Potential prevention of diabetes and obesity by achieving macronutrient balance: a guide for diet and fast food
Keywords:macronutrients, protein, weight loss, fast food, satiety
AbstractProtein is the most satiating macronutrient. Animal studies have indicated that there may be a discrete amount of protein that an individual seeks to consume each day. Given this to be true, a person will continue to eat until this amount of protein has been consumed. Once the target is met, hunger signals are switched off. By altering the proportion of protein in a diet, you can affect how many calories are required to meet this target. A diet with a protein content >15% drives weight loss through the reduction of calories consumed to meet protein needs. We hypothesise that changing the proportion of calories from protein in a person’s diet from 12% to 20% could alter their total intake by 1000 kcal each day. This equates to a weight change of 0.9 kg each week. Maintaining a healthy weight is not as simple as changing a single variable. Eating habits in the UK are governed by a range of complex interdependent factors including hunger, emotions, cost, accessibility, education and culture. However, we suggest that by addressing satiety, and thereby hunger, we may remove a significant barrier for those trying to alter their diet for weight loss.
GOV.UK. Health Survey for England 2017. [Internet]. 2019 (accessed 25 November 2019). Available from: https://www.gov.uk/government/statistics/health-survey-for-england-2017
NHS Digital. Statistics on Obesity, Physical Activity and Diet, England, 2019. [Internet]. 2019 (accessed 25 November 2019). Available from: https://digital.nhs.uk/data-and-information/publications/statistical/statistics-on-obesity-physical-activity-and-diet/statistics-on-obesity-physical-activity-and-diet-england-2019
GOV.UK. Health matters: obesity and the food environment [Internet]. 2019 (accessed 25 November 2019). Available from: https://www.gov.uk/ government/publications/health-matters-obesity-and-the-food-environment/health-matters-obesity-and-the-food-environment--2
GOV.UK. Health matters: preventing type 2 diabetes [Internet]. 2019 (accessed 25 November 2019). Available from: https://www.gov.uk/government/publications/health-matters-preventing-type-2-diabetes/health-matters-preventing-type-2-diabetes
Wishnofsky M. Caloric equivalents of gained or lost weight. Am J Clin Nutr 1958;6:542–6.
Prior G, Hall L, Morris S, Draper A. Exploring food attitudes and behaviours in the UK: findings from the Food and You Survey 2010. Food Standards Agency, 2011:6–9.
De Irala-Estevez J, Groth M, Johansson L, et al. A systematic review of socioeconomic differences in food habits in Europe: consumption of fruit and vegetables. Eur J Clin Nutr 2000;54:706–14. https://doi.org/10.1038/sj.ejcn.1601080
Smeets AJ, Westerterp-Plantenga MS. Acute effects on metabolism and appetite profile of one meal difference in the lower range of meal frequency. Br J Nutr 2008;99:1316–21. https://doi.org/10.1017/S0007114507877646
Angelopoulos T, Kokkinos A, Liaskos C, et al. The effect of slow spaced eating on hunger and satiety in overweight and obese patients with type 2 diabetes mellitus. BMJ Open Diabetes Res Care 2014;2(1):e000013. https://doi.org/10.1136/bmjdrc-2013-000013
Sominsky L, Spencer SJ. Eating behavior and stress: a pathway to obesity. Front Psychol 2014;5:434. https://doi.org/10.3389/fpsyg.2014.00434
Ravussin E, Redman LM, Rochon J, et al. A 2-year randomized controlled trial of human caloric restriction: feasibility and effects on predictors of health span and longevity. J Gerontol A Biol Sci Med Sci 2015;70:1097–104. https://doi.org/10.1093/gerona/glv057
Bradley U, Spence M, Courteney CH, et al. Effects on weight loss, insulin resistance, and cardiovascular risk: a randomized control trial. Diabetes 2009;58:2741–8. https://doi.org/10.2337/db09-0098
Wadden TA. Treatment of obesity by moderate and severe caloric restriction. Results of clinical research trials. Ann Intern Med 1993;119(7 Pt 2):688–93. https://doi.org/10.7326/0003-4819-119-7_part_2-199310011-00012
Grodstein F, Levine R, Troy L, et al. Three-year follow-up of participants in a commercial weight loss program. Can you keep it off? Arch Intern Med 1996;156:1302–6.
