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. 2016 Oct 26;4(1):e000258.
doi: 10.1136/bmjdrc-2016-000258. eCollection 2016.

Remission of pre-diabetes to normal glucose tolerance in obese adults with high protein versus high carbohydrate diet: randomized control trial

Frankie B Stentz  1 , Amy Brewer  1 , Jim Wan  2 , Channing Garber  1 , Blake Daniels  1 , Chris Sands  1 , Abbas E Kitabchi  1
Affiliations

Remission of pre-diabetes to normal glucose tolerance in obese adults with high protein versus high carbohydrate diet: randomized control trial

Frankie B Stentz et al. BMJ Open Diabetes Res Care. .

Abstract

Objective: Remission of pre-diabetes to normal is an important health concern which has had little success in the past. This study objective was to determine the effect on remission of pre-diabetes with a high protein (HP) versus high carbohydrate (HC) diet and effects on metabolic parameters, lean and fat body mass in prediabetic, obese subjects after 6 months of dietary intervention.

Research design and methods: We recruited and randomized 24 pre-diabetes women and men to either a HP (30% protein, 30% fat, 40% carbohydrate; n=12) or HC (15% protein, 30% fat, 55% carbohydrate; n=12) diet feeding study for 6 months in this randomized controlled trial. All meals were provided to subjects for 6 months with daily food menus for HP or HC compliance with weekly food pick-up and weight measurements. At baseline and after 6 months on the respective diets oral glucose tolerance and meal tolerance tests were performed with glucose and insulin measurements and dual energy X-ray absorptiometry scans.

Results: After 6 months on the HP diet, 100% of the subjects had remission of their pre-diabetes to normal glucose tolerance, whereas only 33.3% of subjects on the HC diet had remission of their pre-diabetes. The HP diet group exhibited significant improvement in (1) insulin sensitivity (p=0.001), (2) cardiovascular risk factors (p=0.04), (3) inflammatory cytokines (p=0.001), (4) oxidative stress (p=0.001), (5) increased percent lean body mass (p=0.001) compared with the HC diet at 6 months.

Conclusions: This is the first dietary intervention feeding study, to the best of our knowledge, to report 100% remission of pre-diabetes with a HP diet and significant improvement in metabolic parameters and anti-inflammatory effects compared with a HC diet at 6 months.

Trial registration number: NCT0164284.

Keywords: Cardiovascular Risk Factors; Dietary Intervention; Insulin Sensitivity; Pre-Diabetes.

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Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1
Figure 1
Shows the recruiting and screening of subjects for the participants in the study. HC, high carbohydrate; HP, high protein.
Figure 2
Figure 2
The figure shows the mean±SD of glucose and insulin for the 2-hour OGTTs and MTTs for the 12 HP diet subjects and the 12 HC diets subjects. The symbols represent the following: formula image HP diet baseline (HP_Bl); formula image HP diet at 6 months (HP_6 m); formula image HC diet baseline (HC_Bl); and formula image HC diet at 6 months (HC_6 m). p Values for the glucose AUC for the OGTTs are: HP_Bl versus HP_6 m=0.0005; HC_Bl versus HC_6 m=0.005; HP_6 m versus HC_6 m=0.0001. p Values for the insulin AUC for the OGTTs are: HP_Bl versus HP_6 m=0.0001; HC_Bl versus HC_6 m=0.005; HP_6 m versus HC_6 m=0.0001. p values for the glucose AUC for the MTTs are: HP_Bl versus HP_6 m=0.0005; HC_Bl versus HC_6 m=0.005; HP_Bl versus HC_Bl=0.01; HP_6 m versus HC_6 m=0.0001. p values for the insulin AUC for the MTTs are: HP_Bl versus HP_6 m=0.001; HC_Bl versus HC_6 m=0.01; HP_Bl versus HC_Bl=0.001; HP_6 m versus HC_6 m=0.0001. AUC, area under the curve; HC, high carbohydrate; HP, high protein; OGTT, oral glucose tolerance test.
Figure 3
Figure 3
The figure shows the effect of the HP and HC diets on percent changes in lean body mass and fat body mass at 6 months on the diets. HC, high carbohydrate; HP, high protein.
See this image and copyright information in PMC

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