(P23-076-23) Metabolic Biomarker Responses to a Higher (Egg) Protein Obesity Intervention in Older Adults With Prediabetes

Objectives: The goal of obesity treatment in older adults is to reduce the prevalence/severity of obesity-related diseases, e.g., cardiovascular disease, type 2 diabetes, conditions that also increase with age. However, the metabolic impact of higher protein diets recommended to protect muscle during weight reduction is not well delineated. This study examined secondary (metabolic) outcomes in a randomized controlled trial comparing a higher protein hypocaloric diet (Protein) to an RDA-level protein hypocaloric diet (Control) in older adults with obesity and prediabetes.

Methods: Participants (adults >60 yrs, BMI >30 kg/m², with prediabetes) were randomized to either the Protein (≥30g high quality protein/meal; primarily from eggs; 1.2 g/kg/d) or Control (0.8 g/kg/d protein) arm. Both arms were facilitated by weekly support group meetings with weight measurement during the 4-mo. trial. From baseline and endpoint blood samples, NMR (Labcorp) determined Lipoprotein Insulin Resistance Index (LP-IR), cholesterol, triglycerides, HDL cholesterol, LDL cholesterol, VLDL cholesterol, apolipoprotein A-I, apolipoprotein B, GlycA as a marker of inflammation, gut microbiome markers (TMAO, Betaine), and branched-chain amino acids (BAA).

Results: For 55 participants (n=27 Control, n=28 Protein), results confirm improvements in glucose handling, with a reduced LP-IR score (Control -5.8; p < 0.005; Protein -7.1; p < 0.001). ApoA-1 (p < 0.01) and total cholesterol (p < 0.04) also decreased, with no group difference. Triglycerides, HDL, LDL, and VLDL cholesterol, GlycA and gut microbiome-related markers were unchanged; as expected, BAA trended towards increase in Protein.

Conclusions: The panel of metabolic markers we measured showed mostly improvements or no change in Control and Protein groups with no group differences. This confirms our hypothesis that high-quality protein from egg could be used for increasing protein intake during obesity reduction in those with prediabetes without negative impact on metabolic indicators. This has important clinical implications because protein to protect lean mass during weight loss is especially needed in this population to combat the direct and indirect detrimental effects of Type 2 Diabetes on muscle.

Funding Sources: This study was supported by a research grant from the Egg Nutrition Council.