Abstract

Significant reductions in insulin resistance (IR) can be achieved by either calorie restriction or by the increase of lean mass. However, calorie restriction usually results in significant loss of lean mass. A 6-week randomized controlled feeding trial was conducted to determine if a calorie-restricted, high-protein diet (~125 g protein/day consumed evenly throughout the day) using novel functional foods would be more successful for reducing IR in comparison to a conventional diet (~80 g protein/day) with a similar level of calorie restriction. Healthy adults (age 20–75 years; body mass index, 20–42 kg/m2) with raised triglyceride/high-density lipoprotein ratios were randomly assigned to the control group (CON: test foods prepared using gluten-free commercial pasta and cereal) or to the high-protein group (HPR: test foods prepared using novel high-protein pasta and cereal both rich in wheat gluten). Mean weight loss did not differ between groups (−2.7 ± 2.6 and −3.2 ± 3.0 kg for CON (n = 11) and HPR (n = 10) respectively, p = 0.801); however, the 6-week change in fat-free mass (FFM) differed significantly between groups (−0.5 ± 1.5 and +1.5 ± 3.8 kg for CON and HPR respectively, p = 0.008). IR improved in HPR vs. CON participants (homeostasis model assessment-estimated insulin resistance [HOMAIR] change: −1.7 ± 1.4 and −0.7 ± 0.7 respectively; p = 0.020). The change in HOMA-IR was related to the change in FFM among participants (r = −0.511, p = 0.021). Thus, a high-protein diet using novel functional foods combined with modest calorie restriction was 140% more effective for reducing HOMA-IR in healthy adults compared to a lower protein, standard diet with an equal level of calorie restriction.

Highlights

  • Insulin resistance (IR) is characterized by the decreased ability of insulin to exert its metabolic actions on target cells

  • These latter participants withdrew from the trial during weeks 0–3 due to time conflicts and/or a waning desire to consume the study test foods each day

  • Using intention-to-treat calculations, the 6-week weight loss for all participants randomized to a treatment group did not differ significantly between groups

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Summary

Introduction

Insulin resistance (IR) is characterized by the decreased ability of insulin to exert its metabolic actions on target cells. Significant reductions in IR can be achieved by calorie restriction and/or exercise [4,5]. Strict calorie restriction (1100 calories per day) reduced IR in obese patients with or without type 2 diabetes by approximately 30% after only four days before any substantial weight loss had taken place [6]. Only reduced carbohydrate intake was significantly associated with reductions in fasting glucose concentrations in this trial suggesting an immediate physiological response to dietary carbohydrate restriction. A recent study in individuals with type 2 diabetes demonstrated that 12 weeks of significant calorie restriction (1450 calories per day) and enhanced exercise reduced IR by nearly 40% regardless of the Nutrients 2017, 9, 1182; doi:10.3390/nu9111182 www.mdpi.com/journal/nutrients

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