High protein diet and weight loss

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High protein diet and weight loss

• 12/21
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Background

• In response to the obesity epidemic, there has
  been increased public interest and use of
  alternative weight-loss diet that contravene
  conventional dietary guidelines. (ex atkines
  diet, zone diet ..etc)

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Background

• Popular alternatives include high-protein diets,
  which have a common theme of restricting
  carbohydrate intake while increasing protein.

Side effect?
Effect?
Safety?
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Background

• A high-protein diet with resistance exercise
  training improves weight lossand body
  composition in overweight and obese patients with
  type 2 diabetes.
• Long-term effect of a high-protein weight-loss
  diet.
• Renal function following long-term weight loss in
  individuals with abdominal obesity on a very low
  carbohydrate diet vs high carbohydrate diet.

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A High-Protein Diet With ResistanceExercise
Training Improves Weight Lossand Body
Composition in Overweight andObese Patients With
Type 2 Diabetes.

• Wycherley TP, Noakes M, Clifton PM, Cleanthous X,
  Keogh JB, Brinkworth GD.
• Diabetes Care 33969-976, 2010

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Research design and methods
Questionnaires received (n126)
Eligible for participation (n82)
randomized
CON diet n19
HP diet n21
CON diet RT n22
HP diet RT n20
16 weeks
CON diet n16
HP diet n12
CON diet RT n17
HP diet RT n14
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Research design and methods

• Participants information
• BMI35.34.5 kg/m2
• Age55.08.4
• Type 2 DM (without using insulin)
• No specific diseases
• Lack of regular exercise habit

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Research design and methods
Diet intervention
Exercise intervention
Con diet
High protein diet
?1428kcal/day ?1666kcal/day
CHO53 Protein19 (0.7 kg/day) Fat26
CHO43 Protein33 (1.2 kg/day) Fat22
3 nonconsecutive days /week 8 separate exercise
/day 2 sets /per exercise 8-12 repetitions
/set rest between two set1-2min
every 2 weeks consult qualified dietitian 7
consecutive days diet record
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Research design and methods
24hr urine
Measure project In week 0 /16
Exercise performance
Serum lipids Serum insulin Plasma
glucose C-reactive protein Creatinine
Body weight Body composition Blood pressure WC
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Result
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Result
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Result
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Result
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Result
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Discussion

• Although previous studies have observed
  protective effects of RT and HP diets on FFM
  during caloric restriction, these effects have
  not been consistently shown.
• (protein 1.12g kg/day)
• Diabetes care
  200225431-438, 200225425-430
• 
  Metabolism 1994431481-1487
• 
  
• The previous studies showed that the degree of
  FFM retention during weight loss increases with
  increasing quartiles of protein intake. (protein
  1.4g kg/day)
• 
  Am J Clin Nutr 200683260-274

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Conclusion

• the Participants in RT produced greater weight
  and fat loss and increase in muscular strength
  compared with energy restriction alone.
• Additionally, replacement of some carbohydrate
  for protein further magnified these effects,
  resulting in greatest reductions in weight, fat
  mass, WC, and insulin.
• All treatment had similar improvements in
  glycemic control and CVD risk.

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Long-term effect of a high-protein weight-loss
diet.

• Clifton PM, Keogh JB, Noakes M.
• Am J Clin Nutr. 2008 Jan8723-29.

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Research design and methods
Eligible for participation (n133)
women
Randomization (n119)
LP diet n58
HP diet n61
64 weeks
LP diet n38
HP diet n41
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Research design and methods
Diet intervention
Low protein diet
High protein diet
1333 kcal/day
CHO64 Protein17 Fat20
CHO46 Protein34 Fat20
initial 12 week gt every 4 weeks consult
qualified 2 dietitian 52 week follow up gt 3
monthly intervals consult dietitian 3 days diet
record
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Research design and methods
24hr urine
Measure project In week 0 / 64
Body weight Body composition
Serum lipids Serum insulin Plasma
glucose C-reactive protein Creatinine
Serum homocysteine Iron ferritin folate vitamin
B-12
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Result
CON diet n38
HP diet n41
Participant with diet record (n73)
RHP n27
RLP n46
The prescription for protein in the original
study was 110 g/d. We defined compliance at 80
of this original prescription and found that this
was the top tertile of reported protein intake
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Result
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Result
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Result
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Result
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Result
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Conclusion

• A higher protein intake appears to confer some
  weight-loss benefit after 64 week.
• Overall, cardiovascular disease risk markers
  improved, but protein intake per se did not
  appear to confer any extra benefit.

