A Pharmacist’s Guide to the Role of Protein
in Successful Weight Management
© 2008 by the American Pharmacists Association. All rights reserved.
At any given time in the United States,
approximately 50% of women and 33%
of men are trying to lose weight. Excess
weight usually represents an energy
imbalance: more calories are being con-
sumed than are being expended in daily
✁
activities. People who want to lose
weight generally are advised to create
an energy deficit of about 500 to 1,000
Trim along this line
kcal/day, preferably through a combi-
nation of reduced calorie intake and
increased physical activity.
Macronutrient Composition of
Reduced-Calorie Diets
The primary macronutrients in the
human diet are carbohydrate, protein,
and fat. The current Dietary Guidelines
for Americans (available at www.health.
gov/DietaryGuidelines/) outline an eat-
ing pattern that provides 45% to 65% of
total calories from carbohydrate, 10%
to 35% of calories from protein, and
20% to 35% of calories from fat. This
distribution of macronutrients also is
recommended for weight loss diets.
Notice, though, that this eating pattern
provides considerable flexibility regard-
ing the relative percentages of carbohy-
drate and protein. (Fat intake should be
maintained within the relatively narrow
range of 20% to 35% to promote car-
diovascular health.) Historically, weight
loss experts have advocated diets with a
higher percentage of carbohydrate (55%
or more of total calories) and a lower
percentage of protein (approximately
Reviewed by:
Seena Haines, PharmD, FAACP
Director of Integrated
Pharmacotherapy Services
Director of Pharmacy Practice Residency
Associate Professor of Pharmacy Practice
Palm Beach Atlantic University
West Palm Beach, Florida
This publication was prepared by
Cynthia Knapp Dlugosz, BPharm,
of CKD Associates on behalf of the
American Pharmacists Association.
This program was developed by
and supported by
15% of calories). But not everyone is
able to adhere to these diets; in one
small study by Johnston and colleagues
that compared a diet high in carbo-
hydrate (60% of total calories) with a
diet high in protein (30% of total calo-
ries), 20% of the subjects randomized
to the high-carbohydrate diet withdrew
because of “unendurable hunger.”1
Hunger, Satiation, and Satiety
as Factors in Weight Loss
The preponderance of evidence points
to protein as the macronutrient with
the greatest effect on hunger, satiation,
and satiety. Satiation determines the
size and duration of an eating episode;
satiety influences the amount of time
that elapses between eating episodes.
As shown in the Table, protein has the
highest satiety index (i.e., is the most
“filling”).2 Many people think that fat
is the most filling, but it actually has the
lowest satiety index.
Hunger, satiation, and satiety have clear
implications for weight loss. People are
more likely to abandon a weight reduc-
tion program when feelings of hunger
are strong. Adherence to a reduced-
calorie diet could be facilitated by con-
suming foods that provide high satiation
and satiety, because these foods would
decrease both the amount of food con-
sumed during an eating episode and
the total number of eating episodes.
Conversely, foods with a low satiation
or satiety value might hinder adherence.
Rethinking the Role of Protein in
Weight Management
The widespread popularity of low-
carbohydrate diets in the early 2000s
was fueled in part by their reputation for
facilitating weight loss without feelings
of hunger or “deprivation.” However,
some of these diets (e.g., the “Atkins
diet”) also were high in fat—as high
as 55% to 65% of total daily calories,
with 25% of total calories coming from
saturated fat. These diets were widely
denounced by nutrition and weight loss
experts who feared that they would
have adverse health effects, such as
Table. Energy and Satiety Indices of Macronutrients
Macronutrient Energy (kcal/g)
Protein
Complex carbohydrate
Simple carbohydrate
Fat
Source: Adapted from reference 2.
elevations in both total and low-density
lipoprotein cholesterol.
Recently, there has been growing inter-
est in reduced-calorie diets that are high
in protein but maintain fat intake in the
recommended range. Diets that provide
25% to 35% of total calories as protein
have been shown to result in slightly
greater weight loss while also having
favorable effects on blood pressure, the
lipid profile, and glycemic control.
One strategy for shifting toward a high-
er percentage of protein is to snack
on small amounts of foods that are
relatively high in protein (e.g., reduced-
fat cheese, hummus, dry-roasted nuts),
rather than low-fat, high-carbohydrate
snacks such as pretzels or rice cakes.
However, it is important to check both
the calorie counts and serving sizes on
the Nutrition Facts label to ensure that
the selected snack is compatible with
daily calorie goals. Another strategy is
to take advantage of the growing num-
ber of meal replacement bars, snack
bars, and beverages (such as protein
water or protein water mixes) that are
high in both protein and fiber, which
also contributes to satiety and weight
loss. In a recent small (23 participants)
study conducted in Australia, women
who consumed high-protein, high-fiber
bars as mid-morning and mid-afternoon
snacks ate substantially less at lunch
and dinner than women who consumed
bars high in fat and sugar.3
References
1. Johnston CS, Tjonn SL, Swan PD.
High-protein, low-fat diets are effec-
tive for weight loss and favorably alter
biomarkers in healthy adults. J Nutr.
