Effects of high-protein diet on glycemic control, insulin resistance and blood pressure in type 2 diabetes: A systematic review and meta-analysis of randomized controlled trials

Yu, Zhangping; Nan, Fengwei; Wang, Leslie Yingzhijie; Jiang, Hua; Chen, Wei; Jiang, Yu

doi:10.1016/j.clnu.2019.08.008

Cited by 68 publications

(62 citation statements)

References 36 publications

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“…It is estimated that the prevalence of diabetes in adults worldwide is over 300 million, and it will increase by 55% by 2035 1 . Obesity or overweight is one of the essential risk factors for diabetes and contributes to a twice-higher risk to develop DM 2,3 .…”

Section: Introductionmentioning

confidence: 99%

“…Thus, dietary therapy aiming at weight loss is typically recommended in clinical practice 4 . Due to the fact that diabetes and its complications affect many aspects of physiology, the benefits of weight reduction are not limited to glycemic control but are also related to many cardiovascular risk factors such as blood pressure, highdensity lipoprotein (HDL), total cholesterol (TC) and triglyceride (TG) 2 .…”

Section: Introductionmentioning

confidence: 99%

“…Ketogenic diet (KD), which contains a very low level of carbohydrates (<55 g/d) with the main energy sources of lipid and protein, and which causes ketosis and simulates the physiological state of fasting, has been well reported to be effective for weight loss and glycemic control [4][5][6][7][8][9] . Previous meta-analyses have proved the efficacy of KD in body weight reduction 2,10,11 ; however, systemic reviews on the effect of KD on weight reduction and glycolipid metabolism in patients with DM are still limited. Westman et al 12 and Partsalaki et al 13 demonstrated that KD improved type 2 diabetes mellitus (T2DM) by reducing the glycemic response caused by carbohydrate and improving potential insulin resistance.…”

Section: Introductionmentioning

confidence: 99%

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Effect of the ketogenic diet on glycemic control, insulin resistance, and lipid metabolism in patients with T2DM: a systematic review and meta-analysis

et al. 2020

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Background At present, the beneficial effect of the ketogenic diet (KD) on weight loss in obese patients is generally recognized. However, a systematic research on the role of KD in the improvement of glycemic and lipid metabolism of patients with diabetes is still found scarce. Methods This meta-study employed the meta-analysis model of random effects or of fixed effects to analyze the average difference before and after KD and the corresponding 95% CI, thereby evaluating the effect of KD on T2DM. Results After KD intervention, in terms of glycemic control, the level of fasting blood glucose decreased by 1.29 mmol/L (95% CI: −1.78 to −0.79) on average, and glycated hemoglobin A1c by 1.07 (95% CI: −1.37 to −0.78). As for lipid metabolism, triglyceride was decreased by 0.72 (95% CI: −1.01 to −0.43) on average, total cholesterol by 0.33 (95% CI: −0.66 to −0.01), and low-density lipoprotein by 0.05 (95% CI: −0.25 to −0.15); yet, high-density lipoprotein increased by 0.14 (95% CI: 0.03−0.25). In addition, patients’ weight decreased by 8.66 (95% CI: −11.40 to −5.92), waist circumference by 9.17 (95% CI: −10.67 to −7.66), and BMI by 3.13 (95% CI: −3.31 to −2.95). Conclusion KD not only has a therapeutic effect on glycemic and lipid control among patients with T2DM but also significantly contributes to their weight loss.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Effect of the ketogenic diet on glycemic control, insulin resistance, and lipid metabolism in patients with T2DM: a systematic review and meta-analysis

et al. 2020

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“…Our study showed that a high-protein diet had no signi cant impact on biomarkers of liver, kidney, or lipid metabolism. Tischmann et al [33] revealed that a high-protein diet lasting for approximately 34 months had no signi cant effect on the biomarkers of cardiometabolic health and vascular function in overweight participants. In contrast, a previous study [34] reported that high-protein diets can decrease the levels of low-density lipoprotein, total cholesterol, and triglycerides as well as mitigate insulin resistance in patients with type 2 diabetes mellitus.…”

Section: Discussionmentioning

confidence: 99%

Preoperative High-Protein Diet Can Improve The Serum Albumin Levels of Patients Undergoing Total Knee Arthroplasty