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Renal function following long-term weight loss in
individuals with abdominal obesity on a very low
carbohydrate diet vs high carbohydrate diet.

• Brinkworth GD, Buckley JD, Noakes M, Clifton PM.
• Journal of the American Dietetic Association
• Volume 110, Issue 4, April 2010, Pages 633638

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Research design and methods
Eligible for participation (n122)
Randomization (n118)
Very-low-carbohydrate, high-fat diet n57
High-carbohydrate, low-fat diet n61
1 year
Very-low-carbohydrate, high-fat diet n33
High-carbohydrate, low-fat diet n35
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Research design and methods
Diet intervention
High-carbohydrate, low-fat diet
Very-low-carbohydrate, high-fat diet
14331672 kcal/day
CHO46 Protein24 Fat30
CHO4 Protein35 Fat61
initial 2 month gt every 2 weeks consult
qualified dietitian follow up gt
monthly intervals consult dietitian 3 days diet
record (2 weekday and 1 weekend day)
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Research design and methods
24hr urine
Measure project In week 0 /52
Serum Creatinine
Body weight Body composition
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Result
MDRD equation (eGFR) (mL/min/1.73
m2)186.3(serum creatinine mg/dL)1.154(age)0.20
3 0.742 (if female). Salazar and Corcoran
equation For men eGFR(mL/min)(137-age)(0.285
weight)(12.1height2)/(51creatinine
concentration) for women eGFR
(mL/min)(146-age)(0.287weight)(9.74height2)/
(60creatinine concentration)
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Discussion

• Chronic consumption of a very-low-carbohydrate
  diet (high protein) may affect kidney function by
  increasing glomerular pressure and
  hyperfiltration that may lead to progressive loss
  of renal function
• 
  Nutr Rev. 200260189-200.
• 
  Obes Rev. 20056235-245.
• In this study, the original hypothesis that a
  very-low-carbohydrate diet would adversely affect
  renal function was not supported.

obesity
time
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Conclusion

• In people with abdominal obesity and normal renal
  function, consumption of a very-low-carbohydrate
  high-fat weight loss diet for 52 week does not
  adversely affect renal function compared with a
  conventional high carbohydrate, low-fat diet.

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  A High-Protein Diet With ResistanceExercise Training Improves Weight Lossand Body Composition in Overweight andObese Patients With Type 2 Diabetes. Long-term effect of a high-protein weight-loss diet. Renal function following long-term weight loss in individuals with abdominal obesity on a very low carbohydrate diet vs high carbohydrate diet.
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  A High-Protein Diet With ResistanceExercise Training Improves Weight Lossand Body Composition in Overweight andObese Patients With Type 2 Diabetes. A High-Protein Diet With ResistanceExercise Training Improves Weight Lossand Body Composition in Overweight andObese Patients With Type 2 Diabetes. Long-term effect of a high-protein weight-loss diet. Long-term effect of a high-protein weight-loss diet. Renal function following long-term weight loss in individuals with abdominal obesity on a very low carbohydrate diet vs high carbohydrate diet. Renal function following long-term weight loss in individuals with abdominal obesity on a very low carbohydrate diet vs high carbohydrate diet.
???? Type 2 DM Obese (BMI35.34.5 kg/m2) Type 2 DM Obese (BMI35.34.5 kg/m2) Obese (BMI35.63.3) Obese (BMI35.63.3) Obese (BMI33.54.4) Obese (BMI33.54.4)
???? 16 week 16 week 64 week 64 week 1 year 1 year
????CHO Protein Fat ???? 43 33 22 ??? 53 19 26 ???? 46 34 20 ??? 64 17 20 ???? 4 35 61 ??? 46 24 30
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  A High-Protein Diet With ResistanceExercise Training Improves Weight Lossand Body Composition in Overweight andObese Patients With Type 2 Diabetes. Long-term effect of a high-protein weight-loss diet. Renal function following long-term weight loss in individuals with abdominal obesity on a very low carbohydrate diet vs high carbohydrate diet.
?? Body weight and composition Cardiometabolic outcome and glycemic control Creatinine clearance and urinary alboumin Peripheral fat Cardiometabolic outcome Urea Vit B12 Ferritin Serum creatinine eGFR
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Thank you for attention