Letters |

Dietary Protein and Weight Gain—Reply

George A. Bray, MD; Leanne M. Redman, PhD; Steven R. Smith, MD
JAMA. 2012;307(16):1691-1692. doi:10.1001/jama.2012.533.
Text Size: A A A
Published online


In Reply: Dr Westerterp calculates that the individuals in our study eating the low protein diet should have gained more body fat than we reported. He thinks that differences in fecal fat loss between diets is not an adequate explanation, and we agree. He goes on to offer “an underestimation of energy requirement for weight maintenance” as a potential explanation.

To evaluate this suggestion, we first reexamined the differences between our weight-stabilized estimate of energy requirements and baseline energy expenditure, and found that they did not differ significantly between diet groups (low protein diet: −83 kcal/d [95% CI, −411 to 243 kcal/d]; normal protein diet: 177 kcal/d [95% CI, −146 to 503 kcal/d]; and high protein diet: 273 kcal/d [95% CI, −165 to 711 kcal/d]; P = .28), but cumulatively the low protein diet group ingested less total energy than the normal or high protein diet groups (low protein diet: 46 190 kcal [95% CI, 30 742 to 51 364 kcal]; normal protein diet: 54 819 kcal [95% CI, 47 527 to 62 111 kcal]; high protein diet: 50 666 kcal [95% CI, 43 200 to 58 131 kcal]; P = .13).

Figures in this Article


Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

First Page Preview

View Large
First page PDF preview


Place holder to copy figure label and caption
Figure. Energy Stored in Fat as a Fraction of Total Excess Calories
Graphic Jump Location

The diagonal line was created by a linear regression model.



April 25, 2012
Klaas R. Westerterp, PhD
JAMA. 2012;307(16):1691-1692. doi:10.1001/jama.2012.532.
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).


Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.