A comparison of the effects of diets high in animal or plant protein on metabolic and cardiovascular markers in type 2 diabetes – a randomized clinical trial

Authors

  • Stephanie Sucher,

    1. German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
    2. German Center for Diabetes Research (DZD), Germany
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    • SS and MM contributed equally to this manuscript.
  • Mariya Markova,

    Corresponding author
    1. German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
    2. German Center for Diabetes Research (DZD), Germany
    • Corresponding author: Mariya Markova, Department of Clinical Nutrition, German Institute of Human Nutrition Potsdam-Rehbruecke, Arthur-Scheunert-Allee 114–116, 14558 Nuthetal, Germany, tel.: +49 33200882796, fax: +49 33200882777, email: Mariya.Markova@dife.de., Andreas F. H. Pfeiffer, Department of Clinical Nutrition, German Institute of Human Nutrition Potsdam-Rehbruecke, Arthur-Scheunert-Allee 114–116, 14558 Nuthetal, Germany, tel.: +49 33200882797, fax: +49 33200882777, email: afhp@dife.de; Department of Endocrinology, Diabetes and Nutrition, University Medicine Berlin, Hindenburgdamm 30, 12200 Berlin, Germany, tel/fax: +49 (0) 30 4505 14-422/-992, email: afhp@charite.de.

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    • SS and MM contributed equally to this manuscript.
  • Silke Hornemann,

    1. German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
    2. German Center for Diabetes Research (DZD), Germany
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  • Olga Pivovarova,

    1. German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
    2. German Center for Diabetes Research (DZD), Germany
    3. Department of Endocrinology, Diabetes and Nutrition, Campus Benjamin Franklin, Charité University Medicine, Berlin, Germany
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  • Natalia Rudovich,

    1. German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
    2. German Center for Diabetes Research (DZD), Germany
    3. Department of Endocrinology, Diabetes and Nutrition, Campus Benjamin Franklin, Charité University Medicine, Berlin, Germany
    4. Department of Endocrinology and Diabetology, Clinic of Internal Medicine, Hospital of Buelach, Buelach, Switzerland
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  • Ralph Thomann,

    1. Institut für Getreideverarbeitung GmbH, Nuthetal, Germany
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  • Rosemarie Schneeweiss,

    1. Institute for Food and Environmental Research, Nuthetal, Germany
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  • Sascha Rohn,

    1. Institute for Food and Environmental Research, Nuthetal, Germany
    2. Institute of Food Chemistry, Hamburg School of Food Science, University of Hamburg, Hamburg, Germany
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  • Andreas F. H. Pfeiffer

    Corresponding author
    1. German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
    2. German Center for Diabetes Research (DZD), Germany
    3. Department of Endocrinology, Diabetes and Nutrition, Campus Benjamin Franklin, Charité University Medicine, Berlin, Germany
    • Corresponding author: Mariya Markova, Department of Clinical Nutrition, German Institute of Human Nutrition Potsdam-Rehbruecke, Arthur-Scheunert-Allee 114–116, 14558 Nuthetal, Germany, tel.: +49 33200882796, fax: +49 33200882777, email: Mariya.Markova@dife.de., Andreas F. H. Pfeiffer, Department of Clinical Nutrition, German Institute of Human Nutrition Potsdam-Rehbruecke, Arthur-Scheunert-Allee 114–116, 14558 Nuthetal, Germany, tel.: +49 33200882797, fax: +49 33200882777, email: afhp@dife.de; Department of Endocrinology, Diabetes and Nutrition, University Medicine Berlin, Hindenburgdamm 30, 12200 Berlin, Germany, tel/fax: +49 (0) 30 4505 14-422/-992, email: afhp@charite.de.

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Abstract

Aims

High animal protein diets support body weight and glucose control but may induce insulin resistance and type 2 diabetes (T2DM) while plant protein based diets appear to be metabolically advantageous and reduce cardiovascular events. We therefore compared high animal versus plant protein diets differing in amino acid composition in people with T2DM.

Materials and methods

We compared isocaloric diets containing 30% of energy (E%) either as animal (AP) or plant (PP) protein, using newly developed plant protein enriched foods, both combined with 30 E% fat and 40 E% carbohydrates in 44 patients with T2DM over six weeks in a randomized parallel group study. Insulin sensitivity was assessed by hyperinsulinemic-euglycemic clamps and cardiovascular parameters were determined.

Results

Uric acid decreased in both groups but significantly more in AP than PP. There were no significant differences in other parameters although HbA1c, diastolic blood pressure and fasting NEFA improved significantly in PP but not in AP. Insulin sensitivity (M-value), C-reactive protein and fasting glucose improved significantly in AP but not PP. Total and LDL cholesterol and systolic blood pressure decreased significantly in both groups and urinary albumin excretion rate decreased from baseline in microalbuminuric subjects.

Conclusions

Isocaloric diets high in animal or plant protein allow similar improvements of metabolism and cardiovascular risk factors in T2DM patients indicating that the differences in amino acid composition do not affect the metabolic responses to the interventions.

ClincialTrials.gov number, NCT02402985.

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