
Supplementary Data

Mariman Supplementary Data 2
Mariman Supplementary Data 2

 PDF (43 KB)
43 KB


Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed