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Assessment of food intakes for women adopting the high protein Dukan diet

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  • University of Applied Sciences in Nysa, Poland Państwowa Wyższa Szkoła Zawodowa w Nysie, Polska

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Background: Overweight and obesity are metabolic disorders affecting both adults and children. Effective treatment of these conditions is focused on decreasing the body mass, through individually tailored and well balanced diets, along with increasing physical activity. Obese persons often, however, choose high protein diets for losing weight. Recently in Poland, the high-protein Dukan-diet has become very popular. Objectives: To assess dietary consumption in women adopting the Dukan-diet, including intakes of protein, fat, carbohydrate as well as vitamins and minerals. Materials and methods: Subjects were 51 women aged 19-64 years on the Dukan-diet, who were surveyed by individually conducted interview. Women were asked to provide typical menus from each phase of their diets. Quantitative dietary intake assessment was achieved by an officially used 'Photograph album of foodstuffs and dishes' as custom-designed by the National Food and Nutrition Institute (IZZ) in Warsaw. Results: Protein intakes in all subjects were excessive, especially those of animal origin when compared to recommended nutritional standards. In contrast, dietary carbohydrate intakes were low due to poor consumption of fruit and vegetables. Mineral and vitamin intakes revealed high potassium, iron and vitamins A, D and B2, but low vitamin C and folates. Women's average weight reduction after 8-10 weeks of dieting was approximately 15 kilograms. Conclusions: Many nutritional abnormalities were found in women on the high protein Dukan-diet. Adopting this diet in the long-term may pose health threats through acquiring kidney and liver disease, osteoporosis and cardiovascular disease. Key words: obesity, high protein diet, nutrients.
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Rocz Panstw Zakl Hig 2015;66(2):137-142
*Corresponding author: Joanna Wyka, Institute of Dietetics, University of Applied Sciences in Nysa, Ujejskiego street 12,
48-300 Nysa, Poland, phone +48 77 409 16 52, e-mail: joanna.wyka@pwsz.nysa.pl
© Copyright by the National Institute of Public Health - National Institute of Hygiene
ASSESSMENT OF FOOD INTAKES FOR WOMEN ADOPTING
THE HIGH PROTEIN DUKAN DIET
Joanna Wyka*, Ewa Malczyk, Marta Misiarz, Marzena Zołoteńka-Synowiec,
Beata Całyniuk, Sandra Baczyńska
Institute of Dietetics, University of Applied Sciences in Nysa, Ujejskiego street 12, 48-300 Nysa, Poland
ABSTRACT
Background. Overweight and obesity are metabolic disorders affecting both adults and children. Effective treatment of
these conditions is focused on decreasing the body mass, through individually tailored and well balanced diets, along with
increasing physical activity. Obese persons often, however, choose high protein diets for losing weight. Recently in Poland,
the high-protein Dukan-diet has become very popular.
Objectives. To assess dietary consumption in women adopting the Dukan-diet, including intakes of protein, fat, carbohy-
drate as well as vitamins and minerals.
Materials and Methods. Subjects were 51 women aged 19-64 years on the Dukan-diet, who were surveyed by individu-
ally conducted interview. Women were asked to provide typical menus from each phase of their diets. Quantitative dietary
intake assessment was achieved by an officially used ‘Photograph album of foodstuffs and dishes’ as custom-designed by
the National Food and Nutrition Institute (IZZ) in Warsaw.
Results. Protein intakes in all subjects were excessive, especially those of animal origin when compared to recommended
nutritional standards. In contrast, dietary carbohydrate intakes were low due to poor consumption of fruit and vegetables.
Mineral and vitamin intakes revealed high potassium, iron and vitamins A, D and B2, but low vitamin C and folates. Women’s
average weight reduction after 8-10 weeks of dieting was approximately 15 kilograms.
Conclusions. Many nutritional abnormalities were found in women on the high protein Dukan-diet. Adopting this diet in
the long-term may pose health threats through acquiring kidney and liver disease, osteoporosis and cardiovascular disease.
Key words: obesity, high protein diet, nutrients
STRESZCZENIE
Wprowadzenie. Otyłość i nadwaga są chorobami metabolicznymi, które dotyczą zarówno dorosłych, jak i dzieci. Właści-
wym postępowaniem w leczeniu tych chorób jest zmniejszenie masy ciała poprzez zastosowanie indywidualnej, dobrze
zbilansowanej diety oraz zwiększenie aktywności fizycznej. W celu redukcji masy ciała otyli pacjenci czasami decydują się
na zastosowanie diety wysokobiałkowej. W Polsce, w ostatnich latach, bardzo popularna jest wysokobiałkowa dieta Dukana.
Cel. Celem badań była ocena sposobu żywienia kobiet stosujących dietę wysokobiałkową Dukana. Oceniono zawartość
białek, tłuszczów, węglowodanów, a także witamin i składników mineralnych w diecie badanych kobiet.
Materiały i metody. Badanie zostało przeprowadzone za pomocą 24-godzinnego wywiadu przeprowadzonego indywidualnie
z każdą respondentką. W badaniu wzięło udział 51 kobiet w wieku 19-64 lat stosujących wysokobiałkową dietę Dukana.
Kobiety poproszono o podanie przykładowego jadłospisu z każdej fazy diety. Do oszacowania w wielkości (w gramach)
spożytej żywności wykorzystano „Album fotografii produktów i potraw” opracowany przez Instytut Żywności i Żywienia
w Warszawie.
Wyniki. Kobiety biorące udział w badaniu spożywały nadmierną ilość białka, szczególnie pochodzenia zwierzęcego,
w stosunku do zalecanych norm żywieniowych. Zawartość węglowodanów w racjach pokarmowych była niska i wynikała
z małej podaży warzyw i owoców. Wśród ocenianych składników mineralnych stwierdzono najniższe spożycie potasu
i żelaza, a najwyższe fosforu i sodu. Wykazano także, że ze stosowaną dietą niska była podaż witaminy C i folianów, na-
tomiast wysoka witamin A, D i B2. Wśród badanych kobiet, średnia redukcja masy ciała po 8-10 tygodniach stosowania
diety wynosiła około 15 kilogramów.
