Protein, fiber, and exercise: a narrative review of their roles in weight management and cardiometabolic health

More than 40% of adults in the United States have obesity, which is an independent risk factor for cardiometabolic dysfunction and several chronic diseases, including atherosclerotic cardiovascular disease and type 2 diabetes mellitus. Interventions for obesity include lifestyle modification, pharmacotherapy, and metabolic surgery. Lifestyle interventions have minimal side effects and are the most economical, yet long-term adherence is poor. Challenges for long-term adherence are related, in part, to metabolic adaptations that occur during weight loss that affect appetite and energy expenditure. However, a lifestyle intervention that involves higher intakes of protein and fiber and increased participation in exercise may help to blunt the increases in hunger and cravings that occur with weight loss while increasing energy expenditure, thus assisting with both weight loss and weight loss maintenance. These changes also promote improved cardiometabolic health, independent of weight loss. This narrative review summarizes the evidence for the roles of increasing protein, fiber, and exercise for weight management and improving the cardiometabolic risk factor profile.