Associations of changes in reported and estimated protein and energy intake with changes in insulin resistance, glycated hemoglobin, and BMI during the PREVIEW lifestyle intervention study

Mathijs Drummen, Tanja C Adam, Ian A Macdonald, Elli Jalo, Thomas M Larssen, J Alfredo Martinez, Teodora Handjiev-Darlenska, Jennie Brand-Miller, Sally D Poppitt, Gareth Stratton, Kirsi H Pietiläinen, Moira A Taylor, Santiago Navas-Carretero, Svetoslav Handjiev, Roslyn Muirhead, Marta P Silvestre, Nils Swindell, Maija Huttunen-Lenz, Wolfgang Schlicht, Tony LamJouko Sundvall, Laura Raman, Edith Feskens, Angelo Tremblay, Anne Raben, Margriet S Westerterp-Plantenga

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)
1 Downloads (Pure)

Abstract

BACKGROUND: Observed associations of high-protein diets with changes in insulin resistance are inconclusive.

OBJECTIVES: We aimed to assess associations of changes in both reported and estimated protein (PRep; PEst) and energy intake (EIRep; EIEst) with changes in HOMA-IR, glycated hemoglobin (HbA1c), and BMI (in kg/m2), in 1822 decreasing to 833 adults (week 156) with overweight and prediabetes, during the 3-y PREVIEW (PREVention of diabetes through lifestyle intervention and population studies In Europe and around the World) study on weight-loss maintenance. Eating behavior and measurement errors (MEs) of dietary intake were assessed. Thus, observational post hoc analyses were applied.

METHODS: Associations of changes in EIEst, EIRep, PEst, and PRep with changes in HOMA-IR, HbA1c, and BMI were determined by linear mixed-model analysis in 2 arms [high-protein-low-glycemic-index (GI) diet and moderate-protein-moderate-GI diet] of the PREVIEW study. EIEst was derived from energy requirement: total energy expenditure = basal metabolic rate × physical activity level; PEst from urinary nitrogen, and urea. MEs were calculated as [(EIEst - EIRep)/EIEst] × 100% and [(PRep - PEst)/PEst] × 100%. Eating behavior was determined using the Three Factor Eating Questionnaire, examining cognitive dietary restraint, disinhibition, and hunger.

RESULTS: Increases in PEst and PRep and decreases in EIEst and EIRep were associated with decreases in BMI, but not independently with decreases in HOMA-IR. Increases in PEst and PRep were associated with decreases in HbA1c. PRep and EIRep showed larger changes and stronger associations than PEst and EIEst. Mean ± SD MEs of EIRep and PRep were 38% ± 9% and 14% ± 4%, respectively; ME changes in EIRep and En% PRep were positively associated with changes in BMI and cognitive dietary restraint and inversely with disinhibition and hunger.

CONCLUSIONS: During weight-loss maintenance in adults with prediabetes, increase in protein intake and decrease in energy intake were not associated with decrease in HOMA-IR beyond associations with decrease in BMI. Increases in PEst and PRep were associated with decrease in HbA1c.This trial was registered at clinicaltrials.gov as NCT01777893.

Original languageEnglish
Pages (from-to)1847-1858
Number of pages12
JournalThe American journal of clinical nutrition
Volume114
Issue number5
DOIs
Publication statusPublished - 8 Nov 2021

Keywords

  • Adult
  • Aged
  • Body Mass Index
  • Dietary Proteins/administration & dosage
  • Energy Intake
  • Female
  • Glycated Hemoglobin A/analysis
  • Humans
  • Insulin Resistance
  • Life Style
  • Male
  • Middle Aged

Fingerprint

Dive into the research topics of 'Associations of changes in reported and estimated protein and energy intake with changes in insulin resistance, glycated hemoglobin, and BMI during the PREVIEW lifestyle intervention study'. Together they form a unique fingerprint.

Cite this