Effects of a high-protein, low-carbohydrate <i>v</i>. high-protein, moderate-carbohydrate weight-loss diet on antioxidant status, endothelial markers and plasma indices of the cardiometabolic profile

Johnstone, Alexandra M.; Lobley, G. E.; Horgan, Graham; Bremner, David; Fyfe, Claire; Morrice, Philip C.; Duthie, Garry G.

doi:10.1017/s0007114511000092

Cited by 43 publications

(48 citation statements)

References 46 publications

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“…Short-term body weight and body composition changes Free-living subjects feeding ad libitum from HP diets show a WL of about 1 kg a week (19,20) which is consistent with current dietary advice on rate of WL from health professionals (e.g. British Dietetic Association, http:// www.bda.uk.com).…”

Section: Efficacy Of High-protein Weight Loss Dietssupporting

confidence: 70%

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: 70%

Safety and efficacy of high-protein diets for weight loss

Johnstone

2012

Proc. Nutr. Soc.

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“…This was unexpected given that the majority of the obese individuals without type 2 diabetes complied with at least 3 of the criteria for metabolic syndrome, often regarded as an intermediate stage in the development of type 2 diabetes and associated with systemic inflammation and platelet activation [42]. It has been shown previously, however, that the majority of obese individuals with a similar BMI range as in the current study may not actually exhibit higher than normal levels of circulating inflammatory markers, such as IL6 [43]. This, along with our finding that changes in total and activated PMP are affected more by diabetes than by obesity in a similar BMI range, suggests that the relationship between obesity, the metabolic syndrome, inflammation and type 2 diabetes may not be simple, and questions the predictive value of both inflammatory markers and some MP in the development of diabetes.…”

Section: Pmp Diabetes and Obesitymentioning

confidence: 42%

Platelet-derived microparticle count and surface molecule expression differ between subjects with and without type 2 diabetes, independently of obesity status

Zhang

McGeoch

Johnstone

et al. 2013

J Thromb Thrombolysis

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This study investigated the impact of either type 2 diabetes or obesity, separately or in combination, on the absolute amounts of microparticles (MP) and the pathways by which these are associated with either condition. The concentrations of circulating MP derived from platelets (PMP), leukocytes (LMP) and monocytes (MMP), together with their specific activation markers, were compared in 30 subjects who were characterised across 4 cohorts as obese or type 2 diabetes. The subjects with type 2 diabetes had elevated concentrations of total PMP (P = 0.003), and PMP that were fibrinogen-positive (P = 0.04), tissue factor-positive (P < 0.001), P-selectin-positive (P = 0.03). Type 2 diabetes did not alter either total or activated LMP or MMP. Obesity per se did not impact on any MP measurement. Elevated concentrations of plasma PMP occurred in subjects with type 2 diabetes, whether they were obese or non-obese. In contrast, obesity in the absence of type 2 diabetes had no effect. The increased concentrations of specific marker-positive PMP in the subjects with diabetes might reflect potential pathways by which PMP may contribute to the pathogenesis of atherosclerosis and type 2 diabetes.

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“…In the absence of calorie restriction, high-protein, low-carbohydrate diets can contribute to weight gain and adverse metabolic effects (147). However, metabolic benefits of low-carbohydrate dieting under diverse circumstances have been reported (47,73,159).…”

Section: Mediterraneanmentioning

confidence: 99%

Can We Say What Diet Is Best for Health?

Katz

Meller

2014

Annu. Rev. Public Health

323

204

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Diet is established among the most important influences on health in modern societies. Injudicious diet figures among the leading causes of premature death and chronic disease. Optimal eating is associated with increased life expectancy, dramatic reduction in lifetime risk of all chronic disease, and amelioration of gene expression. In this context, claims abound for the competitive merits of various diets relative to one another. Whereas such claims, particularly when attached to commercial interests, emphasize distinctions, the fundamentals of virtually all eating patterns associated with meaningful evidence of health benefit overlap substantially. There have been no rigorous, long-term studies comparing contenders for best diet laurels using methodology that precludes bias and confounding, and for many reasons such studies are unlikely. In the absence of such direct comparisons, claims for the established superiority of any one specific diet over others are exaggerated. The weight of evidence strongly supports a theme of healthful eating while allowing for variations on that theme. A diet of minimally processed foods close to nature, predominantly plants, is decisively associated with health promotion and disease prevention and is consistent with the salient components of seemingly distinct dietary approaches. Efforts to improve public health through diet are forestalled not for want of knowledge about the optimal feeding of Homo sapiens but for distractions associated with exaggerated claims, and our failure to convert what we reliably know into what we routinely do. Knowledge in this case is not, as of yet, power; would that it were so.

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Effects of a high-protein, low-carbohydrate v. high-protein, moderate-carbohydrate weight-loss diet on antioxidant status, endothelial markers and plasma indices of the cardiometabolic profile

Cited by 43 publications

References 46 publications

Safety and efficacy of high-protein diets for weight loss

Safety and efficacy of high-protein diets for weight loss

Platelet-derived microparticle count and surface molecule expression differ between subjects with and without type 2 diabetes, independently of obesity status

Can We Say What Diet Is Best for Health?

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