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Effect of a high-protein, energy-restricted diet on body composition, glycemic control, and lipid concentrations in overweight and obese hyperinsulinemic men and women
Open accessAbstract
Background It is not clear whether varying the protein-to-carbohydrate ratio of weight-loss diets benefits body composition or metabolism.Objective The objective was to compare the effects of 2 weight-loss diets differing in protein-to-carbohydrate ratio on body composition, glucose and lipid metabolism, and markers of bone turnover.Design A parallel design included either a high-protein diet of meat, poultry, and dairy foods (HP diet: 27% of energy as protein, 44% as carbohydrate, and 29% as fat) or a standard-protein diet low in those foods (SP diet: 16% of energy as protein, 57% as carbohydrate, and 27% as fat) during 12 wk of energy restriction (6-6.3 MJ/d) and 4 wk of energy balance ( approximately 8.2 MJ/d). Fifty-seven overweight volunteers with fasting insulin concentrations > 12 mU/L completed the study.Results Weight loss (7.9 +/- 0.5 kg) and total fat loss (6.9 +/- 0.4 kg) did not differ between diet groups. In women, total lean mass was significantly (P = 0.02) better preserved with the HP diet (-0.1 +/- 0.3 kg) than with the SP diet (-1.5 +/- 0.3 kg). Those fed the HP diet had significantly (P < 0.03) less glycemic response at weeks 0 and 16 than did those fed the SP diet. After weight loss, the glycemic response decreased significantly (P < 0.05) more in the HP diet group. The reduction in serum triacylglycerol concentrations was significantly (P < 0.05) greater in the HP diet group (23%) than in the SP diet group (10%). Markers of bone turnover, calcium excretion, and systolic blood pressure were unchanged.Conclusion Replacing carbohydrate with protein from meat, poultry, and dairy foods has beneficial metabolic effects and no adverse effects on markers of bone turnover or calcium excretion.
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“However, compliance is known to increase when the foods are provided [34,48,56,64,66]”
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“Whether increasing protein intake during weight loss can limit the weight-loss-induced loss of fat-free mass is unclear because of conflicting results reported in the literature (54, 56, 96, 98, 101-108).”
From Preserving Healthy Muscle during Weight Loss (2017) · cites this paper as [102]
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“We determined that 36 total subjects—18 subjects in each of the 2 diet groups—was sufficient to test the main effect of time (ie, resistance training) and the group-by-time interaction (ie, differential response of protein intake during resistance training) (7, 29).”
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“It may also spare lean tissue and induce a greater loss of total and intra-abdominal fat (Parker et al. 2002; Farnsworth et al. 2003).”
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“Also, previous studies report that HP improves insulin sensitivity [10], increases basal metabolism and postprandial energy expenditure, and decreases postprandial glucose [11].”
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“In obese and diabetic individuals, a higher utilization of fat reserves and improved glucose homeostasis was reported while subjected to diets containing higher protein contents (Farnsworth et al., 2003; Layman et al., 2003).”
BackgroundProtein Intake, Weight Loss, and Bone Mineral Density in Postmenopausal Women
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BackgroundInfluentialLupin and soya reduce glycaemia acutely in type 2 diabetes
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“Interestingly, the pattern of change observed is similar to studies previously reported in T2DM individuals [4,5] and overweight and obese adults [30] that show lipids decline with caloric restriction but rebound with weight stabilization and energy balance.”
Self-citationThe effect of diets high in protein or carbohydrate on inflammatory markers in overweight subjects
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The role of high-protein diets in body weight management and health
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“carbohydrate diets high-protein diets appear to preserve lean body mass and/or lead to reduced fat mass during weight loss which is of particular relevance with regard to the metabolic syndrome((40,18,25,41,2,42,30,23,43)).”
Energy balance and hypothalamic effects of a high-protein/low-carbohydrate diet
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“However, we choose to use a relatively high-protein content to ensure that the protein balance was equally positive in all experimental conditions, because a high-protein diet may affect body weight (29).”