Wnioski. U kobiet stosujących wysokobiałkową dietę Dukana stwierdzono wiele nieprawidłowości żywieniowych. Długo-
trwałe stosowanie tej diety może zwiększyć ryzyko zdrowotne związane z wystąpieniem chorób nerek i wątroby, osteoporozy
oraz chorób sercowo-naczyniowych.
Słowa kluczowe: otyłość, dieta wysokobiałkowa, składniki odżywcze
J. Wyka, E. Malczyk, M. Misiarz, et al.
138 No 2
INTRODUCTION
Overweight and obesity are metabolic diseases
which are an ever rising problem in Poland as well as
the majority of economically developed countries of the
world. The WOBASZ study on overweight and obesity
undertaken in Poland, has shown these symptoms in
61.6% men and 50.3% women [1]. Above all, these were
found to arise from excess calorific dietary intake rela-
tive to its utilization [2]. Effective treatment of obesity
requires long-term therapy and a cooperation between
the patient with a multi-disciplinary team of dietician,
doctor, psychologist, physiotherapist and personal tra-
iner. The therapy is based on a multi-tier education of
the obese person, together with an individualised and
well balanced diet having a negative energy balance [21,
34]. Patience and being consistent are traits needed for
keeping to such diets. Obese patients however, usually
wish for quick results in losing weight and they have
often also tried slimming on several previous occasions
– without any lasting success.
Diets of varying nutrient content have become
popular in recent times, of which the most well known
are the single component types, with a preponderance
of protein [4, 6, 8]. The popularity of high protein diets
(i.e. >25% of protein derived calories) are because of
their rapid effects and no limits placed on how much
high protein foodstuffs are to be consumed [5]. Such
diets, where high protein is coupled to low carbohy-
drate, lead to rapid weight loss where, amongst other
things, this is caused by having reduced ghrelin levels;
a hormone produced by gastric parietal cells responsible
for reducing hunger pangs. Ghrelin concentrations de-
crease mainly due to dietary carbohydrate deficiencies,
followed by protein then fats. A carbohydrate-poor diet
leads to dehydration, where together with the utiliza-
tion of glycogen stores from muscle and liver, water is
removed from the body at a rate of 2-3 g water per 1 g
glycogen [3, 10, 22, 27].
Within the Polish scientific literature, not much data
has been gathered on the health impact of the long term
adoption of either high protein or high fat diets intended
for losing body mass [2, 20]. Results from the rest of
the world are from short-term studies that indicate a
clear body weight loss arising from low calorie diets,
vitamin and mineral intake deficiencies as well as in
renal function disorders due to increased glomerular
filtration of toxic products from nitrogen metabolism
[16, 32]. The long-term adoption of high protein diets
may lead to hyper-filtration, glomerular overload and
proteinuria. Filtered protein damages renal tubules
and upon entering the interstitial tissue, inflammation
results. Likewise, a diet containing processed meat
products, rich in protein, delivers excessive phosphates
leading to the development of secondary hyperthyro-
idism. Furthermore, a high protein diet causes increased
metabolic acidosis, a characteristic of advanced renal
failure [13, 15, 17, 28].
The study aim was to perform a dietary assessment
of those women on a high protein Dukan-diet, based on
surveying their menus from each of the diet’s 4 phases.
MATERIALS AND METHODS
The study surveyed 51 women subjects aged 19-64
years, that were on the Dukan-diet with no limits placed
for food consumption. The ‘Snowball Sampling’ method
was used for their recruitment i.e. a non-random sam-
ple selection dependent on existing subjects recruiting
others of their acquaintance [26, 29]. An assessment was
performed by individual interview for each subject on
the nutrition over the last 24 hours.
Table 1. Energy and nutrients in diet of women adopting the high protein Dukan diet according to the diet’s phase
Calories and
nutrient content
Phase I Phase II Phase III Phase IV
x ±SD (% of standards)
Calories [kcal] 888.0±558.0 (44.4%) 1020.0±303.7 (51%) 1014.0 ±407.0 (50.7%) 1008.0 ±482.0 (50.4%)
Protein [g] 109.0 ±18.2 (167.6%) 116.0 ±15.6 (178.4%) 87.0 ±14.8 (133.8%) 114.0 ±13.6 (175.3%)
Fat [g] 34.7 ±27.2 (51.0%) 33.3 ±16.3 (50,0%) 60.9 ±21.0 (92.2%) 48.7 ±19.6 (72.7%)
Carbohydrate [g] 39.7 ±17.8 (13.6%) 70.3 ±25.8 (24.5%) 30.8 ±15.6 (10.5%) 30.7 ±17.8 (10.7%)
Minerals
Calcium [mg] 675.0 ±256.0 (67.5%) 1003.0 ±311.0 (100.0%) 860.0 ±311.0 (86.0%) 954.0 ±372.0 (95.0%)
Iron [mg] 7.8 ±2.4 (43.3%) 11.7 ±3.8 (65.0%) 9.3 ±3.1 (51.6%) 5.3 ±1.4 (29.4%)
Sodium [mg] 1751.0 ±572.0 (116.0%) 1862.0 ±422.0 (124.1%) 1392.0 ±379.0 (92.8%) 1698.0 ±497.0 (113.2%)
Potassium [mg] 2129.0 ±645.0 (45.2%) 3464.0 ±582.0 (73.0%) 2911.0 ±602.0 (61,9%) 2335.0 ±645.0 (49.6%)
Phosphorus [mg] 1670.0 ±207.0 (238.5%) 1312.0 ±197.0 (187.4%) 1526.0 ±251.0 (218.0%) 1706.0 ±232.0 (243.0%)
Vitamins
A [µg] 1386.0 ±158.0 (198.0%) 1383.0 ±563.0 (197.0%) 1523.0 ±488.0 (217.0%) 1331.0 ±165.0 (190.0%)
D [µg] 7.6 ±3.5 (152.0%) 5.9±2.5 (118.0%) 5.5±2.0 (110.0%) 6.3±3.7 (126.0%)
B2 [mg] 2.0±0.5 (181.0%) 2.6±0.7 (236.0%) 1.9±0.6 (172.0%) 2.1±0.7 (190.0%)
C [mg] 2.7±1.7 (3.6%) 4.5±2.6 (6.0%) 2.5±1.9 (3.3%) 3.9±2.3 (5.2%)
Folate [µg] 120.0±53.0 (30.0%) 105.0±43.0 (26.2%) 155.0±62.0 (38.7%) 99.0±39.0 (24.7%)
Food intakes for women adopting the high protein Dukan diet 139No 2
Women subjects were asked to provide a typical
daily menu from the I, II, III and IV phases of their diet.
