Renal Function Following Long-Term Weight Loss in Individuals with Abdominal Obesity on a Very-Low-Carbohydrate Diet vs High-Carbohydrate Diet

2010 ◽  
Vol 110 (4) ◽  
pp. 633-638 ◽  
Author(s):  
Grant D. Brinkworth ◽  
Jonathan D. Buckley ◽  
Manny Noakes ◽  
Peter M. Clifton
Medicine ◽  
2015 ◽  
Vol 94 (47) ◽  
pp. e2181 ◽  
Author(s):  
Jeannie Tay ◽  
Campbell H. Thompson ◽  
Natalie D. Luscombe-Marsh ◽  
Manny Noakes ◽  
Jonathan D. Buckley ◽  
...  

2020 ◽  
Vol 150 (8) ◽  
pp. 2009-2015 ◽  
Author(s):  
Cara B Ebbeling ◽  
Lisa Bielak ◽  
Paul R Lakin ◽  
Gloria L Klein ◽  
Julia M W Wong ◽  
...  

ABSTRACT Background Longer-term feeding studies suggest that a low-carbohydrate diet increases energy expenditure, consistent with the carbohydrate-insulin model of obesity. However, the validity of methodology utilized in these studies, involving doubly labeled water (DLW), has been questioned. Objective The aim of this study was to determine whether dietary energy requirement for weight-loss maintenance is higher on a low- compared with high-carbohydrate diet. Methods The study reports secondary outcomes from a feeding study in which the primary outcome was total energy expenditure (TEE). After attaining a mean Run-in weight loss of 10.5%, 164 adults (BMI ≥25 kg/m2; 70.1% women) were randomly assigned to Low-Carbohydrate (percentage of total energy from carbohydrate, fat, protein: 20/60/20), Moderate-Carbohydrate (40/40/20), or High-Carbohydrate (60/20/20) Test diets for 20 wk. Calorie content was adjusted to maintain individual body weight within ± 2 kg of the postweight-loss value. In analyses by intention-to-treat (ITT, completers, n = 148) and per protocol (PP, completers also achieving weight-loss maintenance, n = 110), we compared the estimated energy requirement (EER) from 10 to 20 wk of the Test diets using ANCOVA. Results Mean EER was higher in the Low- versus High-Carbohydrate group in models of varying covariate structure involving ITT [ranging from 181 (95% CI: 8–353) to 246 (64–427) kcal/d; P ≤0.04] and PP [ranging from 245 (43–446) to 323 (122–525) kcal/d; P ≤0.02]. This difference remained significant in sensitivity analyses accounting for change in adiposity and possible nonadherence. Conclusions Energy requirement was higher on a low- versus high-carbohydrate diet during weight-loss maintenance in adults, commensurate with TEE. These data are consistent with the carbohydrate-insulin model and lend qualified support for the validity of the DLW method with diets varying in macronutrient composition. This trial was registered at clinicaltrials.gov as NCT02068885.


2020 ◽  
Vol 4 (7) ◽  
Author(s):  
Kim J Shimy ◽  
Henry A Feldman ◽  
Gloria L Klein ◽  
Lisa Bielak ◽  
Cara B Ebbeling ◽  
...  

Abstract Context According to the carbohydrate-insulin model of obesity, an elevated insulin-to-glucagon ratio in response to a high-carbohydrate diet directs metabolic fuels toward storage, resulting in lower circulating energy. Objective To determine differences in total circulating energy post-meal related to dietary carbohydrate. Design Ancillary study within the Framingham State Food Study. Setting University community. Participants 29 adults (aged 20 to 65 years) with overweight or obesity (body mass index ≥25 kg/m2) Intervention After achieving 10% to 14% weight loss on a run-in diet, participants were randomized to weight-loss-maintenance test diets varying in carbohydrate content (high-carbohydrate, 60% of total energy, n = 11; moderate-carbohydrate, 40%, n = 8; low-carbohydrate, 20%, n = 10) and controlled for protein (20%). During 24-hour metabolic ward admissions between 10 and 15 weeks on the test diets, metabolic fuels and hormones were measured. Main Outcome Measure Energy availability (EA) based on energy content of blood glucose, beta-hydroxybutyrate, and free fatty acids, in the late postprandial period (180 to 300 minutes). Insulin at 30 minutes into the test meal (Meal Insulin-30) was measured as an effect modifier. Results Insulin-to-glucagon ratio was 7-fold higher in participants on the high- vs low-carbohydrate diet (2.5 and 0.36, respectively). Late postprandial EA was 0.58 kcal/L lower on the high- vs low-carbohydrate diet (P < 0.0001), primarily related to suppression of free fatty acids. Early postprandial EA (30 to 180 minutes) declined fastest in the high-carbohydrate group, and Meal Insulin-30 modified this diet effect. Conclusions During weight-loss maintenance on a high-carbohydrate diet, late postprandial EA is reduced, consistent with the carbohydrate-insulin model.


