Effects of dietary carbohydrate content on circulating metabolic fuel availability in the postprandial state
Open accessAbstract
Context: According to the carbohydrate-insulin model of obesity, an elevated insulin-to-glucagon ratio in response to a high-carbohydrate diet directs metabolic fuels toward storage, resulting in lower circulating energy. Objective: To determine differences in total circulating energy post-meal related to dietary carbohydrate. Design: Ancillary study within the Framingham State Food Study. Setting: University community. Participants: 29 adults (aged 20 to 65 years) with overweight or obesity (body mass index ≥25 kg/m2) Intervention: After achieving 10% to 14% weight loss on a run-in diet, participants were randomized to weight-loss-maintenance test diets varying in carbohydrate content (high-carbohydrate, 60% of total energy, n = 11; moderate-carbohydrate, 40%, n = 8; low-carbohydrate, 20%, n = 10) and controlled for protein (20%). During 24-hour metabolic ward admissions between 10 and 15 weeks on the test diets, metabolic fuels and hormones were measured. Main Outcome Measure: Energy availability (EA) based on energy content of blood glucose, beta-hydroxybutyrate, and free fatty acids, in the late postprandial period (180 to 300 minutes). Insulin at 30 minutes into the test meal (Meal Insulin-30) was measured as an effect modifier. Results: Insulin-to-glucagon ratio was 7-fold higher in participants on the high- vs low-carbohydrate diet (2.5 and 0.36, respectively). Late postprandial EA was 0.58 kcal/L lower on the high- vs low-carbohydrate diet (P < 0.0001), primarily related to suppression of free fatty acids. Early postprandial EA (30 to 180 minutes) declined fastest in the high-carbohydrate group, and Meal Insulin-30 modified this diet effect. Conclusions: During weight-loss maintenance on a high-carbohydrate diet, late postprandial EA is reduced, consistent with the carbohydrate-insulin model.
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Consumption of a high- compared with a low-GL meal results in reduced circulating metabolic fuel concentration after 3-5 h, associated with altered substrate partitioning, reduced energy expenditure, and a counter-regulatory response.
“Consumption of a high- compared with a low-GL meal results in reduced circulating metabolic fuel concentration after 3–5 h (39–41, 79), associated with altered substrate partitioning, reduced energy expenditure, and a counter-regulatory response (31, 39, 41, 80, 81).”
From The carbohydrate-insulin model: A physiological perspective on the obesity pandemic (2021) · cites this paper as [40]
Total metabolic fuel concentration in the blood decreases rapidly in the late postprandial phase after a high-GL meal, possibly to concentrations below that in the fasting state.
“Consequently, total metabolic fuel concentration in the blood (from glucose, nonesterified fatty acids, and ketones) decreases rapidly in the late postprandial phase, possibly to concentrations below that in the fasting state (39–41).”
From The carbohydrate-insulin model: A physiological perspective on the obesity pandemic (2021) · cites this paper as [40]
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The carbohydrate-insulin model: A physiological perspective on the obesity pandemic
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- Authors
- Shimy, K. J., Feldman, H. A., Klein, G. L., Bielak, L., Ebbeling, C. B., & Ludwig, D. S.
- Affiliations
- Boston Children's Hospital (US)
- Corresponding author
- Shimy, Kim J
- Ludwig, David S
- Venue
- Journal of the Endocrine Society
- Publisher
- The Endocrine Society
- Published
- 2020-05-26
- Volume
- 4
- Issue
- 7
- Pages
- bvaa062-bvaa062
- ISSN
- 2472-1972 (ISSN-L)
- PMC
- PMC7326475
- OpenAlex
- W3030011910
- Cited by
- 35
- References
- 40
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 5 · 2023: 4 · 2022: 10 · 2021: 8 · 2020: 2
- FWCI
- 3.61
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Journal of the Endocrine Society (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Funders
- Nutrition Science Initiative
- Laura and John Arnold Foundation
- Robert Lloyd Corkin Charitable Foundation
- New Balance Foundation
- Many Voices Foundation
- Blue Cross Blue Shield
- Pediatric Endocrine Society
- National Institute of Diabetes and Digestive and Kidney Diseases (K24DK082730)
- Topics
- Health Sciences › Medicine › Physiology › Diet and metabolism studies
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diet, Metabolism, and Disease
- Health Sciences › Medicine › Physiology › Dietary Effects on Health
- Keywords
- dietary carbohydrates, insulin, free fatty acids, beta-hydroxybutyrate, blood glucose, weight loss maintenance, obesity, insulin/glucagon ratio, high-carbohydrate diet
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