Higher Protein Diets Consumed Ad Libitum Improve Cardiovascular Risk Markers in Children of Overweight Parents from Eight European Countries

Abstract

Dietary strategies to improve early cardiovascular markers in overweight children are needed. We investigated the effect of dietary protein and glycemic index (GI) on cardiovascular markers and metabolic syndrome (MetS) scores in 5- to 18-y-old children of overweight/obese parents from 8 European centers. Families were randomized to 1 of 5 diets consumed ad libitum: high protein (HP) or low protein (LP) combined with high GI (HGI) or low GI (LGI), or a control diet. At 6 centers, families received dietary instruction (instruction centers); at 2 centers, free foods were also provided (supermarket centers). Diet, anthropometry, blood pressure, and serum cardiovascular markers (lipid profile, glucose regulation, and inflammation) were measured in 253 children at baseline, 1 mo, and/or 6 mo. Protein intake was higher in the HP groups (19.9 ± 1.3% energy) than in the LP groups at 6 mo (16.8 ± 1.2% energy) (P = 0.001). The GI was 4.0 points lower (95% CI: 2.1, 6.1) in the LGI compared with the HGI groups (P < 0.001). In the supermarket centers, the HP and LP groups differed more in protein intake than did the groups in the instruction centers (P = 0.009), indicating better compliance. The HP diets evoked a 2.7-cm (95% CI: 0.9, 5.1) smaller waist circumference and a 0.25-mmol/L (95% CI: 0.09, 0.41) lower serum LDL cholesterol compared with the LP diets at 6 mo (P < 0.007). In a separate supermarket center analysis, the HP compared with LP diets reduced waist circumference (P = 0.004), blood pressure (P < 0.01), serum insulin (P = 0.013), and homeostasis model of assessment-insulin resistance (P = 0.016). In the instruction centers, the HP compared with the LP diets reduced LDL cholesterol (P = 0.004). No consistent effect of GI was seen and the MetS scores were not affected. In conclusion, increased protein intake improved cardiovascular markers in high-risk children, particularly in those undergoing most intensive intervention.

Low Glycemic Index and Load, Hypo Caloric Diet as an Effective Treatment for Obesity and Hyperlipidemia in Girls with Metabolic Syndrome

“…from 16.7% energy initially to 18.8%. This increase is in accordance with the results from the DioGenes study which concluded that a Highprotein/low GI combination was more protective against childhood obesity compared to a Low-protein/High GI alternative [ 34,35]. The reported % energy from fat also increased, to 41.8% which is higher than the 35-40% planned, but representing still a decrease in total fat gram intake within the context of the Mediterranean diet.…”

The role of protein in weight loss and maintenance

“…In the adults who completed the study, the higher-protein diet led to less weight regain (MD: 20.93 kg; 95% CI: 20.31, 21.55 kg; P = 0.003) than the lower-protein diet did (66). The children who followed the higher-protein regimen had reductions in waist circumference (22.7 cm; 95% CI: 0.9, 5.1 cm; P , 0.007) and LDL cholesterol (20.25 mmol/L; 95% CI: 0.09, 0.41 mmol/L; P , 0.007) compared with those following the lower-protein version (78). Collectively, these data suggest that a modest increase in dietary protein leads to long-term maintenance of weight loss and/or improvements in cardiometabolic risk factors in adults and young people.…”

“…As shown in the Diogenes studies (76)(77)(78), the parents exhibited relatively low dropout rates, regardless of protein intake; however, the higher-protein diet group had a lower dropout rate than the lower-protein diet group (26% compared with 37%; P = 0.02).…”

“…Last, although the previous meta-analyses do not include the findings from the Diet, Obesity and Genes (Diogenes) Study, it is the largest trial to date comparing lower-with higher-protein diets for weight-loss maintenance and thus merits specific discussion (76)(77)(78). This pan-European multicenter trial included 938 adults and 253 children (from the adults in the study).…”

Exceso De Proteínas en La Pobreza: La Paradoja Del Exceso De Peso en Niños Colombianos

“…Sin embargo, en Guatemala como en Colombia dado que aún persiste la desnutrición, el discurso sobre el exceso proteínas en los primeros dos años pareciera no tener relevancia, desconociendo que en la desnutrición la calidad de la proteína es otro determinante del aumento del riesgo de enfermedad crónica en la edad adulta (6). De otra parte, dietas altas en proteínas son utilizadas con éxito en el tratamiento de la obesidad en niños y adultos, donde las metas terapéuticas son la reducción de la circunferencia abdominal, la fracción LDL del colesterol, la presión sanguínea y la regulación de la glucosa sérica (8,27). Lo anterior corrobora nuestros hallazgos, en el sentido de que la composición de la dieta, juega un rol importante en la génesis de la obesidad, como también en su tratamiento.…”