Low-Energy Dense Potato- and Bean-Based Diets Reduce Body Weight and Insulin Resistance: A Randomized, Feeding, Equivalence Trial

Abstract

We evaluated the effect of diets low in energy density (1 kcal/g) and high in either potatoes (Potato) or pulses (Bean) on blood glucose control in participants with insulin resistance. We hypothesized that the Potato and Bean diets would have equivalent effects. This was an 8-week randomized, parallel design, controlled feeding study comparing Potato and Bean diets (50-55% carbohydrate, 30-35% fat, 15-20% protein). Equivalence was prespecified as the mean change in the blood glucose concentration for Potato that was within ±20% of the Bean diet. Thirty-six participants (age: 18-60 years, body mass index: 25-40 kg/m²) with insulin resistance (homeostatic model assessment of insulin resistance [HOMA-IR] >2) were enrolled. Body weight was measured, and subjects underwent a mixed meal tolerance test at baseline and after 8 weeks. Intent-to-treat (ITT) and completer analyses were conducted. Equivalence between the two diets in the area under the curve for serum glucose was attained within ±10%, but the reduction from baseline was not statistically significant. For the Bean diet, insulin (area under the response curve: -2136.3 ± 955.5 mg/[dL∙min], P = .03) and HOMA-IR (-1.4 ± 0.6, P = .02) were lower compared with baseline. ITT and completer analyses were similar, except that HOMA-IR was also reduced by the Potato diet (-1.3 ± 0.6, P < .05). Compliance with the diets was 87-88%, and body weight was reduced in both diets (Potato: -5.6% ± 0.6%; Bean: -4.1% ± 0.6%, P < .001) with no significant difference between the two diets. Potato and Bean diets low in energy density were equally effective in reducing insulin resistance and promoting weight loss in individuals with impaired blood glucose control. Clinical Trial: The trial was registered with ClinicalTrials.gov Identifier: NCT04203238.

Keywords: Beans; Potato; energy density; glucose; insulin; lipids.

FIG. 1.

Consort diagram of enrollment and follow-up.

FIG. 2.

Equivalence in change in the area under the curve for glucose and insulin between the Potato and Bean diets.

FIG. 3.

Observed least squares mean and SE in the area under the curve for (A) serum glucose (B) serum insulin, *P = .034; (C) intent-to-treat analysis of HOMA-IR at baseline and after 8 weeks, *P = .017. Potato versus Beans, P = .715. (D) Completers analysis of HOMA-IR at baseline and after 8 weeks, *P < .05. Potato versus Beans, P = .839. HOMA-IR, homeostatic model assessment of insulin resistance; SE, standard error.

FIG. 4.

Observed least squares mean and SE percentage change from baseline in body weight at 8 weeks in the Potato and Bean diet, *P < .001. Potato versus Beans, P = .684.