High protein diet: benefits and risks
https://doi.org/10.14341/omet12662
Abstract
The nature of human nutrition has become increasingly important as an effective element in the prevention and treatment of many pathologies, especially obesity, type 2 diabetes and cardiovascular diseases. High protein diets are some of the most popular eating patterns and the Dukan diet has taken the lead in popularity among the diets of this type. An increase of protein in the diet is effective in reducing body weight, primarily due to the loss of adipose tissue, without a significant effect on muscle mass. Another advantage of a high-protein diet is earlier and longer satiety compared to other diets, which makes it comfortable for use. Besides obesity, high protein diets are presumably effective for treating such diseases as nonalcoholic fatty liver disease, diabetes mellitus and cardiovascular diseases However, despite the important advantages, this nutritional model is not universal and is contraindicated in patients with diseases of liver, kidneys and osteoporosis. Besides, the prolonged use of a high protein diet may increase the risks of urolithiasis and reduced mineral bone density even for healthy individuals. Thus, the increase in the proportion of protein in the diet should take place exclusively under the supervision of a physician.
About the Authors
M. V. Altashina
Endocrinology Research Center
Marina V. Altashina, MD, PhD
Moscow
eLibrary SPIN: 2970-4485
E. V. Ivannikova
Endocrinology research center
Russian Federation
Russian Federation
Ekaterina V. Ivannikova, MD, PhD
11 Dm. Ulyanova street, 117036 Moscow
eLibrary SPIN: 6841-4760
E. A. Troshina
Endocrinology research centre
Ekaterina A. Troshina, MD, PhD, Professor
eLibrary SPIN: 8821-8990
References
1. World Health Organization. [Internet]. Key Facts on Obesity and Overweight. Available from: http://www.who.int/mediacentre/factsheets/fs311/en/
2. Shan Z, Rehm CD, Rogers G, et al. Trends in Dietary Carbohydrate, Protein, and Fat Intake and Diet Quality Among US Adults, 1999-2016. JAMA. 2019;322(12):1178. doi: https://doi.org/10.1001/jama.2019.13771
3. Morales F, Tinsley G, Gordon P. Acute and long-term impact of highprotein diets on endocrine and metabolic function, body composition, and exercise-induced adaptations. J Am Coll Nutr. 2017;36(4):295-305. doi: https://doi.org/10.1080/07315724.2016.1274691
4. Boye J, Wijesinha-Bettoni R, Burlingame B. Protein quality evaluation twenty years after the introduction of the protein digestibility corrected amino acid score method. British Journal of Nutrition. 2012;108(S2):183-211. doi: https://doi.org/10.1017/s0007114512002309
5. Report of an FAO Expert Consultation. Dietary protein quality evaluation in human nutrition. FAO Food Nutr Pap; 2011.
6. Tang J, Moore D, Kujbida G, et al. Ingestion of whey hydrolysate, casein, or soy protein isolate: effects on mixed muscle protein synthesis at rest and following resistance exercise in young men. J Appl Physiol. 2009;107(3):987-992. doi: https://doi.org/10.1152/japplphysiol.00076.2009
7. Wu G. Dietary protein intake and human health. Food Funct. 2016;7(3):1251-1265. doi: https://doi.org/10.1039/c5fo01530h
8. Moore DR, Churchward-Venne TA, Witard O, et al. Protein Ingestion to Stimulate Myofibrillar Protein Synthesis Requires Greater Relative Protein Intakes in Healthy Older Versus Younger Men. Journals Gerontol Ser A Biol Sci Med Sci. 2015;70(1):57-62. doi: https://doi.org/10.1093/gerona/glu103
9. Nowson C, O’Connell S. Protein requirements and recommendations for older people: a review. Nutrients. 2015;7(8):6874-6899. doi: https://doi.org/10.3390/nu7085311
10. Caspero A. Protein and the athlete—how much do you need? Playa del Rey, CA: California Academy of Nutrition and Dietetics; 2016.
