Associations of changes in reported and estimated protein and energy intake with changes in insulin resistance, glycated hemoglobin, and BMI during the PREVIEW lifestyle intervention study.

Abstract

BACKGROUND:

Observed associations of high-protein diets with changes in insulin resistance are inconclusive.

OBJECTIVES:

We aimed to assess associations of changes in both reported and estimated protein (PRep; PEst) and energy intake (EIRep; EIEst) with changes in HOMA-IR, glycated hemoglobin (HbA1c), and BMI (in kg/m2), in 1822 decreasing to 833 adults (week 156) with overweight and prediabetes, during the 3-y PREVIEW (PREVention of diabetes through lifestyle intervention and population studies In Europe and around the World) study on weight-loss maintenance. Eating behavior and measurement errors (MEs) of dietary intake were assessed. Thus, observational post hoc analyses were applied.

METHODS:

Associations of changes in EIEst, EIRep, PEst, and PRep with changes in HOMA-IR, HbA1c, and BMI were determined by linear mixed-model analysis in 2 arms [high-protein-low-glycemic-index (GI) diet and moderate-protein-moderate-GI diet] of the PREVIEW study. EIEst was derived from energy requirement: total energy expenditure = basal metabolic rate × physical activity level; PEst from urinary nitrogen, and urea. MEs were calculated as [(EIEst - EIRep)/EIEst] × 100% and [(PRep - PEst)/PEst] × 100%. Eating behavior was determined using the Three Factor Eating Questionnaire, examining cognitive dietary restraint, disinhibition, and hunger.

RESULTS:

Increases in PEst and PRep and decreases in EIEst and EIRep were associated with decreases in BMI, but not independently with decreases in HOMA-IR. Increases in PEst and PRep were associated with decreases in HbA1c. PRep and EIRep showed larger changes and stronger associations than PEst and EIEst. Mean ± SD MEs of EIRep and PRep were 38% ± 9% and 14% ± 4%, respectively; ME changes in EIRep and En% PRep were positively associated with changes in BMI and cognitive dietary restraint and inversely with disinhibition and hunger.

CONCLUSIONS:

During weight-loss maintenance in adults with prediabetes, increase in protein intake and decrease in energy intake were not associated with decrease in HOMA-IR beyond associations with decrease in BMI. Increases in PEst and PRep were associated with decrease in HbA1c.This trial was registered at clinicaltrials.gov as NCT01777893.

• Authors: Mathijs Drummen, Tanja C Adam, Ian A Macdonald, Elli Jalo, Thomas M Larssen, J Alfredo Martinez, Teodora Handjiev-Darlenska, Jennie Brand-Miller, Sally D Poppitt, Gareth Stratton, Kirsi H Pietiläinen, Moira A Taylor, Santiago Navas-Carretero, Svetoslav Handjiev, Roslyn Muirhead, Marta P Silvestre, Nils Swindell, Maija Huttunen-Lenz, Wolfgang Schlicht, Tony Lam, Jouko Sundvall, Laura Raman, Edith Feskens, Angelo Tremblay, Anne Raben, Margriet S Westerterp-Plantenga
• Journal: The American journal of clinical nutrition (Am J Clin Nutr) Vol. 114 Issue 5 Pg. 1847-1858 (11 08 2021) ISSN: 1938-3207 [Electronic] United States
• PMID: 34375397 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © The Author(s) 2021. Published by Oxford University Press on behalf of the American Society for Nutrition.

Chemical References

• Dietary Proteins
• Glycated Hemoglobin A
• hemoglobin A1c protein, human

Topics

• Adult
• Aged
• Body Mass Index
• Dietary Proteins (administration & dosage)
• Energy Intake
• Female
• Glycated Hemoglobin (analysis)
• Humans
• Insulin Resistance
• Life Style
• Male
• Middle Aged