Effects of macronutrient composition of the diet on body fat in indigenous people at high risk of type 2 diabetes

Aims: We compared, in New Zealand Maori at risk of type 2 diabetes, advice emphasizing fiber rich carbohydrate and fat reduction (HCHF) and a high protein (HP) diet incorporating food preferences of indigenous people, with a control group (CONT). Methods: Eighty-four participants were randomized to three groups. Consecutive 8 week periods of supervised weight loss, supervised weight maintenance and unsupervised adherence to the prescribed diet using culturally sensitive methods were employed in intervention groups. Dietary compliance, body composition, blood pressure and metabolic variables were measured. Results: Body weight was reduced throughout on HP -2.6 (95% confidence interval: -4.4, -0.8) kg and HCHF (-1.6 (-3.0, -0.3) kg) compared with CONT. Total body fat (-1.6 (-3.0, -0.3) kg) and waist circumference (-3.0 (-5.7, -0.2) cm) showed sustained decreases on HP compared with CONT. Diet records suggested reasonable compliance with dietary advice on HP. Carbohydrate intake, but not dietary fiber, increased at the expense of fat on HCHF. Conclusions: While moderate weight loss occurred on both HP and HCHF, HP was associated with some further favorable differences compared with the control group. (C) 2011 Elsevier Ireland Ltd. All rights reserved.