11. Phillips S. A brief review of higher dietary protein diets in weight loss: a focus on athletes. Sports Med. 2014;44(2):149-153. doi: https://doi.org/10.1007/s40279-014-0254-y
12. Antonio J, Peacock CA, Ellerbroek A, et al. The effects of consuming a high protein diet (4.4 g/kg/d) on body composition in resistance-trained individuals. J Int Soc Sports Nutr. 2014;11(1):19. doi: https://doi.org/10.1186/1550-2783-11-19
13. Soenen S, Martens E, Hochstenbach-Waelen A, et al. Normal protein intake is required for body weight loss and weight maintenance, and elevated protein intake for additional preservation of resting energy expenditure and fat free mass. J Nutr. 2013;143(5):591-596. doi: https://doi.org/10.3945/jn.112.167593
14. Dukan Diet UK. Official Site. [Internet]. Weight Loss Plan, Coaching & Diet Recipes. [updated 2020 Aug 30]. Available from: http://www.dukandiet.co.uk/
15. De Chiara F, Checcllo CU, Azcón JR. High Protein Diet and Metabolic Plasticity in Non-Alcoholic Fatty Liver Disease: Myths and Truths. Nutrients. 2019;11(12):2985. doi: https://doi.org/10.3390/nu11122985.
16. Pasiakos SM, Cao JJ, Margolis LM, et al. Effects of high‐protein diets on fat‐free mass and muscle protein synthesis following weight loss: a randomized controlled trial. FASEB J. 2013;27(9):3837-3847. doi: https://doi.org/10.1096/fj.13-230227
17. Tang M, Armstrong CLH, Leidy HJ, Campbell WW. Normal vs. highprotein weight loss diets in men: Effects on body composition and indices of metabolic syndrome. Obesity. 2013;21(3):E204-E210. doi: https://doi.org/10.1002/oby.20078
18. Longland TM, Oikawa SY, Mitchell CJ, et al. Higher compared with lower dietary protein during an energy deficit combined with intense exercise promotes greater lean mass gain and fat mass loss: a randomized trial. Am J Clin Nutr. 2016;103(3):738-746. doi: https://doi.org/10.3945/ajcn.115.119339
19. Moon J, Koh G. Clinical Evidence and Mechanisms of High-Protein Diet-Induced Weight Loss. J Obes Metab Syndr. 2020;29(3):166-173. doi: https://doi.org/10.7570/jomes20028
20. Flint A, Raben A, Blundell JE, Astrup A. Reproducibility, power and validity of visual analogue scales in assessment of appetite sensations in single test meal studies. Int J Obes Relat Metab Disord. 2000;24:38–48. doi: https://doi.org/10.1038/sj.ijo.0801083.
21. Drummen M, Tischmann L, Gatta-Cherifi B, et al. Dietary Protein and Energy Balance in Relation to Obesity and Co-morbidities. Front Endocrinol (Lausanne). 2018;9(3):166-173. doi: https://doi.org/10.3389/fendo.2018.00443
22. Tome D, Schwarz J, Darcel N, et al. Protein, amino acids, vagus nerve signaling, and the brain. Am J Clin Nutr. 2009;90(3):838-843. doi: https://doi.org/10.3945/ajcn.2009.27462W
23. Cuenca-Sánchez М, Navas-Carrillo D, Orenes-Piñero Е. Controversies Surrounding High-Protein Diet Intake: Satiating Effect and Kidney and Bone Health. Adv Nutr. 2015;6(3):260–266. doi: https://doi.org/10.3945/an.114.007716
24. Boey D, Lin S, Enriquez RF, et al. Pyy transgenic mice are protected against diet-induced and genetic obesity. Neuropeptides. 2008;42(1):19-30. doi: https://doi.org/10.1016/j.npep.2007.11.003
25. Blom WA, Lluch A, Stafleu A, et al. Effect of a high-protein breakfast on the postprandial ghrelin response. Am. J. Clin. Nutr. 2006;83(2):211-220. doi: https://doi.org/10.1093/ajcn/83.2.211
