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Effect of the intake of dietary protein on insulin resistance in subjects with obesity: a randomized controlled clinical trial

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Abstract

Purpose

We compared the effect of diets with different amounts and sources of dietary protein on insulin sensitivity (IS) in subjects with obesity and insulin resistance (IR).

Methods

Eighty subjects with obesity (BMI ≥ 30 kg/m2) and IR (Matsuda index < 4.3 and HOMA-IR ≥ 2.5) over 18 years old were randomized to four groups for a one-month period: a normal protein diet (< 20%) with a predominance of animal protein (Animal NP) or vegetable protein (Vegetable NP) and a high-protein diet (25–30%) with a predominance of animal protein (Animal HP) or vegetable protein (Vegetable HP). Baseline and final measurements of body weight, body composition, biochemical parameters, blood pressure (BP), resting energy expenditure and plasma amino acid profiles were performed.

Results

Body weight, BMI and waist circumference decreased in all groups. Interestingly, the IS improved more in the Animal HP (Matsuda index; 1.39 vs 2.58, P = 0.003) and in the Vegetable HP groups (Matsuda index; 1.44 vs 3.14, P < 0.0001) after one month. The fat mass, triglyceride levels, C-reactive protein levels and the leptin/adiponectin index decreased; while, the skeletal muscle mass increased in the Animal and Vegetable HP groups. The BP decreased in all groups except the Animal NP group.

Conclusion

Our study demonstrates that a high-protein hypocaloric diets improves IS by 60–90% after one month in subjects with obesity and IR, regardless of weight loss and the source of protein, either animal or vegetable.

Trial registration

The trial is registered at clinicaltrials.gov (NCT03627104), August 13, 2018.

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Data availability

Data are available upon reasonable request. Data are available upon request to the correspondent author. Open access.

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Acknowledgements

We would like to thank Griselda Puerto-Avila (department secretary) for assistance and support in the billing of the food pantries delivered to the participants and chemist Guillermo Ordaz-Nava, INCMNSZ Mexico City, for all the technical support in this study.

Funding

This study was supported by Consejo Nacional de Ciencia y Tecnología (México) Grant: CONACYT PN- 2016-01-3324.

Author information

Authors and Affiliations

  1. Department of Nutrition Physiology, Instituto Nacional de Ciencias Médicas y Nutrición, Salvador Zubirán, Mexico City, Mexico

    Luis E. González-Salazar, Edgar Pichardo-Ontiveros, Ana Vigil-Martínez, Omar Granados-Portillo, Rocío Guizar-Heredia, Adriana Flores-López, Pamela K. Heredia-G-Cantón, Karla G. Hernández-Gómez, Liliana Arteaga-Sánchez, Lilia G. Noriega-López, Nimbe Torres, Armando R. Tovar & Martha Guevara-Cruz

  2. Scientific Bonding Unit, Medicine Faculty UNAM-INMEGEN, Mexico City, Mexico

    Berenice Palacios-González

  3. Research Methodology Department, Instituto Nacional de Pediatría, Mexico City, Mexico

    Isabel Medina-Vera

  4. Obesity Clinic, Hospital General Tláhuac, Mexico City, Mexico

    Georgina Castelán-Licona & Carlos Zerrweck

  5. Clinical Nutrition Service, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico

    Aurora E. Serralde-Zúñiga

  6. Hospital Regional de Alta Especialidad de la Península de Yucatán, Mérida, Mexico

    Azalia Ávila-Nava

  7. Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional, Mexico City, Mexico

    Juan G. Reyes-García

Authors
  1. Luis E. González-Salazar
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  2. Edgar Pichardo-Ontiveros
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  3. Berenice Palacios-González
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  4. Ana Vigil-Martínez
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  6. Rocío Guizar-Heredia
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  7. Adriana Flores-López
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  14. Azalia Ávila-Nava
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  18. Nimbe Torres
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  19. Armando R. Tovar
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  20. Martha Guevara-Cruz
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Contributions

MGC, ART, LGNL conceived of and designed the study. BPG, AVM, and MGC developed the menus and recipe booklets. LEGS, PKHGC, AVM, MGC, and BPG developed and handled the logistics of the food pantries. LEGS, EPO, AVM, KGHG, LAS, AESZ, GCL, CZL, RGH, and MGC assisted with participant inclusion and follow-up. LEGS, KGHG, PKHGC, AVM, MGC, and AAN determined the biochemical parameters. OGP, RGH, AFL determined the AA concentrations by HPLC. IMV performed the statistical analyses. ART, LEGS, AESZ, BPG, IMV, NT, and MGC completed the data interpretation. ART, LEGS, IMV, JGRG, and MGC wrote the draft manuscript. All authors have seen and approved the final version of the manuscript.

Corresponding authors

Correspondence to Armando R. Tovar or Martha Guevara-Cruz.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethics approval

The study was performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. This protocol was approved by the ethics committee of the Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (reference 2373). Written informed consent was obtained from all patients prior to their inclusion in the study.

Consent to participate

All participants signed the consent statement prior to their inclusion in the study.

Consent for publication

This manuscript is not being simultaneously submitted elsewhere and no portion of the data has been published elsewhere.

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González-Salazar, L.E., Pichardo-Ontiveros, E., Palacios-González, B. et al. Effect of the intake of dietary protein on insulin resistance in subjects with obesity: a randomized controlled clinical trial. Eur J Nutr 60, 2435–2447 (2021). https://doi.org/10.1007/s00394-020-02428-5

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  • DOI: https://doi.org/10.1007/s00394-020-02428-5

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