The effects of hypocaloric, high-protein diets on cardiovascular risk factors and weight loss in obese adults: a systematic review
Abstract
Abstract
Background: This systematic review has been undertaken in order to assess the effects of hypocaloric, high-protein diets on weight loss and cardiovascular risk factors such as serum lipid levels in metabolically healthy obese adults. The primary outcomes measured include changes in pre- and post- diet mean BMI, LDL-C, HDL-C, TAG, and TC levels.
Method: Four databases including: Embase, MEDLINE (via PubMed), Cochrane and Web of Science were searched with no restrictions on language or publication period. Clinicaltrials.gov was also searched in order to identify unpublished or on-going studies.
Results: Three of four studies included in this systematic review noted a significantly greater loss in pre- and post- diet mean BMI levels in the hypocaloric, high-protein diet group as compared to hypocaloric, non-high protein diets (control). Whilst pre- and post-diet mean LDL-C, HDL-C, TAG, and TC levels did not differ significantly among hypocaloric, high-protein and control diet groups.
Conclusion: Hypocaloric, high-protein diets had an unclear effect on blood-lipid levels as compared to control. Weight loss however was significantly greater in the hypocaloric, high-protein group as compared to other hypocaloric, non-high-protein diet groups.
Abete, I. et al. (2009) ‘Effects of two energy-restricted diets differing in the carbohydrate/protein ratio
on weight loss and oxidative changes of obese men.’, International journal of food sciences and nutrition, 60 Suppl 3, pp. 1–13. doi: 10.1080/09637480802232625.
Abete, I., Parra, D. and Martinez, J. A. (2009) ‘Legume-, Fish-, or High-Protein-Based Hypocaloric Diets: Effects on Weight Loss and Mitochondrial Oxidation in Obese Men’, JOURNAL OF MEDICINAL FOOD, 12(1), pp. 100–108. doi: 10.1089/jmf.2007.0700.
Agus, M. S. et al. (2000) ‘Dietary composition and physiologic adaptations to energy restriction’, The
American journal of clinical nutrition, 71(4), pp. 901–907. doi: 10.1093/ajcn/71.4.901.
Amini, P. et al. (2016) ‘Effects of High Protein and Balanced Diets on Lipid Profiles and Inflammation Biomarkers in Obese and Overweight Women at Aerobic Clubs: A Randomized Clinical Trial’, INTERNATIONAL JOURNAL OF PREVENTIVE MEDICINE, 7. doi: 10.4103/2008- 7802.190608. Austin, M. A., Hokanson, J. E. and Edwards, K. L. (1998) ‘Hypertriglyceridemia as a cardiovascular risk factor.’, The American journal of cardiology, 81(4A), pp. 7B-12B. doi: 10.1016/s0002- 9149(98)00031-9.
Azadbakht, L. et al. (2013) ‘Effect of a High Protein Weight Loss Diet on Weight, High-Sensitivity C-Reactive Protein, and Cardiovascular Risk among Overweight and Obese Women: A Parallel Clinical Trial’, International Journal of Endocrinology. Edited by F. Cordido, 2013, p. 971724. doi: 10.1155/2013/971724.
Baba, N. H. et al. (1999) ‘High protein vs high carbohydrate hypoenergetic diet for the treatment of obese hyperinsulinemic subjects’, International journal of obesity and related metabolic disorders, 23(11 CC-HS-HANDSRCH CC-Complementary Medicine CC-Metabolic and Endocrine Disorders), pp. 1202–1206. doi: 10.1038/sj.ijo.0801064.
Bilsborough, S. A. and Crowe, T. C. (2003) ‘Low-carbohydrate diets: what are the potential short- and long-term health implications?’, Asia Pacific journal of clinical nutrition, 12(4), pp. 396–404.Castelli, W. P. (1996) ‘v’, Atherosclerosis, 124 Suppl, pp. S1-9. doi: 10.1016/0021-9150(96)05851-0.D.A., D. L. et al. (2015) ‘Effects of a high-protein/low carbohydrate versus a standard hypocaloric diet on adipocytokine levels and insulin resistance in obese patients along 9 months’, Journal of Diabetes and its Complications, 29(7), pp. 950–954. doi: http://dx.doi.org/10.1016/j.jdiacomp.2015.06.002.
