Insulin sensitivity determines the effectiveness of dietary macronutrient composition on weight loss in obese women
Open accessAbstract
Objective: To determine whether macronutrient composition of a hypocaloric diet can enhance its effectiveness and whether insulin sensitivity (Si) affects the response to hypocaloric diets. Research Methods and Procedures: Obese nondiabetic insulin‐sensitive (fasting insulin < 10 μU/mL; n = 12) and obese nondiabetic insulin‐resistant (fasting insulin > 15 μU/mL; n = 9) women (23 to 53 years old) were randomized to either a high carbohydrate (CHO) (HC)/low fat (LF) (60% CHO, 20% fat) or low CHO (LC)/high fat (HF) (40% CHO, 40% fat) hypocaloric diet. Primary outcome measures after a 16‐week dietary intervention were: changes in body weight (BW), Si, resting metabolic rate, and fasting lipids. Results: Insulin‐sensitive women on the HC/LF diet lost 13.5 ± 1.2% (p < 0.001) of their initial BW, whereas those on the LC/HF diet lost 6.8 ± 1.2% (p < 0.001; p < 0.002 between the groups). In contrast, among the insulin‐resistant women, those on the LC/HF diet lost 13.4 ± 1.3% (p < 0.001) of their initial BW as compared with 8.5 ± 1.4% (p < 0.001) lost by those on the HC/LF diet (p < 0.04 between two groups). These differences could not be explained by changes in resting metabolic rate, activity, or intake. Overall, changes in Si were associated with the degree of weight loss (r = −0.57, p < 0.05). Discussion: The state of Si determines the effectiveness of macronutrient composition of hypocaloric diets in obese women. For maximal benefit, the macronutrient composition of a hypocaloric diet may need to be adjusted to correspond to the state of Si.
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Some variability in weight loss may be due to interactions between diet type and patient genetics or baseline physiology such as insulin sensitivity.
“Some of this variability may be due to interactions between diet type and patient genetics62,63 or baseline physiology such as insulin sensitivity64–67.”
From Maintenance of Lost Weight and Long-Term Management of Obesity (2018) · cites this paper as [64]
A recent report indicates that the effect of low carbohydrate diet on weight will be seen primarily in subjects with insulin resistance.
“A recent report [30] indicates that the effect will be seen primarily in subjects with insulin resistance.”
From The case for low carbohydrate diets in diabetes management (2005) · cites this paper as [30]
A recent study showed that effectiveness of low carbohydrate diets was more visible in a group that was insulin-resistant.
“Finally, a recent study showed that effectiveness of low carbohydrate diets was more visible in a group that was insulin-resistant [30].”
From The case for low carbohydrate diets in diabetes management (2005) · cites this paper as [30]
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References 36 · Cited by 140
- Authors
- Cornier, M., Donahoo, W. T., Pereira, R., Gurevich, I., Westergren, R., Enerback, S., Eckel, P. J., Goalstone, M. L., Hill, J. O., Eckel, R. H., & Draznin, B.
- Affiliations
- Denver VA Medical Center (US)
- University of Gothenburg (SE)
- Corresponding author
- Draznin, Boris
- Venue
- Obesity Research
- Publisher
- Wiley
- Published
- 2005-04
- Volume
- 13
- Issue
- 4
- Pages
- 703-709
- ISSN
- 1071-7323 (ISSN-L)
- 1550-8528
- OpenAlex
- W2004995846
- Semantic Scholar
- e919f7ab6d87b3230a2a5b6a5cc05f50ebf6be09
- Cited by
- 140
- References
- 36
- Citations by year
- 2026: 3 · 2025: 5 · 2024: 4 · 2023: 5 · 2022: 4 · 2021: 8 · 2020: 3 · 2019: 3 · 2018: 11 · 2017: 8 · 2016: 10 · 2015: 7 · 2014: 6 · 2013: 5 · 2012: 8
- FWCI
- 5.82
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Obesity Research (publishedVersion)
- PubMed (publishedVersion)
- Funders
- American Diabetes Association
- American Heart Association
- Deutsches Krebsforschungszentrum
- National Institute of Diabetes and Digestive and Kidney Diseases (DK48520, P30DK048520)
- National Center for Research Resources (M01RR-00051, M01RR000051, K23RR016185, RR16185)
- Topics
- Health Sciences › Medicine › Physiology › Diet and metabolism studies
- Health Sciences › Medicine › Physiology › Dietary Effects on Health
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- insulin sensitivity, insulin resistance, macronutrient composition, hypocaloric diet, weight loss, obesity, high-carbohydrate low-fat diet, low-carbohydrate high-fat diet, resting metabolic rate, fasting lipids, women
- MeSH terms
- Adult, Basal Metabolism, Energy Intake, Diet, Reducing, Dietary Carbohydrates, Dietary Fats, Energy Metabolism, Fasting, Female, Humans, Insulin, Insulin Resistance, Middle Aged, Obesity, Weight Loss, Body Mass Index, Treatment Outcome
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