Protein and diabetes: Much advice, little research

Abstract

In persons with diabetes, moderate hyperglycemia can contribute to an increased turnover of protein. To maintain body composition and nitrogen balance requires metabolic control and sufficient protein and energy intakes. However, because most adults eat at least 50% more protein than is required, people with diabetes appear to be protected from protein malnutrition when consuming a usual diet. Although nonessential amino acids undergo hepatic gluconeogenesis, peripheral glucose concentrations do not increase after protein ingestion. The fate of produced glucose is unknown. Protein does not contribute to sustained elevations of glucose levels, slow absorption of carbohydrate, or help in the treatment of hypoglycemia--advice often given to persons with diabetes. Protein is, however, just as potent a stimulant of insulin secretion as glucose. No long-term research is available to document that high-protein, low-carbohydrate diets are continued long-term or that weight lost initially is maintained better from these diets than from traditional weight loss diets. Furthermore, in persons with type 2 diabetes, weight loss is reported to be related to energy restriction and not to the protein-to-carbohydrate ratio of the diet.

Suppression of the mTORC1/STAT3/Notch1 pathway by activated AMPK prevents hepatic insulin resistance induced by excess amino acids

“…Prolonged exposure to high concentrations of saturated fatty acids leads to oxidative stress and endoplasmic reticulum stress, which may impair insulin signaling and contribute to the development of type 2 diabetes (8). During the past 50 years, meat consumption has increased by one-third in industrialized countries (13). An increase in the intake of protein is associated with the development of type 2 diabetes (35,45).…”

A liver stress-endocrine nexus promotes metabolic integrity during dietary protein dilution

“…While it is well known that dietary protein is essential for normal growth and development, less is known about the interaction of dietary protein with systemic energy homeostasis and glucose homeostasis in adults. Indeed, the specific role of dietary protein in obesity and diabetes is less well understood and controversial (5). On one hand, the satiating effects of dietary protein are well established (6), and there are several studies in rodents (7,8) and even humans (9) demonstrating higher energy intake and subsequent fat mass gain with consumption of a protein-diluted diet.…”

Dietary Intake of Total, Animal, and Vegetable Protein and Risk of Type 2 Diabetes in the European Prospective Investigation into Cancer and Nutrition (EPIC)-NL Study

“…In industrialized countries, dietary protein intake has increased substantially during the last few decades, exceeding 50% of the recommended dietary allowance (5). Moreover, popular weight loss diets, such as the Atkins diet, are often based on extreme low-carbohydrate, high-protein contents with favorable effects on body weight and glucose homeostasis in short-term interventions (6,7).…”