A High-Protein Diet With Resistance Exercise Training Improves Weight Loss and Body Composition in Overweight and Obese Patients With Type 2 Diabetes

Wycherley, Thomas P.; Noakes, Manny; Clifton, Peter M.; Cleanthous, Xenia; Keogh, Jennifer B.; Brinkworth, Grant D.

doi:10.2337/dc09-1974

Cited by 195 publications

(231 citation statements)

References 24 publications

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“…As a result of the WL, there are significant improvements in body composition, blood pressure and bio-markers of health. The reduction in body fat mass (kg) and maintenance of lean mass (kg) during energy restriction and WL has been reported previously by other authors and, in part, is related to the protein-enriched composition of the diet (21) . In a recent meta regression, Krieger et al (22) and Clifton et al (23) examined eightyseven short-term studies and found that protein intakes of > 1 .…”

Section: Efficacy Of High-protein Weight Loss Dietssupporting

confidence: 79%

Safety and efficacy of high-protein diets for weight loss

Johnstone

2012

Proc. Nutr. Soc.

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Dietary strategies that can help reduce hunger and promote fullness are beneficial for weight control, since these are major limiting factors for success. High-protein (HP) diets, specifically those that maintain the absolute number of grams ingested, while reducing energy, are a popular strategy for weight loss (WL) due to the effects of protein-induced satiety to control hunger. Nonetheless, both the safety and efficacy of HP WL diets have been questioned, particularly in combination with low-carbohydrate advice. Nonetheless, for short-to-medium-term intervention studies (over several months), increasing the energetic contribution of protein does appear effective. The effects of HP diets on appetite, bone health, renal function, blood pressure, cardiovascular bio-markers, antioxidant status, gut health and psychological function are discussed. Further research is warranted to validate the physiological effects of HP diets over longer periods of time, including studies that modify the quality of macronutrients (i.e. the type of carbohydrate, fat and protein) and the interaction with other interventions (e.g. exercise and dietary supplements). What is a high-protein diet?An important factor to consider is the definition of a 'highprotein (HP) diet', as there are several ways to consider the protein content of a diet. The composition of the diet can be determined as the absolute amount of the protein (grams), the % of total energy as protein or the amount of protein ingested per kg body weight. Normal protein intake in the UK is approximately 16% of energy intake(1) for a sedentary adult, which is approximately 64-88 g/d at energy balance for females and males, respectively. There is no general consensus as to what a 'high'-protein diet is: the food industry use the term 'protein-enriched' for 20 % protein from energy. The HP diets reported for weight loss (WL) studies often include 30% of energy intake as protein. There are many variants such as the Zone diet (2) and the CSIRO diet (3) . In general, protein as a percentage of energy is doubled from 15 to 30%. Note, this does not mean that absolute protein intake (g) is doubled, as energy intake is reduced, with only a 20 % increase in the actual amount (g) of protein. The guidelines from the Institute of Medicine allow for the inclusion of higher amounts of protein than previously recommended in a healthy diet (4) . This Institute concluded that there is no clear evidence that an HP intake increases the risk of renal stones, osteoporosis, cancer or CVD. Thus, the acceptable protein distribution for maintenance requirements was set to 5-20% of energy for children aged 1-3 years, 10-30 % for children aged 3-18 years and 10-35 % for adults. It is not clear as to how much protein is required to maximise proteininduced satiety for energy restriction and WL or whether there is a relationship with the energy density of the diet.Both the safety (5) and efficacy (5) of HP WL diets have been questioned, particularly in combination with low-carbohydrate advice (6) . Low-ca...

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Section: Efficacy Of High-protein Weight Loss Dietssupporting

confidence: 79%

Safety and efficacy of high-protein diets for weight loss

Johnstone

2012

Proc. Nutr. Soc.

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“…For example, some studies showed better glycemic control and insulin sensitivity in patients taking lower levels of carbohydrate23, 24, 25, whereas some others showed no difference26, 27. Conflicting results were also reported by various studies regarding the clinical outcomes in patients having higher or usual protein intake28, 29, 30, 31. Eating plans and nutrition therapy goals should be set collaboratively with individual needs including the patients’ metabolic targets, personal and cultural preferences, literacy and economic capability, as well as their ability and willingness to change16.…”

Section: Discussionmentioning

confidence: 99%

Dietary and physical activity of adult patients with type 2 diabetes in Zhejiang province of eastern China: Data from a cross‐sectional study

Pan

Ming-xia

et al. 2016

J of Diabetes Invest

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Aims/IntroductionLifestyle management helps improve the clinical outcome of patients with type 2 diabetes. The present study aimed to obtain lifestyle data on the dietary and physical activity of adult type 2 diabetes patients in Zhejiang province of eastern China for better patient education and improvement of clinical management.Materials and MethodsA cross‐sectional survey of 607 adult type 2 diabetes patients was carried out in 12 hospitals within eight cities of Zhejiang province. Data were collected for sex, age, basic physical measurement (blood pressure, height, weight, waist circumference and hip circumference), dietary favor and habit (vegetarian diets vs meat diets, preference of salty or light flavors), detailed dietary intake (24‐h recall method), as well as the weekly physical activity.ResultsThe mean age of the patients in the analysis was 56.39 ± 12.29 years, and 38.71% of the patients had higher levels of body mass index than recommended. The average daily total energy intake was 1887.71 ± 575.10 kcal. The percentage of calories from carbohydrate, protein and fat were 61.36 ± 11.59%, 13.29 ± 3.37% and 25.35 ± 11.16%, respectively. For physical activity, the patients generally spent most of their daily time sitting and sleeping, and the time for moderate vigorous activity was limited.ConclusionsAdult patients with type 2 diabetes in Zhejiang province have a relatively high carbohydrate and low protein diet, with very limited physical activity. Patient education to achieve a better lifestyle intervention needs to improve in this region.

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“…However, data interpretation is limited because the majority of studies (10 of 12) included in the glucose analysis were conducted in nondiabetic individuals (24,43). Furthermore, although FFM (skeletal muscle) is the primary site of glucose uptake (6), a direct relation between the quantity of skeletal muscle and glucose tolerance or insulin sensitivity does not follow (61).…”

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confidence: 99%

Effects of energy-restricted high-protein, low-fat compared with standard-protein, low-fat diets: a meta-analysis of randomized controlled trials

Wycherley

Moran

Clifton

et al. 2012

The American Journal of Clinical Nutrition

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493

370

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Background: It is currently unclear whether altering the carbohydrateto-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.

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A High-Protein Diet With Resistance Exercise Training Improves Weight Loss and Body Composition in Overweight and Obese Patients With Type 2 Diabetes

Cited by 195 publications

References 24 publications

Safety and efficacy of high-protein diets for weight loss

Safety and efficacy of high-protein diets for weight loss

Dietary and physical activity of adult patients with type 2 diabetes in Zhejiang province of eastern China: Data from a cross‐sectional study

Effects of energy-restricted high-protein, low-fat compared with standard-protein, low-fat diets: a meta-analysis of randomized controlled trials

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