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A high-protein diet with resistance exercise training improves weight loss and body composition in overweight and obese patients with type 2 diabetes |
Wycherley TP, Noakes M, Clifton PM, Cleanthous X, Keogh JB, Brinkworth GD |
Diabetes Care 2010 May;33(5):969-976 |
clinical trial |
4/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed* |
OBJECTIVE To evaluate the effects of two low-fat hypocaloric diets differing in the carbohydrate-to-protein ratio, with and without resistance exercise training (RT), on weight loss, body composition, and cardiovascular disease (CVD) risk outcomes in overweight/obese patients with type 2 diabetes. RESEARCH DESIGN AND METHODS A total of 83 men and women with type 2 diabetes (aged 56.1 +/- 7.5 years, BMI 35.4 +/- 4.6 kg/m2) were randomly assigned to an isocaloric, energy-restricted diet (female subjects 6 MJ/day, male subjects 7 MJ/day) of either standard carbohydrate (CON; carbohydrate:protein:fat 53:19:26) or high protein (HP; 43:33:22), with or without supervised RT (3 days/week) for 16 weeks. Body weight and composition, waist circumference (WC), and cardiometabolic risk markers were assessed. RESULTS Fifty-nine participants completed the study. There was a significant group effect (p <= 0.04) for body weight, fat mass, and WC with the greatest reductions occurring in HP+RT (weight CON -8.6 +/- 4.6 kg, HP -9.0 +/- 4.8 kg, CON+RT -10.5 +/- 5.1 kg, HP+RT -13.8 +/- 6.0 kg; fat mass CON -6.4 +/- 3.4 kg, HP -6.7 +/- 4.0 kg, CON+RT -7.9 +/- 3.7 kg, HP+RT -11.1 +/- 3.7 kg; and WC CON -8.2 +/- 4.6 cm, HP -8.9 +/- 3.9 cm, CON+RT -11.3 +/- 4.6 cm, HP+RT -13.7 +/- 4.6 cm). There was an overall reduction (p < 0.001) in fat-free mass (-2.0 +/- 2.3 kg), blood pressure (-15/8 +/- 10/6 mmHg), glucose (-2.1 +/- 2.2 mmol/l), insulin (-4.7 +/- 5.4 mU/l), A1C (-1.25 +/- 0.94%), triglycerides (-0.47 +/- 0.81 mmol/l), total cholesterol (-0.67 +/- 0.69 mmol/l), and LDL cholesterol (-0.37 +/- 0.53 mmol/l), with no difference between groups (p >= 0.17). CONCLUSIONS An energy-restricted HP diet combined with RT achieved greater weight loss and more favorable changes in body composition. All treatments had similar improvements in glycemic control and CVD risk markers.
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