Effect of a high protein/low glycaemic index diet on insulin resistance in adolescents with overweight/obesity-APREVIEWrandomized clinical trial

Elke Dorenbos, Mathijs Drummen, Tanja Adam, Jesse Rijks, Bjorn Winkens, J. Alfredo Martinez, Santiago Navas-Carretero, Gareth Stratton, Nils Swindell, Pauline Stouthart, Kelly Mackintosh, Melitta Mcnarry, Angelo Tremblay, Mikael Fogelholm, Anne Raben, Margriet Westerterp-Plantenga, Anita Vreugdenhil*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

2 Citations (Web of Science)

Abstract

Background Pubertal insulin resistance (IR) is associated with increased risk of type 2 diabetes mellitus development in adolescents with overweight/obesity. Objectives The PREVIEW study was a randomized parallel trial assessing the change in IR, analyzed by Homeostatic Model Assessment of IR (HOMA-IR), at 2 years after randomization to a high protein vs a moderate protein diet in adolescents with overweight/obesity. It was hypothesized that a high protein/low glycaemic index diet would be superior in reducing IR compared to a medium protein/medium GI diet, in insulin resistant adolescents with overweight or obesity. Methods Adolescents with overweight/obesity and IR from the Netherlands, United Kingdom and Spain were randomized into a moderate protein/moderate GI (15/55/30En% protein/carbohydrate/fat, GI >= 56) or high protein/low GI (25/45/30En% protein/carbohydrate/fat, GI <50) diet. Anthropometric and cardiometabolic parameters, puberty, dietary intake and physical activity (PA) were measured and effects on HOMA-IR were analyzed. Results 126 adolescents were included in this study (13.6 +/- 2.2 years, BMI z-score 3.04 +/- 0.66, HOMA-IR 3.48 +/- 2.28, HP n = 68, MP n = 58). At 2 years, changes in protein intake were not significantly different between timepoints or intervention groups and no effects of the intervention on IR were observed. The retention rate was 39%, while no compliance to the diets was observed. Conclusions The PREVIEW study observed no effect of a high protein/low GI diet on IR in adolescents with overweight/obesity and IR because of lack of feasibility, due to insufficient retention and dietary compliance after 2 years.

Original languageEnglish
Article numbere12702
Number of pages8
JournalPediatric Obesity
Volume16
Issue number1
Early online date17 Jul 2020
DOIs
Publication statusPublished - Jan 2021

Keywords

  • dietary protein
  • glycaemic index
  • glycaemic load
  • physical activity
  • pubertal insulin resistance
  • BODY-COMPOSITION
  • PHYSICAL-ACTIVITY
  • OBESE CHILDREN
  • WEIGHT-LOSS
  • PUBERTAL CHANGES
  • SENSITIVITY
  • INTERVENTION
  • GLUCOSE
  • YOUTH
  • QUESTIONNAIRE

Cite this