Publikasi Ilmiah TR90

Am J Clin Nutr. 2013 Apr;97(4):677-88. doi: 10.3945/ajcn.112.053116. Epub 2013 Feb 27.

Beneficial effects of a higher-protein breakfast on the appetitive,

hormonal, and neural signals controlling energy intake regulation in
overweight/obese, "breakfast-skipping," late-adolescent girls.
Leidy HJ1, Ortinau LC, Douglas SM, Hoertel HA.
Author information
Abstract
BACKGROUND:
Breakfast skipping is a common dietary habit practiced among adolescents and is strongly associated with obesity.
OBJECTIVE:
The objective was to examine whether a high-protein (HP) compared with a normal-protein (NP) breakfast leads to
daily improvements in appetite, satiety, food motivation and reward, and evening snacking in overweight or obese
breakfast-skipping girls.
DESIGN:
A randomized crossover design was incorporated in which 20 girls [mean ± SEM age: 19 ± 1 y; body mass index (in
kg/m(2)): 28.6 ± 0.7] consumed 350-kcal NP (13 g protein) cereal-based breakfasts, consumed 350-kcal HP egg- and
beef-rich (35 g protein) breakfasts, or continued breakfast skipping (BS) for 6 d. On day 7, a 10-h testing day was
completed that included appetite and satiety questionnaires, blood sampling, predinner food cue-stimulated functional
magnetic resonance imaging brain scans, ad libitum dinner, and evening snacking.
RESULTS:
The consumption of breakfast reduced daily hunger compared with BS with no differences between meals. Breakfast
increased daily fullness compared with BS, with the HP breakfast eliciting greater increases than did the NP breakfast.
HP, but not NP, reduced daily ghrelin and increased daily peptide YY concentrations compared with BS. Both meals
reduced predinner amygdala, hippocampal, and midfrontal corticolimbic activation compared with BS. HP led to
additional reductions in hippocampal and parahippocampal activation compared with NP. HP, but not NP, reduced
evening snacking of high-fat foods compared with BS.
CONCLUSIONS:
Breakfast led to beneficial alterations in the appetitive, hormonal, and neural signals that control food intake
regulation. Only the HP breakfast led to further alterations in these signals and reduced evening snacking compared
with BS, although no differences in daily energy intake were observed. These data suggest that the addition of
breakfast, particularly one rich in protein, might be a useful strategy to improve satiety, reduce food motivation and
reward, and improve diet quality in overweight or obese teenage girls. This trial was registered at clinicaltrials.gov
as NCT01192100.
Am J Clin Nutr. 2012 Dec;96(6):1281-98. doi: 10.3945/ajcn.112.044321. Epub 2012 Oct 24.

Effects of energy-restricted high-protein, low-fat compared with

standard-protein, low-fat diets: a meta-analysis of randomized controlled
trials.
Wycherley TP1, Moran LJ, Clifton PM, Noakes M, Brinkworth GD.
Author information
Abstract
BACKGROUND:
It is currently unclear whether altering the carbohydrate-to-protein ratio of low-fat, energy-restricted diets augments
weight loss and cardiometabolic risk markers.
OBJECTIVE:
The objective was to conduct a systematic review and meta-analysis of studies that compared energy-restricted,
isocaloric, high-protein, low-fat (HP) diets with standard-protein, low-fat (SP) diets on weight loss, body composition,
resting energy expenditure (REE), satiety and appetite, and cardiometabolic risk factors.
DESIGN:
Systematic searches were conducted by using MEDLINE, EMBASE, PubMed, and the Cochrane Central Register of
Controlled Trials to identify weight-loss trials that compared isocalorically prescribed diets matched for fat intake but
that differed in protein and carbohydrate intakes in participants aged ≥18 y. Twenty-four trials that included 1063
individuals satisfied the inclusion criteria.
RESULTS:
Mean (±SD) diet duration was 12.1 ± 9.3 wk. Compared with an SP diet, an HP diet produced more favorable changes
in weighted mean differences for reductions in body weight (-0.79 kg; 95% CI: -1.50, -0.08 kg), fat mass (FM; -0.87 kg;
95% CI: -1.26, -0.48 kg), and triglycerides (-0.23 mmol/L; 95% CI: -0.33, -0.12 mmol/L) and mitigation of reductions in
fat-free mass (FFM; 0.43 kg; 95% CI: 0.09, 0.78 kg) and REE (595.5 kJ/d; 95% CI: 67.0, 1124.1 kJ/d). Changes in
fasting plasma glucose, fasting insulin, blood pressure, and total, LDL, and HDL cholesterol were similar across
dietary treatments (P ≥ 0.20). Greater satiety with HP was reported in 3 of 5 studies.
CONCLUSION:
Compared with an energy-restricted SP diet, an isocalorically prescribed HP diet provides modest benefits for
reductions in body weight, FM, and triglycerides and for mitigating reductions in FFM and REE.

