Impact of Comprehensive Lifestyle Interventions on Plasma Branched-Chain Amino Acid Concentrations: A Randomized Trial

Document Type

Journal Article

Publication Date

10-15-2025

Journal

The American journal of clinical nutrition

DOI

10.1016/j.ajcnut.2025.10.008

Keywords

branched-chain amino acids; dietary patterns; fitness; randomized controlled trial; weight loss

Abstract

BACKGROUND: Elevated plasma branched-chain amino acid (BCAA) concentrations are associated with a higher risk of type 2 diabetes and cardiovascular diseases. Lifestyle interventions have been proposed as a strategy to manage plasma BCAA concentrations, but evidence of their effectiveness is limited. OBJECTIVE: We investigated the effects of comprehensive lifestyle interventions on plasma BCAA concentrations over six months and associations between changes in Body Mass Index (BMI), physical fitness, and dietary factors and plasma BCAA changes METHODS: The PREMIER study was a randomized trial of the effects of behavioral lifestyle interventions. The interventions included counseling on diet, exercise, and weight loss ('Established'), a similar intervention with additional guidance to follow Dietary Approaches to Stop Hypertension ('Established plus DASH'), and an advice-only control group. We analyzed data from 713 male and female adult participants during the 6-month intervention period. Data and biospecimens were obtained through the NHLBI BioLINCC repository, and plasma BCAA concentrations were measured using NMR spectroscopy. Multiple linear regression was used to assess the association between intervention groups and BCAA concentrations. RESULTS: The Established (-7.19 μmol/L; 95% CI 17.45, 3.08) and Established plus DASH (-8.70 μmol/L; 95% CI -18.95, 1.55) interventions were associated with non-significant decreases in BCAA concentrations compared with the control group. Changes in BMI were correlated with changes in BCAA concentrations during the trial (partial Pearson r=0.24, p<0.001). Although changes in fitness and fiber intake were also significantly correlated with changes in BCAA concentrations, adjustment for BMI attenuated these correlations. Changes in the DASH and healthy plant-based diet indices and BCAA and protein intakes were not significantly correlated with plasma BCAA changes. CONCLUSION: Weight loss resulting from lifestyle interventions was associated with reductions in plasma BCAA concentrations. Improvements in fitness and diet composition were not associated with changes in BCAA concentrations independent of weight loss. CLINICAL TRIAL REGISTRATION: https://clinicaltrials.gov/study/NCT00000616).

Department

Exercise and Nutrition Sciences

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