Impact of High-Protein Diets on Weight Loss Programs: Analyzing Loss of Muscle and Skeletal Mass

Impact of High-Protein Diets on Weight Loss Programs: Analyzing Loss of Muscle and Skeletal Mass | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Impact of High-Protein Diets on Weight Loss Programs: Analyzing Loss of Muscle and Skeletal Mass Yahui Ma, Lina Sun, Zhijing Mu This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4444363/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Objective The objective of this probe is to determine the effects of High-Protein Diets (HPD) on weight loss programs. Methodology From January 2021 to May 2022, 133 patients, who were enrolled in a Chinese-based weight loss program, participated in a clinical trial aimed at investigating the impact of High-Protein Diets (HPD) on weight loss programs. The effects of the diet plan on the patients’ insulin, hemoglobin, and Vitamin D levels were assessed and the findings examined to evaluate the impact of HPD on muscle and skeletal mass. Results and Findings HPD was useful in catalyzing the effectiveness of weight loss programs. It led to reductions in skeletal and muscle mass during the trial period based on its impact on insulin, hemoglobin, and Vitamin D levels among the trial population.. Obesity High-Protein Diet Skeletal Muscle Weight Background Obesity is one of the most prevalent public health issues worldwide. The condition undermines a patient's physical and mental health, thereby leading to the development of chronic diseases, such as cardiovascular complications and high blood pressure. In 2017, the number of obese people in China ranked first in the world at 89.6 million [ 1 ]. In 2016, the American Association of Clinical Endocrinology proposed changing the term “obesity” to “obesity-based chronic disease” to accommodate the scope of health complications associated with this disease [ 2 ]. According to the 2016 Chinese Overweight Medical Nutrition Therapy report, effective and safe reductions in body mass were based on the use of nutritional, exercise, psychotherapy, and behavioral interventions [ 3 ]. This statement indicates that diet control is the key to the success of obesity management programs. Nutritional solutions for weight management are linked to the assessment of changes in food portions to create positive health outcomes for obese patients. A reduction in blood pressure and a lowered risk of developing diabetes are commonly cited health outcomes linked to effective diet management [ 4 ]. Most of the attention directed at improving obesity management outcomes has been focused on restricting dietary intake as the sole method for realizing changes in body mass [ 5 ]. Consequently, nutritionists have proposed diverse interventions to treat obesity. Expert consensus recommends three effective diet patterns for weight loss treatment: calorie-restricted diets (CRD), high-protein diets (HPD), and intermittent fasting [ 6 ].Calorie-restricted treatment plans have been associated with a reduction in body mass and diabetes management programs. At the same time, HPDs have had similar applications in the medical field with a bias toward understanding their efficacy in weight management. The three intervention programs have registered varied levels of success in managing changes to body mass based on differences in their effectiveness. 7 In this regard, it is vital to review the nutritional properties of various intervention programs to evaluate their efficacy. This investigation focuses on HPDs as one of the options for managing weight [ 8 ]. Little is known about its impact on specific weight loss contributors, such as muscle and skeletal mass. The importance of dietary reviews for assessing the impact of nutritional programs is crucial in identifying the best treatment framework to use. Therefore, there is a need to conduct a nutritional profile analysis of weight loss programs to determine their effectiveness in obesity management [ 9 ]. Differences in the efficacy of dietary interventions highlight the importance of understanding nutritional values when designing clinical trials [ 10 ]. At the same time, the effects of daily food intake on weight loss are contextual [ 11 ]. Stemming from this observation, the current investigation will be limited to reviewing the effectiveness of HPD on weight loss management. The HPD has been selected for review in the current probe because it is a common dietary intervention for body mass loss management [ 12 ]. Therefore, this study seeks to evaluate its effectiveness in weight loss management based on an assessment of its impact on skeletal and muscle mass. Materials and Methods Patients who were clinically diagnosed as obese or overweight in a Chinese healthcare facility participated in this study from January 2021 to May 2022. The ethical approval number for the investigation was [2022]074. The criteria for including patients in the clinical trial included a review of their medical history to determine its impact on weight loss outcomes. Notably, patients who had physical diseases, such as cardiovascular conditions, liver, and kidney problems were excluded from the investigation to avoid distortions to the clinical trial findings based on their preexisting conditions. Guided by the need to isolate the effects of the HPD on the respondents’ health outcomes, the impact of the dietary plan was examined based on its influence on muscle and skeletal mass. The Body Composition Meter (BCM) was instrumental in generating baseline and post-intervention data. Testing was done at the same time of day - in body 270 by in body provided baseline and post-intervention data. Patients’ basal metabolic rate was used to determine diet composition patients’ basal metabolic rate using the Harris-Benedict formula [ 13 ]. The formulas for determining the Basal Metabolic Rate (BMR) are distinguished as shown below: Male: (BMR) =66+ (13.7*Weight (kg)) + (5*Height (cm))-(6.8*Age (years)) Female: BMR=655+ (9.6*Weight (kg)) + (1.8*Height (cm))-(4.7*Age (years)) Typically, the Harris-Benedict formula fluctuates between 1200-1700 Kcal/day. At the same time, it is fixed for the fasting days of 5+2 at 600kcal/day for men and 500kcal/day for women [ 14 ]. Based on these considerations, the dietary composition for