Adv Nutr. 2012 Mar 1;3(2):119-26. doi: 10.3945/an.111.001792.

Skeletal muscle responses to negative energy balance: effects of dietary
protein.
Carbone JW 1, McClung JP, Pasiakos SM.
Author information
Abstract
Sustained periods of negative energy balance decrease body mass due to losses of both fat and skeletal muscle
mass. Decreases in skeletal muscle mass are associated with a myriad of negative consequences, including
suppressed basal metabolic rate, decreased protein turnover, decreased physical performance, and increased risk of
injury. Decreases in skeletal muscle mass in response to negative energy balance are due to imbalanced rates of
muscle protein synthesis and degradation. However, the underlying physiological mechanisms contributing to the loss
of skeletal muscle during energy deprivation are not well described. Recent studies have demonstrated that
consuming dietary protein at levels above the current recommended dietary allowance (0.8 g · kg(-1) · d(-1)) may
attenuate the loss of skeletal muscle mass by affecting the intracellular regulation of muscle anabolism and
proteolysis. However, the specific mechanism by which increased dietary protein spares skeletal muscle through
enhanced molecular control of muscle protein metabolism has not been elucidated. This article reviews the available
literature related to the effects of negative energy balance on skeletal muscle mass, highlighting investigations that
assessed the influence of varying levels of dietary protein on skeletal muscle protein metabolism. Further, the
molecular mechanisms that may contribute to the regulation of skeletal muscle mass in response to negative energy
balance and alterations in dietary protein level are described.
Nutr Metab (Lond). 2012 Jun 12;9(1):55. doi: 10.1186/1743-7075-9-55.

