Effects of a high-quality protein diet on glycemic control in patients with prediabetes: a systematic review and network meta-analysis
5 affiliations
- 1College of Nursing, Chengdu University of Traditional Chinese Medicine
- 2Center for Preventive Treatment of Disease, Leshan Hospital of Traditional Chinese Medicine, Affiliated to Chengdu University of Chinese Medicine
- 3Chimkent TCM Center, Sanya Hospital of Traditional Chinese Medicine
- 4Department of Psychiatry and Neurology, Leshan Hospital of Traditional Chinese Medicine, Affiliated to Chengdu University of Chinese Medicine
- 5Dermatology, Leshan Hospital of Traditional Chinese Medicine, Affiliated to Chengdu University of Chinese Medicine
Abstract
Aim: Prediabetes markedly raises the risk of diabetes and cardiovascular complications. High-quality protein diets benefit glucose and lipid metabolism, but protein sources have not been compared systematically. This network meta-analysis (NMA) compared them across core metabolic outcomes in adults with prediabetes, to inform individualized nutrition.
Methods: Electronic searches of Cochrane Library, Embase, PubMed, and Web of Science extended to February 10, 2026. We designated FPG (mmol/L) and HbA1c (%) as primary outcomes, with fasting insulin (μIU/mL), HOMA-IR, BMI (kg/m ² ), total cholesterol (mg/dL), LDL-C (mg/dL), and triglycerides (mg/dL) as secondary outcomes. Bayesian NMA was performed using R 4.4.1, with effects expressed as MD and 95% CrI.
Results: In total, 18 studies (956 patients) were included. Mixed animal protein (MAP) reduced FPG most effectively (MD -0.30, 95% CrI -0.57 to -0.029). Legume protein (LP) was most effective for HOMA-IR (MD -0.49, 95% CrI -0.55 to -0.43), lamb + chicken protein (LCP) for total cholesterol (MD -7.6, 95% CrI -14 to -1.4), and fish protein (FP) for LDL-C (MD -7.7, 95% CrI -15 to -0.64). No diet significantly affected HbA1c, fasting insulin, BMI, or triglycerides.
Conclusions: LP was significantly superior to a low-protein diet for HOMA-IR; LCP significantly reduced total cholesterol and FP significantly reduced LDL-C. No other intervention reached significance. These differences may reflect the nutrients accompanying each protein source rather than protein content alone. Given the few primary studies, heterogeneity among some interventions, and short intervention periods, further well-reported trials and implementation research are needed to bridge evidence and practice.
Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/myprospero , identifier CRD420261325032.
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BibTeX
@article{zeng2026effects,
title = {{Effects of a high-quality protein diet on glycemic control in patients with prediabetes: a systematic review and network meta-analysis}},
author = {Xinyi Zeng and Juhai Huang and Qingsong Wang and Siyuan Chen and Bin Wang and Jun Luo and Chaoming Hou and Jing Gao},
journal = {Frontiers in Endocrinology},
year = {2026},
month = nov,
doi = {10.3389/fendo.2026.1985127},
url = {https://www.frontiersin.org/articles/10.3389/fendo.2026.1985127/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Effects of a high-quality protein diet on glycemic control in patients with prediabetes: a systematic review and network meta-analysis
AU - Xinyi Zeng
AU - Juhai Huang
AU - Qingsong Wang
AU - Siyuan Chen
AU - Bin Wang
AU - Jun Luo
AU - Chaoming Hou
AU - Jing Gao
PY - 2026
DA - 2026/11/06
JO - Frontiers in Endocrinology
DO - 10.3389/fendo.2026.1985127
UR - https://www.frontiersin.org/articles/10.3389/fendo.2026.1985127/full
AB - Aim: Prediabetes markedly raises the risk of diabetes and cardiovascular complications. High-quality protein diets benefit glucose and lipid metabolism, but protein sources have not been compared systematically. This network meta-analysis (NMA) compared them across core metabolic outcomes in adults with prediabetes, to inform individualized nutrition. Methods: Electronic searches of Cochrane Library, Embase, PubMed, and Web of Science extended to February 10, 2026. We designated FPG (mmol/L) and HbA1c (%) as primary outcomes, with fasting insulin (μIU/mL), HOMA-IR, BMI (kg/m ² ), total cholesterol (mg/dL), LDL-C (mg/dL), and triglycerides (mg/dL) as secondary outcomes. Bayesian NMA was performed using R 4.4.1, with effects expressed as MD and 95% CrI. Results: In total, 18 studies (956 patients) were included. Mixed animal protein (MAP) reduced FPG most effectively (MD -0.30, 95% CrI -0.57 to -0.029). Legume protein (LP) was most effective for HOMA-IR (MD -0.49, 95% CrI -0.55 to -0.43), lamb + chicken protein (LCP) for total cholesterol (MD -7.6, 95% CrI -14 to -1.4), and fish protein (FP) for LDL-C (MD -7.7, 95% CrI -15 to -0.64). No diet significantly affected HbA1c, fasting insulin, BMI, or triglycerides. Conclusions: LP was significantly superior to a low-protein diet for HOMA-IR; LCP significantly reduced total cholesterol and FP significantly reduced LDL-C. No other intervention reached significance. These differences may reflect the nutrients accompanying each protein source rather than protein content alone. Given the few primary studies, heterogeneity among some interventions, and short intervention periods, further well-reported trials and implementation research are needed to bridge evidence and practice. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/myprospero , identifier CRD420261325032.
SN - 1664-2392
ER -