26. Valassi E, Scacchi M, Cavagnini F. Neuroendocrine control of food intake. Nutr Metab Cardiovasc Dis. 2008;18(2):158-168. doi: https://doi.org/10.1016/j.numecd.2007.06.004
27. Bowen J, Noakes M, Clifton PM. Appetite regulatory hormone responses to various dietary proteins differ by body mass index status despite similar reductions in ad libitum energy intake. J Clin Endocrinol Metab. 2006;91(8):2913-2919. doi: https://doi.org/10.1210/jc.2006-0609
28. Andrews ZB. Central mechanisms involved in the orexigenic actions of ghrelin. Peptides. 2011;32(11):2248-2255. doi: https://doi.org/10.1016/j.peptides.2011.05.014
29. Blom WAM, Lluch A, Stafleu A, et al. Effect of a high-protein breakfast on the postprandial ghrelin response. Am J Clin Nutr. 2006;83(2):211-220. doi: https://doi.org/10.1093/ajcn/83.2.211
30. Giezenaar C, van der Burgh Y, Lange K, et al. Effects of Substitution, and Adding of Carbohydrate and Fat to Whey-Protein on Energy Intake, Appetite, Gastric Emptying, Glucose, Insulin, Ghrelin, CCK and GLP-1 in Healthy Older Men — A Randomized Controlled Trial. Nutrients. 2018;10(2):113. doi: https://doi.org/10.3390/nu10020113
31. Giezenaar C, Luscombe-Marsh ND, Hutchison AT, et al. Dosedependent effects of randomized intraduodenal whey-protein loads on glucose, gut hormone, and aminoacid concentrations in healthy older and younger men. Nutrients. 2018;10(1):78. doi: https://doi.org/10.3390/nu10010078
32. Pesta DH, Varman TS. A high-protein diet for reducing body fat: mechanisms and possible caveats. Nutr Metab (Lond). 2014;11(1):53. doi: https://doi.org/10.1186/1743-7075-11-53
33. Westerterp KR. Diet induced thermogenesis. Nutr Metab. 2004. doi: https://doi.org/10.1186/1743-7075-1-5
34. Moberg M, Apro W, Ohlsson I, et al. Absence of leucine in an essential amino acid supplement reduces activation of mtorc1 signalling following resistance exercise in young females. Appl Physiol Nutr Metab. 2014;39(2):183-194. doi: https://doi.org/10.1139/apnm-2013-0244
35. Ropelle ER, Pauli JR, Fernandes MF, et al. A central role for neuronal AMP-activated protein kinase (AMPK) and mammalian target of rapamycin (mTOR) in high-protein diet-induced weight loss. Diabetes. 2008;57:594–605. doi: https://doi.org/10.2337/db07-0573
36. McIver CM, Wycherley TP, Clifton PM. Mtor signaling and ubiquitin– proteosome gene expression in the preservation of fat free mass following high protein, calorie restricted weight loss. Nutr Metab (Lond). 2012;9(1):83. doi: https://doi.org/10.1186/1743-7075-9-83
37. Huntriss R, Campbell M, Bedwell C. The interpretation and effect of a lowcarbohydrate diet in the management of type 2 diabetes: a systematic review and meta-analysis of randomised controlled trials. Eur J Clin Nutr. 2018;72:311-325. doi: https://doi.org/10.1038/s41430-017-0019-4
38. Sargrad KR, Homko C, Mozzoli M, et al. Effect of high protein vs high carbohydrate intake on insulin sensitivity, body weight, hemoglobin A1c, and blood pressure in patients with type 2 diabetes mellitus. J Am Diet Assoc. 2005;105:573-580. doi: https://doi.org/10.1016/j.jada.2005.01.009
39. Von Bibra H, Wulf G, St John Sutton M, et al. Low-carbohydrate/highprotein diet improves diastolic cardiac function and the metabolic syndrome in overweight-obese patients with type 2 diabetes. IJC Metab Endocr. 2014;2:11–8.
