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Cited by 238Diet and metabolism studiesDietary Effects on HealthRegulation of Appetite and Obesity

Effect of a plant-based, low-fat diet versus an animal-based, ketogenic diet on ad libitum energy intake

Open access
Hall, Kevin D., Guo, Juen, Courville, Amber B., Boring, James, Brychta, Robert, Chen, Kong Y., Darcey, Valerie, Forde, Ciaran G. +15 more·2021·Nature Medicine
DOI 10.1038/s41591-020-01209-1
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Abstract

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-2 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-1) 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-1) 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-1 less energy intake than the low-carbohydrate diet over 2 weeks (P < 0.0001) and 544 ± 68 kcal d-1 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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Authors
Hall, K. D., Guo, J., Courville, A. B., Boring, J., Brychta, R., Chen, K. Y., Darcey, V., Forde, C. G., Gharib, A. M., Gallagher, I., Howard, R., Joseph, P. V., Milley, L., Ouwerkerk, R., Raisinger, K., Rozga, I., Schick, A., Stagliano, M., Torres, S., Walter, M., Walter, P., Yang, S., & Chung, S. T.
Affiliations
  • National Institutes of Health (US)
  • National Institute of Diabetes and Digestive and Kidney Diseases (US)
  • Singapore Institute of Food and Biotechnology Innovation (SG)
  • National Institute of Nursing Research (US)
Corresponding author
Hall, Kevin D.
ORCID
Venue
Nature Medicine
Publisher
Springer Science and Business Media LLC
Published
2021-01-21
Volume
27
Issue
2
Pages
344-353
ISSN
  • 1078-8956 (ISSN-L)
  • 1546-170X
DOI
10.1038/s41591-020-01209-1
OpenAlex
W3125610267
Semantic Scholar
ba7fda49581bd7d588f59e2e03e5969b0fcbb736
Cited by
238
References
57
Citations by year
2026: 34 · 2025: 42 · 2024: 40 · 2023: 52 · 2022: 46 · 2021: 23
FWCI
25.26
Type
journal article
Language
en
Open access
Licence
Locations
  • Nature Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • Socio-Environmental Systems Modeling (acceptedVersion)
  • Data Archiving and Networked Services (DANS) (submittedVersion)
Funders
U.S. Department of Health & Human Services | NIH | National Institute of Diabetes and Digestive and Kidney Diseases (1-ZIA-DK013037-13)
Topics
  • Health Sciences › Medicine › Physiology › Diet and metabolism studies
  • Health Sciences › Medicine › Physiology › Dietary Effects on Health
  • Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Regulation of Appetite and Obesity
Keywords
ad libitum energy intake, plant-based diet, low-fat diet, ketogenic diet, low-carbohydrate diet, glycemic load, insulin secretion, weight loss, hunger, food enjoyment
MeSH terms
Adult, Body Composition, Energy Intake, Dietary Carbohydrates, Dietary Fats, Energy Metabolism, Female, Humans, Insulin, Male, Middle Aged, Obesity, Diet, Vegetarian, Weight Loss, Body Mass Index, Diet, Fat-Restricted, Overweight, Diet, Ketogenic

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