Research Paper Volume 13, Issue 4 pp 5571—5584

The joint effect of energy reduction with calcium supplementation on the risk factors of type 2 diabetes in the overweight population: a two-year randomized controlled trial

Wei Wei1, *, , Wenbo Jiang1, *, , Wenbo Gu1, , Huanyu Wu1, , Haiyang Jiang1, , Guili Li1, , Qingrao Song1, , Jiaxin Huang2, , Xuanyang Wang1, , Lulu Wang1, , Changhao Sun1, , Tianshu Han1, , Ying Li1, ,

  • 1 Department of Nutrition and Food Hygiene, College of Public Health, Harbin Medical University, Harbin 150081, Heilongjiang Province, P. R. China
  • 2 Department of Postgraduate, The Third Affiliated Hospital of Harbin Medical University, Harbin 150081, Heilongjiang Province, P. R. China
* Equal contribution

Received: October 1, 2020       Accepted: December 10, 2020       Published: February 11, 2021
How to Cite

Copyright: © 2021 Wei et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Both excessive energy intake and low calcium intake are inversely associated with the aging-related diseases, particularly for type 2 diabetes mellitus(T2DM). This study examined whether energy reduction coupled with calcium supplementation aided in the prevention of T2DM among the overweight population. A randomized controlled trial(RCT) of 1021 overweight participants was performed, in which participants were randomly assigned to 4 groups: 1) energy-reduction group(ERG), 2) calcium supplementation group(CSG), 3) energy-reduction with calcium supplementation group(ER-CSG), 4) control group(CG). Nutritional habits, anthropometric and diabetes-related indicators were measured at baseline and each follow-up time. To analyze the separate effects of dietary energy reduction and calcium supplementation, ERG and ER-CSG were integrated into ERGs. Similarly, CSG and ER-CSG were integrated into CSGs. Compared to the non-energy-reduction groups(NERGs), ERGs had lower values of ΔBMI(-0.9kg/m2), ΔFSG (-0.34mmol/L), ΔHbA1c(0.16%), and ΔHOMA-IR(-0.13), and higher value of ΔGutt index(-5.82). Compared to the non-calcium supplementation groups(NCSGs), the ΔGutt index(-5.46) in CSGs showed a significant decrease. Moreover, these risk factors for T2DM were most effectively ameliorated in ER-CSG group with the decreased values of ΔFSG(-0.42mmol/L), ΔGutt index(-0.73), and the slowest increasing rate value of Δ2h-glucose(0.37mmol/L). This RCT demonstrated that energy-reduction with calcium supplementation was a useful dietary intervention strategy for preventing the development of T2DM in the overweight population.


T2DM: type 2 diabetes mellitus; RCT: randomized controlled trial; ERGs: energy-reduction groups; NERGs: non-energy-reduction groups; CSG: calcium supplementation groups; NCSG: non-calcium supplementation groups; ERG: energy-reduction group; CSG: calcium supplementation group; ER-CSG: energy-reduction with calcium supplementation group; CG: control group; IR: insulin resistance; BMI: body mass index; FSG: fasting serum glucose; HbA1c: glycated hemoglobin; HOMA-IR: Homeostasis assessment model for insulin resistance; 2h-glucose: 2 hours post-load serum glucose; 2h-insulin: 2 hours post-load serum insulin; FFQ: Food Frequency Questionnaire; OGTT: oral glucose tolerance test.