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“If the absence of carbohydrate in the diets used in this study indeed played an important role in decreasing body fat and AI in rats with ad libitum consumption and 35% energy restriction, it will be necessary in future studies to test the influence of the ratio of protein to energy concomitantly with the fat to carbo…”
MethodThe Relation between Calcium Intake and Body Composition in a Dutch Population
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Self-citationSex-Specific Variation in Metabolic Responses to Diet
Andrews, R. R., Anderson, K. R., & Fry, J. L. (2024) · Nutrients · doi:10.3390/nu16172921 · Cited by 44
“Similarly, a 16-week trial comparing the effects of a high-protein vs. lower-protein diet in men and women showed that men lost 2.5 kg fat-free body mass on the high-protein diet, while women retained fat-free mass [42].”
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“LM is an important metabolically active tissue contributing to increased resting energy expenditure and improved muscular strength and body functional capacity [6, 7].”
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“Furthermore, it was also established that moderately high-protein caloric restriction (between 20 and 30% of energy intake) induce greater reductions in fat mass (17, 18) while the loss of lean body mass is attenuated in middle-aged healthy obese individuals (19, 20).”
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“Weight loss diets high in protein have also been associated with reductions in abdominal fat and low density lipoprotein cholesterol [14], reduction in serum triacylglycerol concentrations [15] and an improvement of cardiovascular risk profile [16].”
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“5 kg) with high protein CR diets than with a standard protein diet (Table 1) [28,29,31,65], although others show no significant differences in total weight loss or total fat loss between groups.”
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“…evidences suggest that higher protein content diets importantly decrease triglyceride levels compared with lower protein diets (Skov et al. 1999b; Farnsworth et al. 2003), but, in agreement with other studies, patients in the HP-diet group showed no significant change in this variable (Alford et…”
ResultDairy proteins and the regulation of satiety and obesity
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“Twenty-three studies were from North America (34, 38, 39, 42, 44, 45, 49, 50, 52, 53, 55, 57, 59, 60, 62, 63, 65, 68, 70–73), 8 from Europe (33, 35, 46, 47, 54, 61, 67, 69), 4 fromOceania (37, 40, 43, 48), 5 from South America (31, 32, 36, 58, 66), and 4 from Asia (41, 51, 53, 56).”
BackgroundNutrition in patients with Type 2 diabetes: are low‐carbohydrate diets effective, safe or desirable?
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Fiber, Protein, and Lupin-Enriched Foods: Role for Improving Cardiovascular Health
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“We assumed that PRO would maintain FFM (in contrast to CON) [25], but experience a greater decline in FM (SD = 3%).”
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“8 g $ kg(21) $ d(21))—one of the accepted diet strategies for weight loss (5–8)—improves blood lipids and attenuates muscle loss (6, 7, 9, 10) during weight reduction.”
BackgroundBranched-Chain Amino Acids: Metabolism, Physiological Function, and Application
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“Some have shown gender difference in response to higher protein [20,42] while others have not [23,44].”
BackgroundThe physiological effects of weight-cycling: A review of current evidence
Sanaya, N., Janusaite, M., Dalamaga, M., & Magkos, F. (2024) · Current Obesity Reports · doi:10.1007/s13679-023-00539-8 · Cited by 31
“…regimens have been found to lead to a greater loss of LBM than others (e.g., low-protein versus high-protein diets, respectively), with the macronutrient composition and energy content affecting the composition of lost and regained body weight and tissue mass, at least in the short term [55, 56].”
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“Nevertheless, protein-rich diets could have potential beneficial effects by increasing satiety and thermogenesis((10)), and other studies have suggested that replacing carbohydrate with protein from meat, poultry and dairy foods may have beneficial metabolic effects((11)) and help reduce abdominal obesity((12)).”
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“Dietary intervention for these individuals ought to provide an adequate protein intake per LM to prevent loss of LM [36], while guaranteeing a low energy intake for weight loss [37].”
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“The presence of protein has been shown to reduce glucose response by slowing gastric emptying and nutrient absorption (Farnsworth et al. 2003; Karamanlis et al. 2007; Akhavan et al. 2010).”
