Evidence for Protein Leverage in Children and Adolescents with Obesity

Christoph Saner; Daniella Tassoni; Brooke E Harcourt; Kung-Ting Kao; Erin J Alexander; Zoe McCallum; Timothy Olds; Alex V Rowlands; David P Burgner; Stephen J Simpson; David Raubenheimer; Alistair M Senior; Markus Juonala; Matthew A Sabin

doi:10.1002/oby.22755

Evidence for Protein Leverage in Children and Adolescents with Obesity

Obesity (Silver Spring). 2020 Apr;28(4):822-829. doi: 10.1002/oby.22755. Epub 2020 Mar 6.

Authors

Christoph Saner^#^{1

2

3}, Daniella Tassoni^#², Brooke E Harcourt^{1

2

4}, Kung-Ting Kao^{1

2

4}, Erin J Alexander^{1

2}, Zoe McCallum^{1

2}, Timothy Olds⁵, Alex V Rowlands^{6

7}, David P Burgner^{1

4}, Stephen J Simpson^{8

9}, David Raubenheimer^{8

9}, Alistair M Senior^{8

9}, Markus Juonala^{1

3}, Matthew A Sabin^{1

2

4}

Affiliations

¹ Murdoch Children's Research Institute, The Royal Children's Hospital, Parkville, Victoria, Australia.
² Department of Endocrinology, The Royal Children's Hospital, Parkville, Victoria, Australia.
³ Department of Medicine, University of Turku, Turku, Finland.
⁴ Department of Pediatrics, University of Melbourne, Parkville, Victoria, Australia.
⁵ Alliance for Research in Exercise Nutrition and Activity (ARENA), Sansom Institute, School of Health Sciences, University of South Australia, Adelaide, South Australia, Australia.
⁶ Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UK.
⁷ NIHR Leicester Biomedical Research Centre, Leicester, UK.
⁸ Charles Perkins Centre, University of Sydney, Sydney, New South Wales, Australia.
⁹ School of Life and Environmental Sciences, University of Sydney, Sydney, New South Wales, Australia.

^# Contributed equally.

PMID: 32144892
DOI: 10.1002/oby.22755

Abstract

Objective: The aim of this study was to test the protein leverage hypothesis in a cohort of youth with obesity.

Methods: A retrospective study was conducted in a cohort of youth with obesity attending a tertiary weight management service. Validated food questionnaires revealed total energy intake (TEI) and percentage of energy intake from carbohydrates (%EC), fats (%EF), and proteins (%EP). Individuals with a Goldberg cutoff ≥ 1.2 of the ratio of reported TEI to basal metabolic rate from fat-free mass were included. A subgroup had accelerometer data. Statistics included modeling of percentage of energy from macronutrients and TEI, compositional data analysis to predict TEI from macronutrient ratios, and mixture models for sensitivity testing.

Results: A total of 137 of 203 participants were included (mean [SD] age 11.3 [2.7] years, 68 females, BMI z score 2.47 [0.27]). Mean TEI was 10,330 (2,728) kJ, mean %EC was 50.6% (6.1%), mean %EF was 31.6% (4.9%), and mean %EP was 18.4% (3.1%). The relationship between %EP and TEI followed a power function (L coefficient -0.48; P < 0.001). TEI was inversely associated with increasing %EP. In the subgroup with < 60 min/d of moderate to vigorous physical activity (n = 48), lower BMI z scores were associated with higher %EP and moderate %EC.

Conclusions: In youth with obesity, protein dilution by either carbohydrates or fats increases TEI. Assessment of dietary protein may be useful to assist in reducing TEI and BMI in youth with obesity.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Child
Dietary Proteins / adverse effects*
Energy Intake / physiology*
Female
Humans
Male
Obesity / physiopathology*
Retrospective Studies

Substances

Dietary Proteins