Insulin sensitivity affects propensity to obesity in an ethnic-specific manner: results from two controlled weight loss intervention studies
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BACKGROUND: Risk for obesity differs with ethnicity/race and is associated with insulin sensitivity (SI), insulin responsiveness, and dietary glycemic load (GL). The objective of this study was to test the hypotheses that, 1) obesity-prone, normal weight, African-American (AA) women would be more insulin sensitive than BMI-matched, never overweight AA women; 2) increased adiposity over time would be associated with greater baseline SI and higher dietary GL in AA but not European-American (EA) women; and 3) increased adiposity over time would be predicted by SI in women with high but not low acute insulin response to glucose (AIRg). METHODS: Two controlled weight loss interventions were conducted involving overweight (BMI 25.0-29.9 kg/m2) premenopausal AA and EA women. The first included matching with normal-weight (BMI <25.0 kg/m2) controls following weight loss, and then comparing SI. The second included a 1-year follow-up of weight-reduced participants to identify predictors of change in %body fat. Main outcome measure in the first study was insulin sensitivity (SI) as assessed with intravenous glucose tolerance test (IVGTT), and in the second study was change in %fat, as assessed with DXA, over one year. AIRg was assessed during IVGTT, and free-living diet was determined by food record. RESULTS: In the first study, formerly overweight AA women were 43% more insulin sensitive than BMI-matched never overweight AA (P < 0.05). In the second study, SI was positively associated with change in %fat over 1 year only in AA women (P < 0.05) and women with high AIRg (P < 0.05). In addition, AA who were insulin sensitive and who consumed a higher GL diet tended to gain greater %fat (P = 0.086 for diet x SI interaction). In both studies, AA women had higher AIRg (P < 0.001) than EA women. CONCLUSIONS: Formerly overweight (obesity-prone) AA women were more insulin sensitive than never overweight AA women, a quality that may predispose to adiposity, particularly when combined with a high GL diet. This ethnicity/race-specific effect may be due to high insulin responsiveness among AA.
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The degree of insulin sensitivity and the amount of insulin secreted after a glucose challenge affect the extent to which dietary carbohydrate quantity and quality affect change in body weight and body composition over 12-18 months.
“We and others have reported that the degree of insulin sensitivity and the amount of insulin secreted after a glucose challenge affect the extent to which dietary carbohydrate quantity and quality affect the change in body weight and body composition over 12-18 mo (15)(16)(17)(18).”
From A Lower-Carbohydrate, Higher-Fat Diet Reduces Abdominal and Intermuscular Fat and Increases Insulin Sensitivity in Adults at Risk of Type 2 Diabetes (2015) · cites this paper as [16]
The impact of dietary carbohydrate on metabolism may differ with individual phenotype.
“The impact of dietary carbohydrate on metabolism may differ with individual phenotype.”
From A Lower-Carbohydrate, Higher-Fat Diet Reduces Abdominal and Intermuscular Fat and Increases Insulin Sensitivity in Adults at Risk of Type 2 Diabetes (2015) · cites this paper as [16]
Insulin sensitivity was selected as a covariate because it interacts with diet composition in determining changes in body composition over time.
“Insulin sensitivity was selected as a covariate because it interacts with diet composition in determining changes in body composition over time (15,16).”
From A Lower-Carbohydrate, Higher-Fat Diet Reduces Abdominal and Intermuscular Fat and Increases Insulin Sensitivity in Adults at Risk of Type 2 Diabetes (2015) · cites this paper as [16]
Individuals who are more sensitive to insulin, or who secrete a greater amount of insulin in response to a glucose challenge, appear to be more sensitive to the stimulatory effects of dietary carbohydrate on fat deposition.
“Individuals who are more sensitive to insulin, or who secrete a greater amount of insulin in response to a glucose challenge, appear to be more sensitive to the stimulatory effects of dietary carbohydrate on fat deposition.”
From A Lower-Carbohydrate, Higher-Fat Diet Reduces Abdominal and Intermuscular Fat and Increases Insulin Sensitivity in Adults at Risk of Type 2 Diabetes (2015) · cites this paper as [16]
We previously observed that insulin-sensitive African American women who consumed a diet relatively high in glycemic load showed greater gain in body fat under freeliving conditions.
“We previously observed that insulin-sensitive AA women who consumed a diet relatively high in glycemic load showed greater gain in body fat under freeliving conditions (16).”
From A Lower-Carbohydrate, Higher-Fat Diet Reduces Abdominal and Intermuscular Fat and Increases Insulin Sensitivity in Adults at Risk of Type 2 Diabetes (2015) · cites this paper as [16]
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- Authors
- Gower, B. A., Alvarez, J. A., Bush, N. C., & Hunter, G. R.
- Affiliations
- University of Alabama at Birmingham (US)
- Corresponding author
- Gower, Barbara A
- Venue
- Nutrition & Metabolism
- Published
- 2013
- Volume
- 10
- Issue
- 1
- Pages
- 3
- ISSN
- 1743-7075 (ISSN-L)
- PMC
- PMC3571978
- OpenAlex
- W2162279122
- Cited by
- 25
- References
- 38
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 1 · 2023: 2 · 2022: 2 · 2021: 1 · 2020: 5 · 2019: 1 · 2018: 2 · 2017: 1 · 2016: 1 · 2015: 3 · 2014: 3 · 2012: 1
- FWCI
- 1.84
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Nutrition & Metabolism (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Funders
- Center for Clinical and Translational Science, University of Alabama at Birmingham
- National Institute of Diabetes and Digestive and Kidney Diseases (P30DK079626)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Health Sciences › Medicine › Epidemiology › Adipokines, Inflammation, and Metabolic Diseases
- Keywords
- insulin sensitivity, obesity risk, ethnic differences, African American women, European American women, acute insulin response, glycemic load, adiposity, weight loss, body fat changes, insulin responsiveness, premenopausal women
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