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Energy-restricted, high-protein diets more effectively impact cardiometabolic profile in overweight and obese women than lower-protein diets.
Clin Nutr. 2017 04; 36(2):371-379.CN

Abstract

BACKGROUND & AIMS

High-protein energy-restricted diets have demonstrated efficacy in promoting weight loss in overweight and obesity. However, the protein percentage that achieves optimal efficacy and acceptability remains unknown. We sought to assess the effects of three energy-reduced diets with different percentages of calories from protein (20%, 27%, and 35%) on weight loss and lipids. Secondary outcomes included diet acceptability and compliance.

METHODS

Six-month, randomized study included women aged 18-80 years with BMI of 27.5-45 kg/m2 and who were not taking lipid-lowering drugs. We randomly assigned 91 women to one of three calorie-reduced diets with: protein, 20%, 27%, or 35% (80% from animal protein); carbohydrates, 50%, 43%, or 35%; fat, 30%. Dietary intervention involved individual visits with a nutritionist every 2 weeks during the first 3 months. We performed a follow-up visit at 6 months.

RESULTS

Eighty women aged 44.0 ± 9.08 years with BMI of 37.7 ± 3.39 kg/m2 completed the study. At 3 months, weight loss was -8.16 ± 4.18 kg, -9.66 ± 5.28 kg, and -10.7 ± 4.28 kg in the 20%, 27%, and 35%-protein groups, respectively (P = 0.16). These figures slightly and homogeneously increased at 6 months. Around 65% of women following 35%-protein diet lost ≥10% of body weight vs. ∼33% in 20%-protein group (P = 0.023). Significant decreases occurred in fat mass, lipids and insulin resistance, especially in the 35%-protein group (P < 0.05 vs. 20% protein). This improvement was not fully explained by weight loss. Triglyceride change was negatively correlated with animal-protein intake. All groups provided similar responses to an acceptance, palatability, and satisfaction questionnaire.

CONCLUSIONS

An energy-restricted diet with 35% protein, mostly of animal origin, more effectively impacts cardiometabolic profile than an energy-restricted diet with lower protein content although no clear benefit between diets in terms of overall weight loss was observed. The high-protein diet displayed an excellent safety profile and acceptability. This trial was registered in ClinicalTrials.gov as NCT02160496.

CLINICAL TRIAL REGISTRATION

The clinical trial has been registered in ClinicalTrials.gov (Identifier: NCT02160496).

Authors+Show Affiliations

Unidad Clínica y de Investigación en Lípidos y Aterosclerosis, Hospital Universitario Miguel Servet, Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain. Electronic address: rmateo.iacs@aragon.es.Unidad Clínica y de Investigación en Lípidos y Aterosclerosis, Hospital Universitario Miguel Servet, Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain.Unidad Clínica y de Investigación en Lípidos y Aterosclerosis, Hospital Universitario Miguel Servet, Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain.Unidad Clínica y de Investigación en Lípidos y Aterosclerosis, Hospital Universitario Miguel Servet, Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain.Unidad Clínica y de Investigación en Lípidos y Aterosclerosis, Hospital Universitario Miguel Servet, Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain.Unidad Clínica y de Investigación en Lípidos y Aterosclerosis, Hospital Universitario Miguel Servet, Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain.Unidad Clínica y de Investigación en Lípidos y Aterosclerosis, Hospital Universitario Miguel Servet, Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain.Unidad Clínica y de Investigación en Lípidos y Aterosclerosis, Hospital Universitario Miguel Servet, Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain.Unidad Clínica y de Investigación en Lípidos y Aterosclerosis, Hospital Universitario Miguel Servet, Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain.

