Differential effects of protein quality on postprandial lipemia in response to a fat-rich meal in type 2 diabetes: comparison of whey, casein, gluten, and cod protein

Abstract

Background: Enhanced and prolonged postprandial triglyceride responses involve increased cardiovascular disease risk in type 2 diabetes. Dietary fat and carbohydrates profoundly influence postprandial hypertriglyceridemia, whereas little information exists on the effect of proteins. Objective: The objective was to compare the effects of the proteins casein, whey, cod, and gluten on postprandial lipid and incretin responses to a high-fat meal in persons with type 2 diabetes. Design: A crossover study was conducted in 12 patients with type 2 diabetes. Blood samples were collected over 8 h after ingestion of a test meal containing 100 g butter and 45 g carbohydrate in combination with 45 g casein (Cas-meal), whey (Whe-meal), cod (Codmeal), or gluten (Glu-meal). We measured plasma concentrations of triglycerides, retinyl palmitate (RP), free fatty acids, insulin, glucose, glucagon, glucagon-like peptide 1, and glucose-dependent insulinotropic peptide. Results: The incremental area under the curve for triglyceride was significantly lower after the Whe-meal than after the other meals. The RP response was lower after the Whe-meal than after the Casmeal and Cod-meal in the chylomicron-rich fraction and higher after the Whe-meal than after Cod-and Glu-meals in the chylomicron-poor fraction. Free fatty acids were most pronouncedly suppressed after the Whe-meal. The glucose response was lower after the Whe-meal than after the other meals, whereas no significant differences were found in insulin, glucagon, glucagon-like peptide 1, and glucose-dependent insulinotropic peptide responses. Conclusion: The data suggest that as a supplement to a fat-rich meal in patients with type 2 diabetes, whey protein seems to outperform other proteins in terms of postprandial lipemia improvement, possibly because of the formation of fewer chylomicrons or increased clearance of chylomicrons. The trial was registered at clinicaltrials. gov as NCT00817973.Am J Clin Nutr 2009;90:41-8.

Effects of different fractions of whey protein on postprandial lipid and hormone responses in type 2 diabetes

“…14 However, when whey protein, another milk protein, was added to a fat-rich meal it acutely reduces the postprandial triglyceride response in T2DM subjects compared with casein, cod and gluten. 16 Pal et al 17 has confirmed the improvement in PPL after ingestion of whey protein in overweight postmenopausal women.…”

Circulating inflammatory and atherogenic biomarkers are not increased following single meals of dairy foods

“…We excluded the possibility that increments in insulin concentration after these mixed meals had suppressed the levels of the biomarkers by finding no correlation between the changes in plasma insulin concentration and any biomarkers (data not shown). The protein intake with the butter and the cream meals was substantially less than with the cheese and yoghurt meals (Tables 2a and 2b) that may be relevant since Mortensen et al (2009) reported that different sources of protein added to a high-fat meal elicited different triglyceridemic and glycemic responses. Our priority was to minimize the differences in dairy fat and in energy content.…”

Can milk proteins be a useful tool in the management of cardiometabolic health? An updated review of human intervention trials

“…Milk proteins have been extensively investigated for their insulinotropic and glucose-lowering effects in healthy subjects (73,75,82,83,(90)(91)(92)(93)(94)(95)(96)(97)(98)(99) and to a limited extent in individuals with suboptimal glucose control (100)(101)(102)(103)(104)(105)(106) . The dose varied significantly between studies from as little as 10 g (92,105,106) -51 g (91) .…”