Effects of protein intake and gender on body composition changes: a

randomized clinical weight loss trial.
Evans EM1, Mojtahedi MC, Thorpe MP, Valentine RJ, Kris-Etherton PM, Layman DK.
Author information
Abstract
Limited data on sex differences in body composition changes in response to higher protein diets (PRO) compared to
higher carbohydrate diets (CARB) suggest that a PRO diet helps preserve lean mass (LM) in women more so than in
men.
OBJECTIVE:
To compare male and female body composition responses to weight loss diets differing in macronutrient content.
DESIGN:
Twelve month randomized clinical trial with 4mo of weight loss and 8mo weight maintenance.
SUBJECTS:
Overweight (N = 130; 58 male (M), 72 female (F); BMI = 32.5 ± 0.5 kg/m2) middle-aged subjects were randomized to
energy-restricted (deficit ~500 kcal/d) diets providing protein at 1.6 g.kg-1.d-1 (PRO) or 0.8 g.kg-1.d-1 (CARB). LM and
fat mass (FM) were measured using dual X-ray absorptiometry. Body composition outcomes were tested in a
repeated measures ANOVA controlling for sex, diet, time and their two- and three-way interactions at 0, 4, 8 and
12mo.
RESULTS:
When expressed as percent change from baseline, males and females lost similar amounts of weight at 12mo (M:-
11.2 ± 7.1 %, F:-9.9 ± 6.0 %), as did diet groups (PRO:-10.7 ± 6.8 %, CARB:-10.1 ± 6.2 %), with no interaction of gender
and diet. A similar pattern emerged for fat mass and lean mass, however percent body fat was significantly influenced
by both gender (M:-18.0 ± 12.8 %, F:-7.3 ± 8.1 %, p < 0.05) and diet (PRO:-14.3 ± 11.8 %, CARB:-9.3 ± 11.1 %,
p < 0.05), with no gender-diet interaction. Compared to women, men carried an extra 7.0 ± 0.9 % of their total body fat
in the trunk (P < 0.01) at baseline, and reduced trunk fat during weight loss more than women (M:-3.0 ± 0.5 %, F:-
1.8 ± 0.3 %, p < 0.05). Conversely, women carried 7.2 ± 0.9 % more total body fat in the legs, but loss of total body fat
in legs was similar in men and women.
CONCLUSION:
PRO was more effective in reducing percent body fat vs. CARB over 12mo weight loss and maintenance. Men lost
percent total body fat and trunk fat more effectively than women. No interactive effects of protein intake and gender
are evident.
Nutr Metab (Lond). 2011 Mar 4;8(1):13. doi: 10.1186/1743-7075-8-13.

Increased ratio of dietary carbohydrate to protein shifts the focus of

metabolic signaling from skeletal muscle to adipose.
Devkota S1, Layman DK.
Author information
Abstract
BACKGROUND:
The Dietary Reference Intakes (DRI) established acceptable macronutrient distribution ranges (AMDR) for
carbohydrates and protein, however little is known about differences in glycemic regulations and metabolic signaling
across this range. This study examined metabolic outcomes associated with intake of two diets differing in
carbohydrate:protein ratios representing the upper and lower ends of the AMDR.
METHODS:
Adult, male rats were fed either a high carbohydrate (CHO) diet (60% of energy from carbohydrates, 12% protein,
28% fat; n = 30) or a high protein (PRO) diet (35% carbohydrate, 35% protein, 30% fat; n = 30). Rats were meal-fed
3x/d the respective diets for 10 d and then terminated after overnight food deprivation or 30, 60, 90, 120 min post-
prandial (PP). Plasma was collected at each of these points to provide a time course for glucose, insulin and C-
peptide. Skeletal muscle and adipose tissues were collected at 0, 30 and 90 min for measurements of basal, early and
delayed activation of Akt, p70S6K and Erk 1/2. Data were analyzed by two-way ANOVA.
RESULTS:
The CHO group produced a consistently elevated response in plasma glucose, insulin and C-peptide following the
meal through the 120 min time course. In addition, Akt and Erk 1/2 activation in adipose was much higher than in
skeletal muscle. Conversely, the PRO group PP glucose response was minimal and insulin maintained a response
similar to a biphasic pattern. Tissue responses for the PRO group were greater for Akt and p70S6K signaling in
skeletal muscle compared with adipose.
CONCLUSION:
Taken together these data suggest that altering CHO:PRO ratios within the AMDR produce different glycemic
response patterns accompanied by differential metabolic signaling in skeletal muscle and adipose.
Curr Opin Clin Nutr Metab Care. 2010 Jul;13(4):403-7. doi: 10.1097/MCO.0b013e32833a7737.

Protein metabolic roles in treatment of obesity.

