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Randomized Controlled Trial
. 2021 Apr:42:82-89.
doi: 10.1016/j.clnesp.2020.12.028. Epub 2021 Feb 11.

One-month of a low-energy diet, with no additional effect of high-protein, reduces Obstructive Sleep Apnea severity and improve metabolic parameters in obese males

Camila Maria de Melo  1 , Marcus Vinicius Lúcio Dos Santos Quaresma  2 , Mariana Pantaleão Del Re  3 , Sandra Maria Lima Ribeiro  4 , Hanna Karen Moreira Antunes  5 , Sonia M Togeiro  3 , Sergio Tufik  3 , Marco Túlio de Mello  6
Affiliations
Randomized Controlled Trial

One-month of a low-energy diet, with no additional effect of high-protein, reduces Obstructive Sleep Apnea severity and improve metabolic parameters in obese males

Camila Maria de Melo et al. Clin Nutr ESPEN. 2021 Apr.

Abstract

Purpose: Obstructive Sleep Apnea (OSA) is closely associated with obesity. Weight loss ameliorates OSA and its associated metabolic disorders. A high protein intake may improve weight loss through increased energy expenditure, and fat-free mass maintenance during weight loss.

Objectives: To evaluate the effects of a low-energy, high-protein diet on OSA severity and metabolic parameters in obese men.

Methods: Forty-five OSA obese (BMI ≥ 30 kg/m2) males were included in this randomized study and submitted to nocturnal polysomnography, body composition measured by plethysmography, biochemical analyses of blood glucose, insulin and lipids, and food intake evaluations before and after one month of a low-energy diet. Diets were designed to create a 30% deficit in total energy expenditure with 1.6 g of protein/kg/day (High Protein group - HP) or 0.8 g of protein/kg/day (Low Protein group - LP).

Results: Only a time effect of the intervention was observed in body mass (-3.7 ± 2.0% for the LP group and -4.0 ± 1.5% for the HP group; p < 0.001), Body Mass Index (p < 0.001), fat mass in kg (p < 0.01) and fat-free mass in kg (p < 0.01). Significant improvements in Apnea Hypopnea Index were observed in both groups (54.0 ± 25.0 to 33.7 ± 31.7 in LP group; 39.7 ± 24.3 to 21.4 ± 25.9 in HP group; p = 0.06). Improvements of 38% and 46% in the Apnea-Hypopnea Index were observed in the LP and HP groups, respectively. Both interventions provided equivalent metabolic benefits as reductions in glucose (p < 0.001), insulin (p < 0.001), HOMA-IR (p = 0.005), triglycerides (p = 0.002), and in total cholesterol (p = 0.004).

Conclusion: One month of a low-energy diet resulted in significant improvements in OSA severity in obese men. Increased protein intake during a short period of low-energy diet had no further beneficial effects on OSA severity or biochemical parameters than a standard protein diet. Registered under ClinicalTrials.gov Identifier no. NCT01985035.

Keywords: Energy restriction; Protein; Sleep apnea; Weight loss.

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Conflict of interest statement

Declaration of competing interest None of the authors have conflicts of interest to disclose and do not have any financial relationship with a commercial entity that has an interest in the subject of this manuscript.

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