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Effect of a Low-carbohydrate, High-protein Energy-restricted Diet on Weight and Body Composition Using DXA

Not Applicable
Completed
Conditions
Body Composition
Weight Loss
Interventions
Other: No High Protein Diet Group
Other: High Protein Diet Group
Registration Number
NCT04646733
Lead Sponsor
Erik Ramirez Lopez
Brief Summary

People often choose certain diets to lose weight or to change their habits or lifestyle. The Dukan diet was created in the '70s and took on importance in the last decade. It is a 4 phase diet similar to the Atkins diet. However, this diet is aggressive in its first phase because it suppresses carbohydrates, the main source of external energy being saturated low-fat protein. Studies of this diet are scarce and have been limited to describing the contribution of micronutrients. In nutritional practice, it is often assumed that a popular high-protein or low-calorie ketogenic diet could cause rapid or unfavourable changes in a patient's weight and body composition. However, the effect of these diets in the short or long term on weight and on body fat, muscle mass and other components is not clear. This means that body composition has not been the main objective when analyzing the effect of a popular diet. For this reason, the meta-analyzes focus on weight change and the absence of body composition data is a limitation of the selected studies. Changes in body composition due to a popular diet should be evaluated with techniques such as DXA. The aim of this study is to analyze the effect of a low-carbohydrate, high-protein diet with energy restriction on weight and body composition using DXA. For this, a randomized controlled study will be used where a group will receive the diet protocol. The control group will have a normal diet, and only one oatmeal drink will be added (55 g of oats in 250 ml of water). The drink will contain 1.6 g of BetaG per serving according to FDA recommendations that correspond to the 50% BetaG required per day.

Detailed Description

The patients (n = 60) are invited through posters and social networks to recruit a group of 40 overweight subjects (20% above their ideal weight). The protocol is explained in detail to each one, and the patient and two witnesses sign the informed consent. Subjects are assigned to one of two groups: group A: high protein diet (HPD) and group B: non-high protein diet (NHPD). The NHPD is designed according to Mexican nutrition guidelines according to sex and age.

The main anthropometric and biochemical measurements and diet monitoring are performed in the body composition laboratory of the Faculty of Sports Organization (FOD). Four technicians (nutritionists) are in charge of taking the measurements and recording the data. The principal investigators review the quality of the information and the correct completion of the records. Each file will be assigned an identification number. Other nutritionists (graduate students) will be in charge of auditing the information according to the protocol guidelines. Principal Investigators will resolve any discrepancies between technicians and graduate students to ensure data recording, deletion, or reevaluation.

Each patient is asked for a prior medical examination before entering the study. The data from the external medical practitioner are compared with those provided by the patient for the present study.

The main anthropometric variables are measured with the international ISAK methodology. The DXA equipment is calibrated daily, and the result is analyzed and analyzed by a researcher who evaluates whether the measurement is reliable.

The data is recorded in printed formats that are immediately scanned to maintain readability. Later, they are recorded in an Excel sheet with the patient's identification number. In each measurement session, the database is analyzed for abnormal, extreme or unlikely data. Two independent researchers are responsible for reviewing the database every day.

Each patient is cared for by a nutrition student who accompanies him in the basic needs, clothing and transfers to the measurement equipment. At the end of the evaluation, patients receive a complimentary meal and free transportation home.

Patients are monitored through WhatsApp to verify the presence of adverse events with the diet. Also, for any questions with the procedures. All procedures are recorded in paper and electronic form. In addition, they are given an additional number in case of medical emergency or consultation with a nutritionist.

The sample size will be limited in the first stage to 30 patients. Measurements and preliminary analysis will be obtained at 0, day four and day fifteen. The last two measurements will be taken on day 42 and until the subjects reach their ideal body weight.

In the case of missing data or defective quality record, subjects will be removed.

Regarding the statistical analysis, multiple linear regression will be used, where the groups and measurements will be compared on the different measurement days. As covariates, covariates will be incorporated as initial values, age, sex, BMI, among others, will be adjusted. Descriptive statistics will be added.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
150
Inclusion Criteria
  • individuals between the ages of 20 and 30
  • who were not currently consuming any drugs or were on diet or exercise treatment.
  • patients must have 120% or more of the ideal weight until a BMI of 35.
Exclusion Criteria
  • with no cardiovascular disease, kidney, intestinal or liver disease.
  • cholesterol (≥ 200 mg/dL)
  • high triglycerides (≥ 150mg/dL)
  • glucose (≥ 126mg /dL)

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
No High Protein Diet GroupNo High Protein Diet GroupNo high protein diet (NHPD) group received an oat beverage consisted of 55 g of oats in 250 ml of water.
High Protein Diet GroupHigh Protein Diet GroupThe high protein diet (HPD) group is instructed to follow a low carbohydrate, high protein ketogenic diet.
Primary Outcome Measures
NameTimeMethod
Body fatBaseline to three months.

Body fat measurements by DXA

Weight lostBaseline to three months

Weight lost through the various phases

Lean massBaseline to three months

Lean mass measurements by DXA

Secondary Outcome Measures
NameTimeMethod
Serum fasting albuminBaseline to three months

Serum total cholesterol is taken after 9 to 12 h, grams per deciliter (g/dL).

Serum fasting total proteinBaseline to three months

Serum total cholesterol is taken after 9 to 12 h, grams per deciliter (g/dL).

Serum fasting HDL cholesterolBaseline to three months

Serum total cholesterol is taken after 9 to 12 h, milligrams per deciliter (mg/dL).

Resting energy expenditureBaseline to three months

Energy expenditure measure by calorimetry.

Body waterBaseline to three months

Body water changes measured by bioelectrical impedance

Caloric and macronutrient intakeBaseline to three months

Energy and macronutrient distribution intake. To estimate the nutrient intake is used as a weighted dietary record. Each individual weighs the items on a scale before and after consumption by three consecutive days. Scales has a precision of 1 g. The persons record all the food and beverages consumed, including ingredients, preparation method, and quantity of the food consumed and not consumed. We proportionate all the instruction and description for the individual before assigning the task to record. This procedure ensures the accuracy and reliability of the information provided. Records are processed with the software DietOrganizer (R) to obtain caloric and macronutrient intake.

Serum fasting total cholesterolBaseline to three months

Serum total cholesterol is taken after 9 to 12 h, milligrams per deciliter (mg/dL).

Serum fasting triglyceridesBaseline to three months

Serum fasting triglicerides are taken after 9 to 12 h, milligrams per deciliter (mg/dL).

Serum fasting glucoseBaseline to three months

Serum fasting glucose is taken after 9 to 12 h, milligrams per deciliter (mg/dL).

Serum fasting total hemoglobinBaseline to three months

Serum total cholesterol is taken after 9 to 12 h, grams per deciliter (g/dL).

mid-arm perimeterBaseline to three months

mid arm perimeter is measured with a measuring tape and units are expresed as cm

hand strenght with a dynamometerBaseline to three months

Hand strength is measured with a standardized protocol using a chair. A digital dynamometer is employed, and units are expressed as kg.

triceps skinfold with a plicometerBaseline to three months

triceps skinfold is measured with a plicometer and the units are expresed as mm

waist perimeterBaseline to three months

waist perimeter is measured with a measuring tape and units are expresed as cm

Trial Locations

Locations (1)

Facultad de Organización Deportiva, FOD, Universidad Autónoma de Nuevo León

🇲🇽

Monterrey, N.l., Mexico

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