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PROTEIN AND DIABETES & WEIGHT LOSS

This section outlines some of the key findings regarding the relationship between protein, insulin resistance, diabetes and weight loss. 

 

Higher protein intake has been associated with:

a. greater feelings of fullness

b. no difference in feelings of fullness

c. no effect on feelings of fullness in people who already eat relatively high amounts of protein

d. reduced-calorie intake

e. weight loss

f. no weight loss

 

However, high protein intake has also been associated with:

g. increased insulin levels

h. increased risk of type 2 diabetes

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PRACTICAL IMPLICATIONS:

  1. Increasing protein intake may contribute to weight loss by reducing calorie intake because of increased feelings of fullness. 

  2. Long-term high protein intake may raise insulin levels, increasing the risk of type 2 diabetes.

 

REFERENCES

a. Higher protein intake has been associated with greater feelings of fullness

  • Astbury, N. M., Stevenson, E. J., Morris, P., Taylor, M. A., & Macdonald, I. A. (2010). Doseeresponse effect of a whey protein preload on within-day energy intake in lean subjects. British Journal of Nutrition, 104(12), 1858. 

  • Bertenshaw, E. J., Lluch, A., & Yeomans, M. R. (2009). Dose- dependent effects of beverage protein content upon short-term intake. Appetite, 52(3), 580e587. 

  • Barkeling B, Rossner S, Bjorvell H: Effects of a high protein meal and a high carbohydrate meal on satiety measured by automated computerized monitoring of subsequent food intake, motivation to eat and food preferences. Int J Obes 14:743–751, 1990. 

  • De Graaf C, Hulshof T, Weststrate JA, Jas P: Short term effects of different amounts of protein, fats and carbohydrate on satiety. Am J Clin Nutr 55:33–38, 1992. 

  • Fischer, K., Colombani, P. C., & Wenk, C. (2004). Metabolic and cognitive coefficients in the development of hunger sensations after pure macronutrient ingestion in the morning. Appetite, 42(1), 49e61. 

  • Geliebter A: Effects of equicaloric loads of protein, fat, and carbohydrate on food intake in the rat and man. Physiol Behav 22:267–273, 1979. 

  • Hill AJ, Blundell JE: Macronutrients and satiety; The effects of a high protein or high carbohydrate meal on subjective motivation to eat and food preferences. Nutr Behav 3:133–144, 1986. 

  • Holt SHA, Brand Miller JC, Petocz P, Farmakalidis E: A satiety index of common foods. Euro J Clin Nutr 49:675–690, 1995.

  • Johnson J, Vickers Z: Effects of flavour and macronutrient composition of food servings on liking, hunger and subsequent intake. Appetite 21:25–39, 1993.

  • Johnstone AM, Stubbs RJ, Harbron CG: Effect of overfeeding macronutrients on day to day food intake in man. Euro J Clin Nutr 50:418–430, 1996.

  • Poppitt SD, McCormack D, Buffenstein R: Short term effects of macronutrient preloads on appetite and energy intake in lean women. Physiol Behav 64:279–285, 1998.

  • Porrini M, Crovetti R, Testolin G: Evaluation of satiety sensations and food intake after different preloads. Appetite 25:17–30, 1995. 

  • Rolls BJ, Hetherington M, Burley VJ: The specificity of satiety: The influence of foods of different macronutrient content on the development of satiety.Physiol Behav 43:145–153, 1988.

  • Stubbs RJ, Van Wyk MCW, Johnstone AM, Harbron CG: Breakfasts high in protein, fat or carbohydrate: effect on within-day appetite and energy balance. Euro J Clin Nutr 50:409–417, 1996. 

  • Stubbs RJ, O’Reilly LM, Johnstone AM, Harrison CLS, Clark H, Franklin MF: Description and evaluation of an experimental model to examine changes in selection between high protein, high carbohydrate and high-fat foods in humans. Euro J Clin Nutr 53:13–21, 1999. 

  • Teff, K. L., Young, S. N., & Blundell, J. E. (1989). The effect of protein or carbohydrate breakfasts on subsequent plasma amino acid levels, satiety and nutrient selection in normal males. Pharmacology Biochemistry and Behavior, 34(4), 829e837. 

  • Vanderwater K, Vickers Z: Higher protein foods produce greater sensory specific satiety. Physiol Behav 59:579–583, 1996. 

  • Westerterp-Plantenga MS, Rolland V, Wilson SAJ, Westerterp KR: Satiety related to 24 h diet-induced thermogenesis during high protein/carbohydrate vs high fat diets measured in a respiration chamber. Eur J Clin Nutr 53:495–502, 1999. 

