Effect of a high protein/low glycaemic index diet on insulin resistance in adolescents with overweight/obesity—A <scp>PREVIEW</scp> randomized clinical trial
Elke Dorenbos, Mathijs Drummen, Tanja C. Adam, Jesse Rijks, Björn Winkens, J. Alfredo Martínéz, Santiago Navas‐Carretero, Gareth Stratton, Nils Swindell, Pauline Stouthart, Kelly A. Mackintosh, Melitta A. McNarry, Angelo Tremblay, Mikael Fogelholm, Anne Raben, Margriet S. Westerterp‐Plantenga, Anita Vreugdenhil
Abstract
BACKGROUND: Pubertal insulin resistance (IR) is associated with increased risk of type 2 diabetes mellitus development in adolescents with overweight/obesity. OBJECTIVES: The PREVIEW study was a randomized parallel trial assessing the change in IR, analyzed by Homeostatic Model Assessment of IR (HOMA-IR), at 2 years after randomization to a high protein vs a moderate protein diet in adolescents with overweight/obesity. It was hypothesized that a high protein/low glycaemic index diet would be superior in reducing IR compared to a medium protein/medium GI diet, in insulin resistant adolescents with overweight or obesity. METHODS: Adolescents with overweight/obesity and IR from the Netherlands, United Kingdom and Spain were randomized into a moderate protein/moderate GI (15/55/30En% protein/carbohydrate/fat, GI ≥ 56) or high protein/low GI (25/45/30En% protein/carbohydrate/fat, GI < 50) diet. Anthropometric and cardiometabolic parameters, puberty, dietary intake and physical activity (PA) were measured and effects on HOMA-IR were analyzed. RESULTS: 126 adolescents were included in this study (13.6 ± 2.2 years, BMI z-score 3.04 ± 0.66, HOMA-IR 3.48 ± 2.28, HP n = 68, MP n = 58). At 2 years, changes in protein intake were not significantly different between timepoints or intervention groups and no effects of the intervention on IR were observed. The retention rate was 39%, while no compliance to the diets was observed. CONCLUSIONS: The PREVIEW study observed no effect of a high protein/low GI diet on IR in adolescents with overweight/obesity and IR because of lack of feasibility, due to insufficient retention and dietary compliance after 2 years.