Tue, Nov-20-18, 04:02
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Plan: Muscle Centric
Stats: 238/153/160
BF:
Progress: 109%
Location: UK
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Insulin and obesity: Is it time for a paradigm shift?
Quote:
Insulin and obesity: Is it time for a paradigm shift?
19 November 2018
Anssi H Manninen
Director of Research & Development
Dominus Nutrition Oy
Fuengirola (Malaga), Spain
I would like to compliment Ebbeling et al. on their landmark study investigating the effects of diets varying in carbohydrate to fat ratio on total energy expenditure [1]. It is a mystery to me why it is so hard to accept the fact that hyperinsulinemia increases body fat mass without a concomitant increase in energy intake. This phenomenon has been demonstrated in numerous studies using exogenous insulin therapy.
For example, a small group of diabetic patients were studied by Carlson and Cambell on conventional insulin therapy and after 2 months of intensive insulin therapy while maintaining constant caloric intake [2]. As expected, two months of intensive insulin therapy improved glycemic control dramatically. However, this improvement was achieved at a cost of a fat mass gain of about 2.6 kilograms over the 2 months treatment. Of the weight gain, 70% could be accounted for by elimination of glycosuria and 30% by reduction in daily energy expenditure. Although elimination of glycosuria is not relevant to healthy non-diabetic individuals, daily energy expenditure decreased 5% (approximately 120 kcal/day), consistent with the carbohydrate-insulin model of obesity. The authors suggested that the reduction in the energy expenditure was the result of the decrease in 1) triglyceride/free fatty acid cycling (TG/FFA), 2) non-oxidative glucose metabolism and 3) non-oxidative protein metabolism.
1. Ebbeling CB, Feldman HA, Klein GL, Wong JMW, Bielak L, Stelz SK, et al. Effects of a low carbohydrate diet on energy expenditure during weight loss maintenance: randomized trial. BMJ 2018;363:k4583.
2. Carlson MG, Campbell PJ. Intensive insulin therapy and weight gain in IDDM. Diabetes 1993;42:1700–1707.
Research
Effects of a low carbohydrate diet on energy expenditure during weight loss maintenance: randomized trial
BMJ 2018; 363 doi: https://doi.org/10.1136/bmj.k4583 (Published 14 November 2018)
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https://www.bmj.com/content/363/bmj.k4583/rr-7 |
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