British Journal of Nutrition

Full Papers

Behaviour, Appetite and Obesity

Presence or absence of carbohydrates and the proportion of fat in a high-protein diet affect appetite suppression but not energy expenditure in normal-weight human subjects fed in energy balance

Margriet A. B. Veldhorsta1a2 c1, Klaas R. Westerterpa1a2, Anneke J. A. H. van Vughta1a2 and Margriet S. Westerterp-Plantengaa1a2

a1 Department of Human Biology, NUTRIM School for Nutrition, Toxicology and Metabolism, Maastricht University Medical Centre, PO Box 616, 6200 MD Maastricht, The Netherlands

a2 Top Institute Food and Nutrition, Wageningen, The Netherlands


Two types of relatively high-protein diets, with a normal or low proportion of carbohydrates, have been shown effective for weight loss. The objective was to assess the significance of the presence or absence of carbohydrates and the proportion of fat in high-protein diets for affecting appetite suppression, energy expenditure, and fat oxidation in normal-weight subjects in energy balance. Subjects (aged 23 (sd 3) years and BMI 22·0 (sd 1·9) kg/m2) were stratified in two groups. Each was offered two diets in a randomised cross-over design: group 1 (n 22) – normal protein (NP; 10, 60 and 30 % energy (En%) from protein, carbohydrate and fat), high protein (HP; 30, 40 and 30 En%); group 2 (n 23) – normal protein (NP-g; 10, 60 and 30 En%), high protein, carbohydrate-free (HP-0C; 30, 0 and 70 En%) for 2 d; NP-g and HP-0C were preceded by glycogen-lowering exercise (day 1). Appetite was measured throughout day 2 using visual analogue scales (VAS). Energy expenditure (EE) and substrate oxidation (respiratory quotient; RQ) were measured in a respiration chamber (08.00 hours on day 2 until 07.30 hours on day 3). Fasting plasma β-hydroxybutyrate (BHB) concentration was measured (day 3). NP-g and NP did not differ in hunger, EE, RQ and BHB. HP-0C and HP v. NP-g and NP, respectively, were lower in hunger (P < 0·05; P < 0·001) and RQ (P < 0·01; P < 0·001) and higher in EE (P < 0·05; P = 0·07) and BHB (P < 0·05; P < 0·001). Hunger and RQ were lower with HP-0C than HP (693 (sd 208) v. 905 (sd 209) mm VAS × 24 h, P < 0·01; 0·76 (sd 0·01) v. 0·81 (sd 0·02), P < 0·01); BHB was higher (1349 (sd 653) v. 332 (sd 102) μmol/l; P < 0·001). ΔHunger, ΔRQ, and ΔBHB were larger between HP-0C–NP-g than between HP–NP ( − 346 (sd 84) v. − 107 (sd 52) mm VAS ×  24 h, P < 0·01; − 0·09 (sd 0·00) v. − 0·05 (sd 0·00), P < 0·001; 1115 (sd 627) v. 104 (sd 42) μmol/l, P < 0·001). In conclusion, appetite suppression and fat oxidation were higher on a high-protein diet without than with carbohydrates exchanged for fat. Energy expenditure was not affected by the carbohydrate content of a high-protein diet.

(Received September 18 2009)

(Revised April 07 2010)

(Accepted April 21 2010)

(Online publication June 22 2010)


c1 Corresponding author: Dr Margriet Veldhorst, fax +31 43 3670976, email


Abbreviations: EN%, percentage of energy; group 1, diets HP and NP; group 2, diets HO-0C and NP-g; HP, high-protein; HP-0C, high-protein, carbohydrate-free; NP, normal-protein group 1; NP-g, normal-protein group 2 (with glycogen-lowering); RQ, respiratory quotient; VAS, visual analogue scale; Wmax, maximal power output