Welcome to Debate Club! Please be aware that this is a space for respectful debate, and that your ideas will be challenged here. Please remember to critique the argument, not the author.
Protein and Insulin Sensitivity
Options
lemurcat12
Posts: 30,886 Member
in Debate Club
Has anyone seen the recent study discussed in this conversation? I thought it was interesting and would love thoughts on it: http://blog.dansplan.com/is-high-protein-actually-bad-during-weight-loss/
Summary: 34 postmenopausal women in 3 groups:
Group 1: Weight maintenance (control)
Group 2: Lose 8-10% of body weight while taking in a “normal” protein (0.8 g/kg per day) amount = 54 g protein per day for 150 lb person
Group 3: Lose 8-10% of body weight while taking in a “high” protein (1.2 g/kg per day) amount = 81 g protein per day for 150 lb person
"After the subjects lost the weight and stabilized at a new, lower weight, they had several things analyzed including body composition, insulin sensitivity, and biochemical measures from muscle tissue.
There Were Several Key Findings
First, while both weight loss groups lost the same amount of weight, the group following the high protein diet lost 45% less lean mass! In other words, they preserved more muscle while losing weight. This finding is consistent with many previous studies looking at protein and weight loss.
The group of people following the high-protein diet lost 45% less lean mass! It’s the other finding, however, that’s received so much attention. While fasting insulin declined by about 30% in both weight loss groups, suggesting insulin sensitivity improved, the high-protein diet appeared to prevent the improvement in insulin signaling at muscles, which is expected to occur with weight loss. One of the major health benefits of weight is believed to be an increase in insulin sensitivity that accompanies it. So, if there isn’t an improvement in muscle’s sensitivity to insulin, should we be avoiding high-protein diets for weight control purposes?"
Summary: 34 postmenopausal women in 3 groups:
Group 1: Weight maintenance (control)
Group 2: Lose 8-10% of body weight while taking in a “normal” protein (0.8 g/kg per day) amount = 54 g protein per day for 150 lb person
Group 3: Lose 8-10% of body weight while taking in a “high” protein (1.2 g/kg per day) amount = 81 g protein per day for 150 lb person
"After the subjects lost the weight and stabilized at a new, lower weight, they had several things analyzed including body composition, insulin sensitivity, and biochemical measures from muscle tissue.
There Were Several Key Findings
First, while both weight loss groups lost the same amount of weight, the group following the high protein diet lost 45% less lean mass! In other words, they preserved more muscle while losing weight. This finding is consistent with many previous studies looking at protein and weight loss.
The group of people following the high-protein diet lost 45% less lean mass! It’s the other finding, however, that’s received so much attention. While fasting insulin declined by about 30% in both weight loss groups, suggesting insulin sensitivity improved, the high-protein diet appeared to prevent the improvement in insulin signaling at muscles, which is expected to occur with weight loss. One of the major health benefits of weight is believed to be an increase in insulin sensitivity that accompanies it. So, if there isn’t an improvement in muscle’s sensitivity to insulin, should we be avoiding high-protein diets for weight control purposes?"
2
Replies
-
Even 1,2 grams per kilo isn't much. Comparing a normal intake with "semi-starvation" seems a little unscientific. I have nothing else.0
-
Where does the semi-starvation come in? They are comparing RDA* with the higher amount often recommended on a deficit (still likely lower than the usual MFP recommendation, but it depends on how overweight they are) and finding positives and negatives about even that slightly higher amount.
I'm not too concerned about it (my insulin sensitivity seems fine), but thought it was interesting.
*See http://www.health.harvard.edu/blog/how-much-protein-do-you-need-every-day-2015061880960 -
Semi-starvation, call it malnutrition. Recommendations based on the idea that bread with jam is a perfectly fine every day breakfast, does not give me a warm, fuzzy feeling. Not even aiming for high protein, just eating normal food that makes me satisfied eating an appropriate amount of calories, results in an intake of about 1.25 grams of protein per kilo of bodyweight. Less than that would make me want to (and not be able to resist) EAT ALL THE FOOD.
OK, if you are VERY overweight, those percentages can be allright, but the aim for 8-10% loss doesn't make it seem that the participants were very overweight.0 -
They were obese (BMI 30+). To put into context, if one is 30+ at 180, then it's the difference between 65 g and 98 g. Of course at a healthy weight both numbers are much lower (not that 180 can't be a healthy weight, but it's around 30 BMI for a woman of average height, I think, and a little over the obese line for me).
