Higher protein diets consumed ad libitum improve cardiovascular risk markers in children of overweight parents from eight European countries

Camilla Trab Damsgaard, Angeliki Papadaki, Signe Marie Jensen, Christian Ritz, Stine-Mathilde Dalskov, Petr Hlavaty, Wim H M Saris, J Alfredo Martinez, Teodora Handjieva-Darlenska, Malene Rohr Andersen, Steen Stender, Thomas Meinert Larsen, Arne Astrup, Christian Mølgaard, Kim F Michaelsen, on behalf of Diogenes

35 Citationer (Scopus)

Abstract

Dietary strategies to improve early cardiovascular markers in overweight children are needed. We investigated the effect of dietary protein and glycemic index (GI) on cardiovascular markers and metabolic syndrome (MetS) scores in 5- to 18-y-old children of overweight/obese parents from 8 European centers. Families were randomized to 1 of 5 diets consumed ad libitum: high protein (HP) or low protein (LP) combined with high GI (HGI) or low GI (LGI), or a control diet. At 6 centers, families received dietary instruction (instruction centers); at 2 centers, free foods were also provided (supermarket centers). Diet, anthropometry, blood pressure, and serum cardiovascular markers (lipid profile, glucose regulation, and inflammation) were measured in 253 children at baseline, 1mo, and/or 6mo. Protein intake was higher in the HP groups (19.96 ± 1.3% energy) than in the LP groups at 6mo (16.86 ± 1.2% energy) (P = 0.001). The GI was 4.0 points lower (95% CI: 2.1, 6.1) in the LGI compared with the HGI groups (P < 0.001). In the supermarket centers, the HP and LP groups differed more in protein intake than did the groups in the instruction centers (P = 0.009), indicating better compliance. The HP diets evoked a 2.7-cm (95% CI: 0.9, 5.1) smaller waist circumference and a 0.25-mmol/L (95% CI: 0.09, 0.41) lower serumLDL cholesterol compared with the LP diets at 6mo (P < 0.007). In a separate supermarket center analysis, theHP comparedwith LP diets reducedwaist circumference (P=0.004), blood pressure (P < 0.01), serum insulin (P = 0.013), and homeostasis model of assessment-insulin resistance (P = 0.016). In the instruction centers, the HP compared with the LP diets reduced LDL cholesterol (P = 0.004). No consistent effect of GI was seen and the MetS scores were not affected. In conclusion, increased protein intake improved cardiovascular markers in high-risk children, particularly in those undergoing most intensive intervention.

OriginalsprogEngelsk
TidsskriftJournal of Nutrition
Vol/bind143
Udgave nummer6
Sider (fra-til)810-817
Antal sider8
ISSN0022-3166
DOI
StatusUdgivet - jun. 2013

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