2004;134:586–91.
2. Katz DL. Competing dietary claims
for weight loss: finding the forest
through truculent trees. Annu Rev Public
Health. 2005;26:61–88.
3. Williams G, Noakes M, Keogh J, et al.
High protein high fibre snack bars
reduce food intake and improve short
term glucose and insulin profiles com-
pared with high fat snack bars. Asia Pac
J Clin Nutr. 2006;15:443–50.
Satiety Index
3–4 Highest
4 Intermediate (higher)
<4 Intermediate (lower)
08-291
9 Lowest

© 2008 by the American Pharmacists Association. All rights reserved.
At any given time in the United States,
nearly 50% of women and 33% of men
are trying to lose weight. Excess weight
usually is caused by an energy imbal-
ance: people consume more calories
from foods and beverages than they
burn during their daily activities. To
lose weight, you need to cut down on
the number of calories you get from
foods and beverages and increase your
physical activity.
Reducing daily calorie intake by about
500 to 1,000 calories produces a steady,
healthful weight loss of about 1 to 2
pounds per week. For most women, this
means following an eating plan contain-
ing 1,200 to 1,500 calories per day; for
most men, the daily eating plan should
contain 1,500 to 1,800 calories.
Eating for Weight Loss
Our diet consists primarily of carbo-
hydrates, proteins, and fats. (Carbohy-
drates are starches and sugars found
in grain products, vegetables, fruits,
and milk; simple sugars such as table
sugar and honey also are considered to
be carbohydrates.) The current Dietary
Guidelines for Americans recommend
that adults get 45% to 65% of their total
daily calories from carbohydrates, 10%
to 35% of calories from protein, and
20% to 35% of calories from fat. This
recommendation also applies to eating
plans for weight loss.
Notice, though, that there is room for a
good deal of flexibility in those ranges.
Weight loss experts traditionally have
recommended diets containing a larger
amount of carbohydrates (55% or more
of total calories) and a smaller amount
of protein (approximately 15% of calo-
ries), with fat in the 20% to 35% range
that is recommended for heart health.
But people often complain of feeling
too hungry on diets that contain a larger
Table. Examples of High-Protein, High-Fiber Products
Product Name
Atkins Advantage S’Mores bar*
Kashi GoLean Chewy Malted Chocolate Crisp bar
Kellogg’s Special K Protein Chocolate Peanut
Butter meal bar
Luna Chocolate Pecan Pie bar
*The Atkins Advantage bar contains a relatively high amount of saturated fat and may not be
suitable for people who need to limit their fat intake.
A Patient’s Guide to the Role of Protein
in Successful Weight Management
amount of carbohydrates, to the point of higher-protein snacks include low-
that they give up before they lose the fat cheese, hummus, and dry-roasted
desired amount of weight. or oven-roasted nuts. However, it is
important to check the calorie counts
✁
The main reason why people feel and serving sizes on the Nutrition Facts
hungry on higher carbohydrate diets label—for example, only 24 almonds
appears to be that protein is more provide about 170 calories. It also is
Trim along this line
“filling” than either carbohydrates or important to check the amount of satu-
fats. (Many people believe that fat is rated fat on the Nutrition Facts label,
the most filling, but it actually is the because some higher-protein snacks
least filling.) When weight loss eating may be high in unwanted saturated fat.
plans contain larger amounts of protein,
people generally feel less hungry, eat Another strategy is to take advantage
less food during meals, and don’t eat as of the growing number of high-protein
frequently as they otherwise might. meal replacement bars, snack bars, and
beverages (for example, protein water
The widespread popularity of “low- and protein water mixes). Some of
carb” diets in the early 2000s was based these products also are high in fiber,
in part on their reputation for helping which provides additional hunger con-
people lose weight without feeling hun- trol. Examples of these products are
gry or deprived. These diets generally shown in the Table; many others may
were high in protein. Yet, many weight be available. Again, it is important to
loss and nutrition experts criticized check the calorie and fat counts to avoid
these diets, because they also could be eating too many calories or too much
very high in fat—particularly saturated saturated fat.
fat, which is known to contribute to
heart disease.
As an alternative, experts have begun
to recommend weight loss eating plans
that contain larger amounts of pro-
tein (approximately 25% to 35% of
calories) and smaller amounts of carbo-
hydrates (approximately 30% to 55%
of calories) while keeping fat in the
recommended range (20% to 35% of
calories).
Strategies for Higher-Protein Photocopy this page and
Eating give it to appropriate
One strategy for following an eating patients. This piece is for
plan that has a greater amount of protein
and a smaller amount of carbohydrate is informational purposes only
to snack on foods that are relatively and is not a substitute for
high in protein. In the past, people seek-
ing to lose weight often were advised to medical advice.
eat low-fat, high-carbohydrate snacks
such as pretzels or rice cakes. Examples
Calories Protein Fiber
220 17 g 11 g
290 13 g 6g
180 10 g 5g
180 10 g 3g