In phase I they consumed high protein foodstuffs, whilst
in the ensuing phases, other products could also be
introduced; in phase II some vegetables were allowed,
phase III some fruit and starch products whilst phase IV
only permitted high protein foodstuffs with a so called
‘pure protein day’ once per week. Quantitative dietary
intakes were determined by using the aforementioned
‘Photograph album of foodstuffs and dishes’ as custom-
-designed by the IZZ in Warsaw [30].
Menus were evaluated by the ‘Dieta 5’ computer
programme using a data base compiled by Kunachowicz
et al., also from the IZZ [14]. Additional information
was gathered on body mass and height before, during
and after dieting. The diet’s calorific value and nutrient
content were compared to recommended Polish nutritio-
nal standards [11] for each subject. From these, calorific
values were taken as those appropriate to the body mass
of each subject when there are low levels of physical
activity and assuming that dietary calories are derived
from 13% protein, 30% fat and 57% carbohydrate.
Dietary vitamin and mineral values were also compared
to either the Recommended Daily Allowance (RDA) or
the Adequate Intake (AI) for adult women.
Table 1 presents the mean dietary calorific and
macronutrient content (i.e. protein, fat and carbohy-
drate) along with minerals (calcium, iron, potassium
and phosphorus) and vitamins (A, D, B2, C and folates)
during each phase of the Dukan diet and the proportion
that this covers the recommended standards. Mean
dietary calories derived from each macronutrient (i.e.
protein, fat and carbohydrate), for the average diet of
each subject were compared to those recommended
by the IZZ. The subjects were broken down into 3 age
groups as follows; 40% aged 19-30 years, 47% aged 31
to 51 years and 13% aged 51-64%. Before dieting, the
BMI could be grouped into the following ranges; 47%
women (25-29.9), 47% (30-34.9) - 1st degree obesity,
and 6% (35-39.9) 2nd degree obesity.
RESULTS
For the phase I, high protein diet, the mean dietary
calorific values were 888.0 kcal (Table 1) which cove-
red the recommended standards for each subject by an
average of 44.4%, whilst mean protein intakes were 109
g making up a mean of 167.7% to the recommended
standards. Mean dietary fat intakes of 34.7 g covered
these standards by 51% and those for carbohydrates
were respectively 39.7 g and only 13.6%. Calcium
intake made up 67.5% of the recommendations. The
mean body mass loss during phase I was 2.4 kg. In the
following phases, similar nutrient contents were obse-
rved. Phase III showed intakes of 87 g protein and 60
g fat which are closer to standards set. Because of the
diet’s low calorific value (1014 kcal), the proportion
of calories in this phase that is derived from specific
nutrients differs most from the WHO/IZZ recommen-
dations (Figure 1). Calories derived from protein, fat
and carbohydrate during phase III are respectively 34%,
54% and 12% (Figure 1). In phase II, the highest body
mass reduction was found; on average by 10.6 kg. The
dietary intakes in phase IV demonstrated the greatest
iron and potassium deficiencies of respectively 29.4%
and 49.6% to the standards as well as having the highest
excess of phosphorus that covered 243.0% of standards.
Dietary intakes of vitamin C and folates were very low
in all phases; being respectively 3-6% and 24-38% of the
standards. During dieting after 8-10 weeks, the average
body mass loss was by around 15.0 kg.
Figure 1. Dietary calories derived from protein, fat and carbohydrate for women adopting a
high protein diet according to the diet’s phase
Dietary phases
% energy from macronutriens
Figure 1. Dietary calories derived from protein, fat and carbohydrate for women adopting a high protein diet according to
the diet’s phase
J. Wyka, E. Malczyk, M. Misiarz, et al.
140 No 2
DISCUSSION
Despite introducing preventative and therapeutic
programmes of education that deal with obesity each
year to the general public worldwide, attempts to global-
ly reduce the adverse increases in body mass have pro-
ved ineffective. Additionally, obesity is recognised to be
a risk factor in many other metabolic diseases, together
with hypertension, diabetes and cardiovascular disease;
all falling into the category of the Metabolic Syndrome
(MS). Obesity requires long-term treatment, which at
present focuses on lifestyle and genotype, but equally
also extra-nutritional factors such as economic-social
status, education and mental health. The effectiveness
of a rational and safe reductive diet, as recommended
by WHO/IZZ, is conditional on consistently and thoro-
ughly keeping to its principles. Patients however expect
quick outcomes, which directly serves to motivate
them in seeking unconventional and fashionable diets.
Nonetheless, very few are aware of the adverse health
effects in adopting such dieting.
By reducing carbohydrate intakes, high-calorie
foodstuffs become excluded, like pizza, pasta or bread
thereby decreasing a diet’s calories by around 500 kcal.
Limiting dietary energy intake forms the basis of all
slimming diets, as does having a normally balanced
diet to achieve body mass loss. During deficiencies in
dietary carbohydrate intake, free fatty acids are meta-
bolised from which ketone bodies arise. Ketosis status
is an important factor for inhibiting appetite [6]. In
the first days of adopting the diet, various processes
occur leading to the body losing water, such as glyco-
gen mobilisation from muscle or the liver; a glycogen
loss of 400 g reduces water by 1 kg. Another cause of
dehydration is the excretion of ketone bodies in the
urine. Adopting a high protein diet carries the potential
risk for elevated serum homocysteine concentrations,
which is a sulphur containing amino acid produced by
methionine metabolism present in animal meat protein.
For homocysteine to become adequately metabolised,
then vitamin B group vitamins and folates are required
in sufficient amounts; as delivered through the diet.
Dietary deficiencies of these vitamins are observed in
women adopting high protein diets leading to blood
vessel damage and may result in arteriosclerosis [25].
Studies on healthy subjects eating high protein diets
have been unable to show any disorders in glomerular
filtration. Nevertheless, an increased excretion of cal-
cium, urates and phosphates was observed which may
lead to kidney stone formation [12, 24]. Disturbing the
acid-base balance, as a result of high dietary protein
intake, also increases the risk of osteoporosis [19, 33].
