A randomized controlled trial to evaluate the effects of high P rotein C omplete (l A cto) VE geta R ian (PACER) diet in non-diabetic obese Asian Indians in North India

Abstract

In view of the increasing prevalence of obesity in largely vegetarian Asian Indians, it is important to research a high protein, low carbohydrate vegetarian diet. The present study was designed to evaluate the effects of a "High Protein Complete (lacto) VEgetaRian Diet (Acronym; 'PACER diet'), on weight, body composition and metabolic profiles in non-diabetic obese Asian Indians living in north India. In this 8-week randomized control trial, 102 vegetarian subjects with body mass index (BMI) >25 kg/m² were randomized to either a test diet (PACER diet; high protein, high fat and moderately low carbohydrate, lacto-vegetarian diet) or control diet (standard vegetarian diet formulated as the dietary guidelines for Asian Indians) after 4 weeks of diet and exercise run-in period. A standard exercise protocol was followed for both groups. Body weight, BMI, waist circumference (WC), blood pressure, fasting plasma glucose (FPG), fasting serum insulin and lipid profile were assessed before and after the intervention. There was significant weight loss along with improvements in cardio-metabolic risk factors among both the groups post intervention. Percent reductions in the intervention group for weight (6.1± 2.9; p < 0.001), WC (3.9 ± 1.7; p < 0.001), FPG (5.9 ± 3.2; p < 0.001), total cholesterol (10.2 ± 6.3: p < 0.001), serum triacylglycerol (13.6 ± 10.6; p < 0.001) and low-density lipoprotein cholesterol (11.9 ± 7.1; p < 0.001]) were significantly greater than the control diet group. In summary, intervention with a PACER diet (high protein, high fat and moderately low carbohydrate, lacto-vegetarian diet) showed significant improvement in weight loss, body composition and cardio-metabolic profile as compared to a standard vegetarian diet among obese Asian Indians in north India.

Keywords: Nutrition.

Fig. 1

Flow chart of the study design, explaining the subject enrollment process. ^§Investigations: anthropometry (weight, waist circumference, hip circumference, mid upper arm circumference), biochemical investigations (fasting plasma glucose, serum insulin, lipid profile), DEXA scan, 24 hour dietary recall; ^*lost to follow-up in control group; shift based job (n = 2), relocation (n = 1); ^#lost to follow-up in intervention group; relocation (n = 1), lost interest in the study (n = 1).

Fig. 2

Changes in outcome variables between intervention and control group after 8 week intervention. Intervention group, participants following high Protein Complete (lacto) VEgetaRian diet (PACER diet); Control group, participants following standard diet. Values represent mean unit change (reduction) ± SD. BMI, body mass index; DBP, diastolic blood pressure; FPG, fasting plasma glucose; HC, hip circumference; HDL-c, high density lipoprotein-cholesterol; LDL-c, low density lipoprotein-cholesterol; MUAC, mid upper arm circumference; SBP, systolic blood pressure; TC, total cholesterol; TAG, serum triacylglycerol; VLDL-c, very low density lipoprotein-cholesterol; WC: waist circumference.