Devkota S1, Layman DK.
Author information
Abstract
PURPOSE OF REVIEW:
To understand the potential benefits of increased dietary protein during weight loss and the importance of distribution
of high-quality protein at each meal.
RECENT FINDINGS:
Popular weight loss diets emphasize use of protein as a substitute for carbohydrates or fat to reduce insulin and
minimize hunger and food cravings. These diets produce short-term weight loss, but long-term benefits remain
obscured by failure to differentiate between outcomes of subject compliance and diet effectiveness. New molecular
mechanisms have defined the benefits of protein as a meal threshold for the branched-chain amino acid leucine,
which has been characterized as a unique signal regulator of muscle protein synthesis. Leucine consumed at 2.5 g
triggers a postmeal anabolic response that protects metabolic active tissues during weight loss and increases loss of
body fat.
SUMMARY:
Balanced daily distribution of protein with increased intake at breakfast and lunch protects metabolically active tissues
including skeletal muscle during weight loss.

J Nutr. 2009 Mar;139(3):514-21. doi: 10.3945/jn.108.099440. Epub 2009 Jan 21.

A moderate-protein diet produces sustained weight loss and long-term

changes in body composition and blood lipids in obese adults.
Layman DK1, Evans EM, Erickson D, Seyler J, Weber J, Bagshaw D, Griel A, Psota T, Kris-Etherton P.
Author information
Abstract
Diets with increased protein and reduced carbohydrates (PRO) are effective for weight loss, but the long-term effect
on maintenance is unknown. This study compared changes in body weight and composition and blood lipids after
short-term weight loss (4 mo) followed by weight maintenance (8 mo) using moderate PRO or conventional high-
carbohydrate (CHO) diets. Participants (age = 45.4 +/- 1.2 y; BMI = 32.6 +/- 0.8 kg/m(2); n = 130) were randomized to
2 energy-restricted diets (-500 kcal/d or -2093 kJ/d): PRO with 1.6 g x kg(-1) x d(-1) protein and <170 g/d
carbohydrates or CHO with 0.8 g x kg(-1) x d(-1) protein, >220 g/d carbohydrates. At 4 mo, the PRO group had lost
22% more fat mass (FM) (-5.6 +/- 0.4 kg) than the CHO group (-4.6 +/- 0.3 kg) but weight loss did not differ between
groups (-8.2 +/- 0.5 kg vs. -7.0 +/- 0.5 kg; P = 0.10). At 12 mo, the PRO group had more participants complete the
study (64 vs. 45%, P < 0.05) with greater improvement in body composition; however, weight loss did not differ
between groups (-10.4 +/- 1.2 kg vs. -8.4 +/- 0.9 kg; P = 0.18). Using a compliance criterion of participants attaining
>10% weight loss, the PRO group had more participants (31 vs. 21%) lose more weight (-16.5 +/- 1.5 vs. -12.3 +/- 0.9
kg; P < 0.01) and FM (-11.7 +/- 1.0 vs. -7.9 +/- 0.7 kg; P < 0.01) than the CHO group. The CHO diet reduced serum
cholesterol and LDL cholesterol compared with PRO (P < 0.01) at 4 mo, but the effect did not remain at 12 mo. PRO
had sustained favorable effects on serum triacylglycerol (TAG), HDL cholesterol (HDL-C), and TAG:HDL-C compared
with CHO at 4 and 12 mo (P < 0.01). The PRO diet was more effective for FM loss and body composition
improvement during initial weight loss and long-term maintenance and produced sustained reductions in TAG and
increases in HDL-C compared with the CHO diet.
Annu Rev Nutr. 2009;29:21-41. doi: 10.1146/annurev-nutr-080508-141056.

Dietary protein, weight loss, and weight maintenance.