Excessive consumption of animal derived protein, being
a rich source of purines, increases serum concentrations
of uric acid, that leads to hypertension and renal function
disorders. The advantages of rapid weight loss of high
protein diets needs to be reconciled with the potential
health threats such as advancing renal and cardiovascu-
lar disease. Extensive recent studies have compared the
effectiveness for reducing body mass by adopting diets
supplying various macronutrients [7].
In summary, the authors stress that the greatest body
mass loss was seen after 6 months of adopting each diet
(arising from a decreased calorie intake) amounting to
around 6 kg. Following 2 years of following a 15% or
25% protein diet, the loss of body mass were respec-
tively 3 and 3.6 kg. An approximate 3.3 kg body mass
loss was observed in those adopting a 20% and 40%
fat diet, whilst subjects on 65% and 35% carbohydrate
diets lost respectively 2.9 kg and 3.4 kg. When discus-
sing the dietary role of protein, Te Morenga and Mann
[31] emphasised that body mass loss in those obese
subjects adopting high protein diets arises from reduced
calorific intakes. Taking up such eating habits may lead
to an increased cancer risk through excessive red meat
consumption as well as lowering blood pressure and
evening-out the blood lipid profile.
The presented study demonstrated a reduced risk of
contracting diabetes for those taking up a high protein
diet through improved glycaemic control and insulin
resistance. Following a 55-60% carbohydrate diet with
15% protein or a 40-45% carbohydrate diet with 25-30%
protein together with taking physical exercise, led to the
following to become lowered; insulin resistance index
by 0.2, BMI by 6.8% and body adipose tissue in studied
teenagers by 2.4%. When comparing the health benefits
of adopting high carbohydrate, protein and fat diets in 96
women subjects (BMI<27), McAuley et al. [18] found
that, after 8 weeks, all 3 diets caused body mass loss,
reduced waistline and decreased serum triglycerides.
Blood insulin was significantly reduced in women
following high protein and high fat diets compared to
those adopting a high carbohydrate diet.
CONCLUSIONS
1. Women taking up high protein diets demonstrated
deficient calorific intake which was responsible for
the lowering of body mass.
2. The women’s diet had low contents of carbohydrate,
calcium, iron, potassium, vitamin C and folates but
excessive amounts of protein, phosphorus, sodium
along with vitamins A and D.
3. Adopting a high protein diet in the long term may
be harmful to health.
Conflict of interest
The authors declare no conflict of interest.
Food intakes for women adopting the high protein Dukan diet 141No 2
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... High-protein diets are often used as a quick and easy way to achieve weight loss in those who are overweight or obese (1). People using this type of diet are not aware that it can cause serious health problems (2)(3)(4)(5)(6). ...
... Moreover, lowcarb diets lead to dehydration, as a result of the loss of glycogen. The use of glycogen as energy material by the body, in the course of high-protein and low-carb diets, causes a loss of 2 -3 g of water for each gram of glycogen, hence weight loss also results from the loss of water (1). Weight loss during high-protein diets is also explained by an increase in the metabolic rate, as well as increased energy expenditure, associated with the digestion of large amounts of protein, as a result of increased thermogenesis, among other factors (9,12). ...
... During the consolidation phase (phase 3) some fruits are included in small amounts, as well as full-fat cheese, whole meal bread in quantities of 40 g per day and other starch products consumed twice a week in a maximum amount of 200 g. The stabilization phase, which should last until the end of one's life, assumes that for one day per week, the user must adhere to the recommendations of the first phase of the diet by using a high-protein diet (1,13,30). When used for a long time, alongside the previously mentioned health consequences, such a diet might also contribute to an increased risk of gout. ...
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Background. Inflammation is the common denominator of atherosclerosis, cardiovascular diseases, obesity, metabolic syndrome and type 2 diabetes. There are studies confirming the involvement of the immune system in acute myocardial infarction, metabolic syndrome, obesity and diabetes. However, data evaluating the relationship between markers of nutritional status and the concentration of immunoglobulins are insufficient. Aim. The aim of this study was to investigate the relationship between selected markers of nutritional status, age, inflammatory markers CRP and immunoglobulin G, A and M in adults. Material and Methods. The study included 114 people aged 45+. Nutritional status was assessed on the basis of anthropometric measurements, lipid profile indicators and fasting glucose. The concentration of the inflammatory marker CRP was determined by the high-sensitivity method and the concentration of immunoglobulin G, A, M by the immunoturbidimetric method. Assessment of the gender differences was based on one-way analysis of variance and analysis of the relationship between nutritional markers, CRP and immunoglobulin based on linear regression analysis. Results. A major problem in the study population was the occurrence of metabolic disorders in the form of excess body weight, lipid profile and carbohydrate metabolism disorders. It was shown that IgA levels correlated positively with waist circumference and WHR. No significant correlations were found between the remaining nutritional status markers assessed, C-reactive protein and IgA, IgG and IgM concentrations. Conclusions. The findings confirm the hypothesis that the immune system is involved in the pathogenesis of obesity, in particular the abdominal type. More research is needed to explore mechanisms which increase serum IgA among obese patients. However, one limitation of this study is the relatively small experimental group. It is necessary to conduct tests on a large population, which could confirm these dependencies.
... High-protein diets are often used as a quick and easy way to achieve weight loss in those who are overweight or obese (1). People using this type of diet are not aware that it can cause serious health problems (2)(3)(4)(5)(6). ...
... Moreover, lowcarb diets lead to dehydration, as a result of the loss of glycogen. The use of glycogen as energy material by the body, in the course of high-protein and low-carb diets, causes a loss of 2 -3 g of water for each gram of glycogen, hence weight loss also results from the loss of water (1). Weight loss during high-protein diets is also explained by an increase in the metabolic rate, as well as increased energy expenditure, associated with the digestion of large amounts of protein, as a result of increased thermogenesis, among other factors (9,12). ...
... During the consolidation phase (phase 3) some fruits are included in small amounts, as well as full-fat cheese, whole meal bread in quantities of 40 g per day and other starch products consumed twice a week in a maximum amount of 200 g. The stabilization phase, which should last until the end of one's life, assumes that for one day per week, the user must adhere to the recommendations of the first phase of the diet by using a high-protein diet (1,13,30). When used for a long time, alongside the previously mentioned health consequences, such a diet might also contribute to an increased risk of gout. ...
