Abstract
BackgroundAlthough higher-protein diets (HP) can assist with weight loss and glycemic control, their effect on psychological wellbeing has not been established. The objective of this study was to compare the effects of a HP and a higher-carbohydrate diet (HC), combined with regular exercise, on psychological wellbeing both during weight loss (WL) and weight maintenance phases (WM).MethodsIn a parallel RCT, 61 adults with T2D (mean ± SD: BMI 34.3 ± 5.1 kg/m2, aged 55 ± 8 years) consumed a HP diet (29% protein, 34% carbohydrate, 31% fat) or an isocaloric HC diet (21%:48%:24%), with moderate intensity exercise, for 12 weeks of WL and 12 weeks of WM. Secondary data evaluating psychological wellbeing was assessed using: Problems Areas in Diabetes (PAID); Diabetes-39 Quality of Life (D-39); Short Form Health Survey (SF-36); Perceived Stress Scale-10 (PSS-10) and the Leeds Sleep Evaluation Questionnaire (LSEQ) at Weeks 0, 12 and 24 and evaluated with mixed models analysis.ResultsIndependent of diet, improvements for PAID; D-39 diabetes control; D-39 severity of diabetes; SF-36 physical functioning and SF-36 general health were found following WL (d = 0.30 to 0.69, P ≤ 0.04 for all) which remained after 12 weeks of WM. SF-36 vitality improved more in the HP group (group x time interaction P = 0.03). Associations were seen between HbA1c and D-39 severity of diabetes rating (r = 0.30, P = 0.01) and SF-36 mental health (r = − 0.32, P = 0.003) and between weight loss and PAID (r = 0.30, P = 0.01).ConclusionSeveral improvements in diabetes-related and general psychological wellbeing were seen similarly for both diets following weight loss and a reduction in HbA1c with most of these improvements remaining when weight loss was sustained for 12 weeks. A HP diet may provide additional increases in vitality.Trial registrationThe trial was prospectively registered with the Australian New Zealand Clinical Trials Registry (ACTRN 12613000008729) on 4 January 2013.
Highlights
Higher-protein diets (HP) can assist with weight loss and glycemic control, their effect on psychological wellbeing has not been established
To expand the current literature, the objective of this study was to compare the effects of isocaloric higher-protein diets (HP) and higher-carbohydrate diet (HC) diets, combined with regular moderate intensity exercise, on psychological wellbeing and health related quality of life (QoL) (HRQoL) outcomes in overweight and obese adults with type 2 diabetes (T2D) during a 12-week active weight loss phase followed by a 12-week weight maintenance phase where weight was stabilised
Positive associations were seen between body mass and Problems Areas in Diabetes (PAID) (r = 0.30, P = 0.01) and Leeds Sleep Evaluation Questionnaire (LSEQ)-quality of sleep (QOS) (r = 0.28, P = 0.01). In this randomized controlled trial of overweight and obese adults with T2D, similar improvements occurred in general physical aspects of health as well as diabetes-specific emotional distress and QoL after consuming either a hypocaloric HP diet or HC diet combined with exercise training
Summary
Higher-protein diets (HP) can assist with weight loss and glycemic control, their effect on psychological wellbeing has not been established. The fear of developing complications, the social and financial impact of managing their condition, and the burden placed on family members have been reported to underpin the majority of psychological problems [4]. These adverse psychological issues may lead to inadequate self-care, poor dietary intake, reduced physical activity, non-compliance with medications and less vigilance with blood glucose monitoring [6], contributing to poorer long-term health outcomes
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