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

doi:10.3945/jn.112.173427

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 Citations (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.

Original language	English
Journal	Journal of Nutrition
Volume	143
Issue number	6
Pages (from-to)	810-817
Number of pages	8
ISSN	0022-3166
DOIs	https://doi.org/10.3945/jn.112.173427
Publication status	Published - Jun 2013

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Damsgaard, C. T., Papadaki, A., Jensen, S. M., Ritz, C., Dalskov, S-M., Hlavaty, P., Saris, W. H. M., Martinez, J. A., Handjieva-Darlenska, T., Andersen, M. R., Stender, S., Larsen, T. M., Astrup, A., Mølgaard, C., Michaelsen, K. F., & on behalf of Diogenes (2013). Higher protein diets consumed ad libitum improve cardiovascular risk markers in children of overweight parents from eight European countries. Journal of Nutrition, 143(6), 810-817. https://doi.org/10.3945/jn.112.173427

Damsgaard, CT, Papadaki, A, Jensen, SM, Ritz, C, Dalskov, S-M, Hlavaty, P, Saris, WHM, Martinez, JA, Handjieva-Darlenska, T, Andersen, MR, Stender, S, Larsen, TM, Astrup, A, Mølgaard, C , Michaelsen, KF & on behalf of Diogenes 2013, 'Higher protein diets consumed ad libitum improve cardiovascular risk markers in children of overweight parents from eight European countries', Journal of Nutrition, vol. 143, no. 6, pp. 810-817. https://doi.org/10.3945/jn.112.173427

@article{afa3f70e5c404e6ca5c05086ab80f3a7,

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

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.",

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

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doi = "10.3945/jn.112.173427",

language = "English",

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T1 - Higher protein diets consumed ad libitum improve cardiovascular risk markers in children of overweight parents from eight European countries

AU - Damsgaard, Camilla Trab

AU - Papadaki, Angeliki

AU - Jensen, Signe Marie

AU - Ritz, Christian

AU - Dalskov, Stine-Mathilde

AU - Hlavaty, Petr

AU - Saris, Wim H M

AU - Martinez, J Alfredo

AU - Handjieva-Darlenska, Teodora

AU - Andersen, Malene Rohr

AU - Stender, Steen

AU - Larsen, Thomas Meinert

AU - Astrup, Arne

AU - Mølgaard, Christian

AU - Michaelsen, Kim F

AU - on behalf of Diogenes

N1 - CURIS 2013 NEXS 078

PY - 2013/6

Y1 - 2013/6

N2 - 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.

AB - 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.

U2 - 10.3945/jn.112.173427

DO - 10.3945/jn.112.173427

M3 - Journal article

C2 - 23596158

SN - 0022-3166

VL - 143

SP - 810

EP - 817

JO - Journal of Nutrition

JF - Journal of Nutrition

IS - 6

ER -

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

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