Dansinger M, Gleason JA, Griffith JL, Selker HP, Schaefer EJ. Comparison of the Atkins, Ornish, Weight Watchers, and Zone diets for weight loss and heart disease risk reduction: a randomized trial. JAMA 2005;293: 43–53. https://doi.org/10.1001/jama.293.1.43
Alhassan S, Kim S, Bersamin A, King AC, Gardner CD. Dietary adherence and weight loss success among overweight women: results from the A to Z weight loss study. Int J Obesity 2008;32:985–91. https://doi.org/10.1038/ijo.2008.8
Gibson A, Sainsbury A. Strategies to improve adherence to dietary weight loss interventions in research and real-world settings. Behav Sci (Basel) 2017;7:E44. https://doi.org/10.3390/bs7030044
Holt S, Miller J, Petocz P, Farmakalidis E. A satiety index of common foods. Eur J Clin Nutr 1995;49:675–90.
Rolls B, Bell E, Waugh B. Increasing the volume of a food by incorporating air affects satiety in men. Am J Clin Nutr 2000;72:361–8. https://doi.org/10.1093/ajcn/72.2.361
Leidy H, Carnell N, Mattes R, Campbell W. Higher protein intake preserves lean mass and satiety with weight loss in pre-obese and obese women. Obesity (Silver Spring) 2007;15:421–9. https://doi.org/10.1038/oby. 2007.531
Lejeune M, Westerterp KR, Adam TC, Luscombe-Marsh ND, Westerterp-Plantenga MS. Ghrelin and glucagon-like peptide 1 concentrations, 24-h satiety, and energy and substrate metabolism during a high-protein diet and measured in a respiration chamber. Am J Clin Nutr 2006;83:89–94. https://doi.org/10.1093/ajcn/83.1.89
Hill A, Blundell J. Macronutrients and satiety: the effects of a high-protein or high-carbohydrate meal on subjective motivation to eat and food preferences. Nutr Behav 1986;3:133–44.
Burton-Freeman B. Dietary fibre and energy regulation. J Nutr 2000; 130(2S Suppl):272–5S. https://doi.org/10.1093/jn/130.2.272S
Rolls B, Bell E, Thorwart M. Water incorporated into a food but not served with a food decreases energy intake in lean women. Am J Clin Nutr 1999;70:448–55. https://doi.org/10.1093/ajcn/70.4.448
Pesta D, Samuel V. A high-protein diet for reducing body fat: mechanisms and possible caveats. Nutr Metab (Lond) 2014;11:53–60. https://doi.org/10.1186/1743-7075-11-53
Baba N, Sawaya S, Torbay N, Habbal Z, Azar S, Hashim SA. High protein vs high carbohydrate hypoenergetic diet for the treatment of obese hyperinsulinemic subjects. Int J Obes Relat Metab Disord 1999;23:1202–06. https://doi.org/10.1038/sj.ijo.0801064
Griffioen-Roose S, Mars M, Siebelink E, Finlayson G, Tome D, de Graaf C. Protein status elicits compensatory changes in food intake and food preferences. Am J Clin Nutr 2012;95:32–8. https://doi.org/10.3945/ajcn.111.020503
Martens E, Lemmens S, Westerterp-Plantenga M. Protein leverage affects energy intake of high-protein diets in humans. Am J Clin Nutr 2013; 97:86–93. https://doi.org/10.3945/ajcn.112.046540
Westerterp-Plantenga M, Luscombe-Marsh ND, Lejeune M, et al. Dietary protein, metabolism, and body-weight regulation: dose-response effects. Int J Obes 2006;30:S16–23. https://doi.org/10.1038/sj.ijo.0803487
Weigle D, Breen PA, Matthys CC, et al. A high protein diet induces sustained reductionist in appetite, ad libitum caloric intake, and body weight despite compensatory changes in diurnal plasma leptin and ghrelin concentrations. Am J Clin Nutr 2005;82:41–8. https://doi.org/10.1093/ajcn.82.1.41
Skov R, Toubro S, Ronn B, Astrup A. Randomized trial on protein vs carbohydrate in ad libitum fat reduced diet for the treatment of obesity. Int J Obes Relat Metab Disord 1999;23:528–36. https://doi.org/10.1038/sj.ijo.0800867