the 5+2 intervention, which represents five days of energy restriction and two days of light fasting, was 15-20% protein, 40-55% carbohydrate, and 20-30% fat. Comparatively, the HPD had 20-30% protein, 40% carbohydrate, and 20-30% fat. Harris-Benedict formula and fluctuates between 1200-1700 Kcal/day, and was fixed for the fasting days of 5+2 at 600kcal/day for men and 500kcal/day for women 15 . The 5+2 diet had two non-consecutive days of light fasting - 600 for men and 500 for women. Overall, Participants closely adhered to the eating patterns established by the researcher. Simultaneously, a recording tool known as the "diet diary" was used to monitor their adherence to the eating schedules. The goal was to isolate the effects of the interventions on their weight. The effectiveness of the HPD was examined after analyzing differences in insulin, Vitamin D, and hemoglobin levels caused by exposure to the high protein diet. Changes in these variables were measured before and after the trial period. Fluctuations in muscle mass were measured by evaluating disparities in insulin levels. Associated changes were evaluated to assess the impact of the HPD on muscle mass [ 16 ]. The findings demonstrated that decreases in muscle mass were linked to insulin resistance [ 17 ]. This relationship was used to justify the use of insulin as a key variable for measuring the impact of the HPD on muscle mass. Insulin was measured in micro units per milliliter with the normal range being 2 - 20 mIU/mL. Hemoglobin levels were assessed using the ‘A1c” test, which measures average blood glucose levels throughout a clinical trial period [ 18 ]. The normal range for the “A1c” test results is below 5.7 %, while a range of between 5.7 % and 6.4 % is “high.” Comparatively, changes in skeletal mass were measured using Vitamin D as the main variable. This variable was selected as the main variable for the present study because it supports weight loss management [ 19 ]. Relative to this assertion, empirical investigations suggest that patients with high body weights have low levels of Vitamin D, while those with lower body weights have a higher level of Vitamin D [ 20 ]. This variable was measured by evaluating changes in serum 25-hydroxyvitmain D levels via blood tests. Low or deficient levels of vitamin D are deemed to be less than or equal to 10 ng/ml (25 nmol/L), while sufficient levels are between 10 ng/ml and 20 ng/ml (25 to 50 nmol/L) [ 21 ]. Comparatively, patients whose serum 25-hydroxyvitmain D levels were higher than 20 ng/ml (50 nmol/L) met sufficiency standards. Data was analyzed using the Statistical Package for the Social Sciences (SPSS) – version 23. Descriptive analysis was the main analytical technique adopted in the review. It is associated with the breakdown of descriptive measures of data, including mean, mode, frequency, and standard of deviation [ 22 , 23 ]. The use of SPSS in this study is consistent with the views of scholars who suggest that the process of determining the best data collection technique should be consistent with the goal of the study, which is to extrapolate the efficacy of dietary interventions in weight loss management [ 24 ]. Subject to this plan, the efficacy of the HPD on weight loss programs was using descriptive analysis. Results This study sought to understand the impact of HPD on weight loss management. This objective was achieved by observing its impact on the skeletal and muscle mass compositions of patients. The effects of the treatment program on weight loss outcomes were based on an assessment of its effects on patients’ insulin, hemoglobin, and Vitamin D levels. Changes in these variables were assessed and the findings deduced to evaluate the impact of HPD on muscle and skeletal mass. According to Table 1, a mean change in insulin levels for all patients was registered as it increased from 15.506 at the start of the clinical trial to 15.707 at the end. The mode similarly increased from 7.8 at the start of the trial to 9.3 during its completion. Comparatively, changes in hemoglobin levels were examined by monitoring differences in HBA1. As depicted in Table 2, an assessment of this measure reveals a marginal increase from 4.889 at the start of the experiment to 4.985 at its end. However, the mode relatively remained the same at 5.3. In terms of assessing the impact of the HPD on skeletal mass, changes in Vitamin D levels were tracked before and after the clinical trial period.The mean average for Vitamin D levels at the start and end of the experiment decreased marginally from 15.558 to 15.345. However, there was a significant increase of the mode from 9.8 to 17.3. Differences in these figures are highlighted in Table 3. Discussion As shown in the findings section above, an assessment of changes in HBA1 levels during the clinical trial period revealed a marginal increase from 4.889 at the start of the experiment to 4.985 at its end. This peripheral increase in HBA1 levels suggests a decrease in muscle mass - inferring the effectiveness of HPD on weight loss. However, given that the mode for the variable remained relatively constant throughout the trial period, it can be deduced that HPD was not as effective in changing HBA1 levels as it did insulin. However, the HPD diet had a negative effect on muscle mass, thereby underscoring its effectiveness in influencing weight loss programs. In terms of insulin changes, there was a significant increase in mode from 7.8 at the start of the trial period to 9.3 during the completion stage. The findings suggest that the impact of the HPD on insulin resistance could have been masked by the marginal increases in mean values reported during the clinical trial. Overall, the increase in insulin levels among the patients, supported by differences in mode, suggests a significant increase in insulin levels during the trial period. Alternatively, based on the relationship between insulin and muscle bulk identified in the methodology section of this document, one could assume that the HPD had a negative effect on muscle mass. The implication of this finding on the research question is that HPD is effective in promoting favorable weight loss outcomes through inferred reductions in muscle mass. These findings imply that muscle loss is achievable after prolonged exposure to