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Background. High-protein diets are often used as a quick and easy way to achieve weight loss in those who are overweight or obese. People using for a long time this type of diet are not aware that it can cause serious health problems, therefore it is very important to monitor the effects of long-term use of high-protein diets. Aim. The aim of this study was to evaluate the high-protein diet (Dukan Diet) and after its completion, as well as to assess the nutritional status of women on the basis of biochemical parameters of blood: morphology, blood sugar, lipid profile and hepatic profile, in order to determine the health consequences of the high-protein diet. Material and Methods. The study included 32 women aged 19 to 56, who had followed the Dukan Diet in the past (2 year ago). A 7-day nutrition diary was used to assess nutrition after the Dukan Diet, where 5 days were working days and 2 days were non-working days. Nutritional status was assessed on the basis of anthropometric measurements and the morphological and biochemical parameters of blood: blood count, fasting blood glucose levels, lipid profile, the profile of the hepatic were analyzed in an accredited analytical laboratory, and these values were determined using haematological and biochemical indicators measured on an Analyzer at Sysmex K-1000 and Vitalab Flexor, respectively. Results. The resulting analysis shows that women did not receive adequate amounts of energy from the diets. Diets were deficient in terms of most nutrients, while in other cases the values exceeded the recommended standards. Analysis has shown that the Dukan Diet is deficient in many vitamins, including vitamins C and B, nor does this diet provide a sufficient amount of dietary fiber. It has been observed of minerals deficiency (iron, magnesium, copper) both during and after the protein diet. Moreover, subjects revealed an increased concentration of eosinophils, basophils, monocytes, triglycerides, LDL cholesterol, glucose in the blood. Conclusions. The diet of women after the end of high-protein diet is still abnormal as evidenced by improper blood chemistry markers. Women should be under the control of a dietitian.
... Furthermore, it was tested by the University of Granada, in laboratory rats (according to the first phase of the four that consists of the Dukan diet), which developed severe kidney problems including formation of kidney stones, a decrease of up to 88% in urinary citrate and a pH markedly more acid urinary 48 . In 2014, a case report 49 reflected that a woman 42-year-old Iranian after two days of starting the Dukan diet is admitted with nausea, vomiting and a secondary ketoacidosis and Wyka et al. 50 observed 51 women who followed this diet reducing 15 kg in weight during the treatment for 8 to 10 weeks (means losing up to 1.87 kg/week), but it could be a health risk causing osteoporosis and kidney disease, liver and cardiovascular diseases. ...
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Introduction: In the last years, confusing or misleading use of the term called miracle or magic diets, using to weight loss treatment, has increased, along with several classification of them. Objectives: The purpose of this narrative review is to discuss miracle slimming diets and proposal new term and new classification for these diets. Methods: A narrative review up to September 2021 was carried out in the PubMed, Google Scholar, and Web of Knowledge. Furthermore, this strategy was complemented with a comprehensive search of the ‘grey’ literature [7] based in four different searching strategies: i) grey literature databases, ii) customized Google search engines, iii) targeted websites, and iv) consultation with contact experts. Results: Our proposal is to use the new concept called hazardous slimming diets defined as diets that propose rapid weight loss (> 1 kg/week), to be performed effortlessly, without the super-vision of a medical/nutritional professional, excessive energy restrictions and/or exclusion from the diet of food or nutrients for the body. Furthermore, the development of a new algorithm reflected as is possible to classify the diet as non-effective, hazardous and effective diet. Conclusions: Our review could help to classify and develop a new terminology about the miracle slimming diets focusing in the knowledge to guarantee the quality in the treatments for weight loss.
... Individuals following a low-carbohydrates diet (carbohydrates provided less than 45% total energy intake) consumed lower amounts of vitamin C, vegetables and fruits than the subjects in the control group [105]. Additionally, a diet based on guidelines of the Dukan diet (high protein diet, carbohydrates provide 10-25% of total energy intake) results in a lower vitamin C intake (2.5-4.5 mg) [106]. In fact, the ascorbic acid intake was 94 ± 59 mg in the Atkins diet. ...
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Recent research studies have shown that vitamin C (ascorbic acid) may affect bone mineral density and that a deficiency of ascorbic acid leads to the development of osteoporosis. Patients suffering from an inflammatory bowel disease are at a risk of low bone mineral density. It is vital to notice that patients with Crohn’s disease and ulcerative colitis also are at risk of vitamin C deficiency which is due to factors such as reduced consumption of fresh vegetables and fruits, i.e., the main sources of ascorbic acid. Additionally, some patients follow diets which may provide an insufficient amount of vitamin C. Moreover, serum vitamin C level also is dependent on genetic factors, such as SLC23A1 and SLC23A2 genes, encoding sodium-dependent vitamin C transporters and GSTM1, GSTP1 and GSTT1 genes which encode glutathione S-transferases. Furthermore, ascorbic acid may modify the composition of gut microbiota which plays a role in the pathogenesis of an inflammatory bowel disease.
... Such diet does not allow to supply the demand of brain cells on glucose. Body mass reduction on Dukan diet is connected to total calories limitation, increased satiety due to the development of ketosis formed as an effect of glucose deficiency, but also to dehydration, which occurs due to the release of glycogen from muscles and liver (the loss of 400g of glycogen is related to the loss of 1kg of water) [23,24]. Additionally, each of the phases of this diet increases the risk of cardiovascular diseases as a result of high consumption of saturated fatty acids and cholesterol, with simultaneous low consumption of folates, which regulate the concentration of homocysteine in blood [22]. ...
... A dieta Dukan, por sua vez, apresentou VRB inicialmente crescente entre as 78ª e 99ª semanas embora, a partir daí verifica-se queda da linha de tendência com curtos picos esporádicos (Figura 7). Mesmo apresentando característica mais processual que outras dietas da moda, a dieta Dukan também prescreve baixa quantidade de carboidratos e alto valor protéico 57,58 . Teve origem a partir do método Dukan, que foi proposto pelo médico nutrólogo Pierre Dukan a partir de estudos realizados nos últimos 40 anos 59 e é baseada em quatro fases. ...