Aller E, Larsen TM, Claus H, et al. Weight loss maintenance in overweight subjects on ad libitum diets with high or low protein content and glycemic index: the DIOGENES trial 12-month results. Int J Obes 2014;38:1511–17. https://doi.org/10.1038/ijo.2014.52
Johnston C, Tjonn S, Swan P. High-protein, low fat diets are effective for weight loss and favourably alter biomarkers in healthy adults. J Nutr 2004;134:586–91. https://doi.org/10.1093/jn/134.3.586
Simpson S, Raubenheimer D. A multi-level analysis of feeding behaviour: the geometry of nutritional decisions. Phil Trans R Soc London Series B: Biol Sci 1993;342:381–402. https://doi.org/10.1098/rstb.1993.0166
Thibault L, Booth D. Macronutrient-specific dietary selection in rodents and its neural bases. Neurosci Biobehav Rev 1999;23:457–528. https://doi.org/10.1016/s0149-7634(98)00047-5
Berthoud H, Münzberg H, Richards B, Morrison C. Neural and metabolic regulation of macronutrient intake and selection. Proc Nutr Soc 2012;71:390–400. https://doi.org/10.1017/S0029665112000559
Martinez-Corderoa C. Testing the protein leverage hypothesis in a free-living human population. Appetite 2012;59:312–5.
Rolls B, Hetherington M, Burley V. The specificity of satiety: the influence of foods of different macronutrient content on the development of satiety. Physiol Behav 1988;43:145–53.
Simpson S, Batley R, Raubenheimer D. Geometric analysis of macronutrient intake in humans: the power of protein? Appetite 2003;41:123–40.
Gosby A, Conjgrave AD, Lau NS, et al. Testing protein leverage in lean humans: a randomized controlled experimental study. PLoS One 2011;6:e25929. https://doi.org/10.1371/journal.pone.0025929
Wycherley T, Moran LJ, Clifton PM, Noakes M, Brinkworth GD. Effects of energy-restricted high-protein, low-fat compared with standard-protein, low-fat diets: a meta-analysis of randomized controlled trials. Am J Clin Nutr 2012;96:1281–98. https://doi.org/10.3945/ajcn.112.044321
Clifton P, Bastiaans K, Keogh J. High protein diets decrease total and abdominal fat and improve CVD risk profile in overweight and obese men and women with elevated triacylglycerol. Nutr Metab Cardiovasc Dis 2009;19:548–54. https://doi.org/10.1016/j.numecd.2008.10.006
Te Morenga L, Levers MT, Williams SM, Brown RC, Mann J. Comparison of high protein and high fiber weight-loss diets in women with risk factors for the metabolic syndrome: a randomized trial. Nutr J 2011;10:40. https://doi.org/10.1186/1475-2891-10-40
Astrup A, Raben A, Geiker N. The role of higher protein diets in weight control and obesity-related comorbidities. Int J Obes 2015;39:721–6. https://doi.org/10.1038/ijo.2014.216
Esmeijer K, Geleijnse JM, de Fijter JW, Kromhout D, Hoogeveen EK. Dietary protein intake and kidney function decline after myocardial infarction: the Alpha Omega Cohort. Nephrol Dial Transplant 2020;35:106–15. https://doi.org/10.1093/ndt/gfz015
Jhee JH, Kee YK, Park S, et al. High-protein diet with renal hyperfiltration is associated with rapid decline rate of renal function: community-based prospective cohort study. Nephrol Dial Transplant 2020;35:98–106. https://doi.org/10.1093/ndt/gfz115
Farhadnejad H, Asghari G, Emamat H, Mirmiran P, Azizi F. Low-carbohydrate high-protein diet is associated with increased risk of incident chronic kidney diseases among Tehranian adults. J Renal Nutr 2019;29:343–9. https://doi.org/10.1053/j.jrn.2018.10.007
Santesso N, Akl EA, Bianchi M, et al. Effects of higher- versus lower- protein diets on health outcomes: a systematic review and meta-analysis. Eur J Clin Nutr 2012;66:780–8. https://doi.org/10.1038/ejcn.2012.37
Holesh J, Martin A. Physiology, Carbohydrates. [Internet]. StatPearls, 2019. Available from: https://www.ncbi.nlm.nih.gov/books/NBK459280/ (accessed 25 November 2019).