BackgroundHaghighat, N., Ashtary‐Larky, D., Bagheri, R., Mahmoodi, M., Rajaei, M., Alipour, M., Kooti, W., Aghamohammdi, V., & Wong, A. (2020) · British Journal Of Nutrition · doi:10.1017/s0007114520002019 · Cited by 31
“Our rationale for sample size was based on a previous study evaluating LBM in obese individuals receiving HP or SP diet (47) .”
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“In the present study and others reporting a benefit of increased protein intake [8,9,11,26,27], investigators manipulated multiple macronutrients, with elevated protein intake matched by reductions in carbohydrate intake.”
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“…has been shown to mitigate muscle loss and promote muscle repair in individuals experiencing a negative energy balance (Carbone et al., 2012; Farnsworth et al., 2003; Fisher, Yagaloff, & Burn, 1999; Kayser, 1992; Koopman et al., 2004; Layman et al., 2003; Rodriguez & Garlick, 2007; Skov et…”
BackgroundSlow and fast dietary proteins differentially modulate postprandial metabolism
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“, 2003; Gannon & Nuttall, 2004) or obesity (Farnsworth et al., 2003; Layman et al., 2003).”
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“Consumption of a high-protein diet has been linked to improved glycemic response, in both the short- [12,20,31] and long-term [30,37,46].”
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Effects of weight loss and calorie restriction on carbohydrate metabolism
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Carbohydrate and weight control: where do we stand?
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Self-citationProtein synthesis regulation by leucine
Vianna, D., Teodoro, G. F. R., Torres‐Leal, F. L., & Tirapegui, J. (2010) · Brazilian Journal of Pharmaceutical Sciences · doi:10.1590/s1984-82502010000100004 · Cited by 26
“These changes were partially attributed to increased BCAA consumption, particularly leucine (Layman et al., 2003b; Farnsworth et al., 2003; Westerterp-Plantenga et al., 2004).”
Background
Metadata
- Authors
- Farnsworth, E., Luscombe, N. D., Noakes, M., Wittert, G., Argyiou, E., & Clifton, P. M.
- Affiliations
- Commonwealth Scientific and Industrial Research Organisation (AU)
- Corresponding author
- Clifton, Peter M
- Venue
- The American Journal of Clinical Nutrition
- Publisher
- Elsevier BV
- Published
- 2003-07
- Volume
- 78
- Issue
- 1
- Pages
- 31-39
- ISSN
- 0002-9165 (ISSN-L)
- OpenAlex
- W2167607978
- Cited by
- 438
- References
- 52
- Citations by year
- 2026: 2 · 2025: 6 · 2024: 15 · 2023: 2 · 2022: 8 · 2021: 15 · 2020: 14 · 2019: 14 · 2018: 11 · 2017: 12 · 2016: 25 · 2015: 14 · 2014: 21 · 2013: 24 · 2012: 37
- FWCI
- 16.10
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- American Journal of Clinical Nutrition (publishedVersion)
- PubMed (publishedVersion)
- Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion)
- Topics
- Health Sciences › Medicine › Physiology (medical) › Diet and metabolism studies
- Health Sciences › Medicine › Physiology (medical) › Dietary Effects on Health
- Health Sciences › Nursing › Nutrition and Dietetics › Muscle metabolism and nutrition
- Keywords
- high-protein diet, caloric restriction, weight loss, protein-carbohydrate ratio, body composition, lean mass preservation, glycemic control, insulin resistance, hyperinsulinemia, obesity, overweight, lipid metabolism, triglycerides, bone turnover, calcium excretion, systolic blood pressure
- MeSH terms
- Blood Glucose, Body Composition, Energy Intake, Diet, Dietary Proteins, Fatty Acids, Nonesterified, Female, Humans, Hyperinsulinism, Insulin Resistance, Lipids, Cholesterol, HDL, Cholesterol, LDL, Male, Middle Aged, Obesity, Triglycerides
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