HPD [ 25 ]. Studies have supported the above-mentioned findings by re-affirming the effects of dietary effectiveness on weight loss [ 26 ]. Therefore, the findings generated have emphasized the importance of understanding the nutritional compounds of various dietary plans to comprehend their overall effectiveness [ 27 ]. Patients’ characteristics equally play an important role in determining the effectiveness of HPD programs. For example, some patients harbor a C-reactive compound in their genetic makeup, which may worsen, or improve, their metabolic reactions to HPD [ 28 ]. Such causative agents may lead to variations in muscle and skeletal mass during analysis [ 29 ].At the same time, certain population groups, such as older adults or people with pre-existing health conditions, may require high levels of protein intake owing to age-related factors [ 30 ]. For instance, studies have shown that the elderly have a significant risk of skeletal and muscle mass reduction owing to age-related factors [ 31 ]. Therefore, they may require a higher protein intake than the general population. Most affiliated studies have taken a keen interest in understanding the impact of sex and age-related factors on weight loss programs. For example, women tend to lose skeletal muscle density faster than men [ 32 ]. This outcome remains consistent across various nutritional programs, including HPD [ 33 ]. However, scholars have used the Skeletal Mass Index (SMI) to investigate the effects of diets on weight loss programs. Their findings suggest that patients with low SMI are prone to several negative health outcomes, including low life expectancy and high rates of acute or chronic illnesses [ 34 ].Similarly, obesity may lead to lower bone density, while its effects further worsen with aging [ 35 ].Therefore, body mass gains lead to the deterioration of skeletal mass as a weight indicator [ 36 These statements suggest that the impact of HPD on weight loss could be moderated by patient’s demographic characteristics. Subject to the influence of the above-mentioned effects of dietary interventions on weight loss, some strategies adopted by healthcare practitioners to manage obesity involve making changes to protein-based diets [ 37 ]. The same plan has been used to assess the effectiveness of protein-based diets on weight loss programs [ 38 ]. For example, researchers who have used nutritional interventions aimed at promoting body mass reductions through variations in protein levels have employed nitrogen balance as a key determinant of clinical effectiveness [ 39 ]. Their studies have had mixed results on obesity management. An overview of the above limitations suggests that the HPD nutritional program may be associated with significant changes in body mass outcomes. These results are consistent with research showing that a HPD is associated with the preservation of lean body mass [ 40 ]. Therefore, one could argue that the emergence of HPD as an effective dietary plan for influencing weight reduction programs is consistent with extant literature. The results highlighted in the findings section of this study revealed that the mean change for Vitamin D levels among the clinical trial group was 15.558 at the start to 15.345 in the end. Comparatively, out of all the three variables assessed in this investigation, changes in Vitamin D had the highest difference in mode. This statement means that there may have been significant differences in vitamin D response outcomes within the clinical trial group. However, they did not undermine the insignificance of the Vitamin D changes observed among the larger trial group after exposure to HPD. The rise of the HPD in promoting the efficacy of nutritional intervention programs could create a paradigm shift in the use of protein-based nutritional plans in obesity management. Relative to this assertion, restrictions on calorie intake and intermediate fasting are equally important to this review but less effective in causing weight loss [ 41 ]. The effectiveness of HPD could be contrasted to past uses of the dietary method in clinical studies. Indeed, most researchers used it to suppress hunger and enhance satiety, as opposed to reducing body mass [ 42 ]. At the same time, researchers have used HPD to promote muscle mass growth and minimize fat gain by supporting the intake of protein-rich foods above the recommended daily intake levels [ 43 ]. Researchers who have highlighted the use of HPD this way have the opportunity to expand it to improve the effectiveness of programs designed to manage obesity [ 44 ]. Relative to these findings, HPD emerged as an effective dietary plan for weight loss treatment. Conclusion Dietary interventions are a source of knowledge for understanding the metabolic processes associated with obesity management programs. Overall, the findings of this study showed that reductions in muscle mass were more poignant than similar changes that occurred in the skeletal mass based on exposure to HPDs. These findings are consistent with other researchers who have affirmed the impact of HPDs on weight loss programs. The implication of this finding on the management of obesity is rooted in the continued use of HPD to support linked programs, relative to other dietary interventions. These findings are relevant to clinical practice because they promote the adoption of targeted interventions for different groups of patients. Abbreviations BCM - Body Composition Meter CRD - Calorie-restricted Data HPD – High-Protein Diets SMI - Skeletal Muscle Index Declarations Data Availability Statement Question Response Has data associated with your study been deposited into a publicly available repository? No. Please select why. Data will be made available on request Declarations Acknowledgment Approval to conduct this study was obtained from participating institutions in China. All patients who took part in the clinical trials were briefed of its contents and objectives. They provided informed consent before recruitment, which was pivotal in completing the investigation under the ethical approval number - [2022]074. Ethics Declaration This study is compliant with the ethical guidelines of the Department of Endocrinology, Xuanwu Hospital, Capital Medical University. The Internal Review Board of the institution was