Substituting Lean Beef for Carbohydrate in a Healthy Dietary Pattern Does Not Adversely Affect the Cardiometabolic Risk Factor Profile in Men and Women at Risk for Type 2 Diabetes

Abstract

<jats:title>ABSTRACT</jats:title> <jats:sec> <jats:title>Background</jats:title> <jats:p>Observational evidence suggests that red meat intake is associated with type 2 diabetes (T2D) and cardiovascular disease incidence, but few randomized controlled trials have assessed effects of lean, unprocessed red meat intake on insulin sensitivity and other cardiometabolic risk factors.</jats:p> </jats:sec> <jats:sec> <jats:title>Objective</jats:title> <jats:p>This study compared the USDA Healthy US-Style Eating Pattern, low in saturated fat and red meat (&amp;lt;40 g/d red meat; USDA-CON), with a modified version with an additional 150 g/d lean beef as an isocaloric replacement for carbohydrate (USDA-LB) on insulin sensitivity and cardiometabolic risk markers.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p>Participants (7 men, 26 women; 44.4 y old) with overweight/obesity [BMI (kg/m2) = 31.3] and prediabetes and/or metabolic syndrome completed this randomized, crossover, controlled-feeding trial consisting of two 28-d treatments (USDA-CON and USDA-LB) separated by a ≥14-day washout. Insulin sensitivity (primary outcome variable), lipoprotein lipids, apolipoproteins (apoA-I and apoB), and high-sensitivity C-reactive protein (hs-CRP) (secondary outcome variables), in plasma or serum, and blood pressures were assessed at baseline and the end of each diet period.</jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>USDA-LB and USDA-CON did not differ significantly in effects on whole-body insulin sensitivity and other indicators of carbohydrate metabolism, lipoprotein lipids, apoA-I and apoB, hs-CRP, and blood pressures. USDA-LB produced a shift toward less cholesterol carried by smaller LDL subfractions compared with USDA-CON [least-squares geometric mean ratios for LDL1+2 cholesterol of 1.20 (P = 0.016) and LDL3+4 cholesterol of 0.89 (P = 0.044)] and increased peak LDL time versus USDA-CON (1.01; P = 0.008).</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions</jats:title> <jats:p>Substituting lean, unprocessed beef for carbohydrate in a Healthy US-Style Eating Pattern resulted in a shift toward larger, more buoyant LDL subfractions, but otherwise had no significant effects on the cardiometabolic risk factor profile in men and women with prediabetes and/or metabolic syndrome.</jats:p> <jats:p>This trial was registered at clinicaltrials.gov as NCT03202680.</jats:p> </jats:sec>

Red meat consumption and risk factors for type 2 diabetes: a systematic review and meta-analysis of randomized controlled trials

“…Two studies reported additional outcomes of interest, but two comparisons were insufficient to conduct a meta-analysis; therefore, these were excluded (Supplemental Table 2 ). Overall, 21 studies could be included in the meta-analysis [ 11 – 13 , 27 – 44 ]. The only outcomes with sufficient comparisons (≥3) to include in a meta-analysis were fasting glucose, fasting insulin, insulin sensitivity (all measures), HOMA-IR, postprandial glucose, postprandial insulin, HbA1c, pancreatic beta-cell function, and GLP-1.…”

“…Study characteristics are in Supplemental Table 3 . Fourteen of the studies were crossover [ 11 , 12 , 28 , 31 – 37 , 39 – 42 ] and seven were parallel [ 14 , 27 , 29 , 34 , 38 , 43 , 44 ]. Four of the studies were acute (postprandial) feeding trials and the remainder ranged from 1 week [ 27 ] to 10 weeks [ 29 ], with most studies in the range of 4–8 weeks [ 11 – 13 , 28 , 30 , 34 , 36 , 38 – 44 ].…”

“…Fourteen of the studies were crossover [ 11 , 12 , 28 , 31 – 37 , 39 – 42 ] and seven were parallel [ 14 , 27 , 29 , 34 , 38 , 43 , 44 ]. Four of the studies were acute (postprandial) feeding trials and the remainder ranged from 1 week [ 27 ] to 10 weeks [ 29 ], with most studies in the range of 4–8 weeks [ 11 – 13 , 28 , 30 , 34 , 36 , 38 – 44 ]. Only seven studies included healthy individuals [ 27 – 29 , 32 , 36 , 37 , 41 ], with the remaining studies in subjects with metabolic syndrome, prediabetes, T2D, and/or overweight/obesity.…”

“…Ten studies compared a red meat or mixed animal protein diet to a plant protein diet [ 14 , 27 , 28 , 31 , 32 , 34 , 37 – 39 , 42 ], while seven studies compared red meat to other animal protein sources (e.g., dairy, seafood, white meat) [ 12 , 13 , 35 , 36 , 40 , 41 , 43 ]. Four studies used red meat to replace refined carbohydrate [ 11 , 29 , 33 , 44 ].…”

The effect of TCF7L2 polymorphisms on inflammatory markers after 16 weeks of legume-based dietary approach to stop hypertension (DASH) diet versus a standard DASH diet: a randomised controlled trial

“…However, there is no clear evidence on the effects of changes in red meat intake and replacement of red meat with other protein sources on inflammation biomarkers in dietary interventions. Although substituting carbohydrates with proteins in interventional studies has shown no effects on inflammatory markers [ 16 , 17 , 34 , 35 ], the results related to the substitution of red meat with other protein sources are controversial. High-protein diets, both animal and plant proteins, have been suggested to reduce inflammatory markers [ 18 ].…”