 

b. Higher protein intake has been associated with no difference in feelings of fullness

  • Barkeling B, Rossner S, Bjorvell H: Effects of a high protein meal and a high carbohydrate meal on satiety measured by automated computerized monitoring of subsequent food intake, motivation to eat and food preferences. Int J Obes 14:743–751, 1990. 

  • De Graaf C, Hulshof T, Weststrate JA, Jas P: Short term effects of different amounts of protein, fats and carbohydrate on satiety. Am J Clin Nutr 55:33–38, 1992. 

  • Geliebter A: Effects of equicaloric loads of protein, fat, and carbohydrate on food intake in the rat and man. Physiol Behav 22:267–273, 1979. 

 

c. People who normally eat relatively high amounts of protein have reported relatively feelings of fullness

  • Long SJ, Jeffcoat AR, Millward DJ: Effect of habitual dietary protein intake on appetite and satiety. Appetite 35:79–88, 2000. 

 

d. Higher protein intake has been associated with reduced calorie intake

  • Johnson J, Vickers Z: Effects of flavor and macronutrient composition of food servings on liking, hunger and subsequent intake. Appetite 21:25–39, 1993.

  • Poppitt SD, McCormack D, Buffenstein R: Short term effects of macronutrient preloads on appetite and energy intake in lean women. Physiol Behav 64:279–285, 1998.

  • Porrini M, Crovetti R, Testolin G: Evaluation of satiety sensations and food intake after different preloads. Appetite 25:17–30, 1995. Porrini M, Santangelo A, Crovetti R, Riso P, Testolin G,

  • Blundell JE: Weight, protein, fat and timing of preloads affect food intake. Physiol Behav 62:563–570, 1997. 

  • Rolls BJ, Hetherington M, Burley VJ: The specificity of satiety: The influence of foods of different macronutrient content on the development of satiety. Physiol Behav 43:145–153, 1988.

  • Araya H, Hills J, Alvina M, Vera G: Short-term satiety in preschool children: a comparison between high protein meal and a high complex carbohydrate meal. Int J Food Sci Nutr 51:119–124, 2000.
    0.05). 

  • Barkeling B, Rossner S, Bjorvell H: Effects of a high protein meal and a high carbohydrate meal on satiety measured by automated computerized monitoring of subsequent food intake, motivation to eat and food preferences. Int J Obes 14:743–751, 1990. 

  • Ludwig DS, Majzoub JA, Al-Zahrani A, Dallal GE, Blanco I, Roberts SB: High glycemic index foods, overeating and obesity. Pediatrics 103:E261–266, 1999. 

  • Booth DA, Chase A, Cambell AT: Relative effectiveness of protein in the late stages of appetite suppression in man. Physiol Behav 5:1299–1302, 1970. 

  • De Graaf C, Hulshof T, Weststrate JA, Jas P: Short term effects of different amounts of protein, fats and carbohydrate on satiety. Am J Clin Nutr 55:33–38, 1992. 

  • Geliebter A: Effects of equicaloric loads of protein, fat, and car- bohydrate on food intake in the rat and man. Physiol Behav 22:267–273, 1979. 

  • Johnstone AM, Stubbs RJ, Harbron CG: Effect of overfeeding macronutrients on day to day food intake in man. Euro J Clin Nutr 50:418–430, 1996.

 

e. Higher protein intake has been associated with weight loss

  • Baba NH, Sawaya S, Torbay N, Habbal Z, Azar S, Hashim SA: High protein vs high carbohydrate hypoenergetic diet for the treatment of obese hyperinsulinemic subjects. Int J Obes 23:1202– 1206, 1999. 

  • Brehm BJ, Seeley RJ, Daniels SR, D’Alessio DA: A randomized trial comparing a very low carbohydrate diet and a calorie re- stricted low fat diet on body weight and cardiovascular risk factors in healthy women. J Clin Endocrinol Metab 88:1617–1623, 2003. 

  • Foster GD, Wyatt HR, Hill JO, McGuckin BG, Brill C, Moham- med S: A randomized trial of a low-carbohydrate diet. N Eng J Med 348:2082–2090, 2003. 

  • Samaha FF, Iqbal N, Seshadri P, Chicano KL, Daily D, Mcgrory J: A low carbohydrate as compared with a low fat diet in severe obesity. N Eng J Med 348:2074–2081, 2003.

  • Skov AR, Toubro S, Ronn B, Holm L, Astrup A: Randomized trial on protein vs carbohydrate in ad libitum fat reduced diet for the treatment of obesity. Int J Obes 23:528–536, 1999. 

  • Worthington BS, Taylor LE: Balanced low calorie vs high protein, low carbohydrate reducing diets. J Am Diet Assoc 64:47–51, 1974. 