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Resumo Este trabalho objetivou descrever e analisar conteúdos de notícias associadas a ciclos de buscas ao Google ligados a 8 tipos de dieta: a cetogênica; da lua; da proteína; da sopa; detox; dos pontos; paleo; e Dukan. Estas foram selecionadas por terem sido apontadas pelo Google Trends® (GT) como as mais frequentemente associadas ao termo dieta. Os conteúdos dos sites vinculados aos maiores picos de buscas foram apontados pelo Google News®. O volume de buscas às dietas foram estimados pelo GT com filtros de região (Brasil) e temática (Saúde) considerando o período de 01/01/2012 a 01/01/2017. Os acessos retratam ciclos efêmeros com centenas de picos e quedas de interesse pelas 8 dietas da moda. A ênfase se concentra nas orientações para rápida perda de peso em prol de um ideal de saúde tido como proxy de um ideal estético. A dimensão dos riscos associados às dietas mais restritivas é citada frequentemente e validada por informações de especialistas. Destaca-se a exposição e a influência da opinião de celebridades relatando suas experiências dietéticas. Ao contrário do ideal de variedade e equilíbrio, as dietas da moda retratam a pressão pelo autocontrole alimentar como recurso à construção de um corpo idealizado e tipificado por imagens das celebridades.
... The final phase, the stabilization phase, is followed throughout the life span to maintain weight and avoid any unwanted weight gain. During this, the person can have whatever they desire but based on certain rules viz., eating oat bran every day, taking the stairs and a high protein diet [22]. ...
Article
The health issues, mainly overweight and obesity are the growing concerns nowadays due to the associated factors and lifestyle changes which significantly has increased the individual’s health care expenditures. Fad diets are promoted as the easiest and simplest way of shedding the extra weight despite of availability of a number of treatments available. The prevention and treatment measurements, including, modification in lifestyle, dietary pattern and physical activity are the foundation of weight loss. However, the standard treatment measurements are not effective for certain population as they require long time adherence, which leads to the search of the other approaches like fad diet. We steered a comprehensive literature review to present the facts related to fad diets to their efficacy and sustainability. Although, fad diets have yielded tremendous positive results in weight loss and cardiovascular risk prevention, but the studies reported dearth in long-term interventions and the results and some of them shows side effects too. Randomized controlled trials have significantly reported the weight loss in comparison with the popular fad diets, however; persisting on the same diet has also reported kidney problem, ketosis and other metabolic related problems. The conclusion of this critical review reported that gradual weight loss could be attained by the combination of lifestyle modifications, physical activity and recommended dietary approaches.
... Again, attention Unauthenticated Download Date | 2/15/18 1:35 PM is paid to the metabolic effects of the deficiency of carbohydrates in the diet, which in the mechanism of incomplete metabolism of fatty acids, consist in the development of ketonaemia and ketonuria, and the related metabolic acidosis. Also, during the short period of application of this type of diets, a number of undesirable symptoms were noted on the part of gastrointestinal tract, including constipation, diarrhoea, nausea, as well as weakness and fatigue, headaches and dizziness, sleeplessness, bad breath and increased thirst [21,22]. concLuSIon Dietetic management is an integral and basic element of medical treatment of obesity. ...
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The objective of the study is a critical analysis of the selected alternative diets used in the treatment of obesity inconsistent with the recommended standards, from the perspective of clinical dieticians, based on up-to-date guidelines for dietary management of obesity. Attention was paid to the assumptions of the selected alternative diets, some physiological mechanisms related with their use, as well as the deficit of data pertaining their distant effectiveness and safety. In the context of the current epidemiological situation concerning the prevalence of obesity, it is justifiable to undertake actions aimed at the professionalization of dietary management in obesity, consisting in the application of the treatment methods based on data generated in the EBM paradigm, with a simultaneous indication and criticism of dietary pseudo-therapies with unconfirmed curative value which, in addition, do not guarantee the reduction of the risk of metabolic complications of obesity.
... Previously cited various studies have shown the efficiency of rationally composed low-energy diet (20% energy from protein, 30% from fat and 50% from carbohydrate) compared with alternative diets [13,37]. It shows from own research that the use of the low-energy diet for 5 months, both in case of women and men, resulted in considerable reduction of the fat percentage content in the organism. ...
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Background: Excess body weight is one of the most common health and economic problems of the contemporary world. According to the assessments of the World Health Organization (WHO), almost billion adults are overweight and at least 300 million were diagnosed with clinical obesity. Health consequences of overweight are: ischemic heart disease, congestive cardiac failure, hypertension, arteriosclerotic vascular disease, diabetes mellitus type 2, tumours, degenerative joint disease and many more. Objective: The aim of the study was to evaluate the effectiveness of the low-energy diet used in the period of 5 months by women and men treated from overweight or obesity in the diet centre. Material and methods: The research included 296 overweight or obese patients, treated in the diet centre: (1) 104 women without co-morbidities, between 18 to 61 years old; (2) 58 women with the accompanying insulin resistance between 19 to 61 years old; (3) 49 women additionally suffering from hypothyroidism, between 19 to 61 years old; (4) 85 men without co-morbidities, between 19 to 62 years old. Treated patients were recommended the use of the low-energy diet, where 20% of energy came from protein, 30% of energy from fat and 50% of energy from carbohydrates. The energy content of the diet was considered to be dependent on the individual daily demand that was estimated taking into consideration the physical activity and that was reduced with 1000 kcal. Patients applied suggested reductive diet for 5 months. Results: The use of diet in each group brought positive results. In all groups, body fat decreased significantly after 5 months of dietary treatment. It has been shown to increase the average percentage of water content in the body of subjects. There was also an average reduction in total cholesterol, LDL, TG, glucose levels and increasing HDL for each group. Conclusions: Diet proceedings consisting in reduced energy value of the diet has a beneficial effect on reducing body mass, metabolic age, reducing BMI and influences the percentage change in body fat, causing its reduction, change in percentage of water content, leading to a slight increase in its levels in the body . In addition, favourably nutritional proceedings influenced the changes in blood levels of lipid indicators, thus reducing risk factors for coronary heart disease.
