One-month of a low-energy diet, with no additional effect of high-protein, reduces Obstructive Sleep Apnea severity and improve metabolic parameters in obese males

Author(s)

de Melo, Camila Maria ^{[1, 2]} ; Quaresma, Marcus Vinicius Lucio dos Santos ^{[3, 4, 5]} ; del Re, Mariana Pantalea ^[1] ; Ribeiro, Sandra Maria Lima ^{[4, 5]} ; Antunes, Hanna Karen Moreira ^[3] ; Togeiro, Sonia M. ^[1] ; Tufik, Sergio ^[1] ; de Mello, Marco Tulio ^{[1, 6]}

Affiliation

^[1] Univ Fed Sao Paulo, Dept Psychobiol, Sao Paulo - Brazil

^[2] Univ Fed Lavras, Dept Nutr, Lavras - Brazil

^[3] Univ Fed Sao Paulo, Dept Biocsci, Sao Paulo - Brazil

^[4] Univ Fed Sao Paulo, Sch Publ Hlth, Sao Paulo - Brazil

^[5] Univ Fed Sao Paulo, Sch Arts Sci & Humanities, Sao Paulo - Brazil

^[6] Escola Educ Fis Fisioterapia & Terapia Ocupac, Dept Esportes, Ave Presidente Antonio Carlos 6627, BR-31270901 Belo Horizonte, MG - Brazil

• Document type: Journal article
• Source: CLINICAL NUTRITION ESPEN; v. 42, p. 82-89, APR 2021.
• Web of Science Citations: 1

Abstract

Purpose: Obstructive Sleep Apnea (OSA) is closely associated with obesity. Weight loss ameliorates OSA and its associated metabolic disorders. A high protein intake may improve weight loss through increased energy expenditure, and fat-free mass maintenance during weight loss. Objectives: To evaluate the effects of a low-energy, high-protein diet on OSA severity and metabolic parameters in obese men. Methods: Forty-five OSA obese (BMI > 30 kg/m(2)) males were included in this randomized study and submitted to nocturnal polysomnography, body composition measured by plethysmography, biochemical analyses of blood glucose, insulin and lipids, and food intake evaluations before and after one month of a low-energy diet. Diets were designed to create a 30% deficit in total energy expenditure with 1.6 g of protein/kg/day (High Protein group - HP) or 0.8 g of protein/kg/day (Low Protein group - LP). Results: Only a time effect of the intervention was observed in body mass (-3.7 +/- 2.0% for the LP group and -4.0 +/- 1.5% for the HP group; p < 0.001), Body Mass Index (p < 0.001), fat mass in kg (p < 0.01) and fat-free mass in kg (p < 0.01). Significant improvements in Apnea Hypopnea Index were observed in both groups (54.0 +/- 25.0 to 33.7 +/- 31.7 in LP group; 39.7 +/- 24.3 to 21.4 +/- 25.9 in HP group; p = 0.06). Improvements of 38% and 46% in the Apnea-Hypopnea Index were observed in the LP and HP groups, respectively. Both interventions provided equivalent metabolic benefits as reductions in glucose (p < 0.001), insulin (p < 0.001), HOMA-IR (p = 0.005), triglycerides (p = 0.002), and in total cholesterol (p = 0.004). Conclusion: One month of a low-energy diet resulted in significant improvements in OSA severity in obese men. Increased protein intake during a short period of low-energy diet had no further beneficial effects on OSA severity or biochemical parameters than a standard protein diet. Registered under ClinicalTrials.gov Identifier no. NCT01985035. (C) 2021 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved. (AU)

• FAPESP's process: 12/09700-2 - Physiological and immunological effects of sleep restriction on three approaches: experimental sleep restriction, shift work and sleep disorders
• Grantee: Marco Túlio de Mello
• Support Opportunities: Regular Research Grants