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Article

High-Protein, Low-Glycaemic Meal Replacement Decreases Fasting Insulin and Inflammation Markers—A 12-Month Subanalysis of the ACOORH Trial

1
West-German Center of Diabetes and Health, Düsseldorf Catholic Hospital Group, 40591 Düsseldorf, Germany
2
Department of Sports Medicine, Institute for Sports and Sport Science, University of Frankfurt, 60487 Frankfurt, Germany
3
Department of Sports and Movement Medicine, Faculty of Psychology and Human Movement Sciences, University of Hamburg, 20148 Hamburg, Germany
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Department of Prevention, Rehabilitation and Sports Medicine, Klinikum rechts der Isar, Technical University of Munich (TUM), 80992 Munich, Germany
5
DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, 80802 Munich, Germany
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Public Health Nutrition Research Group, London Metropolitan University, London N7 8DB, UK
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Institute of Cardiovascular Research and Sports Medicine, German Sport University Cologne, 50933 Cologne, Germany
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KARDIOS, Cardiologists in Berlin, 10787 Berlin, Germany
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Department of Endocrinology, Diabetes and Metabolism and Division of Laboratory Research, University Hospital Essen, University Duisburg-Essen, 45122 Essen, Germany
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Department of Medicine, Division of Endocrinology, Medical University of Graz, 8010 Graz, Austria
11
Faculty of Medicine, University of Freiburg, 79117 Freiburg, Germany
12
Faculty of Medicine, Heinrich-Heine-University Düsseldorf, 40591 Düsseldorf, Germany
*
Author to whom correspondence should be addressed.
These authors contributed equally to this work.
Almased Concept Against Overweight and Obesity and Related Health Risk.
Academic Editors: Antonio Brunetti and Casper Schalkwijk
Nutrients 2021, 13(5), 1433; https://doi.org/10.3390/nu13051433
Received: 9 March 2021 / Revised: 19 April 2021 / Accepted: 20 April 2021 / Published: 23 April 2021
Lifestyle interventions, including meal replacement, are effective in the prevention and treatment of type-2-diabetes and obesity. Since insulin is the key weight regulator, we hypothesised that the addition of meal replacement to a lifestyle intervention reduces insulin levels more effectively than lifestyle intervention alone. In the international multicentre randomised controlled ACOORH (Almased Concept against Overweight and Obesity and Related Health Risk) trial, overweight or obese persons who meet the criteria for metabolic syndrome (n = 463) were randomised into two groups. Both groups received nutritional advice focusing on carbohydrate restriction and the use of telemonitoring devices. The intervention group substituted all three main meals per day in week 1, two meals per day in weeks 2–4, and one meal per day in weeks 5–26 with a protein-rich, low-glycaemic meal replacement. Data were collected at baseline and after 1, 3, 6 and 12 months. All datasets providing insulin data (n = 446) were included in this predefined subanalysis. Significantly higher reductions in insulin (−3.3 ± 8.7 µU/mL vs. −1.6 ± 9.8 µU/mL), weight (−6.1 ± 5.2 kg vs. −3.2 ± 4.6 kg), and inflammation markers were observed in the intervention group. Insulin reduction correlated with weight reduction and the highest amount of weight loss (−7.6 ± 4.9 kg) was observed in those participants with an insulin decrease > 2 µU/mL. These results underline the potential for meal replacement-based lifestyle interventions in diabetes prevention, and measurement of insulin levels may serve as an indicator for adherence to carbohydrate restriction. View Full-Text
Keywords: fasting insulin; lifestyle intervention; protein-rich; low-glycaemic meal replacement; low-carbohydrate; overweight; obesity; weight reduction; multicentre study; RCT fasting insulin; lifestyle intervention; protein-rich; low-glycaemic meal replacement; low-carbohydrate; overweight; obesity; weight reduction; multicentre study; RCT
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MDPI and ACS Style

Kempf, K.; Röhling, M.; Banzer, W.; Braumann, K.M.; Halle, M.; McCarthy, D.; Predel, H.G.; Schenkenberger, I.; Tan, S.; Toplak, H.; Berg, A.; Martin, S.; on behalf of ACOORH Study Group. High-Protein, Low-Glycaemic Meal Replacement Decreases Fasting Insulin and Inflammation Markers—A 12-Month Subanalysis of the ACOORH Trial. Nutrients 2021, 13, 1433. https://doi.org/10.3390/nu13051433

AMA Style

Kempf K, Röhling M, Banzer W, Braumann KM, Halle M, McCarthy D, Predel HG, Schenkenberger I, Tan S, Toplak H, Berg A, Martin S, on behalf of ACOORH Study Group. High-Protein, Low-Glycaemic Meal Replacement Decreases Fasting Insulin and Inflammation Markers—A 12-Month Subanalysis of the ACOORH Trial. Nutrients. 2021; 13(5):1433. https://doi.org/10.3390/nu13051433

Chicago/Turabian Style

Kempf, Kerstin, Martin Röhling, Winfried Banzer, Klaus M. Braumann, Martin Halle, David McCarthy, Hans G. Predel, Isabelle Schenkenberger, Susanne Tan, Hermann Toplak, Aloys Berg, Stephan Martin, and on behalf of ACOORH Study Group. 2021. "High-Protein, Low-Glycaemic Meal Replacement Decreases Fasting Insulin and Inflammation Markers—A 12-Month Subanalysis of the ACOORH Trial" Nutrients 13, no. 5: 1433. https://doi.org/10.3390/nu13051433

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