Here's more information: https://source.wustl.edu/2016/10/high-protein-diet-curbs-metabolic-benefits-weight-loss/
http://www.cell.com/cell-reports/abstract/S2211-1247(16)31286-4?_returnURL=http://linkinghub.elsevier.com/retrieve/pii/S2211124716312864?showall=true
I'll be curious about the further examination of the metabolic effect, since it seems weird to me. (The thing about preserving lean mass with the higher protein is positive.)0 -
lemurcat12 wrote: »Where does the semi-starvation come in? They are comparing RDA* with the higher amount often recommended on a deficit (still likely lower than the usual MFP recommendation, but it depends on how overweight they are) and finding positives and negatives about even that slightly higher amount.
I'm not too concerned about it (my insulin sensitivity seems fine), but thought it was interesting.
*See http://www.health.harvard.edu/blog/how-much-protein-do-you-need-every-day-201506188096
Well, RDA is a minimum. Basically a "Hey, you really shouldn't eat less than that for extended periods of time."1 -
stevencloser wrote: »lemurcat12 wrote: »Where does the semi-starvation come in? They are comparing RDA* with the higher amount often recommended on a deficit (still likely lower than the usual MFP recommendation, but it depends on how overweight they are) and finding positives and negatives about even that slightly higher amount.
I'm not too concerned about it (my insulin sensitivity seems fine), but thought it was interesting.
*See http://www.health.harvard.edu/blog/how-much-protein-do-you-need-every-day-201506188096
Well, RDA is a minimum. Basically a "Hey, you really shouldn't eat less than that for extended periods of time."
Yeah, agreed.
This is what the study seems to say -- eating "high" (which is not that high unless someone is obese (but they were), only 1.2 g/kg) has definitely benefits over just eating the RDA in maintaining muscle mass. The "high" protein people lost the same but more was fat than the "normal" protein people. This is what I would have expected based on other studies and is consistent with the advice people on MFP (including me) give (I say keep protein around .65-.85 g/lb of healthy weight or (for ease) .8 g/lb of healthy weight goal). Examine.com gives various cites that support this number, among other sources.
More concerning, at least in general (it doesn't seem to have been a problem for me) -- weight loss normally comes with improvements in insulin sensitivity and did here for the "normal" protein people, but not for the "high" protein people. I thought that was interesting, and am curious if it's an aberration or if they will find an explanation with further research. It wouldn't change my advice (not yet, anyway), but I found it interesting, and the discussion with Guyenet linked above also interesting.0 -
34 women in total puts about 11 people in each of the groups.
This is far to small a cohort to draw any conclusions from, other than suggesting further large scale studies may be warranted.
I wouldn't go changing your diet based on this or any other stand alone, very small study.3 -
34 women in total puts about 11 people in each of the groups.
This is far to small a cohort to draw any conclusions from, other than suggesting further large scale studies may be warranted.
I wouldn't go changing your diet based on this or any other stand alone, very small study.
To be fair, most studies like this end up being really small, due to funding constraints, especially when humans are involved, and not just rats.0 -
Gallowmere1984 wrote: »34 women in total puts about 11 people in each of the groups.
This is far to small a cohort to draw any conclusions from, other than suggesting further large scale studies may be warranted.
I wouldn't go changing your diet based on this or any other stand alone, very small study.
To be fair, most studies like this end up being really small, due to funding constraints, especially when humans are involved, and not just rats.
In the field I work (healthcare) a legitimate finding would usually look at at least >1000 subjects. Or meta-analysis of studies often looking at responses over tens of thousands of cases.
Even then, substantial and repeated results are needed to change best practice or clinical guidelines.
Not all 'evidence' is equal.
As I previously stated, findings from a study group of 34 subjects might say hey, let's study this further.
Small studies, so long as the research design was valid theoretically could help a researcher to get funding for a greater study. Or make a better funded group repeat the experiment to attempt to replicate results.
Findings from a small group of participants can raise interest, but should be considered in the context of the entire trial and particularly the small sample size.
