Efecto de diferentes dietas hipocalóricas con distinta distribución de macronutrientes y alimentos en el tratamiento de la obesidad y síndrome metabólico

Résumé

The purpose of this study was to assess through different dietary approaches the metabolic effects of a high protein intake within a hypocaloric diet in comparison with energy-restricted balanced diets with different food selection, which aimed to increase the polyunsaturated fatty acid intake (by fatty fish inclusion) or fiber consumption (by legume inclusion). The study was performed in 57 overweight/obese subjects (BMI: 32,2¿b3,6 kg/m2; 37¿b7 y.o) which were randomly included in one of the four energy-restricted diets: 1) Control diet (C-diet): 17% protein, 30 % lipids, 53% carbohydrates; 2) High-protein diet (HP-diet): 30% protein, 30 % lipids, 40% carbohydrates; 3) Fatty-fish diet (FF-diet): 17% protein, 30 % lipids, 53% carbohydrates and 4) Legume diet (L-diet): 17% protein, 30 % lipids, 53% carbohydrates. The energy restriction was -30% in relation to energy expenditure. Anthropometry, body composition, energy expenditure, biochemical variables and mitochondrial oxidation were assessed at baseline and at the end-point of the 8-week dietary intervention period. The four diets were effective reducing body weight and fat mass; however, the HP-diet and L-diet achieved the greater body weight reduction as compared with the other groups. HP-diet was effective improving insulin levels as well as HOMA index and increased the mitochondrial oxidation percentage, decreasing the negative effects associated to energy restriction. The FF-diet was effective improving insulin metabolism, but also produced an important decrease in circulating leptin levels, an energy metabolism related hormone, directly involved in body weight regulation. The L-diet was effective improving lipid metabolism, but also increased the mitochondrial oxidation percentage, minimizing the resting energy expenditure decrease, during the energy restriction period. In summary, the specific consumption of legumes or high protein content within a hypocaloric diet could activate mitochondrial oxidation, which could involve additional benefits to those associated to the weight reduction and fatty-fish included in an energy-restricted diet appears as a valid strategy to specifically improve insulin sensitivity and leptin levels, which could involve a better body weight regulation after a nutritional intervention period.