Westerterp-Plantenga MS1, Nieuwenhuizen A, Tomé D, Soenen S, Westerterp KR.
Author information
Abstract
The role of dietary protein in weight loss and weight maintenance encompasses influences on crucial targets for body
weight regulation, namely satiety, thermogenesis, energy efficiency, and body composition. Protein-induced satiety
may be mainly due to oxidation of amino acids fed in excess, especially in diets with "incomplete" proteins. Protein-
induced energy expenditure may be due to protein and urea synthesis and to gluconeogenesis; "complete" proteins
having all essential amino acids show larger increases in energy expenditure than do lower-quality proteins. With
respect to adverse effects, no protein-induced effects are observed on net bone balance or on calcium balance in
young adults and elderly persons. Dietary protein even increases bone mineral mass and reduces incidence of
osteoporotic fracture. During weight loss, nitrogen intake positively affects calcium balance and consequent
preservation of bone mineral content. Sulphur-containing amino acids cause a blood pressure-raising effect by loss of
nephron mass. Subjects with obesity, metabolic syndrome, and type 2 diabetes are particularly susceptible groups.
This review provides an overview of how sustaining absolute protein intake affects metabolic targets for weight loss
and weight maintenance during negative energy balance, i.e., sustaining satiety and energy expenditure and sparing
fat-free mass, resulting in energy inefficiency. However, the long-term relationship between net protein synthesis and
sparing fat-free mass remains to be elucidated.

Nutr Metab Cardiovasc Dis. 2009 Oct;19(8):548-54. doi: 10.1016/j.numecd.2008.10.006. Epub 2009 Jan 29.

High protein diets decrease total and abdominal fat and improve CVD
risk profile in overweight and obese men and women with elevated
triacylglycerol.
Clifton PM1, Bastiaans K, Keogh JB.
Author information
Abstract
BACKGROUND AND AIMS:
It is unclear whether high protein weight loss diets have beneficial effects on weight loss, abdominal fat mass, lipids,
glucose and insulin compared to conventional low fat diets in subjects at increased risk of cardiovascular disease
(CVD) because of elevated glucose and triglyceride concentrations. Our objective was to determine the effects of high
protein (HP) compared to standard protein (SP) diets on CVD risk in obese adults.
METHODS AND RESULTS:
Data from three, 12 week, randomized parallel trials with subjects assigned to either HP or SP diet (5500-6500 kJ/day)
were pooled. Weight, body composition (dual energy X-ray absorptiometry), lipids, insulin and glucose were measured
before and after weight loss. Data from 215 subjects (49.9+/-9.8 years, BMI 33.5+/-3.7 kg/m(2)), 108 HP, 107 SP were
analyzed. Weight loss (HP diet 7.82+/-0.37 kg; SP diet 7.65+/-0.39 kg, NS) and total fat loss were not different (HP
6.8+/-4.3 kg; LP 6.4+/-4.7 kg, NS on intention to treat analysis). The reduction in triacylglycerol (TAG) was greater on
HP than SP 0.48+/-0.07 mmol/L vs 0.27+/-0.06 mmol/L, (P<0.001). Subjects with TAG greater than the median (>1.54
mmol/L at baseline) lost more weight (HP 8.5+/-0.6; SP 6.9+/-0.6 kg, P=0.01, diet by TG group), total (HP 6.17+/-0.50
kg; SP 4.52+/-0.52 kg, P=0.007) and abdominal fat (HP 1.92+/-0.17 kg; SP 1.23+/-0.19 kg, P=0.005) on HP. Total
cholesterol (12 vs 6%, HP vs SP) and TAG (39 vs 20%, HP vs SP) decreased to a greater extent in these subjects
(both P</=0.05) on HP.
CONCLUSION:
Short-term high protein weight loss diets had beneficial effects on total cholesterol and triacylglycerol in overweight
and obese subjects and achieved greater weight loss and better lipid results in subjects at increased risk of CVD.
These observations provide further information regarding the utility of this dietary approach in effectively managing
body weight and composition and reducing CVD risk in overweight and obese individuals.
Curr Opin Clin Nutr Metab Care. 2009 Jan;12(1):86-90. doi: 10.1097/MCO.0b013e32831cef8b.

Dietary protein recommendations and the prevention of sarcopenia.

