British Journal of Nutrition

Human and Clinical Nutrition

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

Ping Wanga1, Claus Holsta2, Arne Astrupa3, Freek G. Bouwmana1, Sanne van Otterdijka1, Will K. W. H. Wodziga4, Malene R. Andersena5, Marleen A. van Baaka1, Lone G. Rasmussena3, J. Alfredo Martineza6, Susan A. Jebba7, Andreas F. H. Pfeiffera8a9, Anthony Kafatosa10, Teodora Handjieva-Darlenskaa11, Petr Hlavatya12, Wim H. M. Sarisa1 and Edwin C. M. Marimana1 c1

on behalf of Diogenes Consortium

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

a2 Institute of Preventive Medicine, Copenhagen University Hospital, Copenhagen, Denmark

a3 Department of Human Nutrition, Faculty of Life Sciences, University of Copenhagen, Copenhagen, Denmark

a4 Department of Clinical Chemistry, Maastricht University Medical Centre, Maastricht, The Netherlands

a5 Department of Clinical Biochemistry, Copenhagen University Hospital, Gentofte, Denmark

a6 Department of Physiology and Nutrition, University of Navarra, Pamplona, Spain

a7 MRC Human Nutrition Research, Elsie Widdowson Laboratory, Cambridge, UK

a8 Department of Clinical Nutrition, German Institute of Human Nutrition, Nuthetal, Germany

a9 Department of Endocrinology, Diabetes and Nutrition, Charité Universitaetsmedizin Berlin, Berlin, Germany

a10 Department of Social Medicine, Preventive Medicine and Nutrition Clinic, University of Crete, Crete, Greece

a11 Department of Nutrition, Dietetics and Metabolic Diseases, National Multiprofile Transport Hospital, Sofia, Bulgaria

a12 Obesity Management Centre, Institute of Endocrinology, Prague, The Czech Republic


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.

(Received December 16 2010)

(Revised March 15 2011)

(Accepted March 25 2011)

(Online publication June 23 2011)


c1 Corresponding author: Professor Dr Edwin C. M. Mariman, fax +31 43 3670976; email

† Diogenes is the acronym of the project ‘Diet, Obesity and Genes’ supported by the European Commission (contract no. FP6-2005-513946),

Abbreviations: AGT, angiotensinogen; CID1, clinical investigation day before weight loss; CID2, clinical investigation day after weight loss; CID3, clinical investigation day after weight maintenance; CRP, C-reactive protein; %E, percentage of energy; GCG, glucagon; GH, growth hormone; GI, glycaemic index; HGI, high glycaemic index; HP, high protein; IGFBP1, insulin-like growth factor binding protein 1; INS, insulin; LEP, leptin; LGI, low glycaemic index; LH, luteinising hormone; LP, low protein; PAI1, plasminogen activator inhibitor 1; RBP4, retinol-binding protein 4; TES, testosterone; WL, continued weight losers; WR, weight regainers