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Cited by 184Diet and metabolism studiesNutritional Studies and DietMuscle metabolism and nutrition

The DOI matches its Crossref record; 46 of the 47 references it cites were found in a registry or an index.

Long-term effects of low-fat diets either low or high in protein on cardiovascular and metabolic risk factors: a systematic review and meta-analysis

Open access
Schwingshackl, Lukas, Hoffmann, Georg·2013·Nutrition Journal
DOI 10.1186/1475-2891-12-48PMC PMC3636027
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Abstract

BACKGROUND: Meta-analyses of short-term studies indicate favorable effects of higher protein vs. lower protein diets on health outcomes like adiposity or cardiovascular risk factors, but their long-term effects are unknown. METHODS: Electronic databases (MEDLINE, EMBASE, Cochrane Trial Register) were searched up to August 2012 with no restriction to language or calendar date. A random effect meta-analysis was performed using the Software package by the Cochrane Collaboration Review Manager 5.1. Sensitivity analysis was performed for RCTs with a Jadad Score ≥ 3, and excluding type 2 diabetic subjects (T2D). RESULTS: 15 RCTs met all objectives and were included in the present meta-analysis. No significant differences were observed for weight, waist circumference, fat mass, blood lipids (i.e. total cholesterol, LDL-cholesterol, HDL-cholesterol, triacylglycerols), C-reactive protein, diastolic and systolic blood pressure, fasting glucose and glycosylated hemoglobin. In contrast, improvements of fasting insulin was significantly more pronounced following high protein diets as compared to the low protein counterparts (weighted mean difference: -0.71 μIU/ml, 95% CI -1.36 to -0.05, p = 0.03). Sensitivity analysis of high quality RCTs confirmed the data of the primary analyses, while exclusion of studies with diabetic subjects resulted in an additional benefit of high-protein diets with respect to a more marked increase in HDL-cholesterol. CONCLUSION: According to the present meta-analysis of long-term RCTs, high-protein diets exerted neither specific beneficial nor detrimental effects on outcome markers of obesity, cardiovascular disease or glycemic control. Thus, it seems premature to recommend high-protein diets in the management of overweight and obesity.

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Crossref · 10.1186/1475-2891-12-48

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Figures

Figure 1 Risk of bias assessment tool. Across trials, information is either from trials at a low risk of bias (green), or from trials at unclear risk of bias (yellow), or from trials at high risk of bias (red).
Figure 1 Risk of bias assessment tool. Across trials, information is either from trials at a low risk of bias (green), or from trials at unclear risk of bias (yellow), or from trials at high risk of bias (red).CC BY · PubMed Central
Figure 2 Flow diagram.
Figure 2 Flow diagram.CC BY · PubMed Central
Figure 3 Forest plot showing pooled WMD with 95% CI for fasting insulin (μIU/ml) for 10 randomized controlled high-protein diet studies. For each high-protein study, the shaded square represents the point estimate of the intervention effect. The horizontal line joins the lower and upper limits of the 95% CI of these effects. The area of the shaded square reflects the relative weight of the study in the respective meta-analysis. The diamond at the bottom of the graph represents the pooled WMD with the 95% CI for the 10 study groups. Abbreviations: HP = high-protein; LP = low-protein; I2 = Inconsistency.
Figure 3 Forest plot showing pooled WMD with 95% CI for fasting insulin (μIU/ml) for 10 randomized controlled high-protein diet studies. For each high-protein study, the shaded square represents the point estimate of the intervention effect. The horizontal line joins the lower and upper limits of the 95% CI of these effects. The area of the shaded square reflects the relative weight of the study in the respective meta-analysis. The diamond at the bottom of the graph represents the pooled WMD with the 95% CI for the 10 study groups. Abbreviations: HP = high-protein; LP = low-protein; I2 = Inconsistency.CC BY · PubMed Central
Figure 4 Forest plot showing pooled WMD with 95% CI for HDL-cholesterol (mg/dl) for 10 randomized controlled high-protein diet studies (excluding T2D subjects). For each high-protein study, the shaded square represents the point estimate of the intervention effect. The horizontal line joins the lower and upper limits of the 95% CI of these effects. The area of the shaded square reflects the relative weight of the study in the respective meta-analysis. The diamond at the bottom of the graph represents the pooled WMD with the 95% CI for the 10 study groups. Abbreviations: HP = high-protein; LP = low-protein; I2 = Inconsistency; T2D = type 2 diabetes.
Figure 4 Forest plot showing pooled WMD with 95% CI for HDL-cholesterol (mg/dl) for 10 randomized controlled high-protein diet studies (excluding T2D subjects). For each high-protein study, the shaded square represents the point estimate of the intervention effect. The horizontal line joins the lower and upper limits of the 95% CI of these effects. The area of the shaded square reflects the relative weight of the study in the respective meta-analysis. The diamond at the bottom of the graph represents the pooled WMD with the 95% CI for the 10 study groups. Abbreviations: HP = high-protein; LP = low-protein; I2 = Inconsistency; T2D = type 2 diabetes.CC BY · PubMed Central

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Research works printed but not linked: 1

  1. Higgins JP, Green S: Cochrane Handbook of systematic reviews, Version 5.1.0. 2011, updated March http://handbook.cochrane.org/ (accessed August 2012)

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Metadata

Authors
Schwingshackl, L., & Hoffmann, G.
Affiliations
University of Vienna (AT)
Corresponding author
Schwingshackl, Lukas
ORCID
Venue
Nutrition Journal
Publisher
Springer Science and Business Media LLC
Published
2013-04-15
Volume
12
Issue
1
Pages
48-48
ISSN
1475-2891 (ISSN-L)
DOI
10.1186/1475-2891-12-48
PMC
PMC3636027
OpenAlex
W2160520777
Cited by
184
References
47
Citations by year
2026: 4 · 2025: 11 · 2024: 11 · 2023: 15 · 2022: 8 · 2021: 16 · 2020: 16 · 2019: 11 · 2018: 14 · 2017: 19 · 2016: 18 · 2015: 18 · 2014: 19 · 2013: 2
FWCI
2.09
Type
journal article
Language
en
Open access
Licence
Locations
  • Nutrition Journal (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Phaidra (Universität Wien) (submittedVersion, cc-by-nc-nd)
Topics
  • Health Sciences › Medicine › Physiology (medical) › Diet and metabolism studies
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
  • Health Sciences › Nursing › Nutrition and Dietetics › Muscle metabolism and nutrition
Keywords
high-protein diet, low-fat diet, protein intake, cardiovascular risk factors, metabolic risk factors, fasting insulin, serum lipids, HDL cholesterol, obesity, weight, blood pressure, glycemic control, long-term dietary effects
MeSH terms
Blood Glucose, Blood Pressure, C-Reactive Protein, Cardiovascular Diseases, Dietary Proteins, Glycated Hemoglobin, Humans, Cholesterol, HDL, Cholesterol, LDL, Obesity, Risk Factors, Time Factors, Triglycerides, Biomarkers, Weight Loss, Randomized Controlled Trials as Topic, Databases, Factual, Diet, Fat-Restricted, Metabolic Syndrome, Glycemic Index, Waist Circumference

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