Effect of a high-protein, energy-restricted diet on body composition, glycemic control, and lipid concentrations in overweight and obese hyperinsulinemic men and women

Background: It is not clear whether varying the protein-to-carbohydrate ratio of weight-loss diets benefits body composition or metabolism. Objective: The objective was to compare the effects of 2 weight-loss diets differing in protein-to-carbohydrate ratio on body composition, glucose and lipid metabolism, and markers of bone turnover. Design: A parallel design included either a high-protein diet of meat, poultry, and dairy foods (HP diet: 27% of energy as protein, 44% as carbohydrate, and 29% as fat) or a standard-protein diet low in those foods (SP diet: 16% of energy as protein, 57% as carbohydrate, and 27% as fat) during 12 wk of energy restriction (6-6.3 MJ/d) and 4 wk of energy balance (approximate to8.2 MJ/d). Fifty-seven overweight volunteers with fasting insulin concentrations > 12 mU/L completed the study. Results: Weight loss (7.9 +/- 0.5 kg) and total fat loss (6.9 +/- 0.4 kg) did not differ between diet groups. In women, total lean mass was significantly (P = 0.02) better preserved with the HP diet (-0.1 +/- 0.3 kg) than with the SP diet (-1.5 +/- 0.3 kg). Those fed the HP diet had significantly (P < 0.03) less glycemic response at weeks 0 and 16 than did those fed the SP diet. After weight loss, the glycemic response decreased significantly (P < 0.05) more in the HP diet group. The reduction in serum triacylglycerol concentrations was significantly (P < 0.05) greater in the HP diet group (23%) than in the SP diet group (10%). Markers of bone turnover, calcium excretion, and systolic blood pressure were unchanged. Conclusion: Replacing carbohydrate with protein from meat, poultry, and dairy foods has beneficial metabolic effects and no adverse effects on markers of bone turnover or calcium excretion.