The Effects of Different Quantities and Qualities of Protein Intake in People with Diabetes Mellitus

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  • Andreas F H Pfeiffer, German Center for Diabetes Research (DZD), 85764 München-Neuherberg, Germany. andreas.pfeiffer@charite.de.
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  • Eva Pedersen, University of Adelaide
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  • Ursula Schwab, Department of Medicine, Endocrinology and Clinical Nutrition, Kuopio University Hospital, 70029 KYS Kuopio, Finland.
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  • Ulf Risérus, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Box 564, 75122 Uppsala, Sweden.
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  • Anne-Marie Aas, Oslo University Hospital, Division of Medicine, Department of Clinical Service, Section of Nutrition and Dietetics, 0424 Oslo, Norway.
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  • Matti Uusitupa, Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, Kuopio Campus, 70211 Kuopio, Finland.
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  • Anastasia Thanopoulou, Diabetes Center, Second Department of Internal Medicine, Medical School, National and Kapodistian University of Athens 11527, Greece.
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  • Cyril Kendall, Toronto 3D Knowledge Synthesis and Clinical trials Unit, Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, ON M5C 2T2, Canada.
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  • John L Sievenpiper, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON M5C 2T2, Canada.
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  • Hana Kahleová, Physicians Committee for Responsible Medicine, Washington, DC 20016, USA.
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  • Dario Rahélic, Department of Obstetrics and Gynaecology, School of Medicine, University of Zagreb, Šalata ul. 2, 10000 Zagreb, Croatia.
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  • Jordi Salas-Salvadó, CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain.
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  • Stephanie Gebauer, German Center for Diabetes Research (DZD), 85764 München-Neuherberg, Germany. andreas.pfeiffer@charite.de.
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  • Kjeld Hermansen

The recommended amount and quality of protein in diets of diabetic patients are highly controversial. In order to provide evidence-based information, the Diabetes Nutrition Study Group (DNSG) used a grading procedure used for quality of evidence and strength of recommendations (GRADE). A protein intake of 10% to 20% of energy intake (E%) or about 0.8 to 1.3 g/kg body weight in people below 65 years of age, and 15% to 20% of E% in people above 65 years of age appeared safe in weight-stable conditions. There were no intervention studies addressing metabolic effects, mortality, or cardiovascular events over prolonged periods. Body weight is closely linked to metabolic control and high protein diets are often recommended. Weight-loss diets that include 23% to 32% of E% as protein for up to one year reduced blood pressure and body weight slightly but significantly more than lower protein diets, whereas blood lipids, fasting blood glucose, and HbA1c improved similarly with higher or lower protein intakes in participants with a glomerular filtration rate (GFR) >60 mL/min/1.73 m2. Patients with a GFR <60 mL/min/1.73 m2 did not show a faster decline of GFR or kidney function with protein intakes around 0.8 g/kg body weight as compared with lower intakes, thereby arguing against a restriction. The effects of protein intake on diabetic eye or nerve disease have not been reported. There are a number of studies that have compared different types of animal proteins (milk, chicken, beef, pork, and fish) or compared animal with plant protein in diabetic patients and have reported a greater reduction of serum cholesterol with plant protein. In summary, the suggested range of protein intake appears to be safe and can be adapted according to personal dietary preferences.

OriginalsprogEngelsk
ArtikelnummerE365
TidsskriftNutrients
Vol/bind12
Nummer2
Antal sider12
ISSN2072-6643
DOI
StatusUdgivet - jan. 2020

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