consulted before undertaking the research and permission granted to proceed. Consent to Participate Participants who chose to partake in the investigation did so voluntarily. Therefore, the researcher did not coerce or incentivize them to contribute to the probe. Consent for Publication Relevant permission was obtained from Xuanwu Hospital, Capital Medical University to publish the findings of this study. Authors ’ contributions Y.M. conceived and designed the study, conducted the clinical trial, collected the data, and performed the data analysis. L.S. and Z.M. assisted with data collection and analysis. Y.M. drafted the initial manuscript. L.S. and Z.M. reviewed and provided critical revisions to the manuscript. All authors read and approved the final manuscript. Funding The researcher did not receive financial contributions for the study Availability of data and materials All materials included in this investigation were open-sourced, meaning that the researcher did not need prior approval from the original authors to use information. All documents requiring authorization before use were omitted from the probe to prevent any breach of intellectual property rights. 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McCarthy D, Berg A (2021) Weight loss strategies and the risk of skeletal muscle mass loss. Nutrients 13: 2473-2477. Verreijen AM, Engberink MF, Memelink RG, van der Plas SE, Visser M, et al. (2017) Effect of a high protein diet and/or resistance exercise on the preservation of fat-free mass during weight loss in overweight and obese older adults: a randomized controlled trial. Nutr J 16: 1-10. Kossoff E, Cervenka M (2020) Ketogenic dietary therapy controversies for its second century. Epilepsy Curr 20: 125-129. Tables Tables 1 to 3 are available in the Supplementary Files section Additional Declarations No competing interests reported. Supplementary Files ListofTables.docx Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4444363","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":309869738,"identity":"3c993af1-1339-4915-83a5-5509f462631f","order_by":0,"name":"Yahui Ma","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA7UlEQVRIiWNgGAWjYBACgwMMDMwMDBJybOztBx8kVNQQ1mIJ1WLMz3Mm2eDBmWOEtdhDtDAkzpyRYCb5sIWZsBaz42cMPxe2WTBuOJCQVpHYwMbA396dgF/LmRxj6ZltEswGBw4eu5G4Q4ZB4szZDfi1HMgxkOZtk2AzONiQdiPxDBuDgUQufi0G598Y/wZq4TE4zGBWkNjGTISWGzlmIFskJNsYzBiI1PKszJrnnIQBPw9PskTCmWM8BP1icD55822esrr6NvnnBz/+qKiR42/vxa+FgYHDAIXLQ0A5CLA/IELRKBgFo2AUjGgAAGuGTB/ZodFpAAAAAElFTkSuQmCC","orcid":"","institution":"Xuanwu Hospital Capital Medical University","correspondingAuthor":true,"prefix":"","firstName":"Yahui","middleName":"","lastName":"Ma","suffix":""},{"id":309869739,"identity":"3e587a25-1a8f-49e8-b32d-988c3543fafd","order_by":1,"name":"Lina Sun","email":"","orcid":"","institution":"Xuanwu Hospital Capital Medical University","correspondingAuthor":false,"prefix":"","firstName":"Lina","middleName":"","lastName":"Sun","suffix":""},{"id":309869740,"identity":"4f09f8b3-cc85-489d-a8cc-b2872c10df33","order_by":2,"name":"Zhijing Mu","email":"","orcid":"","institution":"Xuanwu Hospital Capital Medical University","correspondingAuthor":false,"prefix":"","firstName":"Zhijing","middleName":"","lastName":"Mu","suffix":""}],"badges":[],"createdAt":"2024-05-19 12:54:29","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4444363/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4444363/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":58372038,"identity":"15ede762-ac30-4867-8869-0e0890a45462","added_by":"auto","created_at":"2024-06-14 14:13:42","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":339880,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4444363/v1/57ef68e6-ba1d-422e-b981-12a9a7364904.pdf"},{"id":58353540,"identity":"003c8dd4-2d23-4d10-ad55-3845655de7fb","added_by":"auto","created_at":"2024-06-14 09:30:37","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":16703,"visible":true,"origin":"","legend":"","description":"","filename":"ListofTables.docx","url":"https://assets-eu.researchsquare.com/files/rs-4444363/v1/ecfb982c81b9d4fd4cf040a9.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Impact of High-Protein Diets on Weight Loss Programs: Analyzing Loss of Muscle and Skeletal Mass","fulltext":[{"header":"Background","content":"\u003cp\u003eObesity is one of the most prevalent public health issues worldwide. The condition undermines a patient\u0026apos;s physical and mental health, thereby leading to the development of chronic diseases, such as cardiovascular complications and high blood pressure. In 2017, the number of obese people in China ranked first in the world at 89.6 million [\u003csup\u003e1\u003c/sup\u003e]. In 2016, the American Association of Clinical Endocrinology proposed changing the term \u0026ldquo;obesity\u0026rdquo; to \u0026ldquo;obesity-based chronic disease\u0026rdquo; to accommodate the scope of health complications associated with this disease [\u003csup\u003e2\u003c/sup\u003e]. According to the 2016 Chinese Overweight Medical Nutrition Therapy report, effective and safe reductions in body mass were based on the use of nutritional, exercise, psychotherapy, and behavioral interventions [\u003csup\u003e3\u003c/sup\u003e]. This statement indicates that diet control is the key to the success of obesity management programs.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eNutritional solutions for weight management are linked to the assessment of changes in food portions to create positive health outcomes for obese patients. A reduction in blood pressure and a lowered risk of developing diabetes are commonly cited health outcomes linked to effective diet management [\u003csup\u003e4\u003c/sup\u003e]. Most of the attention directed at improving obesity management outcomes has been focused on restricting dietary intake as the sole method for realizing changes in body mass [\u003csup\u003e5\u003c/sup\u003e]. Consequently, nutritionists have proposed diverse interventions to treat obesity.