A high-protein diet with resistance exercise training improves weight loss and body composition in overweight and obese patients with type 2 diabetes.
OBJECTIVE To evaluate the effects of two low-fat hypocaloric diets differing in the carbohydrate-to-protein ratio, with and without resistance exercise training (RT), on weight loss, body composition, and cardiovascular disease (CVD) risk outcomes in overweight/obese patients with type 2 diabetes. RESEARCH DESIGN AND METHODS A total of 83 men and women with type 2 diabetes (aged 56.1 +/- 7.5 years, BMI 35.4 +/- 4.6 kg/m(2)) were randomly assigned to an isocaloric, energy-restricted diet (female subjects 6 MJ/day, male subjects 7 MJ/day) of either standard carbohydrate (CON; carbohydrate:protein:fat 53:19:26) or high protein (HP; 43:33:22), with or without supervised RT (3 days/week) for 16 weeks. Body weight and composition, waist circumference (WC), and cardiometabolic risk markers were assessed. RESULTS Fifty-nine participants completed the study. There was a significant group effect (P <or= 0.04) for body weight, fat mass, and WC with the greatest reductions occurring in HP+RT (weight [CON: -8.6 +/- 4.6 kg, HP: -9.0 +/- 4.8 kg, CON+RT: -10.5 +/- 5.1 kg, HP+RT: -13.8 +/- 6.0 kg], fat mass [CON: -6.4 +/- 3.4 kg, HP: -6.7 +/- 4.0 kg, CON+RT: -7.9 +/- 3.7 kg, HP+RT: -11.1 +/- 3.7 kg], and WC [CON: -8.2 +/- 4.6 cm, HP: -8.9 +/- 3.9 cm, CON+RT: -11.3 +/- 4.6 cm, HP+RT: -13.7 +/- 4.6 cm]). There was an overall reduction (P < 0.001) in fat-free mass (-2.0 +/- 2.3 kg), blood pressure (-15/8 +/- 10/6 mmHg), glucose (-2.1 +/- 2.2 mmol/l), insulin (-4.7 +/- 5.4 mU/l), A1C (-1.25 +/- 0.94%), triglycerides (-0.47 +/- 0.81 mmol/l), total cholesterol (-0.67 +/- 0.69 mmol/l), and LDL cholesterol (-0.37 +/- 0.53 mmol/l), with no difference between groups (P >or= 0.17). CONCLUSIONS An energy-restricted HP diet combined with RT achieved greater weight loss and more favorable changes in body composition. All treatments had similar improvements in glycemic control and CVD risk markers.
Wycherley
Thomas P
TP
Preventative Health Flagship, Commonwealth Scientific and Industrial Research Organisation, Food and Nutritional Sciences, Adelaide, Australia.
Noakes
Manny
M
Clifton
Peter M
PM
Cleanthous
Xenia
X
Keogh
Jennifer B
JB
Brinkworth
Grant D
GD
D000419:Albuminuria / Q000453:epidemiology / Q000378:metabolism; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D001823:Body Composition; D002318:Cardiovascular Diseases / Q000453:epidemiology; D003404:Creatinine / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000178:diet therapy* / Q000453:epidemiology; D018752:Diet, Fat-Restricted; D004044:Dietary Proteins / Q000008:administration & dosage*; D002149:Energy Intake; D015444:Exercise; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength; D009765:Obesity / Q000178:diet therapy* / Q000453:epidemiology; D010349:Patient Compliance; D012307:Risk Factors; D016896:Treatment Outcome; D015431:Weight Loss
D001786:Blood Glucose; D004044:Dietary Proteins; D003404:Creatinine