A High Protein Diet Is More Effective in Improving Insulin Resistance and Glycemic Variability Compared to a Mediterranean Diet-A Cross-Over Controlled Inpatient Dietary Study

• Published in: Nutrients 2021-12, Vol.13 (12), p.4380
• Main Authors: Tettamanzi, Francesca, Bagnardi, Vincenzo, Louca, Panayiotis, Nogal, Ana, Monti, Gianna Serafina, Mambrini, Sara P, Lucchetti, Elisa, Maestrini, Sabrina, Mazza, Silvia, Rodriguez-Mateos, Ana, Scacchi, Massimo, Valdes, Ana M, Invitti, Cecilia, Menni, Cristina
• Format: Article
• Language: English
• Subjects: Adult; Blood pressure; Body composition; Body weight; Carbohydrates; Cross-Over Studies; Diabetes; Diet; Diet, High-Protein; Diet, Mediterranean; Digestive system; Fatty acids; Female; Gastrointestinal Microbiome; Glucose; Glucose monitoring; Glycemic Index; Heart rate; High protein diet; Homeostasis; Humans; Insulin; Insulin Resistance; Intestinal microflora; Legumes; Lipids; Metabolism; Microbiomes; Microbiota; Microorganisms; Middle Aged; Nutrition research; Obesity; Obesity - diet therapy; Obesity - metabolism; Obesity - microbiology; Polyphenols; Proteins; Risk analysis; Risk factors; Standard deviation; Treatment Outcome; Variability; Weight control; Womens health; Young Adult
• ISSN: 2072-6643; 2072-6643
• DOI: 10.3390/nu13124380

The optimal dietary pattern to improve metabolic function remains elusive. In a 21-day randomized controlled inpatient crossover feeding trial of 20 insulin-resistant obese women, we assessed the extent to which two isocaloric dietary interventions-Mediterranean (M) and high protein (HP)-improved metabolic parameters. Obese women were assigned to one of the following dietary sequences: M-HP or HP-M. Cardiometabolic parameters, body weight, glucose monitoring and gut microbiome composition were assessed. Sixteen women completed the study. Compared to the M diet, the HP diet was more effective in (i) reducing insulin resistance (insulin: Beta (95% CI) = -6.98 (-12.30, -1.65) µIU/mL, = 0.01; HOMA-IR: -1.78 (95% CI: -3.03, -0.52), = 9 × 10 ); and (ii) improving glycemic variability (-3.13 (-4.60, -1.67) mg/dL, = 4 × 10 ), a risk factor for T2D development. We then identified a panel of 10 microbial genera predictive of the difference in glycemic variability between the two diets. These include the genera and , previously associated with glucose homeostasis and insulin resistance. Our results suggest that morbidly obese women with insulin resistance can achieve better control of insulin resistance and glycemic variability on a high HP diet compared to an M diet.