40. Malaeb S, Bakker C, Chow LS , et al. High-Protein Diets for Treatment of Type 2 Diabetes Mellitus: A Systematic Review. Adv Nutr. 2019;10(4):621–633. doi: https://doi.org/10.1093/advances/nmz002
41. Hu FB. Protein, body weight, and cardiovascular health. Am J Clin Nutr. 2005;82(1):242-247. doi: https://doi.org/10.1093/ajcn.82.1.242S
42. Sucher S, Markova M, Hornemann S, et al. Comparison of the effects of diets high in animal or plant protein on metabolic and cardiovascular markers in type 2 diabetes: a randomized clinical trial. Diabetes Obes Metab. 2017;19:944–952. doi: https://doi.org/10.1111/dom.12901
43. Navas-Carretero S, San-Cristobal R, Livingstone KM, et al. Higher vegetable protein consumption, assessed by an isoenergetic macronutrient exchange model, is associated with a lower presence of overweight and obesity in the web-based Food4me European study. Int J Food Sci Nutr. 2019;70(2):240-253. doi: https://doi.org/10.1080/09637486.2018.1492524
44. Pedersen AN, Kondrup J, Børsheim E. Health effects of protein intake in healthy adults: a systematic literature review. Food Nutr Res. 2013;57(1):21245. doi: https://doi.org/10.3402/fnr.v57i0.21245
45. Anderson JW, Fuller J, Patterson K, et al. Soy compared to casein meal replacement shakes with high energy restricted diets for obese women: randomized controlled trial. Metabolism. 2006;56:280-288. doi: https://doi.org/10.1016/j.metabol.2006.10.013
46. Haring B, Gronroos N, Nettleton JA, et al. Dietary Protein Intake and Coronary Heart Disease in a Large Community Based Cohort: Results from the Atherosclerosis Risk in Communities (ARIC) Study. Bayer A, ed. PLoS One. 2014;9(10):e109552. doi: https://doi.org/10.1371/journal.pone.0109552
47. Bernstein AM, Sun Q, Hu FB, et al. Major dietary protein sources and thew risk of coronary heart disease in women. Circulation. 2010;122:876-883. doi: https://doi.org/10.1161/CIRCULATIONAHA.109.915165
48. Bernstein AM, Pan A, Rexrode KM, et al. Dietary protein sources and the risk of stroke in men and women. Stroke. 2012;43:637-644. doi: https://doi.org/10.1161/STROKEAHA.111.633404
49. Teunissen-Beekman KFM, Dopheide J, Geleijnse JM, et al. Differential effects of proteins and carbohydrates on postprandial blood. Br J Nutr. 2014;112:600-608. doi: https://doi.org/10.1017/S0007114514001251
50. Fekete AA, Givens DI, Lovegrove JA. The impact of milk proteins and peptides on blood pressure and vascular function: a review of evidence from human intervention studies. Nutr. Res. Rev. 2013;26:177-190. doi: https://doi.org/10.1017/S0954422413000139
51. Tielemans SMAJ, Kromhout D, Altdorf-van der Kuil W, et al. Associations of plant and animal protein intake with 05-year changes in blood pressure: the Zutphen elderly study. NutrMetab Cardiovasc Dis. 2014;24:1228-1233. doi: https://doi.org/10.1016/j.numecd.2014.05.013
52. Bortolotti M, Maiolo E, Corazza M, et al. Effects of a whey protein supplementation on intrahepatocellular lipids in obese female patients. Clin Nutr. 2011;30:494-498. doi: https://doi.org/10.1016/j.clnu.2011.01.006
53. Theytaz F, Noguchi Y, Egli L, et al. Effects of supplementation with essential amino acids on intrahepatic lipid concentrations during fructose overfeeding in humans. Am J Clin Nutr. 2012;96:1008-1016. doi: https://doi.org/10.3945/ajcn.112.035139