\u003c/p\u003e\n\u003cp\u003eExpert consensus recommends three effective diet patterns for weight loss treatment: calorie-restricted diets (CRD), high-protein diets (HPD), and intermittent fasting [\u003csup\u003e6\u003c/sup\u003e].Calorie-restricted treatment plans have been associated with a reduction in body mass and diabetes management programs. At the same time, HPDs have had similar applications in the medical field with a bias toward understanding their efficacy in weight management. The three intervention programs have registered varied levels of success in managing changes to body mass based on differences in their effectiveness.\u003csup\u003e7\u003c/sup\u003e In this regard, it is vital to review the nutritional properties of various intervention programs to evaluate their efficacy. This investigation focuses on HPDs as one of the options for managing weight [\u003csup\u003e8\u003c/sup\u003e]. Little is known about its impact on specific weight loss contributors, such as muscle and skeletal mass.\u003c/p\u003e\n\u003cp\u003eThe importance of dietary reviews for assessing the impact of nutritional programs is crucial in identifying the best treatment framework to use. Therefore, there is a need to conduct a nutritional profile analysis of weight loss programs to determine their effectiveness in obesity management [\u003csup\u003e9\u003c/sup\u003e]. \u0026nbsp; Differences in the efficacy of dietary interventions highlight the importance of understanding nutritional values when designing clinical trials [\u003csup\u003e10\u003c/sup\u003e]. At the same time, the effects of daily food intake on weight loss are contextual [\u003csup\u003e11\u003c/sup\u003e]. Stemming from this observation, the current investigation will be limited to reviewing the effectiveness of HPD on weight loss management. The HPD has been selected for review in the current probe because it is a common dietary intervention for body mass loss management [\u003csup\u003e12\u003c/sup\u003e]. Therefore, this study seeks to evaluate its effectiveness in weight loss management based on an assessment of its impact on skeletal and muscle mass.\u003c/p\u003e"},{"header":"Materials and Methods","content":"\u003cp\u003ePatients who were clinically diagnosed as obese or overweight in a Chinese healthcare facility participated in this study from January 2021 to May 2022. The ethical approval number for the investigation was [2022]074. The criteria for including patients in the clinical trial included a review of their medical history to determine its impact on weight loss outcomes. Notably, patients who had physical diseases, such as cardiovascular conditions, liver, and kidney problems were excluded from the investigation to avoid distortions to the clinical trial findings based on their preexisting conditions. Guided by the need to isolate the effects of the HPD on the respondents\u0026rsquo; health outcomes, the impact of the dietary plan was examined based on its influence on muscle and skeletal mass.\u003c/p\u003e\n\u003cp\u003eThe Body Composition Meter (BCM) was instrumental in generating baseline and post-intervention data. Testing was done at the same time of day - in body 270 by in body provided baseline and post-intervention data. Patients\u0026rsquo; basal metabolic rate was used to determine diet composition patients\u0026rsquo; basal metabolic rate using the Harris-Benedict formula [\u003csup\u003e13\u003c/sup\u003e]. \u0026nbsp;The formulas for determining the Basal Metabolic Rate (BMR) are distinguished as shown below:\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eMale: (BMR) =66+ (13.7*Weight (kg)) + (5*Height (cm))-(6.8*Age (years))\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eFemale: BMR=655+ (9.6*Weight (kg)) + (1.8*Height (cm))-(4.7*Age (years))\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eTypically, the Harris-Benedict formula fluctuates between 1200-1700 Kcal/day. At the same time, it is fixed for the fasting days of 5+2 at 600kcal/day for men and 500kcal/day for women [\u003csup\u003e14\u003c/sup\u003e]. Based on these considerations, the dietary composition for the 5+2 intervention, which represents five days of energy restriction and two days of light fasting, was 15-20% protein, 40-55% carbohydrate, and 20-30% fat. Comparatively, the HPD had 20-30% protein, 40% carbohydrate, and 20-30% fat. Harris-Benedict formula and fluctuates between 1200-1700 Kcal/day, and was fixed for the fasting days of 5+2 at 600kcal/day for men and 500kcal/day for women\u003csup\u003e15\u003c/sup\u003e. The 5+2 diet had two non-consecutive days of light fasting - 600 for men and 500 for women.\u0026nbsp;Overall,\u0026nbsp;Participants closely adhered to the eating patterns established by the researcher. Simultaneously, a recording tool known as the \u0026quot;diet diary\u0026quot; was used to monitor their adherence to the eating schedules. The goal was to isolate the effects of the interventions on their weight.\u003cstrong\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe effectiveness of the HPD was examined after analyzing differences in insulin, Vitamin D, and hemoglobin levels caused by exposure to the high protein diet. Changes in these variables were measured before and after the trial period.\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eFluctuations in muscle mass were measured by evaluating disparities in insulin levels. Associated changes were evaluated to assess the impact of the HPD on muscle mass [\u003csup\u003e16\u003c/sup\u003e]. The findings demonstrated that decreases in muscle mass were linked to insulin resistance [\u003csup\u003e17\u003c/sup\u003e]. This relationship was used to justify the use of insulin as a key variable for measuring the impact of the HPD on muscle mass. Insulin was measured in micro units per milliliter with the normal range being 2 - 20 mIU/mL. Hemoglobin levels were assessed using the \u0026lsquo;A1c\u0026rdquo; test, which measures average blood glucose levels throughout a clinical trial period [\u003csup\u003e18\u003c/sup\u003e]. The normal range for the \u0026ldquo;A1c\u0026rdquo; test results is below 5.7 %, while a range of between 5.7 % and 6.4 % is \u0026ldquo;high.