Eliminate Pre-Diabetes: Diet Comparison

February 10, 2017

In a randomized controlled trial, 24 men and women with pre-diabetes were assigned to either a diet high in protein or high in carbohydrate.

A high protein diet can lead to 100% remission of pre-diabetes to normal glucose tolerance, while a high carbohydrate diet may lead to only 33% remission, according to a new study.

“Our results show that high efficacy can be achieved with dietary modification if parameters are rigorously controlled and monitored,” stated researchers led by Dr. Frankie B. Stentz of the University of Tennessee Health Science Center, Memphis, TN.

The high protein group had greater improvement in insulin sensitivity, greater reduction in cardiovascular risk factors, oxidative stress, and inflammation than the high carbohydrate diet group.

In a randomized controlled trial, 24 men and women with pre-diabetes were assigned to either a diet high in protein (30% protein, 30% fat, 40% carbohydrate) or high in carbohydrate (15% protein, 30% fat, 55% carbohydrate). All meals were provided to the participants for 6 months, with weekly food pick-up and weight measurements. At baseline and after 6 months on the respective diets, the participants underwent oral glucose tolerance and meal tolerance tests with glucose and insulin measurements and dual energy X-ray absorptiometry scans.

The study did not include any physical activity modification during the 6 months on the diets, but all participants were minimally physically active, the researchers noted.

After 6 months on the high protein diet, all of the participants had remission of their pre-diabetes to normal glucose tolerance, whereas only one-third of those on the high carbohydrate diet had remission of their pre-diabetes.

The high protein diet group exhibited significant improvement in insulin sensitivity, cardiovascular risk factors, inflammatory cytokines, oxidative stress, and increased percent lean body mass as compared with the high carbohydrate diet.

The researchers concluded that “this is the first dietary intervention feeding study, to the best of our knowledge, to report 100% remission of pre-diabetes with a high protein diet and significant improvement in metabolic parameters and anti-inflammatory effects compared with a high carbohydrate diet at 6 months.”

The greater insulin response with the high carbohydrate diet likely equates to greater β cells stress, the researcher stated. “The higher sustained glucose elevation with ingestion of glucose or higher glycemic foods as in the high carbohydrate diet correlates with increased oxidative stress and inflammation in the high carbohydrate group compared with the high protein group,” they stated.

They also noted that the high protein diet led to a significantly greater reduction in reactive oxygen species and inflammation markers than the high carbohydrate diet, which is “of great health importance.”

The daily cost of either diet was about $13 with minimal personnel involvement, except for weekly pick-up of diet supplies. “The diet plans are adjustable to the subjects’ food likes and dislike with a wide variety of choices with different meal plans for each day of the week. Weekly meal plans and initial instructions could be provided to the subject and phone and email consultation provided when needed,” the researchers stated, adding that a high protein diet plan may offer an economical means of a nutritional weight loss and remission of pre-diabetes.

Reference: Stentz FB, et al. Remission of pre-diabetes to normal glucose tolerance in obese adults with high protein versus high carbohydrate diet: randomized control trial. BMJ Open Diabetes Res Care. 2016 Oct 26;4(1):e000258.