TY - JOUR
T1 - 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
AU - Drummen, Mathijs
AU - Adam, Tanja C
AU - Macdonald, Ian A
AU - Jalo, Elli
AU - Larssen, Thomas M
AU - Martinez, J Alfredo
AU - Handjiev-Darlenska, Teodora
AU - Brand-Miller, Jennie
AU - Poppitt, Sally D
AU - Stratton, Gareth
AU - Pietiläinen, Kirsi H
AU - Taylor, Moira A
AU - Navas-Carretero, Santiago
AU - Handjiev, Svetoslav
AU - Muirhead, Roslyn
AU - Silvestre, Marta P
AU - Swindell, Nils
AU - Huttunen-Lenz, Maija
AU - Schlicht, Wolfgang
AU - Lam, Tony
AU - Sundvall, Jouko
AU - Raman, Laura
AU - Feskens, Edith
AU - Tremblay, Angelo
AU - Raben, Anne
AU - Westerterp-Plantenga, Margriet S
N1 - © The Author(s) 2021. Published by Oxford University Press on behalf of the American Society for Nutrition.
PY - 2021/11/8
Y1 - 2021/11/8
N2 - 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.
AB - 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.
KW - Adult
KW - Aged
KW - Body Mass Index
KW - Dietary Proteins/administration & dosage
KW - Energy Intake
KW - Female
KW - Glycated Hemoglobin A/analysis
KW - Humans
KW - Insulin Resistance
KW - Life Style
KW - Male
KW - Middle Aged
U2 - 10.1093/ajcn/nqab247
DO - 10.1093/ajcn/nqab247
M3 - Article
C2 - 34375397
SN - 0002-9165
VL - 114
SP - 1847
EP - 1858
JO - The American journal of clinical nutrition
JF - The American journal of clinical nutrition
IS - 5
ER -