A high-protein diet or combination exercise training to improve metabolic health in individuals with long-standing spinal cord injury: A pilot randomized study
Study compared the effects of an 8‐week isocaloric high‐protein (HP) diet versus a combined exercise regimen (Comb‐Ex) in individuals with long‐standing spinal cord injury (SCI). Twenty individuals with SCI enrolled in the University of Alabama at Birmingham SCI Model System were randomly assigned to the Comb-Ex or HP-diet group; 11 participants (5 HP diet; 6 Comb‐Ex) completed the study. The Comb‐Ex regimen included upper-body resistance training (RT) and neuromuscular electrical stimulation‐induced‐RT for paralytic quadriceps muscles, interspersed with high‐intensity arm cranking exercises 3 days a week. The HP diet included approximately 30 percent total energy as protein, with a carbohydrate to protein ratio <1.5, and about 30 percent energy from fat. Oral glucose tolerance tests and muscle biopsies of the vastus lateralis (VL) and deltoid muscles were performed before and after the trial. Effects on metabolic profiles, markers of inflammation, and signaling proteins associated with glucose transporter 4 (GLUT‐4) translocation in muscles were evaluated. Fasting plasma glucose levels decreased in the Comb‐Ex group compared to the HP‐diet group. A decrease in areas under the curve for insulin and TNF‐α concentrations was observed for all participants regardless of group assignment. Although both groups exhibited a quantitative increase in insulin sensitivity as measured by the Matsuda Index, the change was clinically meaningful only in the HP diet group. No changes were observed in proteins associated with GLUT‐4 translocation in VL or deltoid muscles. Results suggest that the HP‐diet and Comb‐Ex regimen may improve insulin sensitivity and decrease TNF‐α concentrations in individuals with SCI.
Author(s):
Li, Jia|Polston, Keith F. L.|Eraslan, Mualla|Bickel, C> Scott|Windham, Samuel T.|McLain, Amie B.|Oster, Robert A.|Bamman, Marcas M.|Yarar-Fisher, Ceren|