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Accumulating evidence indicates that microbiota plays a critical role in physiological processes in humans. However, it might also contribute to body malodor by producing numerous odorous molecules such as ammonia, volatile sulfur compounds or trimethylamine. Although malodor is commonly overlooked by physicians, it constitutes a major problem for many otherwise healthy people. Thus, this review aims to investigate most common causes of malodor and describe potential therapeutic options. We searched PUBMED and Google Scholar databases to identify the clinical and pre-clinical studies on bad body smell, malodor, halitosis and microbiota. Unpleasant smell might originate from the mouth, skin, urine or reproductive fluids and is usually caused by odorants that are produced by resident bacterial flora. The accumulation of odorous compounds might result from diet, specific composition of microbiota, as well as compromised function of the liver, intestines and kidneys. Evidence-based guidelines for management of body malodor are lacking and no universal treatment exists. However, the alleviation of the symptoms may be achieved by controlling the diet and physical elimination of bacteria and/or accumulated odorants.
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Osteoporosis is defined as a skeletal disease with low bone mass and micro-architectural deterioration of bone tissue. Osteoporosis is an insidious disease and usually develops for some time before being detected. Usually the first indication of osteoporosis is fracture. Common sites for osteoporotic fracture are hip, spine and wrist. Osteoporosis is categorized as either primary or secondary. The aim of osteoporosis management is to reduce fracture risk. The primary clinical goal is identification of patients at high risk of fracture rather than identification of women or men with osteoporosis. Bone mineral density (BMD) is most commonly measured for information about bone strength but it is only one component of fracture risk. A large number of clinical risk factors for fracture have been identified and can provide information on fracture risk independently of BMD.
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BackgroundA higher protein to carbohydrate ratio in the diet may potentiate weight loss, improve body composition and cardiometabolic risk, including glucose homeostasis in adults. The aim of this randomised control trial was to determine the efficacy of two structured lifestyle interventions, differing in dietary macronutrient content, on insulin sensitivity and body composition in adolescents. We hypothesised that a moderate-carbohydrate (40-45% of energy), increased-protein (25-30%) diet would be more effective than a high-carbohydrate diet (55-60%), moderate-protein (15%) diet in improving outcomes in obese, insulin resistant adolescents.Methods Obese 10¿17 year olds with either pre-diabetes and/or clinical features of insulin resistance were recruited at two hospitals in Sydney, Australia. At baseline adolescents were prescribed metformin and randomised to one of two energy restricted diets. The intervention included regular contact with the dietician and a supervised physical activity program. Outcomes included insulin sensitivity index measured by an oral glucose tolerance test and body composition measured by dual-energy x-ray absorptiometry at 12 months.ResultsOf the 111 adolescents recruited, 85 (77%) completed the intervention. BMI expressed as a percentage of the 95th percentile decreased by 6.8% [95%CI: ¿8.8 to ¿4.9], ISI increased by 0.2 [95%CI: 0.06 to 0.39] and percent body fat decreased by 2.4% [95%CI: ¿3.4 to ¿1.3]. There were no significant differences in outcomes between diet groups at any time.Conclusion When treated with metformin and an exercise program, a structured, reduced energy diet, which is either high-carbohydrate or moderate-carbohydrate with increased-protein, can achieve clinically significant improvements in obese adolescents at risk of type 2 diabetes.Trial registrationAustralian New Zealand Clinical Trail Registry ACTRN12608000416392. Registered 25 August 2008.
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Studies examining the health benefits of high-protein diets typical of most affluent and many developing countries are not consistent. Prospective epidemiological studies relating dietary protein to clinical and metabolic endpoints suggest increased weight gain and increased risk of diabetes amongst those with a high protein intake and an increased risk of cancer with high intakes of red meat, but lower blood pressure and possibly a reduced risk of heart disease with higher protein intakes. The potential for high-protein diets to confer greater benefit than other diets has been examined using ad libitum and energy restricted diets. Of greatest interest have been the comparisons between high-protein and high-carbohydrate diets. Many trials have reported greater weight loss especially in the context of ad libitum diets over the short-to medium-term, sparing of lean body mass, lowering of triglyceride levels, improved HDL: total cholesterol ratio and improved glycaemic control. Limited data regarding insulin sensitivity are less consistent. A major difficulty in interpreting the results of these studies is that carbohydrate quality has not been taken into account. Furthermore, longer term comparisons of weight reducing diets differing in macronutrient composition have reported similar outcomes, suggesting that compliance is a more important consideration. Nevertheless dietary patterns with high-protein intakes are appropriate for weight reduction and weight maintenance and may be useful for those who have high triglyceride levels and other features of the metabolic syndrome.
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To study the long term consequences of low carbohydrate diets, generally characterised by concomitant increases in protein intake, on cardiovascular health. Prospective cohort study. Uppsala, Sweden. From a random population sample, 43,396 Swedish women, aged 30-49 years at baseline, completed an extensive dietary questionnaire and were followed-up for an average of 15.7 years. Association of incident cardiovascular diseases (ascertained by linkage with nationwide registries), overall and by diagnostic category, with decreasing carbohydrate intake (in tenths), increasing protein intake (in tenths), and an additive combination of these variables (low carbohydrate-high protein score, from 2 to 20), adjusted for intake of energy, intake of saturated and unsaturated fat, and several non-dietary variables. A one tenth decrease in carbohydrate intake or increase in protein intake or a 2 unit increase in the low carbohydrate-high protein score were all statistically significantly associated with increasing incidence of cardiovascular disease overall (n=1270)--incidence rate ratio estimates 1.04 (95% confidence interval 1.00 to 1.08), 1.04 (1.02 to 1.06), and 1.05 (1.02 to 1.08). No heterogeneity existed in the association of any of these scores with the five studied cardiovascular outcomes: ischaemic heart disease (n=703), ischaemic stroke (n=294), haemorrhagic stroke (n=70), subarachnoid haemorrhage (n=121), and peripheral arterial disease (n=82). Low carbohydrate-high protein diets, used on a regular basis and without consideration of the nature of carbohydrates or the source of proteins, are associated with increased risk of cardiovascular disease.
