Effect of a high protein/low glycaemic index diet on insulin resistance in adolescents with overweight/obesity-A PREVIEW randomized clinical trial.


Journal

Pediatric obesity
ISSN: 2047-6310
Titre abrégé: Pediatr Obes
Pays: England
ID NLM: 101572033

Informations de publication

Date de publication:
01 2021
Historique:
received: 19 07 2019
revised: 10 06 2020
accepted: 20 06 2020
pubmed: 19 7 2020
medline: 21 5 2021
entrez: 19 7 2020
Statut: ppublish

Résumé

Pubertal insulin resistance (IR) is associated with increased risk of type 2 diabetes mellitus development in adolescents with overweight/obesity. The PREVIEW study was a randomized parallel trial assessing the change in IR, analyzed by Homeostatic Model Assessment of IR (HOMA-IR), at 2 years after randomization to a high protein vs a moderate protein diet in adolescents with overweight/obesity. It was hypothesized that a high protein/low glycaemic index diet would be superior in reducing IR compared to a medium protein/medium GI diet, in insulin resistant adolescents with overweight or obesity. Adolescents with overweight/obesity and IR from the Netherlands, United Kingdom and Spain were randomized into a moderate protein/moderate GI (15/55/30En% protein/carbohydrate/fat, GI ≥ 56) or high protein/low GI (25/45/30En% protein/carbohydrate/fat, GI < 50) diet. Anthropometric and cardiometabolic parameters, puberty, dietary intake and physical activity (PA) were measured and effects on HOMA-IR were analyzed. 126 adolescents were included in this study (13.6 ± 2.2 years, BMI z-score 3.04 ± 0.66, HOMA-IR 3.48 ± 2.28, HP n = 68, MP n = 58). At 2 years, changes in protein intake were not significantly different between timepoints or intervention groups and no effects of the intervention on IR were observed. The retention rate was 39%, while no compliance to the diets was observed. The PREVIEW study observed no effect of a high protein/low GI diet on IR in adolescents with overweight/obesity and IR because of lack of feasibility, due to insufficient retention and dietary compliance after 2 years.

Sections du résumé

BACKGROUND
Pubertal insulin resistance (IR) is associated with increased risk of type 2 diabetes mellitus development in adolescents with overweight/obesity.
OBJECTIVES
The PREVIEW study was a randomized parallel trial assessing the change in IR, analyzed by Homeostatic Model Assessment of IR (HOMA-IR), at 2 years after randomization to a high protein vs a moderate protein diet in adolescents with overweight/obesity. It was hypothesized that a high protein/low glycaemic index diet would be superior in reducing IR compared to a medium protein/medium GI diet, in insulin resistant adolescents with overweight or obesity.
METHODS
Adolescents with overweight/obesity and IR from the Netherlands, United Kingdom and Spain were randomized into a moderate protein/moderate GI (15/55/30En% protein/carbohydrate/fat, GI ≥ 56) or high protein/low GI (25/45/30En% protein/carbohydrate/fat, GI < 50) diet. Anthropometric and cardiometabolic parameters, puberty, dietary intake and physical activity (PA) were measured and effects on HOMA-IR were analyzed.
RESULTS
126 adolescents were included in this study (13.6 ± 2.2 years, BMI z-score 3.04 ± 0.66, HOMA-IR 3.48 ± 2.28, HP n = 68, MP n = 58). At 2 years, changes in protein intake were not significantly different between timepoints or intervention groups and no effects of the intervention on IR were observed. The retention rate was 39%, while no compliance to the diets was observed.
CONCLUSIONS
The PREVIEW study observed no effect of a high protein/low GI diet on IR in adolescents with overweight/obesity and IR because of lack of feasibility, due to insufficient retention and dietary compliance after 2 years.

Identifiants

pubmed: 32681547
doi: 10.1111/ijpo.12702
pmc: PMC7757177
doi:

Types de publication

Journal Article Multicenter Study Randomized Controlled Trial Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

e12702

Informations de copyright

© 2020 The Authors. Pediatric Obesity published by John Wiley & Sons Ltd on behalf of World Obesity Federation.

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Auteurs

Elke Dorenbos (E)

NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands.
Centre for Overweight Adolescent and Children's Healthcare (COACH), Maastricht University Medical Centre, Maastricht, The Netherlands.

Mathijs Drummen (M)

NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands.

Tanja Adam (T)

NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands.

Jesse Rijks (J)

Centre for Overweight Adolescent and Children's Healthcare (COACH), Maastricht University Medical Centre, Maastricht, The Netherlands.

Bjorn Winkens (B)

Department of Methodology and Statistics, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands.

J Alfredo Martínez (JA)

Department of Nutrition, Food Science and Physiology, Centre for Nutrition Research (CIN), Universidad de Navarra, Pamplona, Spain.
CIBERobn, Instituto de Salud Carlos III, Madrid, Spain.
IMDEA Research Institute on Food and Health Sciences, Madrid, Spain.

Santiago Navas-Carretero (S)

Department of Nutrition, Food Science and Physiology, Centre for Nutrition Research (CIN), Universidad de Navarra, Pamplona, Spain.
CIBERobn, Instituto de Salud Carlos III, Madrid, Spain.

Gareth Stratton (G)

Research Centre in Applied Sports, Technology, Exercise and Medicine (A-STEM), Swansea University, Swansea, UK.

Nils Swindell (N)

Research Centre in Applied Sports, Technology, Exercise and Medicine (A-STEM), Swansea University, Swansea, UK.

Pauline Stouthart (P)

Centre for Overweight Adolescent and Children's Healthcare (COACH), Maastricht University Medical Centre, Maastricht, The Netherlands.

Kelly Mackintosh (K)

Research Centre in Applied Sports, Technology, Exercise and Medicine (A-STEM), Swansea University, Swansea, UK.

Melitta Mcnarry (M)

Research Centre in Applied Sports, Technology, Exercise and Medicine (A-STEM), Swansea University, Swansea, UK.

Angelo Tremblay (A)

Department of Kinesiology, Université Laval, Québec, Canada.

Mikael Fogelholm (M)

Department of Food and Nutrition, University of Helsinki, Helsinki, Finland.

Anne Raben (A)

Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Frederiksberg, Denmark.

Margriet Westerterp-Plantenga (M)

NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands.

Anita Vreugdenhil (A)

NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands.
Centre for Overweight Adolescent and Children's Healthcare (COACH), Maastricht University Medical Centre, Maastricht, The Netherlands.

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