Due, A. et al. (2004) ‘Effect of normal-fat diets, either medium or high in protein, on body weight in overweight subjects: a randomised 1-year trial’, INTERNATIONAL JOURNAL OF OBESITY,
28(10), pp. 1283–1290. doi: 10.1038/sj.ijo.0802767.
Van Gaal, L. F., Mertens, I. L. and Ballaux, D. (2005) ‘What is the relationship between risk factor reduction and degree of weight loss?’, European Heart Journal Supplements, 7(suppl_L), pp. L21– L26. doi: 10.1093/eurheartj/sui082. Halton, T. L. and Hu, F. B. (2004) ‘The effects of high protein diets on thermogenesis, satiety and weight loss: a critical review.’, Journal of the American College of Nutrition, 23(5), pp. 373–385. doi: 10.1080/07315724.2004.10719381.
Higgins PT Julian, Savović Jelena , Page J Matthew, Elbers G Roy, S. A. J. (2020) ‘Cochrane Handbook for Systematic Reviews of Interventions version 6.1’, in Higgins PT Julian, Savović Jelena, Page J Matthew, Elbers G Roy, S. A. J. (ed.) Cochrane Handbook for Systematic Reviews of Interventions version 6.1. Cochrane Training, p. Chapter 8: Assessing risk of bias in a randomized. Available at: https://training.cochrane.org/handbook/current/chapter-08.
Hu, F. B. (2005) ‘Protein, body weight, and cardiovascular health.’, The American journal of clinical nutrition, 82(1 Suppl), pp. 242S-247S. doi: 10.1093/ajcn/82.1.242S.
J., B., E., B. and G., J.-M. (2018) ‘Randomized trial of a high protein, partial meal replacement program with or without alternate day fasting: Similar effects on weight loss, retention status, nutritional, metabolic, and behavioral outcomes’, Nutrients, 10(9), p. 1145. doi: http://dx.doi.org/10.3390/nu10091145.
Johnstone, A. M. et al. (2011) ‘Effects of a high-protein, low-carbohydrate v. high-protein, moderate- carbohydrate weight-loss diet on antioxidant status, endothelial markers and plasma indices of the cardiometabolic profile’, BRITISH JOURNAL OF NUTRITION, 106(2), pp. 282–291. doi: 10.1017/S0007114511000092.
Lam, Y. Y. and Ravussin, E. (2017) ‘Indirect calorimetry: an indispensable tool to understand and predict obesity.’, European journal of clinical nutrition, 71(3), pp. 318–322. doi: 10.1038/ejcn.2016.220.
LaPorte, D. J. and Stunkard, A. J. (1990) ‘Predicting attrition and adherence to a very low calorie diet:
a prospective investigation of the eating inventory’, International journal of obesity, 14(3), p. 197- 206. Available at: http://europepmc.org/abstract/MED/2341226.
Layman, D. K. et al. (2003) ‘A reduced ratio of dietary carbohydrate to protein improves body composition and blood lipid profiles during weight loss in adult women.’, The Journal of nutrition, 133(2), pp. 411–417. doi: 10.1093/jn/133.2.411.
Layman, D. K. and Baum, J. I. (2004) ‘Dietary protein impact on glycemic control during weight loss.’, The Journal of nutrition, 134(4), pp. 968S–73S. doi: 10.1093/jn/134.4.968S.
Leibel, R., Rosenbaum, M. and Hirsch, J. (1995) ‘Changes in Energy Expenditure Resulting from Altered Body Weight’, The New England journal of medicine, 332, pp. 621–628. doi: 10.1056/NEJM199503093321001.
Leidy, H. J. et al. (2015) ‘The role of protein in weight loss and maintenance.’, The American journal of clinical nutrition, 101(6), pp. 1320S-1329S. doi: 10.3945/ajcn.114.084038.
