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

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German Institute of Human Nutrition Potsdam-Rehbrücke, Clinical Nutrition-DZD, Arthur-Scheunert-Allee 114-116, D-14558 Nuthetal, Germany
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Charité University Medicine, Department of Endocrinology, Diabetes and Nutrition, Campus Benjamin Franklin, Hindenburgdamm 30, D-12203 Berlin, Germany
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German Center for Diabetes Research (DZD), 85764 München-Neuherberg, Germany
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School of Pharmacy and Medical sciences, University of South Australia, Adelaide SA 5000, Australia
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Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, Kuopio Campus, 70211 Kuopio, Finland
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Department of Medicine, Endocrinology and Clinical Nutrition, Kuopio University Hospital, 70029 KYS Kuopio, Finland
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Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Box 564, 75122 Uppsala, Sweden
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Oslo University Hospital, Division of Medicine, Department of Clinical Service, Section of Nutrition and Dietetics, 0424 Oslo, Norway
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Diabetes Center, Second Department of Internal Medicine, Medical School, National and Kapodistian University of Athens 11527, Greece
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Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, University of Toronto, Toronto, ON M5S 1A8, Canada
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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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Division of Endocrinology & Metabolism, Department of Medicine, St. Michael’s Hospital, Toronto, ON M5C 2T2, Canada
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Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, ON M5C 2T2, Canada
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Institute for Clinical and Experimental Medicine, 14021 Prague, Czech Republic
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Physicians Committee for Responsible Medicine, Washington, DC 20016, USA
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Endocrinology and Metabolic Diseases, Vuk Vrhovac University Clinic for Diabetes, Merkur University Hospital, 10000 Zagreb, Croatia
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University of Zagreb School of Medicine, 10000 Zagreb, Croatia
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Human Nutrition Unit, Faculty of Medicine and Health Sciences, Institute of Health Pere Virgili, Universitat Rovira i Virgili, 43201 Reus, Spain
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CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain
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Department of Endocrinology and Metabolism, Aarhus University Hospital, 8200 AarhusAarhus, Denmark
*
Author to whom correspondence should be addressed.
Nutrients 2020, 12(2), 365; https://doi.org/10.3390/nu12020365
Received: 12 December 2019 / Revised: 17 January 2020 / Accepted: 24 January 2020 / Published: 30 January 2020
(This article belongs to the Special Issue Nutritional Therapy for Diabetes Mellitus)
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. View Full-Text
Keywords: protein intake; type 2 diabetes; hypocaloric diet; weight loss; animal protein; plant protein protein intake; type 2 diabetes; hypocaloric diet; weight loss; animal protein; plant protein
MDPI and ACS Style

Pfeiffer, A.F.; Pedersen, E.; Schwab, U.; Risérus, U.; Aas, A.-M.; Uusitupa, M.; Thanopoulou, A.; Kendall, C.; Sievenpiper, J.L.; Kahleová, H.; Rahélic, D.; Salas-Salvadó, J.; Gebauer, S.; Hermansen, K. The Effects of Different Quantities and Qualities of Protein Intake in People with Diabetes Mellitus. Nutrients 2020, 12, 365.

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