The Upside of Protein (continued)

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• Blood fats. Many people worry that high-protein, low-carb diets will worsen cholesterol and triglyceride levels. But the New England Journal report, like many other research studies, found the opposite. People eating the high-protein diet benefited from an average 23.7 mg/dl (1.32 mmol) decrease in triglyceride levels — almost 10 times greater than those on the low-fat diet. (People eating a Mediterranean diet also had substantial decreases in triglycerides.) Meanwhile, the “bad” low-density lipoprotein (LDL) form of cholesterol decreased in both the high-protein and Mediterranean diet groups, but not in the low-fat group. And the “good” high-density lipoprotein (HDL) form of cholesterol increased about 30 percent more in the high-protein group, compared with the others. All of these changes would reduce the risk of heart disease, the leading cause of death among people with diabetes.**

How to Eat
Both the high-protein, low-carb and the Mediterranean diets produced the greatest benefits, compared with a low-fat diet. But you don’t have to go on a strict Atkins-style diet to see your health improve. Another study, published in the Journal of Nutrition, found that even moderate increases in protein and decreases in carbohydrates led to a reduction in abdominal fat.

To put a protein-rich diet into practice, eat a variety of proteins — emphasizing fish, lean meat, and poultry. Legumes (beans, peanuts, lentils, snow peas, sugar snaps) are good sources of protein, although they also contain substantial amounts of carbohydrate, so eat small portions at a time and test to see how your blood sugar reacts. And along with that protein, get plenty of non-starchy, high-fiber vegetables and fruits, including salad greens, tomatoes, broccoli, cauliflower, raspberries, blueberries, and kiwifruit. Not only are these plants foods brimming with health-giving nutrients, the fiber in them helps stabilize blood sugar levels.

Note of caution: Patients with end-stage kidney failure are routinely advised to limit their protein intake. So if you have been diagnosed with any type of kidney problem — even a mild reduction in kidney function — please consult with your physician before adopting a higher protein diet.

* Editor's Update: A 2011 study published in the Nutrition Journal tracked 83 overweight or obese women who followed either a high protein, low fat diet or a high fiber, low fat diet. After 8 weeks, participants on both diets lost weight. However, when compared to women on the high fiber diet, women on the high protein diet lost more weight (9.9 pounds versus 7.3 pounds), lost more total body fat (8.8 pounds versus 5.5 pounds), and experienced lower blood pressure.

** Editor's Update: A 2010 study published in the European Journal of Clinical Nutrition followed 17 obese participants with type 2 diabetes. The participants followed two diets, for four weeks each. One was a high protein, low fat diet and the other was a low protein, high fat diet. The high protein diet had a significantly greater impact on lowering triglyceride levels and reducing both systolic and diastolic blood pressure.

SOURCES:
1 - Knight E.L., M.J. Stampfer, S.E. Hankinson, D. Spiegelman, and G.C. Curhan. 2007. The impact of protein intake on renal function decline in women with normal renal function or mild renal insufficiency. Annals of Internal Medicine 138(6): 460-467.
2 - Lentine K., E.M. Wrone. 2004. New insights into protein intake and progression of renal disease. Current Opinion in Nephrology and Hypertension 13(3): 333-336.
3 - Merchant A.T., S.S. Anand, V. Vuksan, et al. 2005. Protein intake is inversely associated with abdominal obesity in a multi-ethnic population. Journal of Nutrition 135:1196-1201.
4 - Nielsen J.V., E.A. Joensson. 2008. Low-carbohydrate diet in type 2 diabetes: stable improvement of bodyweight and glycemic control during 44 months follow-up. Nutrition & Metabolism 5:14.
5 - Papakonstantinou, E., D. Triantafillidou, D.B. Panagiotakos, et al. 2010. A high-protein low-fat diet is more effective in improving blood pressure and triglycerides in calorie-restriced obese individuals with newly diagnosed type 2 diabetes. European Journal of Clinical Nutrition 64(6): 595-602. http://www.ncbi.nlm.nih.gov/pubmed/20216558 (Accessed 6/01/2011).
6 - Parker B., M. Noakes, N. Luscombe, et al. 2002. Effect of a high-protein, high-monounsaturated fat weight loss diet on glycemic control and lipid levels in type 2 diabetes. Diabetes Care 25:425-430.
7 - Shai I., D. Schwartzfuchs, Y. Henkin, et al. 2008. Weight loss with a low-carbohydrate, Mediterranean, or low-fat diet. New England Journal of Medicine 359:229-241.
8 - Te Morenga, L.A., M.T. Levers, S.M. Williams, et al. 2011. Comparison of high protein and high fiber weight-loss diets in women with risk factors for the metabolic syndrome: a randomized trial. Nutrition Journal. http://www.nutritionj.com/content/10/1/40/abstract (Accessed 05/31/11).

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Reviewed by Susan Weiner, R.D., M.S., C.D.E., C.D.N. 10/08