***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND : A relatively high percentage of energy intake as protein has been shown to increase satiety and decrease energy efficiency during overfeeding . AIM : To investigate whether addition of protein may improve weight maintenance by preventing or limiting weight regain after weight loss of 5–10 % in moderately obese subjects . DESIGN OF THE STUDY : In a r and omized parallel design , 148 male and female subjects ( age 44.2±10.1 y ; body mass index ( BMI ) 29.5±2.5 kg/m2 ; body fat 37.2±5.0 % ) followed a very low-energy diet ( 2.1 MJ/day ) during 4 weeks . For subsequent 3 months weight-maintenance assessment , they were stratified according to age , BMI , body weight , restrained eating , and resting energy expenditure ( REE ) , and r and omized over two groups . Both groups visited the University with the same frequency , receiving the same counseling on dem and by the dietitian . One group ( n=73 ) received 48.2 g/day additional protein to their diet . Measurements at baseline , after weight loss , and after 3 months weight maintenance were body weight , body composition , metabolic measurements , appetite profile , eating attitude , and relevant blood parameters . RESULTS : Changes in body mass , waist circumference , REE , respiratory quotient ( RQ ) , total energy expenditure ( TEE ) , dietary restraint , fasting blood-glucose , insulin , triacylglycerol , leptin , β-hydroxybutyrate , glycerol , and free fatty acids were significant during weight loss and did not differ between groups . During weight maintenance , the ‘ additional-protein group ’ showed in comparison to the nonadditional-protein group 18 vs 15 en% protein intake , a 50 % lower body weight regain only consisting of fat-free mass , a 50 % decreased energy efficiency , increased satiety while energy intake did not differ , and a lower increase in triacylglycerol and in leptin ; REE , RQ , TEE , and increases in other blood parameters measured did not differ . CONCLUSION : A 20 % higher protein intake , that is , 18 % of energy vs 15 % of energy during weight maintenance after weight loss , result ed in a 50 % lower body weight regain , only consisting of fat-free mass , and related to increased satiety and decreased energy efficiency BACKGROUND Studies of weight-control diets that are high in protein or low in glycemic index have reached varied conclusions , probably owing to the fact that the studies had insufficient power . METHODS We enrolled overweight adults from eight European countries who had lost at least 8 % of their initial body weight with a 3.3-MJ ( 800-kcal ) low-calorie diet .  Participants were r and omly assigned , in a two-by-two factorial design , to one of five ad libitum diets to prevent weight regain over a 26-week period : a low-protein and low-glycemic-index diet , a low-protein and high-glycemic-index diet , a high-protein and low-glycemic-index diet , a high-protein and high-glycemic-index diet , or a control diet . RESULTS A total of 1209 adults were screened ( mean age , 41 years ; body-mass index [ the weight in kilograms divided by the square of the height in meters ] , 34 ) , of whom 938 entered the low-calorie-diet phase of the study . A total of 773 participants who completed that phase were r and omly assigned to one of the five maintenance diets ; 548 completed the intervention ( 71 % ) . Fewer participants in the high-protein and the low-glycemic-index groups than in the low-protein-high-glycemic-index group dropped out of the study ( 26.4 % and 25.6 % , respectively , vs. 37.4 % ; P=0.02 and P=0.01 for the respective comparisons ) . The mean initial weight loss with the low-calorie diet was 11.0 kg . In the analysis of participants who completed the study , only the low-protein-high-glycemic-index diet was associated with subsequent significant weight regain ( 1.67 kg ; 95 % confidence interval [ CI ] , 0.48 to 2.87 ) . In an intention-to-treat analysis , the weight regain was 0.93 kg less ( 95 % CI , 0.31 to 1.55 ) in the groups assigned to a high-protein diet than in those assigned to a low-protein diet ( P=0.003 ) and 0.95 kg less ( 95 % CI , 0.33 to 1.57 ) in