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Effect of a plant-based, low-fat diet versus an animal-based, ketogenic diet on ad libitum energy intake
Open accessAbstract
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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Metadata
- 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
- Published
- 2021-01-21
- Volume
- 27
- Issue
- 2
- Pages
- 344-353
- ISSN
- 1078-8956 (ISSN-L)
- 1546-170X
- 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
- green
- research.wur.nl
- 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 (medical) › Diet and metabolism studies
- Health Sciences › Medicine › Physiology (medical) › 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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