  • Yancy Jr WS, Olsen MK, Guyton JR, Bakst RP, Westman EC: A low-carbohydrate, ketogenic diet versus a low-fat diet to treat obesity and hyperlipidemia. Ann Intern Med 140:769–777, 2004. 

  • Leidy, H. J., Carnell, N. S., Mattes, R. D., & Campbell, W. W. (2007). Higher protein intake preserves lean mass and satiety with weight loss in pre-obese and obese women. Obesity, 15(2), 421e429. 

  • Skov, A., Toubro, S., Rønn, B., Holm, L., & Astrup, A. (1999). Randomized trial on protein vs carbohydrate in ad libitum fat reduced diet for the treatment of obesity. International Journal of Obesity and Related Metabolic Disorders: Journal of the International Association for the Study of Obesity, 23(5), 528e536

  • Weigle, D. S., Breen, P. A., Matthys, C. C., Callahan, H. S., Meeuws, K. E., Burden, V. R., et al. (2005). A high-protein diet induces sustained reductions in appetite, ad libitum caloric intake, and body weight despite compensatory changes in diurnal plasma leptin and ghrelin concentrations. American Journal of Clinical Nutrition, 82(1), 41e48. 

 

f. Higher protein intake has been associated with no decrease in bodyweight

  • Luscombe ND, Clifton PM, Noakes M, Farnsworth E, Wittert G: Effect of a high protein, energy restricted diet on weight loss and energy expenditure after weight stabilization in hyperinsulinemic subjects. Int J Obes 27:582–590, 2003. 

  • Luscombe ND, Clifton PM, Noakes M, Parker B, Wittert G: Effects of energy-restricted diets containing increased protein on weight loss, resting energy expenditure and the thermic effect of feeding in type-2 diabetes. Diabetes Care 25:652–657, 2002. 

  • Alford BB, Blankenship AC, Hagen RD: The effects of variations in carbohydrate, protein and fat content of the diet upon weight loss, blood values and nutrient intake of adult obese women. J Am Diet Assoc 90:534–540, 1990. 

  • Farnsworth E, Luscombe ND, Noakes M, Wittert G, Argyiou E, Clifton PM: Effect of a high protein, energy restricted diet on body composition, glycemic control and lipid concentrations in over- weight and obese hyperinsulinemic men and women. Am J Clin Nut 78:31–39, 2003. 

  • Layman DK, Boileau RA, Erickson DJ, Painter JE, Shiue H, Sather C: A reduced ratio of dietary carbohydrate to protein improves body composition and blood lipid profiles during weight loss in adult women. J Nutr 133:411–417, 2003.

  • Parker B, Noakes M, Luscombe N, Clifton P: Effect of a high protein, high monounsaturated fat weight loss diet on glycemic control and lipid levels in type-2 diabetes. Diabetes Care 25:425– 430, 2002. 

  • Piatti PM, Monti LD, Magni F, Fermo I, Baruffaldi L, Nasser R: Hypocaloric high protein diet improves glucose oxidation and spares lean body mass: Comparison to hypocaloric high carbohy- drate diet. Metabolism 43:1481–1487, 1994. 

  • Whitehead JM, McNeill G, Smith JS: The effect of protein intake on 24 h energy expenditure during energy restriction. Int J Obes 20:727–732, 1996.

 

g. High protein intake has also been associated with increased insulin levels

  • El Khoury D, Hwalla N. Metabolic and appetite hormone responses of hyperinsulinemic normoglycemic males to meals with varied macronutrient compositions. Ann Nutr Metab 2010; 57: 59–67.

 

h. High protein intake has been associated with increased risk of type 2 diabetes

  • Ricci G, Canducci E, Pasini V, Rossi A, Bersani G, Ricci E et al. Nutrient intake in Italian obese patients: Relationships with insulin resistance and markers of non-alcoholic fatty liver disease. Nutrition 2011; 27: 672–676.

  • Sluijs I, Beulens JWJ, Van Der A DL, AMW Spijkerman, Grobbee DE, Van Der Schouw YT. Dietary intake of total, animal, and vegetable protein and risk of type 2 diabetes in the European Prospective Investigation into Cancer and Nutrition (EPIC)-NL study. Diabetes Care 2010; 33: 43–48.

  • Song Y, Manson JE, Buring JE, Liu S. A prospective study of red meat consumption and type 2 diabetes in middle-aged and elderly women: the women's health study. Diabetes Care 2004; 27: 2108–2115.

  • Pounis GD, Tyrovolas S, Antonopoulou M, Zeimbekis A, Anastasiou F, Bountztiouka V et al. Long-term animal-protein consumption is associated with an increased prevalence of diabetes among the elderly: the Mediterranean islands (MEDIS) study. Diabetes Metab 2010; 36: 484–490. 

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