Paddon-Jones D1, Rasmussen BB.
Author information
Abstract
PURPOSE OF REVIEW:
To draw attention to recent work on the role of protein and the amount of protein needed with each meal to preserve
skeletal muscle mass in ageing.
RECENT FINDINGS:
Ageing does not inevitably reduce the anabolic response to a high-quality protein meal. Ingestion of approximately 25-
30 g of protein per meal maximally stimulates muscle protein synthesis in both young and older individuals. However,
muscle protein synthesis is blunted in elderly when protein and carbohydrate are coingested or when the quantity of
protein is less than approximately 20 g per meal. Supplementing regular mixed-nutrient meals with leucine may also
enhance the muscle protein synthetic response in elders.
SUMMARY:
On the basis of recent work, we propose a novel and specific dietary approach to prevent or slow down muscle loss
with ageing. Rather than recommending a large, global increase in the recommended dietary allowance (RDA) for
protein for all elderly individuals, clinicians should stress the importance of ingesting a sufficient amount of protein with
each meal. To maximize muscle protein synthesis while being cognizant of total energy intake, we propose a dietary
plan that includes 25-30 g of high quality protein per meal.

Am J Clin Nutr. 2006 Feb;83(2):260-74.

Effects of variation in protein and carbohydrate intake on body mass and

composition during energy restriction: a meta-regression 1.
Krieger JW 1, Sitren HS, Daniels MJ, Langkamp-Henken B.
Author information
Abstract
BACKGROUND:
It is unclear whether low-carbohydrate, high-protein, weight-loss diets benefit body mass and composition beyond
energy restriction alone.
OBJECTIVE:
The objective was to use meta-regression to determine the effects of variations in protein and carbohydrate intakes on
body mass and composition during energy restriction.
DESIGN:
English-language studies with a dietary intervention of > or =4200 kJ/d (1000 kcal/d), with a duration of > or =4 wk,
and conducted in subjects aged > or =19 y were considered eligible for inclusion. A self-reported intake in conjunction
with a biological marker of macronutrient intake was required as a minimum level of dietary control. A total of 87
studies comprising 165 intervention groups met the inclusion criteria.
RESULTS:
After control for energy intake, diets consisting of < or =35-41.4% energy from carbohydrate were associated with a
1.74 kg greater loss of body mass, a 0.69 kg greater loss of fat-free mass, a 1.29% greater loss in percentage body
fat, and a 2.05 kg greater loss of fat mass than were diets with a higher percentage of energy from carbohydrate. In
studies that were conducted for >12 wk, these differences increased to 6.56 kg, 1.74 kg, 3.55%, and 5.57 kg,
respectively. Protein intakes of >1.05 g/kg were associated with 0.60 kg additional fat-free mass retention compared
with diets with protein intakes < or =1.05 g/kg. In studies conducted for >12 wk, this difference increased to 1.21 kg.
No significant effects of protein intake on loss of either body mass or fat mass were observed.
CONCLUSION:
Low-carbohydrate, high-protein diets favorably affect body mass and composition independent of energy intake, which
in part supports the proposed metabolic advantage of these diets.
J Nutr. 2006 Jan;136(1 Suppl):319S-23S.

Potential importance of leucine in treatment of obesity and the metabolic

syndrome.
Layman DK1, Walker DA.
Author information
Abstract
Diets with total protein intake >1.5 g.kg(-1).d(-1) and carbohydrate intake <150 g/d are effective for treatment of
obesity, type 2 diabetes, and the Metabolic Syndrome. These diets improve body composition and enhance glycemic
control. During weight loss, protein-rich diets reduce loss of lean tissue and increase loss of body fat. Specific
mechanisms to explain each of these clinical outcomes remain to be fully elucidated. We propose that keys to
understanding the relationship between dietary protein and carbohydrates are the relationships between the
branched-chain amino acid leucine and insulin and glucose metabolism. Leucine is known to interact with the insulin
signaling pathway to stimulate downstream signal control of protein synthesis, resulting in maintenance of muscle
protein during periods of restricted energy intake. Leucine also appears to modulate insulin signaling and glucose use
by skeletal muscle. Whereas total protein is important in providing substrates for gluconeogenesis, leucine appears to
regulate oxidative use of glucose by skeletal muscle through stimulation of glucose recycling via the glucose-alanine
cycle. These mechanisms produce protein sparing and provide a stable glucose environment with low insulin
responses during energy-restricted periods.

