Effect of Dietary Protein and Energy Restriction in the Improvement of Insulin Resistance in Subjects With Obesity

STUDY PROGRAM The study will consist of a previous examination and 4 visits during the follow-up period.

Previous visit: pre-admission (Duration approximately 40 minutes)

• Participants who meet the inclusion criteria will be selected. These will be captured through advertising.
• Participants will be informed of the characteristics of the study, the risks and the benefits expected after the dietary intervention.
• Anthropometric and body composition measurements will be made.
• History of food frequency
• A blood sample will be taken for the determination of glucose, insulin, total cholesterol, HDL cholesterol, LDL cholesterol, creatinine, and urea nitrogen (BUN) in serum. A fecal sample for gut microbiota analysis will be collected.
• The consent letter will be signed by the participants. Subsequently according to the previous visit if insulin resistance is diagnosed according to the HOMA index (IR-HOMA), The patient will be included in the visit one of the research protocol.

Visit one:

a) Nutritional assessment (Ambulatory Patient Unit)

• A clinical-nutritional history
• The determination of anthropometric measurements such as weight, height and waist circumference and body composition by bioimpedance.
• Resting energy expenditure will be determined by indirect calorimetry
• A glucose tolerance curve will be performed for 2 hours to determine the area under the insulin and glucose curve and determination of the insulinemic and glycemic indexes.
• A whole blood sample will be taken for the determination of the serum concentration of glucose, total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides, c reactive protein (CRP), insulin, leptin, and plasma amino acid profile.
• A sample will be taken to isolate leukocytes, for the determination of the expression of enzymes related to branched-chain amino acids in leukocytes (BCAT and BCKDH).
• A fecal sample for gut microbiota analysis will be collected.
• The physical activity questionnaire will be carried out (IPAQ long version). The patient will be advised not to change the level of habitual physical activity
• Patients will start consuming the diet corresponding to their group. The different menus will be delivered and explained to the patients.
• A food guide will be given so that they have food exchange options.
• You will be taught to fill the feed log.
• Patients will be cited within a week.

Visit two:

• A 24-hour dietary record.
• Food logs will be collected and new ones will be delivered.
• They will be given and explained the corresponding treatment menus.
• They will be summoned in a week.

Visit three:

• A 24-hours dietary record
• Food logs will be collected and new ones will be delivered.
• They will be given and explained the corresponding treatment menus.
• They will be summoned in a week.

Visit four:

a) Nutritional assessment

• The determination of anthropometric measurements such as weight, waist circumference and body composition measurement will be made by means of bioimpedance.
• The resting energy expenditure will be determined by indirect calorimetry.
• A glucose tolerance curve will be carried out for 2 hours to determine the area under the insulin and glucose curve and determination of the insulinemic and glycemic indexes.
• A whole blood sample will be taken to determine the serum concentration of glucose, total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides, c-reactive protein (CRP), insulin, leptin, adiponectin and plasma amino acid profile.
• A fecal sample for gut microbiota analysis will be collected.
• There will be a 24-hour reminder.
• The physical activity questionnaire will be carried out (IPAQ long version). The patient will be advised not to change the level of habitual physical activity.
• Full feed logs will be collected.
• It will be scheduled within fifteen days for delivery of results. Actions that will be carried out at the end of the study to maintain the continuity of the treatment

All patients after the end of the study, will be cited at 15 days where:

• You will be given the results

Inclusion criteria

• Adults (men and women) between the ages of 18 and 60.
• Patients with obesity (BMI ≥ 30 and ≤ 50 kg / m2) and with insulin resistance (HOMA - IR Index ≥ 2.5).
• Mexican mestizos (parents and grandparents born in Mexico).
• Patients who can read and write.

Exclusion criteria

• Patients with any type of diabetes.
• Patients with kidney disease diagnosed by a medical or with creatinine> 1.3 mg / dL for men and > 1.1 mg / dL for women and / or BUN> 20 mg / dL.
• Patients with acquired diseases that produce obesity and diabetes secondarily.
• Patients who have suffered a cardiovascular event.
• Patients with weight loss > 3 kg in the last 3 months.
• Patients with any catabolic diseases.
• Gravidity status
• Positive smoking
• Treatment with any medication