\u0026rdquo;\u003c/p\u003e\n\u003cp\u003eComparatively, changes in skeletal mass were measured using Vitamin D as the main variable. This variable was selected as the main variable for the present study because it supports weight loss management [\u003csup\u003e19\u003c/sup\u003e]. Relative to this assertion, empirical investigations suggest that patients with high body weights have low levels of Vitamin D, while those with lower body weights have a higher level of Vitamin D [\u003csup\u003e20\u003c/sup\u003e]. This variable was measured by evaluating changes in serum 25-hydroxyvitmain D levels via blood tests. Low or deficient levels of vitamin D are deemed to be less than or equal to 10 ng/ml (25 nmol/L), while sufficient levels are between 10 ng/ml and 20 ng/ml (25 to 50 nmol/L) [\u003csup\u003e21\u003c/sup\u003e]. Comparatively, patients whose serum 25-hydroxyvitmain D levels were higher than 20 ng/ml (50 nmol/L) met sufficiency standards.\u003c/p\u003e\n\u003cp\u003eData was analyzed using the Statistical Package for the Social Sciences (SPSS) \u0026ndash; version 23. Descriptive analysis was the main analytical technique adopted in the review. It is associated with the breakdown of descriptive measures of data, including mean, mode, frequency, and standard of deviation [\u003csup\u003e22\u003c/sup\u003e,\u003csup\u003e23\u003c/sup\u003e]. The use of SPSS in this study is consistent with the views of scholars who suggest that the process of determining the best data collection technique should be consistent with the goal of the study, which is to extrapolate the efficacy of dietary interventions in weight loss management [\u003csup\u003e24\u003c/sup\u003e]. Subject to this plan, the efficacy of the HPD on weight loss programs was using descriptive analysis.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eThis study sought to understand the impact of HPD on weight loss management. This objective was achieved by observing its impact on the skeletal and muscle mass compositions of patients. The effects of the treatment program on weight loss outcomes were based on an assessment of its effects on patients’ insulin, hemoglobin, and Vitamin D levels. Changes in these variables were assessed and the findings deduced to evaluate the impact of HPD on muscle and skeletal mass.\u003c/p\u003e\n\u003cp\u003eAccording to Table 1, a mean change in insulin levels for all patients was registered as it increased from 15.506 at the start of the clinical trial to 15.707 at the end. The mode similarly increased from 7.8 at the start of the trial to 9.3 during its completion. Comparatively, changes in hemoglobin levels were examined by monitoring differences in\u0026nbsp;HBA1. As depicted in Table 2,\u0026nbsp;an assessment of this measure reveals a marginal increase from 4.889 at the start of the experiment to 4.985 at its end. \u0026nbsp;However, the mode relatively remained the same at 5.3. In terms of assessing the impact of the HPD on skeletal mass, changes in Vitamin D levels were tracked before and after the clinical trial period.The mean average for Vitamin D levels at the start and end of the experiment decreased marginally from 15.558 to 15.345. However, there was a significant increase of the mode from 9.8 to 17.3. Differences in these figures are highlighted in Table 3.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eAs shown in the findings section above, an assessment of changes in HBA1 levels during the clinical trial period revealed a marginal increase from 4.889 at the start of the experiment to 4.985 at its end. \u0026nbsp;This peripheral increase in HBA1 levels suggests a decrease in muscle mass - inferring the effectiveness of HPD on weight loss. However, given that the mode for the variable remained relatively constant throughout the trial period, it can be deduced that HPD was not as effective in changing HBA1 levels as it did insulin. However, the HPD diet had a negative effect on muscle mass, thereby underscoring its effectiveness in influencing weight loss programs.\u003c/p\u003e\n\u003cp\u003eIn terms of insulin changes, there was a significant increase in mode from 7.8 at the start of the trial period to 9.3 during the completion stage. The findings suggest that the impact of the HPD on insulin resistance could have been masked by the marginal increases in mean values reported during the clinical trial. \u0026nbsp; Overall, the increase in insulin levels among the patients, supported by differences in mode, suggests a significant increase in insulin levels during the trial period. Alternatively, based on the relationship between insulin and muscle bulk identified in the methodology section of this document, one could assume that the HPD had a negative effect on muscle mass. The implication of this finding on the research question is that HPD is effective in promoting favorable weight loss outcomes through inferred reductions in muscle mass.\u0026nbsp;These findings imply that muscle loss is achievable after prolonged exposure to HPD [\u003csup\u003e25\u003c/sup\u003e].\u003c/p\u003e\n\u003cp\u003eStudies have supported the above-mentioned findings by re-affirming the effects of dietary effectiveness on weight loss [\u003csup\u003e26\u003c/sup\u003e]. Therefore, the findings generated have emphasized the importance of understanding the nutritional compounds of various dietary plans to comprehend their overall effectiveness [\u003csup\u003e27\u003c/sup\u003e]. Patients’ characteristics equally play an important role in determining the effectiveness of HPD programs. For example, some patients harbor a C-reactive compound in their genetic makeup, which may worsen, or improve, their metabolic reactions to HPD [\u003csup\u003e28\u003c/sup\u003e]. Such causative agents may lead to variations in muscle and skeletal mass during analysis [\u003csup\u003e29\u003c/sup\u003e].At the same time, certain population groups, such as older adults or people with pre-existing health conditions, may require high levels of protein intake owing to age-related factors [\u003csup\u003e30\u003c/sup\u003e]. For instance, studies have shown that the elderly have a significant risk of skeletal and muscle mass reduction owing to age-related factors [\u003csup\u003e31\u003c/sup\u003e]. Therefore, they may require a higher protein intake than the general population.