J Nutr. 2003 Feb;133(2):405-10.

Increased dietary protein modifies glucose and insulin homeostasis in

adult women during weight loss.
Layman DK1, Shiue H, Sather C, Erickson DJ, Baum J.
Author information
Abstract
Amino acids interact with glucose metabolism both as carbon substrates and by recycling glucose carbon via alanine
and glutamine; however, the effect of protein intake on glucose homeostasis during weight loss remains unknown.
This study tests the hypothesis that a moderate increase in dietary protein with a corresponding reduction of
carbohydrates (CHO) stabilizes fasting and postprandial blood glucose and insulin during weight loss. Adult women (n
= 24; >15% above ideal body weight) were assigned to either a Protein Group [protein: 1.6 g/(kg. d); CHO <40% of
energy] or CHO Group [protein: 0.8 g/(kg. d); CHO >55%]. Diets were equal in energy (7100 kJ/d) and fat (50 g/d).
After 10 wk, the Protein Group lost 7.53 +/- 1.44 kg and the CHO Group lost 6.96 +/- 1.36 kg. Plasma amino acids,
glucose and insulin were determined after a 12-h fast and 2 h after a 1.67 MJ test meal containing either 39 g CHO,
33 g protein and 13 g fat (Protein Group) or 57 g CHO, 12 g protein and 14 g fat (CHO Group). After 10 wk, subjects
in the CHO Group had lower fasting (4.34 +/- 0.10 vs 4.89 +/- 0.11 mmol/L) and postprandial blood glucose (3.77 +/-
0.14 vs. 4.33 +/- 0.15 mmol/L) and an elevated insulin response to meals (207 +/- 21 vs. 75 +/- 18 pmol/L). This study
demonstrates that consumption of a diet with increased protein and a reduced CHO/protein ratio stabilizes blood
glucose during nonabsorptive periods and reduces the postprandial insulin response.
Am J Clin Nutr. 2003 Oct;78(4):734-41.

An increase in dietary protein improves the blood glucose response in

persons with type 2 diabetes.
Gannon MC1, Nuttall FQ, Saeed A, Jordan K, Hoover H.
Author information
Abstract
BACKGROUND:
In single-meal studies, dietary protein does not result in an increase in glucose concentrations in persons with or
without type 2 diabetes, even though the resulting amino acids can be used for gluconeogenesis.
OBJECTIVE:
The metabolic effects of a high-protein diet were compared with those of the prototypical healthy (control) diet, which
is currently recommended by several scientific organizations.
DESIGN:
The metabolic effects of both diets, consumed for 5 wk each (separated by a 2-5-wk washout period), were studied in
12 subjects with untreated type 2 diabetes. The ratio of protein to carbohydrate to fat was 30:40:30 in the high-protein
diet and 15:55:30 in the control diet. The subjects remained weight-stable during the study.
RESULTS:
With the fasting glucose concentration used as a baseline from which to determine the area under the curve, the high-
protein diet resulted in a 40% decrease in the mean 24-h integrated glucose area response. Glycated hemoglobin
decreased 0.8% and 0.3% after 5 wk of the high-protein and control diets, respectively; the difference was significant
(P < 0.05). The rate of change over time was also significantly greater after the high-protein diet than after the control
diet (P < 0.001). Fasting triacylglycerol was significantly lower after the high-protein diet than after the control diet.
Insulin, C-peptide, and free fatty acid concentrations were not significantly different after the 2 diets.
CONCLUSION:
A high-protein diet lowers blood glucose postprandially in persons with type 2 diabetes and improves overall glucose
control. However, longer-term studies are necessary to determine the total magnitude of response, possible adverse
effects, and the long-term acceptability of the diet.