The eleven (11) people in the high protein group should not be enough to make anyone go, yep this is true ... maybe go, hmm I'll watch for further research in this area.4 -
Gallowmere1984 wrote: »34 women in total puts about 11 people in each of the groups.
This is far to small a cohort to draw any conclusions from, other than suggesting further large scale studies may be warranted.
I wouldn't go changing your diet based on this or any other stand alone, very small study.
To be fair, most studies like this end up being really small, due to funding constraints, especially when humans are involved, and not just rats.
In the field I work (healthcare) a legitimate finding would usually look at at least >1000 subjects. Or meta-analysis of studies often looking at responses over tens of thousands of cases.
Even then, substantial and repeated results are needed to change best practice or clinical guidelines.
Not all 'evidence' is equal.
As I previously stated, findings from a study group of 34 subjects might say hey, let's study this further.
Small studies, so long as the research design was valid theoretically could help a researcher to get funding for a greater study. Or make a better funded group repeat the experiment to attempt to replicate results.
Findings from a small group of participants can raise interest, but should be considered in the context of the entire trial and particularly the small sample size.
The eleven (11) people in the high protein group should not be enough to make anyone go, yep this is true ... maybe go, hmm I'll watch for further research in this area.
Oh, I completely agree with you. In fact, I'd posit that the only people who will take this at face value, given the constraints, are those who either don't understand numerical values, or have a bias against high protein diets to begin with.
My point was more that, with stuff like this, we do end up with a whole lot of smaller studies instead of singular large scales. This of course, leads us back to what you said about relying in metas.1 -
Gallowmere1984 wrote: »34 women in total puts about 11 people in each of the groups.
This is far to small a cohort to draw any conclusions from, other than suggesting further large scale studies may be warranted.
I wouldn't go changing your diet based on this or any other stand alone, very small study.
To be fair, most studies like this end up being really small, due to funding constraints, especially when humans are involved, and not just rats.
In the field I work (healthcare) a legitimate finding would usually look at at least >1000 subjects. Or meta-analysis of studies often looking at responses over tens of thousands of cases.
Even then, substantial and repeated results are needed to change best practice or clinical guidelines.
Not all 'evidence' is equal.
As I previously stated, findings from a study group of 34 subjects might say hey, let's study this further.
Small studies, so long as the research design was valid theoretically could help a researcher to get funding for a greater study. Or make a better funded group repeat the experiment to attempt to replicate results.
Findings from a small group of participants can raise interest, but should be considered in the context of the entire trial and particularly the small sample size.
The eleven (11) people in the high protein group should not be enough to make anyone go, yep this is true ... maybe go, hmm I'll watch for further research in this area.
The problem is that studies with 1000+ subjects can't be all that in depth. They end up being filling out a food recall questionnaire and maybe getting some blood work once then check back in after a month and do the same. Small scale studies you can throw them into a metabolic ward, exercise complete control about what they eat and when and do in depth medical examinations for what you are looking at, multiple times after different events.
Both have advantages and disadvantages.2 -
Would you take a medicine that had been effectively tested on 11 people?
I doubt it.0 -
stevencloser wrote: »Gallowmere1984 wrote: »34 women in total puts about 11 people in each of the groups.
This is far to small a cohort to draw any conclusions from, other than suggesting further large scale studies may be warranted.
I wouldn't go changing your diet based on this or any other stand alone, very small study.
To be fair, most studies like this end up being really small, due to funding constraints, especially when humans are involved, and not just rats.
In the field I work (healthcare) a legitimate finding would usually look at at least >1000 subjects. Or meta-analysis of studies often looking at responses over tens of thousands of cases.
Even then, substantial and repeated results are needed to change best practice or clinical guidelines.
Not all 'evidence' is equal.
As I previously stated, findings from a study group of 34 subjects might say hey, let's study this further.
Small studies, so long as the research design was valid theoretically could help a researcher to get funding for a greater study. Or make a better funded group repeat the experiment to attempt to replicate results.
Findings from a small group of participants can raise interest, but should be considered in the context of the entire trial and particularly the small sample size.
The eleven (11) people in the high protein group should not be enough to make anyone go, yep this is true ... maybe go, hmm I'll watch for further research in this area.
The problem is that studies with 1000+ subjects can't be all that in depth. They end up being filling out a food recall questionnaire and maybe getting some blood work once then check back in after a month and do the same. Small scale studies you can throw them into a metabolic ward, exercise complete control about what they eat and when and do in depth medical examinations for what you are looking at, multiple times after different events.