\u003c/p\u003e\n\u003cp\u003eMost affiliated studies have taken a keen interest in understanding the impact of sex and age-related factors on weight loss programs. For example, women tend to lose skeletal muscle density faster than men [\u003csup\u003e32\u003c/sup\u003e]. This outcome remains consistent across various nutritional programs, including HPD [\u003csup\u003e33\u003c/sup\u003e]. However, scholars have used the Skeletal Mass Index (SMI) to investigate the effects of diets on weight loss programs. Their findings suggest that patients with low SMI are prone to several negative health outcomes, including low life expectancy and high rates of acute or chronic illnesses [\u003csup\u003e34\u003c/sup\u003e].Similarly, obesity may lead to lower bone density, while its effects further worsen with aging [\u003csup\u003e35\u003c/sup\u003e].Therefore, body mass gains lead to the deterioration of skeletal mass as a weight indicator [\u003csup\u003e36\u003c/sup\u003e These statements suggest that the impact of HPD on weight loss could be moderated by patient’s demographic characteristics.\u003c/p\u003e\n\u003cp\u003eSubject to the influence of the above-mentioned effects of dietary interventions on weight loss, some strategies adopted by healthcare practitioners to manage obesity involve making changes to protein-based diets [\u003csup\u003e37\u003c/sup\u003e]. The same plan has been used to assess the effectiveness of protein-based diets on weight loss programs [\u003csup\u003e38\u003c/sup\u003e]. For example, researchers who have used nutritional interventions aimed at promoting body mass reductions through variations in protein levels have employed nitrogen balance as a key determinant of clinical effectiveness [\u003csup\u003e39\u003c/sup\u003e]. Their studies have had mixed results on obesity management.\u003c/p\u003e\n\u003cp\u003eAn overview of the above limitations suggests that the HPD nutritional program may be associated with significant changes in body mass outcomes. These results are consistent with research showing that a HPD is associated with the preservation of lean body mass [\u003csup\u003e40\u003c/sup\u003e]. Therefore, one could argue that the emergence of HPD as an effective dietary plan for influencing weight reduction programs is consistent with extant literature.\u003c/p\u003e\n\u003cp\u003eThe results highlighted in the findings section of this study revealed that the mean change for Vitamin D levels among the clinical trial group was 15.558 at the start to 15.345 in the end. Comparatively, out of all the three variables assessed in this investigation, changes in Vitamin D had the highest difference in mode. This statement means that there may have been significant differences in vitamin D response outcomes within the clinical trial group. However, they did not undermine the insignificance of the Vitamin D changes observed among the larger trial group after exposure to HPD.\u003c/p\u003e\n\u003cp\u003eThe rise of the HPD in promoting the efficacy of nutritional intervention programs could create a paradigm shift in the use of protein-based nutritional plans in obesity management. Relative to this assertion, restrictions on calorie intake and intermediate fasting are equally important to this review but less effective in causing weight loss [\u003csup\u003e41\u003c/sup\u003e]. The effectiveness of HPD could be contrasted to past uses of the dietary method in clinical studies. Indeed, most researchers used it to suppress hunger and enhance satiety, as opposed to reducing body mass [\u003csup\u003e42\u003c/sup\u003e]. At the same time, researchers have used HPD to promote muscle mass growth and minimize fat gain by supporting the intake of protein-rich foods above the recommended daily intake levels [\u003csup\u003e43\u003c/sup\u003e]. Researchers who have highlighted the use of HPD this way have the opportunity to expand it to improve the effectiveness of programs designed to manage obesity [\u003csup\u003e44\u003c/sup\u003e]. Relative to these findings, HPD emerged as an effective dietary plan for weight loss treatment.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eDietary interventions are a source of knowledge for understanding the metabolic processes associated with obesity management programs. Overall, the findings of this study showed that reductions in muscle mass were more poignant than similar changes that occurred in the skeletal mass based on exposure to HPDs. These findings are consistent with other researchers who have affirmed the impact of HPDs on weight loss programs. The implication of this finding on the management of obesity is rooted in the continued use of HPD to support linked programs, relative to other dietary interventions. These findings are relevant to clinical practice because they promote the adoption of targeted interventions for different groups of patients.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003e\u003cstrong\u003eBCM\u003c/strong\u003e - Body Composition Meter\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCRD\u003c/strong\u003e - Calorie-restricted Data\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eHPD –\u0026nbsp;\u003c/strong\u003eHigh-Protein Diets\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSMI\u003c/strong\u003e - Skeletal Muscle Index\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eData Availability Statement\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"50%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eQuestion\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"50%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eResponse\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50%\" valign=\"top\"\u003e\n \u003cp\u003eHas data associated with your study been deposited into a publicly available repository?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"50%\" valign=\"top\"\u003e\n \u003cp\u003eNo.\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50%\" valign=\"top\"\u003e\n \u003cp\u003ePlease select why.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"50%\" valign=\"top\"\u003e\n \u003cp\u003eData will be made available on request\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eDeclarations\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;Acknowledgment\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eApproval to conduct this study was obtained from participating institutions in China. All patients who took part in the clinical trials were briefed of its contents and objectives. They provided informed consent before recruitment, which was pivotal in completing the investigation under the ethical approval number - [2022]074.