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Effect of a high protein/low glycaemic index diet on insulin resistance in adolescents with overweight/obesity-APREVIEWrandomized clinical trial

Autores: Dorenbos, E.; Drummen, M.; Adam, T. ; Rijks, J.; Winkens, B.; Martínez Hernández, Alfredo; Navas Carretero, Santiago; Stratton, G.; Swindell, N. ; Stouthart, P. ; Mackintosh, K.; Mcnarry, M.; Tremblay, A. ; Fogelholm, M. ; Raben, A. ; Westerterp-Plantenga, M.; Vreugdenhil, A. (Autor de correspondencia)
Título de la revista: PEDIATRIC OBESITY
ISSN: 2047-6310
Volumen: 16
Páginas: e12702
Fecha de publicación: 2021
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.