Eat More Protein and Lower Your Blood Glucose!
Abstract & Commentary
Synopsis: A high-protein diet lowers the blood glucose postprandially in persons with type 2 diabetes and improves overall glucose control. However, longer-term studies are necessary to determine the total magnitude of response, possible adverse effects, and long-term acceptability of the diet.
Source: Gannon MC, et al. Am J Clin Nutr. 2003;78:734-739.
The focus of the type and amount of dietary protein recommended for diabetics is usually to provide adequate protein for the maintenance of lean body mass. There are apparently no reports considering the role of protein in the management of hyperglycemia. The object of this study was to compare the metabolic effects of a high-protein diet with those of a control diet that is currently recommended by several scientific organizations.
The metabolic effects of both diets, consumed for 5 weeks each, (separated by a 2-5 week washout period), were studied in 12 subjects with untreated type 2 diabetes. The ratio of protein to carbohydrate to fat was 30:40:30 in the high-protein diet and 15:55:30 in the control diet. The subjects remained weight stable during the study. All food was provided by Gannon and associates. With fasting glucose concentration used as a baseline from which to determine the area under the curve, the high-protein diet resulted in a 40% decrease in the mean 24-hour integrated glucose area response. Glycated hemoglobin decreased 0.8% and 0.3% after 5 weeks on the high-protein and control diets, respectively. The difference was significant (P < .05). Fasting triacylglycerol was significantly lower after the high-protein diet than after the control diet (P < .001) Insulin, C-peptide, and free fatty acid concentrations were not significantly different after the 2 diets.
A high-protein diet lowers the blood glucose postprandially in persons with type 2 diabetes and improves overall glucose control. However, longer-term studies are necessary to determine the total magnitude of response, possible adverse effects, and long-term acceptability of the diet.
Comment by Ralph R. Hall, MD, FACP
In the accompanying editorial Eckel notes that typical glycemic studies involve "the examination of the effect of a single meal of added protein compared with that of other macronutrients on postingestion glucose and insulin concentrations."1 Although the sample size was small, the design of the study, which involved the patients having all their meals provided by the study group, was excellent.
More information is needed before we assign patients to this diet. Although recent studies continue to show short-term benefits by increasing protein in the diet, there are no long-term studies to examine the effects on atherosclerosis.
Will diets low in saturated and trans fat and high in protein and mono and polyunsaturated fat accelerate the development of vascular disease? The primary concern regarding most new-onset type 2 diabetes is weight loss. How will patients respond to increased protein and a low-caloric diet for prolonged periods of time? What will be the effects of oral hypoglycemic medication on such a diet?
Long-term nutritional studies in which patients receive all their nutrients require dedicated subjects and are expensive to carry out. The potential benefits of these nutritional studies are so great, however, that the funds for this research must be provided.
Dr. Hall, Emeritus Professor of Medicine, University of Missouri-Kansas City School of Medicine, is Associate Editor of Internal Medicine Alert.
Reference
1. Eckel RH. Am J Clin Nutr. 2003;78:671-672.
A high-protein diet lowers the blood glucose postprandially in persons with type 2 diabetes and improves overall glucose control. However, longer-term studies are necessary to determine the total magnitude of response, possible adverse effects, and long-term acceptability of the diet.
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