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics Declaration\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study is compliant with the ethical guidelines of the Department of Endocrinology, Xuanwu Hospital, Capital Medical University. The Internal Review Board of the institution was consulted before undertaking the research and permission granted to proceed.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent to Participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eParticipants who chose to partake in the investigation did so voluntarily. Therefore, the researcher did not coerce or incentivize them to contribute to the probe.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for Publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eRelevant permission was obtained from Xuanwu Hospital, Capital Medical University to publish the findings of this study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u003c/strong\u003e\u003cstrong\u003e’\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eY.M. conceived and designed the study, conducted the clinical trial, collected the data, and performed the data analysis. L.S. and Z.M. assisted with data collection and analysis. Y.M. drafted the initial manuscript. L.S. and Z.M. reviewed and provided critical revisions to the manuscript. All authors read and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe researcher did not receive financial contributions for the study\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll materials included in this investigation were open-sourced, meaning that the researcher did not need prior approval from the original authors to use information. All documents requiring authorization before use were omitted from the probe to prevent any breach of intellectual property rights.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003e\u003cstrong\u003e Hachem F, Vanham D, Moreno LA (2022) Territorial and sustainable healthy diets. Food Nutr Bull 41:87-103.\u003c/strong\u003e\u003c/li\u003e\n \u003cli\u003e(n.d.) Clinical Practice Guidelines. American Association of Clinical Endocrinology. 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Ther Adv Endocrinol Metab 11: 1-12.\u003c/li\u003e\n \u003cli\u003eBansal P, Bhandari U, Sharma K, Arya P (2021) Embelin modulates metabolic endotoxemia and associated obesity in the high-fat diet fed C57BL/6 mice. Hum Exp Toxicol 40: 60-70.\u003c/li\u003e\n \u003cli\u003eMacFarland TW, Yates JM (2021) Using R for biostatistics. Springer Nature, New York, NY.\u003c/li\u003e\n \u003cli\u003ePavlidou E, Papadopoulou SK, Seroglou K, Giaginis C (2023) Revised Harris-Benedict Equation: new human resting metabolic rate equation. Metabolites 28:189-191.\u003c/li\u003e\n \u003cli\u003eO\u0026apos;Neill JER, Corish CA, Horner K. (2023) Accuracy of resting metabolic rate prediction equations in athletes: a systematic review with meta-analysis. Sports Med 53:2373-2398.\u003c/li\u003e\n \u003cli\u003eEdda C, Nai CY, Mittendorfer B (2017) Preserving healthy muscle during weight loss. 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Springer, New York, USA.\u003c/li\u003e\n \u003cli\u003eFang J, Xu B (2021) Blood urea nitrogen to serum albumin ratio independently predicts mortality in critically ill patients with acute pulmonary embolism. Clin Appl Thromb Hemost 27: 112-119.\u003c/li\u003e\n \u003cli\u003eWright CS, Li J, Campbell WW (2019) Effects of dietary protein quantity on bone quantity following weight loss: a systematic review and meta-analysis. Adv Nutr 10: 1089-1107.\u003c/li\u003e\n \u003cli\u003eMcCarthy D, Berg A (2021) Weight loss strategies and the risk of skeletal muscle mass loss. Nutrients 13: 2473-2477.\u003c/li\u003e\n \u003cli\u003eVerreijen AM, Engberink MF, Memelink RG, van der Plas SE, Visser M, et al. (2017) Effect of a high protein diet and/or resistance exercise on the preservation of fat-free mass during weight loss in overweight and obese older adults: a randomized controlled trial. Nutr J 16: 1-10.\u003c/li\u003e\n \u003cli\u003eKossoff E, Cervenka M (2020) Ketogenic dietary therapy controversies for its second century. Epilepsy Curr 20: 125-129.\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003eTables 1 to 3 are available in the Supplementary Files section\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Obesity, High-Protein Diet, Skeletal, Muscle, Weight","lastPublishedDoi":"10.21203/rs.3.rs-4444363/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4444363/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eObjective\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe objective of this probe is to determine the effects of High-Protein Diets (HPD) on weight loss programs.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethodology\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFrom January 2021 to May 2022, 133 patients, who were enrolled in a Chinese-based weight loss program, participated in a clinical trial aimed at investigating the impact of High-Protein Diets (HPD) on weight loss programs. The effects of the diet plan on the patients’ insulin, hemoglobin, and Vitamin D levels were assessed and the findings examined to evaluate the impact of HPD on muscle and skeletal mass.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults and Findings\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eHPD was useful in catalyzing the effectiveness of weight loss programs. It led to reductions in skeletal and muscle mass during the trial period based on its impact on insulin, hemoglobin, and Vitamin D levels among the trial population..\u003c/p\u003e","manuscriptTitle":"Impact of High-Protein Diets on Weight Loss Programs: Analyzing Loss of Muscle and Skeletal Mass","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-06-14 09:30:33","doi":"10.21203/rs.3.rs-4444363/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"012c69fe-201c-43e2-a250-f6eaccfbb7de","owner":[],"postedDate":"June 14th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2024-06-14T14:05:35+00:00","versionOfRecord":[],"versionCreatedAt":"2024-06-14 09:30:33","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4444363","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4444363","identity":"rs-4444363","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}