Liu

Xie

et al. 2020

Preprint

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Background: Preoperative hypoproteinemia are risk factors for complications in patients undergoing total knee arthroplasty (TKA). However, the relationship between preoperative albumin levels and postoperative use of albumin is unclear, as are the effects of a high-protein diet on preoperative serum albumin levels for these patients. Methods: We retrospectively enrolled 660 patients who underwent primary TKA from January to December 2019, of whom 97 received postoperative albumin and 563 did not. Logistic and restrictive cubic spline regression analyses were used to explore the relationship between preoperative serum albumin levels and postoperative albumin use. Additionally, 88 patients undergoing primary TKA were educated to follow a high-protein diet during the preoperative waiting period from January to July 2020. From these 88 patients, data from laboratory tests on the day of the outpatient visit and admission were collected and compared to evaluate the effect of high-protein diet on preoperative serum albumin levels. Results: Higher preoperative serum albumin levels were negatively associated with risk of postoperative albumin use (relative risk 0.725, 95% confidence interval 0.666-0.789), and the risk of needing postoperative albumin decreased with increasing preoperative albumin level with a negative dose-response relationship (P overall < 0.001; P nonlinear = 0.186). After an average of 39.05±22.78 days on a high-protein diet, the albumin levels on admission (46.04±2.49 g/L) were significantly higher than on outpatient (42.79±4.09) g/L), while the biomarkers of liver and kidney function and lipid metabolism did not differ significantly between the two time points. Conclusions: Preoperative albumin levels were highly associated with postoperative albumin use, showing an obvious dose-response relationship. Preoperative high-protein diet could improve the albumin levels in patients undergoing TKA. Trial registration: The study was registered in the Chinese Clinical Trial Registry (registration no. ChiCTR2000034978) on July 26, 2020.

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“…Several systematic review and meta-analyses of randomised controlled trials in overweight/ obese adults and those with type 2 diabetes have found that high-protein diets and supplementation with whey protein can improve measures of body composition as well as glycaemic control and blood lipids. [65][66][67][68][69] While trials in older type 2 diabetes populations are lacking, questions also remain as to whether there is an optimal type and dose of protein for this population. In one of the few studies investigating the effects of protein supplementation alone on muscle mass in 60 older men with type 2 diabetes (mean age 71 years), Leenders and colleagues reported that 7.5g per day of leucine (2.5g per meal) for 6 months had no effect on lean body mass, muscle fibre size, strength or glycaemic control when compared to an isocaloric control, 70 which may be due to the adequate habitual basal dietary protein intake of the men (~1.0 g/kg/ day) as compliance with the supplement was high (>90%) and only 1 participant dropped out in the intervention arm.…”

Section: Supplementation In Patients With Comorbiditiesmentioning

confidence: 99%

Effects of protein supplementation on muscle wasting disorders: A brief update of the evidence

et al. 2020

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To examine the effects of protein supplementation on muscle mass, strength and function in individuals at risk of muscle wasting disorders. Methods: A narrative overview of the literature based on a PubMed search. Results: Increasing protein intake beyond the recommended dietary intake may prevent or attenuate muscle loss in people at risk of muscle wasting disorders; however, there is inconsistent evidence for any benefits on muscle strength or physical function. This is likely due to the significant heterogeneity and bias regarding baseline demographics, basal protein/energy intakes and protein supplement type, dose, timing and compliance. Conclusion: Protein supplementation attenuates muscle loss in some populations at increased risk of muscle wasting, but there is no consistent evidence to support benefits on muscle strength or physical function. Further randomised controlled trials are needed that focus on whether there is an optimal type, dose and timing of protein intake, and potential interaction with other nutrients.

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Effects of high-protein diet on glycemic control, insulin resistance and blood pressure in type 2 diabetes: A systematic review and meta-analysis of randomized controlled trials

Cited by 68 publications

References 36 publications

Effect of the ketogenic diet on glycemic control, insulin resistance, and lipid metabolism in patients with T2DM: a systematic review and meta-analysis

Effect of the ketogenic diet on glycemic control, insulin resistance, and lipid metabolism in patients with T2DM: a systematic review and meta-analysis

Preoperative High-Protein Diet Can Improve The Serum Albumin Levels of Patients Undergoing Total Knee Arthroplasty

Effects of protein supplementation on muscle wasting disorders: A brief update of the evidence

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