Diet composition, adherence to calorie restriction, and cardiometabolic disease risk modification

Authors: DAS, SAI KRUPA - Jean Mayer Human Nutrition Research Center On Aging At Tufts University; SILVER, RACHEL - Jean Mayer Human Nutrition Research Center On Aging At Tufts University; SENIOR, ALLSTAIR - University Of Sydney; GILHOOLY, CHERYL - Jean Mayer Human Nutrition Research Center On Aging At Tufts University; BHAPKAR, M - Duke University School Of Medicine; LE COUTEUR, DAVID - University Of Sydney

Submitted to: Aging Cell
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 10/5/2023
Publication Date: 10/24/2023
Citation: Das, S., Silver, R., Senior, A., Gilhooly, C.H., Bhapkar, M., Le Couteur, D. 2023. Diet composition, adherence to calorie restriction, and cardiometabolic disease risk modification. Aging Cell. https://doi.org/10.1111/acel.14018.
DOI: https://doi.org/10.1111/acel.14018

Interpretive Summary: Calorie restriction is shown to reduce the risk for age related disease and slow the aging process. However, it is unclear if the type of diet influences one's ability to maintain a calorie restricted diet and if this in turn has an impact on cardiometabolic risk factors. This study examined the effect of diet composition during a calorie-restricted intervention and the risk of cardiometabolic disease. Participants who received a 2-year calorie restriction intervention consumed a higher percentage of energy from proteins and carbohydrates, and lower fat while those who were not calorically restricted did not change the composition of their diet. Consumption of proteins with higher carbohydrates was associated with greater ability to be calorically restricted. Diet composition was not associated with cardiometabolic risk factors in this population of healthy adults.

Technical Abstract: Calorie restriction (CR) is a promising approach for attenuating the risk of age-related disease. However, the role of diet composition on adherence to CR and the effects of CR on cardiometabolic markers of healthspan remains unknown. We used the Geometric Framework for Nutrition approach to examine the association between macronutrient composition and CR adherence during the 2-year CALERIE trial. Adult participants without obesity were randomized to a 25% CR intervention or an ad libitum intake control. Correlations of cardiometabolic risk factors with macronutrient composition and standard dietary pattern indices [Alternate Mediterranean Diet Index (aMED), Dietary Inflammatory Index (DII), and Healthy Eating Index (HEI)] were also evaluated by Spearman's correlation at each time point. The mean age was 38.1 + or - 7.2 years at baseline and the mean BMI was 25.1 + or - 1.7. The study population was 70% female. The CR group, but not the control, consumed a higher percentage reported energy intake from protein and carbohydrate and lower fat at 12 months compared to baseline; comparable results were observed at 24 months. Protein in the background of higher carbohydrate intake was associated with greater adherence at 24 months. There was no correlation between macronutrient composition and cardiometabolic risk factors in the CR group. However, statistically significant correlations were observed for the DII and HEI. These findings suggest that individual self-selected macronutrients have an interactive but not independent role in CR adherence. Additional research is required to examine the impact of varying macronutrient compositions on adherence to CR and resultant modification to cardiometabolic risk factors.