Dummies.com. How to calculate your metabolic rate. 2019. Available from: https://www.dummies.com/health/nutrition/how-to-calculate-your-metabolic-rate/ (accessed 25 November 2019).
Statista. Fast food restaurants: most popular 2015. [Online]. 2019. Available from: https://www.statista.com/statistics/527217/leading-fast-food-restaurants-in-the-united-kingdom-uk/ (accessed 25 November 2019).
SELFNutritionData. Fullness Factor™ – NutritionData.com [Internet]. 2019 Available from: https://nutritiondata.self.com/topics/fullness-factor (accessed 25 November 2019).
Subway.com [Internet]. 2019. Available from: https://www.subway.com/ en-GB/MenuNutrition/Menu/All (accessed 25 November 2019).
mcdonalds.com [Internet]. 2019. Available from: https://www.mcdonalds.com/gb/en-gb/good-to-know/nutrition-calculator.html (accessed 25 November 2019).
kfc.co.uk [Internet]. 2019. Available from: https://www.kfc.co.uk/nutrition.pdf (accessed 25 November 2019).
Burgerking.co.uk [Internet]. 2019. Available from: https://bk-emea-prd.s3.amazonaws.com/sites/burgerking.co.uk/files/documents/BK19-1233-UK-NUTRITIONAL-REPORT-A3-F2.pdf (accessed 25 November 2019).
Pizzahut.co.uk [Internet]. 2019. Available from: https://www.pizzahut.co.uk/order/pdfs/Nutritional-Information.78477dd3eb5a16ababfff5be216bada8.pdf 3 (accessed 25 November 2019).
fastfoodprice.co.uk [Internet]. 2019. Available from: https://fastfoodprice.co.uk/ (accessed 25 November 2019).
burgerlad.com [Internet]. 2019. Available from: https://burgerlad.com/ (accessed 25 November 2019).
Nettleton J, Lutsey PL, Wang Y, Lima JA, Michos ED, Jacobs DR Jr. Diet soda intake and risk of incident metabolic syndrome and type 2 diabetes in the multi-ethnic study of atherosclerosis (MESA). Diabetes Care 2009;32:688–94. https://doi.org/10.2337/dc08-1799
NHS.UK [Internet]. 5 a day. What counts? 2018. Available from: https://www.nhs.uk/live-well/eat-well/5-a-day-what-counts/ (accessed 25 November 2019).
NHS.UK [Internet]. Water, drinks and your health. 2019. Available from: https://www.nhs.uk/live-well/eat-well/water-drinks-nutrition/ (accessed 25 November 2019).
Popkin B, D'Anci K, Rosenberg I. Water, hydration, and health. Nutr Rev 2010;68:439–58. https://doi.org/10.1111/j.1753-4887.2010.00304.x
Drichoutis AC, Lazaridis P, Nayga RM. Consumers’ use of nutritional labels: a review of research studies and issues. Acad Marketing Sci Rev 2006;9:93–118.
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