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Hall, Kevin D; Guo, Juen; Courville, Amber B; Boring, James; Brychta, Robert; Chen, Kong Y; Darcey, Valerie; Forde, Ciaran G; Gharib, Ahmed M; Gallagher, Isabelle; Howard, Rebecca; Joseph, Paule V; Milley, Lauren; Ouwerkerk, Ronald; Raisinger, Klaudia; Rozga, Irene; Schick, Alex; Stagliano, Michael; Torres, Stephan; Walter, Mary; Walter, Peter; Yang, Shanna; Chung, Stephanie T
Nature medicine, 02/2021, Volume: 27, Issue: 2Journal Article
The carbohydrate-insulin model of obesity posits that high-carbohydrate diets lead to excess insulin secretion, thereby promoting fat accumulation and increasing energy intake. Thus, low-carbohydrate diets are predicted to reduce ad libitum energy intake as compared to low-fat, high-carbohydrate diets. To test this hypothesis, 20 adults aged 29.9 ± 1.4 (mean ± s.e.m.) years with body mass index of 27.8 ± 1.3 kg m were admitted as inpatients to the National Institutes of Health Clinical Center and randomized to consume ad libitum either a minimally processed, plant-based, low-fat diet (10.3% fat, 75.2% carbohydrate) with high glycemic load (85 g 1,000 kcal ) or a minimally processed, animal-based, ketogenic, low-carbohydrate diet (75.8% fat, 10.0% carbohydrate) with low glycemic load (6 g 1,000 kcal ) for 2 weeks followed immediately by the alternate diet for 2 weeks. One participant withdrew due to hypoglycemia during the low-carbohydrate diet. The primary outcomes compared mean daily ad libitum energy intake between each 2-week diet period as well as between the final week of each diet. We found that the low-fat diet led to 689 ± 73 kcal d less energy intake than the low-carbohydrate diet over 2 weeks (P < 0.0001) and 544 ± 68 kcal d less over the final week (P < 0.0001). Therefore, the predictions of the carbohydrate-insulin model were inconsistent with our observations. This study was registered on ClinicalTrials.gov as NCT03878108 .
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