54. Westerterp-Plantenga MS, Lemmens SG, Westerterp KR. Dietary protein- its role in satiety, energetics, weight loss and health. Br J Nutr. 2012;108:105-112. doi: https://doi.org/10.1017/S0007114512002589
55. Veldhorst MA, Westerterp-Plantenga MS, Westerterp KR. Gluconeogenesis and energy expenditure after a high-protein, carbohydrate-free diet. Am J Clin Nutr. 2009;90(3):519-526. doi: https://doi.org/10.3945/ajcn.2009.27834
56. Torres N, Tovar AR. The role of dietary protein on lipotoxicity. Nutr Rev. 2007;65:64–68. doi: https://doi.org/10.1301/nr.2007.jun.S64-S68
57. Watanabe M, Houten SM, Wang L, et al. Bile acids lower triglyceride levels via a pathway involving FXR, SHP, and SREBP-1c. J Clin Invest. 2004;113:1408-1418. doi: https://doi.org/10.1172/JCI21025
58. Hudgins LC, Hellerstein MK, Seidman CE, et al. Relationship between carbohydrate-induced hypertriglyceridemia and fatty acid synthesis in lean and obese subjects. J Lipid Res. 2000;41(4):595-604. doi: https://doi.org/10.1016/S0022-2275(20)32407-X
59. Zelber-Sagi S, Nitzan-Kaluski D, Goldsmith R, et al. Long term nutritional intake and the risk for non-alcoholic fatty liver disease (NAFLD): A population based study. J. Hepatol. 2007;47:711–717. doi: https://doi.org/10.1016/j.jhep.2007.06.020
60. Rand WM, Pellett PL, Young VR. Meta-analysis of nitrogen balance studies for estimating protein requirements in healthy adults. Am J Clin Nutr. 2003;77(1):109-127. doi: https://doi.org/10.1093/ajcn/77.1.109
61. Simpson SJ, Raubenheimer D. The nature of nutrition: a unifying framework from animal adaptation to human obesity. Choice Rev Online. 2013;50(05):50-2662-50-2662. doi: https://doi.org/10.5860/CHOICE.50-2662
62. Nouvenne A, Ticinesi A, Morelli I, et al. Fad diets and their effect on urinary stone formation. Transl Androl Urol. 2014;3(3):303–312. doi: https://doi.org/10.3978/j.issn.2223-4683.2014.06.01
63. Cuenca-Sanchez M, Navas-Carrillo D, Orenes-Pinero E. Controversies surrounding high-protein diet intake: satiating effect and kidney and bone health. Adv Nutr. 2015;6(3):260-266. doi: https://doi.org/10.3945/an.114.007716.
64. Martin WF, Cerundolo LH, Pikosky MA, et al. Effects of dietary protein intake on indexes of hydration. J Am Diet Assoc. 2006;106(4):587-589. doi: https://doi.org/10.1016/j.jada.2006.01.011
65. Huang MC, Chen ME, Hung HC, et al. Inadequate energy and excess protein intakes may be associated with worsening renal function in chronic kidney disease. J Ren Nutr. 2008;18(2):187-194. doi: https://doi.org/10.1053/j.jrn.2007.08.003
66. Fink HA, Akornor JW, Garimella PS, et al. Diet, Fluid, or Supplements for Secondary Prevention of Nephrolithiasis: A Systematic Review and MetaAnalysis of Randomized Trials. Eur Urol. 2009;56(1):72-80. doi: https://doi.org/10.1016/j.eururo.2009.03.031
67. Antonio J, Ellerbroek A, Silver T, et al. A high protein diet (3.4 g/kg/d) combined with a heavy resistance training program improves body composition in healthy trained men and women – a follow-up investigation. J Int Soc Sports Nutr. 2015;12(1):39. doi: https://doi.org/10.1186/s12970-015-0100-0
Review
For citations:
Altashina M.V., Ivannikova E.V., Troshina E.A. High protein diet: benefits and risks. Obesity and metabolism. 2020;17(4):393-400. (In Russ.) https://doi.org/10.14341/omet12662
Views:
78755
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND 4.0).
Email this article 
