OR12-3 Whey Protein  Induces Greater Reduction of Postprandial Glycemia and HbA1c, Weight Loss and Satiety Compared to Other Protein Sources  in Type 2 Diabetes

Program: Abstracts - Orals, Poster Previews, and Posters
Session: OR12-Fresh Thoughts on Diabetes Treatment
Clinical
Friday, April 1, 2016: 11:45 AM-1:15 PM
Presentation Start Time: 12:15 PM
Room 210 (BCEC)
Daniela Jakubowicz*1, Zohar Landau2, Julio Wainstein3, Yosefa Bar-Dayan4 and Oren Froy5
1Tel Aviv University, Tel Aviv, Israel, 2Wolfson Med Ctr, Holon, Holon, Israel, 3E. Wolfson Medical Center. Tel Aviv University, Holon, Israel, 4Tel Aviv University, Israel, Holon, Israel, 5The Hebrew University of Jerusalem, Rehovot, Israel
Background: Substantial evidence supports that a diet with high caloric protein breakfast (B) and reduced dinner (D) is a successful strategy for weight loss (WL), increased overall satiety (S) and reduced overall postprandial glycemia (PPG) and HbA1c in obese and type 2 diabetes (T2D). Particularly whey protein exerts potent direct insulinotropic  effect and through stimulation of glucagon-like peptide 1 (GLP-1) leading to reduction of PPG in T2D,

Objective: To search whether high protein B consisting of whey protein has a greater impact on WL, overall PPG, S and HbA1c than B with different protein sources.

Methods: 48 T2D, 22 males, BMI 32.1 0.9 kg/m2, aged 58.9 4.5 y, were randomized to 3 isocaloric (1500 kcal) WL diets during 12 weeks. The 3 diets had breakfast (660 kcal), lunch (567 kcal) and dinner (276 kcal) with the same composition at lunch (% of carb:prot:fat 20:45:25%) and dinner (13:40:47%), but differed in the B composition and protein content.

The 3 meals were: 1) A high-carbohydrate B Diet (CBd), n=15, with 13 g protein at B: (65:15:20%), i.e., ready-to-eat cereals. 2) A high-protein B Diet (PBd), n=16, with 36 g protein in B: (40:40:20%), i.e., eggs, tuna and cheese. 3) A whey B Diet (WBd), n=17, with 36 g protein in B, (40:40:20%), i.e., whey protein shake. Additionally, on 3 separate days between day 10 and 15 after diet initiation, all participants underwent 3 all day CBd, PBd and WBd meal tests, to assess PPG, insulin, intact GLP-1 and S after B, lunch and D.

Results: After 12 weeks, WL was -3.5 ± 0.3 kg (-3.8%) in CBd, -6.1 ± 0.3 kg (- 6.8 %) in PBd and the greater WL was found in WBd, -7.6 ± 0.3 kg (- 8.4%)  (p<0.0001). Compared to CBd, the % of WL in PBd was higher by 44 %, and in WBd was greater by 55% (p<0.0001).

The reduction of HbA1c was lower in CBd by -0.36 ± 0.04%, in PBd was -0.6 ± 0.04% and the greater reduction was found in WBd, 0.89 ± 0.05% (p<0.0001). The % of change for HbA1c was 4.6 % in CBd, 7.7% in PBd and the greatest reduction changes were in WBd by 11.5% (p<0.0001). Compared to CBd the % of the reduction of HbA1c was greater by 41 % in PBd, and by 64 % in WBd (p<0.0001).

Overall AUC for PPG was 95522 ± 565 mg/dl*min in CBd, 84065 ± 299 mg/dl*min in PBd and 77452 ± 292 mg/dl*min in WBd (p<0.0001). Compared to CBd the AUC for overall PPG was 12 % lower in PBd and 19 % lower in WBd (p<0.0001). The AUC for overall Insulin was 27% higher in PBd and 38% higher in WBd (p<0.0001). The AUC for overall intact GLP-1 increased more than in CBd, by 32% in PBd and by 41% in WBd (p<0.0001) and AUC for overall S was enhanced by 24% in PBd and by 30% in WBd compared to CBd (p<0.0001).

Conclusions: This study demonstrates that increasing protein content from 13 g to 36 g at breakfast has a significant impact on WL, overall S, HbA1c and overall PPG. However, for the same protein content, whey protein vs other protein sources, yields additional benefits on WL, overall S, reduction of PPG and HbA1c. Whey protein should be considered an important adjuvant in the management of T2D

Nothing to Disclose: DJ, ZL, JW, YB, OF

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