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Background: The possible advantage for weight loss of a diet that emphasizes protein, fat, or carbohydrates has not been established, and there are few studies that extend beyond 1 year. Methods: We randomly assigned 811 overweight adults to one of four diets; the targeted percentages of energy derived from fat, protein, and carbohydrates in the four diets were 20, 15, and 65%; 20, 25, and 55%; 40, 15, and 45%; and 40, 25, and 35%. The diets consisted of similar foods and met guidelines for cardiovascular health. The participants were offered group and individual instructional sessions for 2 years. The primary outcome was the change in body weight after 2 years in two-by-two factorial comparisons of low fat versus high fat and average protein versus high protein and in the comparison of highest and lowest carbohydrate content. Results: At 6 months, participants assigned to each diet had lost an average of 6 kg, which represented 7% of their initial weight; they began to regain weight after 12 months. By 2 years, weight loss remained similar in those who were assigned to a diet with 15% protein and those assigned to a diet with 25% protein (3.0 and 3.6 kg, respectively); in those assigned to a diet with 20% fat and those assigned to a diet with 40% fat (3.3 kg for both groups); and in those assigned to a diet with 65% carbohydrates and those assigned to a diet with 35% carbohydrates (2.9 and 3.4 kg, respectively) (P>0.20 for all comparisons). Among the 80% of participants who completed the trial, the average weight loss was 4 kg; 14 to 15% of the participants had a reduction of at least 10% of their initial body weight. Satiety, hunger, satisfaction with the diet, and attendance at group sessions were similar for all diets; attendance was strongly associated with weight loss (0.2 kg per session attended). The diets improved lipid-related risk factors and fasting insulin levels. Conclusions: Reduced-calorie diets result in clinically meaningful weight loss regardless of which macronutrients they emphasize. (ClinicalTrials.gov number, NCT00072995.)
Article
Considering health and life threatening complications resulting from obesity World Health Organization (WHO) in 1998 recognised obesity as a disease entity. A principle in weight loss management is an individually matched diet leading to calorie restriction accompanied by physical activity. For several years low-carbohydrate diets favouring high content of consumed fat and protein have gained worldwide popularity, including Poland. Atkins diet and its Polish modification, so called Kwasniewski diet advocate unlimited consumption of animal fat with restriction of vegetables, fruit and fibre, what contradicts the recommendations of international scientific societies. 2003 brought two randomised studies evaluating efficacy and safety of low-carbohydrate diets and its influence on metabolic parameters. The paper is an analysis of the results of these studies and systemic effects of low-carbohydrate diets. Although this dietary approach leads to greater initial weight reduction when compared to conventional diet, it cannot be safely recommended as there is paucity of long term data on influence of low-carbohydrate diet on cardiovascular risk.
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The comparison encompassed involvement of calcium, phosphorus, magnesium, iron, zinc and copper in the daily food rations of the 'optimals'(131 fem. 101 mal.), and persons maintaining classical diet (260 fem. 231 mal.). The investigation was conducted between 2006 and 2008. Classical 24 hour- recall method was consistently applied. The data were analyzed with the use of advanced computer programs. The analysis resulted in exposition of serious abnormalities in both groups investigated. The only elements which DFR content turned out to be within recommended limits were phosphorus and zinc.
Ghrelin was discovered in 1999 as an endogenous ligand of the growth hormone secretagogue receptor (GHS-R). About 60-70% of ghrelin in the blood is released from oxyntic cells (X/A-like cells) of the stomach body and fundus. Ghrelin acts via interactions with specific receptors located, for example, in the hypothalamus, pituitary gland, pancreas, kidneys, myocardium, blood vessels, adipose tissue, ovaries and placenta. Ghrelin is directly related to the control of energy balance through appetite stimulation, food intake increase and meal initiation as well as reduction of adipose tissue utilization. Moreover, ghrelin increases hydrochloric acid secretion and gastrin release, controls gastric motility, and also protects the mucous membrane of the stomach and intestine. Besides its effects on the gastrointestinal tract, ghrelin influences the cardiovascular system, bone metabolism, insulin secretion, gonad function and the immune system. It exerts anti-inflammatory effects and inhibits apoptosis of cardiomyocytes and endothelium. The plasma ghrelin level depends on the nutrition level and lifestyle factors. This article describes the most important functions of ghrelin in the organism.
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Data from short-term experiments suggest that drinking water may promote weight loss by lowering total energy intake and/or altering metabolism. The long-term effects of drinking water on change in body weight and composition are unknown, however. This study tested for associations between absolute and relative increases in drinking water and weight loss over 12 months. Secondary analyses were conducted on data from the Stanford A TO Z weight loss intervention on 173 premenopausal overweight women (aged 25-50 years) who reported <1 l/day drinking water at baseline. Diet, physical activity, body weight, percent body fat (dual-energy X-ray absorptiometry), and waist circumference were assessed at baseline, 2, 6, and 12 months. At each time point, mean daily intakes of drinking water, noncaloric, unsweetened caloric (e.g., 100% fruit juice, milk) and sweetened caloric beverages, and food energy and nutrients were estimated using three unannounced 24-h diet recalls. Beverage intake was expressed in absolute (g) and relative terms (% of beverages). Mixed models were used to test for effects of absolute and relative increases in drinking water on changes in weight and body composition, controlling for baseline status, diet group, and changes in other beverage intake, the amount and composition of foods consumed and physical activity. Absolute and relative increases in drinking water were associated with significant loss of body weight and fat over time, independent of covariates. The results suggest that drinking water may promote weight loss in overweight dieting women.
Article
Excess protein and amino acid intake have been recognized as hazardous potential implications for kidney function, leading to progressive impairment of this organ. It has been suggested in the literature, without clear evidence, that high protein intake by athletes has no harmful consequences on renal function. This study investigated body-builders (BB) and other well-trained athletes (OA) with high and medium protein intake, respectively, in order to shed light on this issue. The athletes underwent a 7-day nutrition record analysis as well as blood sample and urine collection to determine the potential renal consequences of a high protein intake. The data revealed that despite higher plasma concentration of uric acid and calcium, Group BB had renal clearances of creatinine, urea, and albumin that were within the normal range. The nitrogen balance for both groups became positive when daily protein intake exceeded 1.26 g.kg but there were no correlations between protein intake and creatinine clearance, albumin excretion rate, and calcium excretion rate. To conclude, it appears that protein intake under 2. 8 g.kg does not impair renal function in well-trained athletes as indicated by the measures of renal function used in this study