1984 ◽  
Vol 247 (6) ◽  
pp. R1054-R1061 ◽  
Author(s):  
J. G. Granneman ◽  
E. M. Stricker

Recent studies suggest that the rate of nutrient transit through the upper gastrointestract may provide cues that are important to the control of food intake. We examined gastrointestinal function in rats with streptozotocin-induced diabetes and related these findings to concomitant changes in food intake. Control and diabetic rats were adapted to one of two isocaloric diets either high in carbohydrate or fat. Control rats ate similar amounts of each diet. In contrast, diabetic animals fed high-carbohydrate diet were hyperphagic, whereas those fed low-carbohydrate diet ate normal amounts of food. Gastric emptying, intestinal mass, disaccharidase activity, and glucose absorption were increased in normophagic diabetic rats fed a low-carbohydrate diet. Feeding diabetic rats high-carbohydrate diet potentiated each of these effects, and food intake was highly correlated with rate of gastric emptying. These and other results indicate that diabetes enhances gastric emptying and intestinal carbohydrate digestion and absorption, even in the absence of hyperphagia. Consequently, the hyperphagia of diabetic rats may be in part a behavioral response to a greatly accelerated clearance of nutrients from the upper gastrointestinal tract that occurs when these animals are fed diets rich in carbohydrate.


BMJ ◽  
2018 ◽  
pp. k4583 ◽  
Author(s):  
Cara B Ebbeling ◽  
Henry A Feldman ◽  
Gloria L Klein ◽  
Julia M W Wong ◽  
Lisa Bielak ◽  
...  

AbstractObjectiveTo determine the effects of diets varying in carbohydrate to fat ratio on total energy expenditure.DesignRandomized trial.SettingMulticenter collaboration at US two sites, August 2014 to May 2017.Participants164 adults aged 18-65 years with a body mass index of 25 or more.InterventionsAfter 12% (within 2%) weight loss on a run-in diet, participants were randomly assigned to one of three test diets according to carbohydrate content (high, 60%, n=54; moderate, 40%, n=53; or low, 20%, n=57) for 20 weeks. Test diets were controlled for protein and were energy adjusted to maintain weight loss within 2 kg. To test for effect modification predicted by the carbohydrate-insulin model, the sample was divided into thirds of pre-weight loss insulin secretion (insulin concentration 30 minutes after oral glucose).Main outcome measuresThe primary outcome was total energy expenditure, measured with doubly labeled water, by intention-to-treat analysis. Per protocol analysis included participants who maintained target weight loss, potentially providing a more precise effect estimate. Secondary outcomes were resting energy expenditure, measures of physical activity, and levels of the metabolic hormones leptin and ghrelin.ResultsTotal energy expenditure differed by diet in the intention-to-treat analysis (n=162, P=0.002), with a linear trend of 52 kcal/d (95% confidence interval 23 to 82) for every 10% decrease in the contribution of carbohydrate to total energy intake (1 kcal=4.18 kJ=0.00418 MJ). Change in total energy expenditure was 91 kcal/d (95% confidence interval −29 to 210) greater in participants assigned to the moderate carbohydrate diet and 209 kcal/d (91 to 326) greater in those assigned to the low carbohydrate diet compared with the high carbohydrate diet. In the per protocol analysis (n=120, P<0.001), the respective differences were 131 kcal/d (−6 to 267) and 278 kcal/d (144 to 411). Among participants in the highest third of pre-weight loss insulin secretion, the difference between the low and high carbohydrate diet was 308 kcal/d in the intention-to-treat analysis and 478 kcal/d in the per protocol analysis (P<0.004). Ghrelin was significantly lower in participants assigned to the low carbohydrate diet compared with those assigned to the high carbohydrate diet (both analyses). Leptin was also significantly lower in participants assigned to the low carbohydrate diet (per protocol).ConclusionsConsistent with the carbohydrate-insulin model, lowering dietary carbohydrate increased energy expenditure during weight loss maintenance. This metabolic effect may improve the success of obesity treatment, especially among those with high insulin secretion.Trial registrationClinicalTrials.govNCT02068885.


2017 ◽  
Vol 313 (4) ◽  
pp. R347-R356 ◽  
Author(s):  
Hugh S. Winwood-Smith ◽  
Craig E. Franklin ◽  
Craig R. White

Long-term studies have found that low-carbohydrate diets are more effective for weight loss than calorie-restricted diets in the short term but equally or only marginally more effective in the long term. Low-carbohydrate diets have been linked to reduced glycogen stores and increased feelings of fatigue. We propose that reduced physical activity in response to lowered glycogen explains the diminishing weight loss advantage of low-carbohydrate compared with low-calorie diets over longer time periods. We explored this possibility by feeding adult Drosophila melanogaster a standard or a low-carbohydrate diet for 9 days and measured changes in metabolic rate, glycogen stores, activity, and body mass. We hypothesized that a low-carbohydrate diet would cause a reduction in glycogen stores, which recover over time, a reduction in physical activity, and an increase in resting metabolic rate. The low-carbohydrate diet reduced glycogen stores, which recovered over time. Activity was unaffected by diet, but metabolic rate was reduced, in the low-carbohydrate group. We conclude that metabolic depression could explain the decreased effectiveness of low-carbohydrate diets over time and recommend further investigation of long-term metabolic effects of dietary interventions and a greater focus on physiological plasticity within the study of human nutrition.