Both have advantages and disadvantages.
Right -- the large scale studies are usually recall and correlation and can't control for things like calories. You need both kinds. I also personally would never base a dietary change on one study, but that doesn't mean that a study can't be interesting to discuss.5 -
Gallowmere1984 wrote: »34 women in total puts about 11 people in each of the groups.
This is far to small a cohort to draw any conclusions from, other than suggesting further large scale studies may be warranted.
I wouldn't go changing your diet based on this or any other stand alone, very small study.
To be fair, most studies like this end up being really small, due to funding constraints, especially when humans are involved, and not just rats.
In the field I work (healthcare) a legitimate finding would usually look at at least >1000 subjects. Or meta-analysis of studies often looking at responses over tens of thousands of cases.
Even then, substantial and repeated results are needed to change best practice or clinical guidelines.
Not all 'evidence' is equal.
As I previously stated, findings from a study group of 34 subjects might say hey, let's study this further.
Small studies, so long as the research design was valid theoretically could help a researcher to get funding for a greater study. Or make a better funded group repeat the experiment to attempt to replicate results.
Findings from a small group of participants can raise interest, but should be considered in the context of the entire trial and particularly the small sample size.
The eleven (11) people in the high protein group should not be enough to make anyone go, yep this is true ... maybe go, hmm I'll watch for further research in this area.
RCTs with 1000 subjects? Sure?0 -
34 women in total puts about 11 people in each of the groups.
This is far to small a cohort to draw any conclusions from, other than suggesting further large scale studies may be warranted.
I wouldn't go changing your diet based on this or any other stand alone, very small study.
I agree also, and the differences in amounts are pretty small in reality. Without really knowing much about the diets it's hard to say what's happening here as well. I've seen the abstract before but haven't seen the methodology and if the difference in diet is, let's say, from animal protein high in saturated fats that alone might explain the difference in insulin sensitivity since it has already been established that saturated fats can reduce insulin sensitivity in the muscle. Also, exercise was not indicated and that too can affect insulin sensitivity so it's really hard to say how much this study really shows.
Of course, increased insulin sensitivity is only one marker for metabolic issues so that alone may not be the biggest issue and other health benefits from losing weight may be more important here.
Noting that I haven't been able to find much in the way of supporting studies I would say that this is just an interesting footnote but not something I would put too much stock in.2 -
Would you take a medicine that had been effectively tested on 11 people?
I doubt it.
No, but these diet studies rarely have a large amount of participants. I don't think I can recall any such research with more than 30 or so participants in controlled settings due to cost. Medical research is a whole different kettle of fish because of the potential consequences and human trials are only conducted in the final phase of development, which take many years to get to.
The only studies that I've seen that involve large numbers would be uncontrolled survey research or meta studies. However, I agree that it would be much better to have such controlled research I just don't see it happening, at least not very often.0 -
-
Wheelhouse15 wrote: »Would you take a medicine that had been effectively tested on 11 people?
I doubt it.
No, but these diet studies rarely have a large amount of participants. I don't think I can recall any such research with more than 30 or so participants in controlled settings due to cost. Medical research is a whole different kettle of fish because of the potential consequences and human trials are only conducted in the final phase of development, which take many years to get to.
The only studies that I've seen that involve large numbers would be uncontrolled survey research or meta studies. However, I agree that it would be much better to have such controlled research I just don't see it happening, at least not very often.
I don't disagree with anyone's points. I think I have a partial bias as I'm accustomed to analysing clinical research for medical or pharmaceutical intervention.
With that in mind, I tend to consider diet as a medical intervention in itself so apply the same scrutiny to research evidences in that field.
...........
Back to this specific study though.
The participants were limited.
Plus they were all post menopausal women, so findings (if at all) should only be applied to this demographic.
............
What I get from this study : perhaps high protein is good for some things but not everything and maybe more research into which demographics would benefit and how could be useful.
(Edited due to late night typos: it's midnight here)
1 -
Interesting study.
I wish they did the same study on young women at the same time. The possible role of diminished / fluctuating levels of adrenal and thyroid hormones in menopause on insulin resistance and muscle metabolism was not discussed and could have something to do with it.
