Pretreatment fasting glucose and insulin as determinants of weight loss on diets varying in macronutrients and dietary fibers - The POUNDS LOST Study

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Documents

  • Hjorth, Mads Fiil
  • George A Bray
  • Yishai Zohar
  • Lorien Urban
  • Derek C Miketinas
  • Donald A Williamson
  • Donna H Ryan
  • Jennifer Rood
  • Catherine M Champagne
  • Frank M Sacks
  • Arne Astrup

Efforts to identify a preferable diet for weight management based on macronutrient composition have largely failed, but recent evidence suggests that satiety effects of carbohydrates may depend on the individual's insulin-mediated cellular glucose uptake. Therefore, using data from the POUNDS LOST trial, pre-treatment fasting plasma glucose (FPG), fasting insulin (FI), and homeostatic model assessment of insulin resistance (HOMA-IR) were studied as prognostic markers of long-term weight loss in four diets differing in carbohydrate, fat, and protein content, while assessing the role of dietary fiber intake. Subjects with FPG <100 mg/dL lost 2.6 (95% CI 0.9;4.4, p = 0.003) kg more on the low-fat/high-protein (n = 132) compared to the low-fat/average-protein diet (n = 136). Subjects with HOMA-IR ≥4 lost 3.6 (95% CI 0.2;7.1, p = 0.038) kg more body weight on the high-fat/high-protein (n = 35) compared to high-fat/average-protein diet (n = 33). Regardless of the randomized diet, subjects with prediabetes and FI below the median lost 5.6 kg (95% CI 0.6;10.6, p = 0.030) more when consuming ≥35 g (n = 15) compared to <35 g dietary fiber/10 MJ (n = 16). Overall, subjects with normal glycemia lost most on the low-fat/high-protein diet, subjects with high HOMA-IR lost most on the high-fat/high protein diet, and subjects with prediabetes and low FI had particular benefit from dietary fiber in the diet.

Original languageEnglish
Article number586
JournalNutrients
Volume11
Issue number3
Number of pages12
ISSN2072-6643
DOIs
Publication statusPublished - 2019

    Research areas

  • Faculty of Science - Glucose, Insulin, Weight, Diet, Macronutrient composition, Clinical nutrition

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