2020 ◽  
Author(s):  
Naba Al-Sari ◽  
Signe Schmidt ◽  
Tommi Suvitaival ◽  
Min Kim ◽  
Kajetan Trost ◽  
...  

Aims/hypothesis: Lipid metabolism might be compromised in type 1 diabetes and the understanding of their physiology is critically important. This study aimed to compare the change in plasma lipid concentrations during carbohydrate dietary changes in individuals with type 1 diabetes and identify predictive biomarkers and early-stage pathophysiology for dyslipidaemia. We hypothesized that: (1) the lipidomics profiles before and after ingesting low or high carbohydrate diet for 12 weeks would be different; and (2) specific annotated lipid species would have significant associations with metabolic outcomes. Methods: Ten adults with type 1 diabetes (mean+/-SD: age 43.6+/-13.8 years, diabetes duration 24.5+/-13.4 years, BMI 24.9+/-2.1 kg/m2, HbA1c 57.67+/-2.6 mmol/mol) using insulin pumps participated in a randomized 2-period crossover study with a 12-week intervention period of low carbohydrate diet (< 100 g carbohydrates/day) or high carbohydrate diet (> 250 g carbohydrates/day) respectively, separated by a 12-week washout period. A large-scale non-targeted lipidomics was performed with mass spectrometry for fasting plasma samples obtained before and after each diet intervention. Logitudinal lipid levels were analysed using linear mixed-effects models. Results: In total, 289 lipid species were identified from 14 major lipid classes (triacylglycerides, phosphatidylcholines, phosphatidylethanolamines, hexosyl-ceramide, sphingomyelins, lyso-phosphatidylcholines, ceramides, lactosyl-ceramide, lyso-phoshatidylethanolamine, free fatty acids, phosphatidylinositols, phosphatidylglycerols, phosphatidylserines and sulfatides). Comparing the two diets, 11 lipid species belonging to sphingomyelins, phosphatidylcholines and LPC(O-16:0) were changed. All the 11 lipid species were significantly elevated during low carbohydrate diet. Two lipid species were most differentiated between diets, namely SM(d36:1) (B+/-SE: 1.44+/-0.28, FDR = 0.010) and PC(P-36:4)/PC(O-36:5) (B+/-SE: 1.34+/-0.25, FDR = 0.009) species. Poly-unsaturated PC(35:4) was inversely associated with BMI and positively associated with HDL-cholesterol (p < 0.001). Conclusion/interpretation: Lipidome-wide outcome analysis of a randomized cross-over trial of individuals with type 1 diabetes following a low carbohydrate diet showed an increase in sphingomyelins and phosphatidylcholines which are thought to reduce dyslipidaemia. The poly-unsaturated phosphatidylcholine 35:4 was inversely associated with BMI and positively associated with HDL-cholesterol (p < 0.001). Results from this study warrant for more investigation on the long-term effect of PC(35:4) lipid-species in lipid homeostasis in type 1 diabetes. Trial registration Clinicaltrials.gov NCT02888691 Keywords Biomarker ∙ Cardiovascular disease ∙ Dyslipidaemia ∙ Lipidomics ∙ Low carbohydrate diet ∙ Randomized trial ∙ Type 1 diabetes.


2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1823-1823
Author(s):  
Neal Malik ◽  
Serena Tonstad ◽  
Ella Haddad

Abstract Objectives We compared a high-fiber bean-rich diet with a low-carbohydrate diet in a randomized controlled trial to assess their effects on body weight, blood lipids and micronutrient adequacy. Methods One hundred and seventy-three women and men with a mean body mass index of approximately 36 kg · m−2 were randomized to a high-fiber bean-rich diet that achieved mean (SD) fiber intakes of 35.5 (18.6) g · day−1 for women and 42.5 (30.3) g · day−1 for men, or a low-carbohydrate diet (&lt;120 g · day−1). Both diets were induced gradually over 4 weeks and included a 3-day feeding phase. Results After 52 weeks, the low-carbohydrate (n = 24) group tended to retain weight loss better than the high-fiber group (n = 30) (P = 0.06), although total cholesterol remained lower with the bean-rich diet (P = 0.049). The low-carbohydrate group consumed more vitamin K (P = 0.006), thiamin (P = 0.001), and niacin (P = 0.02) whereas those in the high-fiber group consumed more folate (P = 0.006), magnesium (P = 0.046) and copper (P = 0.017). Both groups consumed less than the RDA for vitamin D, vitamin E, calcium, magnesium and copper. Conclusions A high-fiber bean-rich diet was as effective as a low-carbohydrate diet for weight loss. However, both diets were deficient in micronutrients. These results may have implications for long-term disease risk and morbidity management. Funding Sources Lifestyle Center of America (Sulphur, OK).


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