McAuley, K. A. et al. (2006) ‘Long-term effects of popular dietary approaches on weight loss and features of insulin resistance’, INTERNATIONAL JOURNAL OF OBESITY, 30(2), pp. 342–349. doi: 10.1038/sj.ijo.0803075.
Mikkelsen, P. B., Toubro, S. and Astrup, A. (2000) ‘Effect of fat-reduced diets on 24-h energy expenditure: comparisons between animal protein, vegetable protein, and carbohydrate’, The American Journal of Clinical Nutrition, 72(5), pp. 1135–1141. doi: 10.1093/ajcn/72.5.1135.
Müller, H. et al. (2003) ‘The serum LDL/HDL cholesterol ratio is influenced more favorably by exchanging saturated with unsaturated fat than by reducing saturated fat in the diet of women.’, The Journal of nutrition, 133(1), pp. 78–83. doi: 10.1093/jn/133.1.78.
Pasman, W. J., Saris, W. H. and Westerterp-Plantenga, M. S. (1999) ‘Predictors of weight maintenance.’, Obesity research, 7(1), pp. 43–50. doi: 10.1002/j.1550-8528.1999.tb00389.x. Petrisko, M. et al. (2020) ‘Biochemical, Anthropometric, and Physiological Responses to arbohydrate-Restricted Diets Versus a Low-Fat Diet in Obese Adults: A Randomized Crossover Trial.’, Journal of medicinal food, 23(3), pp. 206–214. doi: 10.1089/jmf.2019.0266.
Shimokata, H. and Kuzuya, F. (1993) ‘[Aging, basal metabolic rate, and nutrition].’, Nihon Ronen Igakkai zasshi. Japanese journal of geriatrics, 30(7), pp. 572–576. doi: 10.3143/geriatrics.30.572.Strasser, B., Spreitzer, A. and Haber, P. (2007) ‘Fat loss depends on energy deficit only, independently of the method for weight loss.’, Annals of nutrition & metabolism, 51(5), pp. 428–432. doi: 10.1159/000111162.
Stubbs, R. J. et al. (1996) ‘Breakfasts high in protein, fat or carbohydrate: effect on within-day appetite and energy balance.’, European journal of clinical nutrition, 50(7), pp. 409–417. Tentolouris, N. et al. (2008) ‘Diet-induced thermogenesis and substrate oxidation are not different between lean and obese women after two different isocaloric meals, one rich in protein and one rich in fat.’, Metabolism: clinical and experimental, 57(3), pp. 313–320. doi: 10.1016/j.metabol.2007.10.004.
Westerterp-Plantenga, M. S. et al. (2009) ‘Dietary protein, weight loss, and weight maintenance.’, Annual review of nutrition, 29, pp. 21–41. doi: 10.1146/annurev-nutr-080508-141056. Westerterp, K. R. (2004) ‘Diet induced thermogenesis.’, Nutrition & metabolism, 1(1), p. 5. doi: 10.1186/1743-7075-1-5.
WHO (2020) Obesity and overweight. Available at: https://www.who.int/news-room/fact- sheets/detail/obesity-and-overweight (Accessed: 19 December 2020).
Wycherley, T. P. et al. (2012) ‘Effects of energy-restricted high-protein, low-fat compared with standard-protein, low-fat diets: a meta-analysis of randomized controlled trials.’, The American journal of clinical nutrition, 96(6), pp. 1281–1298. doi: 10.3945/ajcn.112.044321.
Yang, M. U. and Van Itallie, T. B. (1976) ‘Composition of weight lost during short-term weight reduction. Metabolic responses of obese subjects to starvation and low-calorie ketogenic and nonketogenic diets’, The Journal of clinical investigation, 58(3), pp. 722–730. doi: 10.1172/JCI108519.
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Issue | Vol 10 No 1 (2024) | |
Section | Articles | |
DOI | https://doi.org/10.18502/jbe.v10i1.17151 | |
Keywords | ||
High protein intake Cardiovascular risk factors Weight loss Low caloric diets Obese adults Systematic review |
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