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  • Systematic Review
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Clinical Research

Impact of other macronutrient composition within high-protein diet on body composition and cardiometabolic health: a systematic review, pairwise, and network meta-analysis of randomized controlled trials

International Journal of Obesity volume 49, pages 1480–1489 (2025)Cite this article

Subjects

Abstract

Background/obejctive

Although the high-protein diets (HPDs) on weight control and body composition management are well investigated, mix results have been reported across studies and this variability may be attributed to differences in the composition of other macronutrients within HPDs. The aim of this study was to evaluate the impacts of HPDs with varied macronutrient compositions on body composition and cardiometabolic health outcomes through a systematic review, pairwise, and network meta-analysis.

Methods

A comprehensive search of four databases (PubMed, Embase, CINAHL, and Web of Science) was conducted to identify relevant randomized controlled trials. A total of 83 articles were selected for systematic review and both meta-analyses.

Results

Significant reduction in body mass (BM) (standardized mean difference [SMD] = −0.25; 95% CI: −0.40, −0.11), body mass index (BMI) (SMD = −0.26; 95% CI: −0.38, −0.15), waist circumference (WC) (SMD = −0.19; 95% CI: −0.33, −0.04), fat mass (FM) (mean difference [MD] = −0.64 kg; 95% CI: −0.98, −0.29), along with increase in lean body mass (LBM) (MD = 0.34 kg; 95% CI: 0.11, 0.57) were observed with HPDs regiments compared to normal-protein diets. Specifically, the high-protein, moderate-carbohydrate and high-fat diet ranked the best in reducing BM, BMI, WC, FM, systolic blood pressure, diastolic blood pressure and increasing LBM; while the high-protein, low-carbohydrate and high-fat diet obtained the highest score in reducing triglyceride and increasing high-density lipoprotein cholesterol.

Conclusion

HPDs effectively reduce FM and increase LBM, and offers potential cardiometabolic benefits. Additionally, the manipulation of carbohydrate content in HPDs may further influence these outcomes.

Registration

PROSPERO (CRD42023483907).

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Fig. 1
Fig. 2: Results of treatments with various macronutrient compositions ranked on the improvement of body mass and body composition.
Fig. 3: Results of treatments with various macronutrient compositions ranked on the improvement of cardiometabolic health.

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Data availability

Data described in the manuscript, code book, and analytic code will be made available upon request.

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Funding

This research was funded by National University of Singapore.

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  1. Department of Food Science and Technology, National University of Singapore, Singapore, Singapore

    Yueying Yao, Shiqi Lin, Ziqi He & Jung Eun Kim

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  1. Yueying Yao
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  2. Shiqi Lin
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Contributions

The authors’ responsibilities were as follows—JEK and YY: conceived and designed the study; YY, SL, and ZH: screened and collected the data; YY: analyzed the data and wrote the manuscript; JEK: supervised and revised the manuscript; JEK and YY: had primary responsibility for final content; all authors: read and approved the final manuscript.

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Correspondence to Jung Eun Kim.

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Yao, Y., Lin, S., He, Z. et al. Impact of other macronutrient composition within high-protein diet on body composition and cardiometabolic health: a systematic review, pairwise, and network meta-analysis of randomized controlled trials. Int J Obes 49, 1480–1489 (2025). https://doi.org/10.1038/s41366-025-01806-5

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