the groups assigned to a low-glycemic-index diet than in those assigned to a high-glycemic-index diet ( P=0.003 ) . The analysis involving participants who completed the intervention produced similar results . The groups did not differ significantly with respect to diet-related adverse events . CONCLUSIONS In this large European study , a modest increase in protein content and a modest reduction in the glycemic index led to an improvement in study completion and maintenance of weight loss . ( Funded by the European Commission ; Clinical Trials.gov number , NCT00390637 . ) Overweight and obese men and women ( 24 - 61 yr of age ) were recruited into a r and omized trial to compare the effects of a low-fat ( LF ) vs. a low-carbohydrate ( LC ) diet on weight loss .  Thirty-one subjects completed all 10 wk of the diet intervention ( retention , 78 % ) . Subjects on the LF diet consumed an average of 17.8 % of energy from fat , compared with their habitual intake of 36.4 % , and had a result ing energy restriction of 2540 kJ/d . Subjects on the LC diet consumed an average of 15.4 % carbohydrate , compared with habitual intakes of about 50 % carbohydrate , and had a result ing energy restriction of 3195 kJ/d . Both groups of subjects had significant weight loss over the 10 wk of diet intervention and nearly identical improvements in body weight and fat mass . LF subjects lost an average of 6.8 kg and had a decrease in body mass index of 2.2 kg/m2 , compared with a loss of 7.0 kg and decrease in body mass index of 2.1 kg/m2 in the LC subjects . The LF group better preserved lean body mass when compared with the LC group ; however , only the LC group had a significant decrease in circulating insulin concentrations . Group results indicated that the diets were equally effective in reducing systolic blood pressure by about 10 mm Hg and diastolic pressure by 5 mm Hg and decreasing plasminogen activator inhibitor-1 bioactivity . Blood beta-hydroxybutyrate concentrations were increased in the LC only , at the 2- and 4-wk time points . These data suggest that energy restriction achieved by a very LC diet is equally effective as a LF diet strategy for weight loss and decreasing body fat in overweight and obese adults OBJECTIVE To evaluate the effect of a high-protein diet on anthropometry , body composition , subjective appetite , and mood sensations in overweight and obese children attending a residential weight-loss camp . RESEARCH METHODS AND PROCEDURES Children ( 120 ; BMI , 33.1 + /- 5.5 kg/m(2 ) ; age , 14.2 + /- 1.9 years ) were r and omly assigned to either a st and ard or high-protein diet group ( 15 % vs. 22.5 % protein , respectively ) . All children were assessed at baseline and at the end of the camp for anthropometry , body composition , blood pressure , biochemical variables ( n = 27 ) , and subjective appetite and mood sensations ( n = 50 ) . RESULTS Attendance at the weight-loss camp result ed in significant improvements in most measures . Campers lost 5.5 + /- 2.9 kg in body weight ( p < 0.001 ) and 3.8 + /- 5.4 kg in fat mass ( p < 0.001 ) and reduced their BMI st and ard deviation score by 0.27 + /- 0.1 ( p < 0.001 ) and their waist circumference by 6.6 + /- 2.8 cm ( p < 0.001 ) . Subjective sensations of hunger increased significantly over the camp duration , but no other changes in appetite or mood were observed . There were no significant differences between the two diets on any physical or subjective measures . DISCUSSION Weight-loss camps are effective in assisting children to lose weight and improve on a range of health outcomes , independently of the protein content of the diet . The implication s of an increase in hunger associated with weight loss needs to be considered . Further work is warranted to investigate whether higher levels of dietary protein are feasible or effective in longer-term weight-loss interventions of this type This study aim ed to evaluate the weight loss and hunger motivation effects of an energy-restricted high-protein ( HP ) diet in overweight and obese children . In total , 95 overweight and obese children attended an 8-week ( maximum ) program of physical activity , reduced-energy intake , and behavior change education . Children were r and omly assigned to one of two isoenergetic diets ( st and ard ( SP ) : 15 % protein ; HP : 25 % protein ) , based on individually estimated energy requirements . Anthropometry and body composition were assessed at the start and end of the program and appetite and mood ratings completed on the first 3 consecutive weekdays of each week children attended camp . The HP diet had no greater effect on weight loss , body composition , or changes in appetite or mood when compared to the SP diet . Overall , campers lost 5.2 + /- 3.0 kg in body weight and reduced their BMI st and ard deviation score ( sds ) by 0.25 . Ratings of desire to eat increased significantly over the duration of the intervention , irrespective of diet . This is the third time we have reported an increase in hunger motivation in weight-loss campers and replicates our previous failure to block this with a higher protein diet . Further work is warranted into the management of hunger motivation as a result of negative energy balance Since long-term weight maintenance ( WM ) is a major problem , interventions to improve WM are needed . The aim of the study was to investigate whether the addition of protein to the diet might limit weight regain after a weight loss of 5 - 10 % in overweight subjects . In a r and omised parallel study design , 113 overweight subjects ( BMI 29.3 ( SD 2.5 ) kg/m2 ) ; age 45.1 ( SD 10.4 ) years ) followed a very-low-energy diet for 4 weeks , after which there was a 6-month period of WM . During WM , subjects were r and omised into either a protein group or a control group . The protein group received 30 g/d protein in addition to their own usual diet . During the very-low-energy diet , no differences were observed between the groups . During WM , the protein group showed a higher protein intake ( 18 % v. 15 % ; P<0.05 ) , a lower weight regain ( 0.8 v. 3.0 kg ; P<0.05 ) , a decreased waist circumference ( -1.2 ( SD 0.7 ) v. 0.5 ( SD 0.5 ) cm ; P<0.05 ) and a smaller increase in respiratory quotient ( 0.03 ( SD 0.01 ) v. 0.07 0.01 ; (SD/)P < 0.05 ) compared with the control group . Weight regain in the protein group consisted of only fat-free mass , whereas the control group gained fat mass as well . Satiety in the fasted state before breakfast increased significantly more in the protein group than in the control group . After 6 months follow-up , body weight showed a significant group x time interaction . A protein intake of 18 % compared with 15 % result ed in improved WM  in overweight subjects after a weight loss of 7.5 % . This improved WM implied several factors , i.e. improved body composition , fat distribution , substrate oxidation and satiety OBJECTIVE : To study the effect on weight loss in obese subjects by replacement of carbohydrate by protein in ad libitum consumed fat-reduced diets . DESIGN : R and omized dietary intervention study over six months comparing two ad libitum fat reduced diets ( 30 % of total energy ) strictly controlled in composition : High-carbohydrate ( HC , protein 12 % of total energy ) or high-protein ( HP , protein 25 % of total energy ) . SETTING AND PARTICIPANTS : Subjects were 65 healthy , overweight and obese subjects ( 50 women , 15 men , aged 18–55 y ) r and omly assigned to HC ( n=25 ) , HP ( n=25 ) or a control group ( C , n=15 ) . All food was provided by self- selection in a shop at the department , and compliance to the diet composition was evaluated by urinary nitrogen excretion . MAIN OUTCOME MEASURE : Change in body weight , body composition and blood lipids . RESULTS : More than 90 % completed the trial . Weight loss after six months was 5.1 kg in the HC group and 8.9 kg in the HP group ( difference 3.7 kg , 95 % confidence interval (CI)(1.3–6.2 kg ) P<0.001 ) , and fat loss was 4.3 kg and 7.6 kg , respectively ( difference 3.3 kg ( 1.1–5.5 kg ) P<0.0001 ) , whereas no changes occurred in the control group . More subjects lost > 
    Output:
    
Current evidence suggests that improved weight status can be achieved in overweight or obese children and adolescents irrespective of the macronutrient distribution of a reduced-energy diet .