Another thing that sort of made me wonder about is the 3-4 week "recovery" period at their TDEE before final testing. Tests while they were still in a deficit might show something different.
Also this part of the discussion:They speculate that ... there may actually still have been an improvement in insulin sensitivity in other tissues including the liver, and there were a couple of different suggestions of that in the paper.1 -
Wheelhouse15 wrote: »34 women in total puts about 11 people in each of the groups.
This is far to small a cohort to draw any conclusions from, other than suggesting further large scale studies may be warranted.
I wouldn't go changing your diet based on this or any other stand alone, very small study.
I agree also, and the differences in amounts are pretty small in reality. Without really knowing much about the diets it's hard to say what's happening here as well. I've seen the abstract before but haven't seen the methodology and if the difference in diet is, let's say, from animal protein high in saturated fats that alone might explain the difference in insulin sensitivity since it has already been established that saturated fats can reduce insulin sensitivity in the muscle. Also, exercise was not indicated and that too can affect insulin sensitivity so it's really hard to say how much this study really shows.
Of course, increased insulin sensitivity is only one marker for metabolic issues so that alone may not be the biggest issue and other health benefits from losing weight may be more important here.
Noting that I haven't been able to find much in the way of supporting studies I would say that this is just an interesting footnote but not something I would put too much stock in.
I was wondering about physical exercise as well.
It looks like what they eat was controlled, just different calories and additional whey for the high protein group.Diet Intervention
Subjects attended weekly sessions led by an experienced weight management dietician to ensure compliance with the diet prescription, monitor body weight, and counsel subjects throughout the dietary intervention. The energy content of the initial packed meals given to the weight loss groups was targeted to provide 30% fewer calories than each person’s estimated total daily energy expenditure, based on their resting metabolic rate (RMR) multiplied by an activity factor of 1.4 (Black et al., 1996); subsequent meals and dietary intake were adjusted weekly as needed to achieve a 0.5%–1% weight loss per week until 8%–10% was achieved. Once the targeted weight loss goal was achieved, dietary energy intake was modified to maintain a stable body weight for 3–4 weeks before the testing procedures performed at baseline were repeated. Protein intake and macronutrient distribution of the diet were kept constant in accordance with the initial diet prescription throughout the intervention period. In the WM group, each subject’s energy intake was adjusted as needed to maintain body weight within 2% of the initial body weight. Target protein intake for the WL group was 0.8 g protein/kg body weight per day and 1.2 g protein/kg body weight per day for subjects in the WL-HP group.
All subjects were provided with a base diet of frozen entrees (eLiving meals, Morrison Healthcare; Lean Cuisine, Nestlé USA; Revel Kitchen) for lunch and dinner. For breakfast, subjects consumed two energy bars (NuGo Nutrition) per day. Subjects in the WL-HP diet group also consumed two servings of a whey protein isolate (Unjury, ProSynthesis Laboratories) per day, whereas subjects in the WL group consumed snacks that provided mostly carbohydrates and fat (in proportion to their contribution to total non-protein dietary energy content of the base diet; i.e., ∼63 and 37%, respectively) instead. Additional calories needed to meet each subject’s total energy and macronutrient requirements were consumed as fruits, vegetables, dairy products, and starches. Dietary compliance was monitored by having subjects record their dietary intake every day by using the https://www.myfitnesspal.com computer app; the study dietician reviewed diet records weekly. In addition, 24-hr urinary urea nitrogen excretion was evaluated before and during the final week of the dietary intervention.
Oh look, they used Myfitnesspal.2
Categories
- All Categories
- 1.4M Health, Wellness and Goals
- 391.5K Introduce Yourself
- 43.5K Getting Started
- 259.7K Health and Weight Loss
- 175.6K Food and Nutrition
- 47.3K Recipes
- 232.3K Fitness and Exercise
- 391 Sleep, Mindfulness and Overall Wellness
- 6.4K Goal: Maintaining Weight
- 8.5K Goal: Gaining Weight and Body Building
- 152.7K Motivation and Support
- 7.8K Challenges
- 1.3K Debate Club
- 96.3K Chit-Chat
- 2.5K Fun and Games
- 3.2K MyFitnessPal Information
- 22 News and Announcements
- 925 Feature Suggestions and Ideas
- 2.3K MyFitnessPal Tech Support Questions