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26875447

Citation

Mateo-Gallego, Rocío, et al. "Energy-restricted, High-protein Diets More Effectively Impact Cardiometabolic Profile in Overweight and Obese Women Than Lower-protein Diets." Clinical Nutrition (Edinburgh, Scotland), vol. 36, no. 2, 2017, pp. 371-379.
Mateo-Gallego R, Marco-Benedí V, Perez-Calahorra S, et al. Energy-restricted, high-protein diets more effectively impact cardiometabolic profile in overweight and obese women than lower-protein diets. Clin Nutr. 2017;36(2):371-379.
Mateo-Gallego, R., Marco-Benedí, V., Perez-Calahorra, S., Bea, A. M., Baila-Rueda, L., Lamiquiz-Moneo, I., de Castro-Orós, I., Cenarro, A., & Civeira, F. (2017). Energy-restricted, high-protein diets more effectively impact cardiometabolic profile in overweight and obese women than lower-protein diets. Clinical Nutrition (Edinburgh, Scotland), 36(2), 371-379. https://doi.org/10.1016/j.clnu.2016.01.018
Mateo-Gallego R, et al. Energy-restricted, High-protein Diets More Effectively Impact Cardiometabolic Profile in Overweight and Obese Women Than Lower-protein Diets. Clin Nutr. 2017;36(2):371-379. PubMed PMID: 26875447.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Energy-restricted, high-protein diets more effectively impact cardiometabolic profile in overweight and obese women than lower-protein diets. AU - Mateo-Gallego,Rocío, AU - Marco-Benedí,Victoria, AU - Perez-Calahorra,Sofía, AU - Bea,Ana M, AU - Baila-Rueda,Lucía, AU - Lamiquiz-Moneo,Itziar, AU - de Castro-Orós,Isabel, AU - Cenarro,Ana, AU - Civeira,Fernando, Y1 - 2016/01/29/ PY - 2015/06/25/received PY - 2015/12/17/revised PY - 2016/01/24/accepted PY - 2016/2/16/pubmed PY - 2018/3/1/medline PY - 2016/2/16/entrez KW - Diets KW - Energy restriction KW - Lipids KW - Protein KW - Weight loss SP - 371 EP - 379 JF - Clinical nutrition (Edinburgh, Scotland) JO - Clin Nutr VL - 36 IS - 2 N2 - BACKGROUND & AIMS: High-protein energy-restricted diets have demonstrated efficacy in promoting weight loss in overweight and obesity. However, the protein percentage that achieves optimal efficacy and acceptability remains unknown. We sought to assess the effects of three energy-reduced diets with different percentages of calories from protein (20%, 27%, and 35%) on weight loss and lipids. Secondary outcomes included diet acceptability and compliance. METHODS: Six-month, randomized study included women aged 18-80 years with BMI of 27.5-45 kg/m2 and who were not taking lipid-lowering drugs. We randomly assigned 91 women to one of three calorie-reduced diets with: protein, 20%, 27%, or 35% (80% from animal protein); carbohydrates, 50%, 43%, or 35%; fat, 30%. Dietary intervention involved individual visits with a nutritionist every 2 weeks during the first 3 months. We performed a follow-up visit at 6 months. RESULTS: Eighty women aged 44.0 ± 9.08 years with BMI of 37.7 ± 3.39 kg/m2 completed the study. At 3 months, weight loss was -8.16 ± 4.18 kg, -9.66 ± 5.28 kg, and -10.7 ± 4.28 kg in the 20%, 27%, and 35%-protein groups, respectively (P = 0.16). These figures slightly and homogeneously increased at 6 months. Around 65% of women following 35%-protein diet lost ≥10% of body weight vs. ∼33% in 20%-protein group (P = 0.023). Significant decreases occurred in fat mass, lipids and insulin resistance, especially in the 35%-protein group (P < 0.05 vs. 20% protein). This improvement was not fully explained by weight loss. Triglyceride change was negatively correlated with animal-protein intake. All groups provided similar responses to an acceptance, palatability, and satisfaction questionnaire. CONCLUSIONS: An energy-restricted diet with 35% protein, mostly of animal origin, more effectively impacts cardiometabolic profile than an energy-restricted diet with lower protein content although no clear benefit between diets in terms of overall weight loss was observed. The high-protein diet displayed an excellent safety profile and acceptability. This trial was registered in ClinicalTrials.gov as NCT02160496. CLINICAL TRIAL REGISTRATION: The clinical trial has been registered in ClinicalTrials.gov (Identifier: NCT02160496). SN - 1532-1983 UR - https://www.unboundmedicine.com/medline/citation/26875447/Energy_restricted_high_protein_diets_more_effectively_impact_cardiometabolic_profile_in_overweight_and_obese_women_than_lower_protein_diets_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0261-5614(16)00045-5 DB - PRIME DP - Unbound Medicine ER -