Dietary protein and the glycemic index handle insulin resistance within a nutritional program for avoiding weight regain after energy-restricted induced weight loss

Fernando Vidal-Ostos, Omar Ramos-Lopez, Susan A Jebb, Angeliki Papadaki, Andreas F H Pfeiffer, Teodora Handjieva-Darlenska, Marie Kunešová, Ellen E Blaak, Arne Astrup, J Alfredo Martinez, Diet, Obesity, and Genes (Diogenes) Project, Fernando Vidal-Ostos, Omar Ramos-Lopez, Susan A Jebb, Angeliki Papadaki, Andreas F H Pfeiffer, Teodora Handjieva-Darlenska, Marie Kunešová, Ellen E Blaak, Arne Astrup, J Alfredo Martinez, Diet, Obesity, and Genes (Diogenes) Project

Abstract

Background and aim: The role of dietary protein and glycemic index on insulin resistance (based on TyG index) within a nutritional program for weight loss and weight maintenance was examined.

Methods: This study analyzed 744 adults with overweight/obesity within the DIOGenes project. Patients who lost at least 8% of their initial weight (0-8 weeks) after a low-calorie diet (LCD) were randomly assigned to one of five ad libitum diets designed for weight maintenance (8-34 weeks): high/low protein (HP/LP) and high/low glycemic index (HGI/LGI), plus a control. The complete nutritional program (0-34 weeks) included both LCD plus the randomized diets intervention. The TyG index was tested as marker of body mass composition and insulin resistance.

Results: In comparison with the LP/HGI diet, the HP/LGI diet induced a greater BMI loss (p < 0.05). ∆TyG was positively associated with resistance to BMI loss (β = 0.343, p = 0.042) during the weight maintenance stage. In patients who followed the HP/LGI diet, TyG (after LCD) correlated with greater BMI loss in the 8-34 weeks period (r = -0.256; p < 0.05) and during the 0-34 weeks intervention (r = -0.222, p < 0.05) periods. ΔTyG1 value was associated with ΔBMI2 (β = 0.932; p = 0.045) concerning the HP/LGI diet.

Conclusions: A HP/LGI diet is beneficial not only for weight maintenance after a LCD, but is also related to IR amelioration as assessed by TyG index changes. Registration Clinical Trials NCT00390637.

Keywords: Glycemic index; Insulin resistance; Metabolic improvement; Precision nutrition; Protein diet; TyG index.

Conflict of interest statement

The authors have nothing to disclose.

© 2022. The Author(s).

Figures

Fig. 1
Fig. 1
Flow chart and design concerning the participants enrolled in the current nutritional intervention
Fig. 2
Fig. 2
Change in TyG index after LCD and modifications in BMI (kg/m2) for each type of randomized diet, A Change in BMI (kg/m2) corresponding to the complete nutritional intervention, (period 3, 0–34 weeks); B Change in BMI (kg/m2) concerning the maintenance nutritional intervention, (period 2, 8–34 weeks). Results shown are based on ITT analysis. Types of diets: Control (healthy diet), LP/LGI (low protein, low glycemic index diet), LP/HGI (low protein, high glycemic index diet), HP/LGI (high protein, low glycemic index diet), HP/HGI (high protein, high glycemic index diet). Only significant differences were obtained between Low Protein/High Glycemic Index and High Protein/Low Glycemic Index (HP/LGI) diet (p = 0.015). Period 3: Corresponds to the differences between baseline and final parameters, encompassing the complete nutritional period (during 34 weeks); Period 2: Corresponds to the differences between the parameters after the low-calorie diet intervention (8 weeks) and after the nutritional treatment focused on weight maintenance for each type of randomized diet (8–34 weeks)

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