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Cited by 699Regulation of Appetite and ObesityFood composition and propertiesDiet, Metabolism, and Disease

High glycemic index foods, overeating, and obesity

Ludwig, David S., Majzoub, Joseph A., Al-Zahrani, Ahmad, Dallal, Gerard E., Blanco, Isaac, Roberts, Susan B.·1999·Pediatrics
DOI 10.1542/peds.103.3.e26
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Abstract

Objective.: The prevalence of obesity has increased dramatically in recent years. However, the role of dietary composition in body weight regulation remains unclear. The purpose of this work was to investigate the acute effects of dietary glycemic index (GI) on energy metabolism and voluntary food intake in obese subjects. Methods.: Twelve obese teenage boys were evaluated on three separate occasions using a crossover study protocol. During each evaluation, subjects consumed identical test meals at breakfast and lunch that had a low, medium, or high GI. The high- and medium-GI meals were designed to have similar macronutrient composition, fiber content, and palatability, and all meals for each subject had equal energy content. After breakfast, plasma and serum concentrations of metabolic fuels and hormones were measured. Ad libitum food intake was determined in the 5-hour period after lunch. Results.: Voluntary energy intake after the high-GI meal (5.8 megajoule [mJ]) was 53% greater than after the medium-GI meal (3.8 mJ), and 81% greater than after the low-GI meal (3.2 mJ). In addition, compared with the low-GI meal, the high-GI meal resulted in higher serum insulin levels, lower plasma glucagon levels, lower postabsorptive plasma glucose and serum fatty acids levels, and elevation in plasma epinephrine. The area under the glycemic response curve for each test meal accounted for 53% of the variance in food intake within subjects. Conclusions.: The rapid absorption of glucose after consumption of high-GI meals induces a sequence of hormonal and metabolic changes that promote excessive food intake in obese subjects. Additional studies are needed to examine the relationship between dietary GI and long-term body weight regulation. glycemic index, obesity, dietary carbohydrate, diets, insulin.

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Crossref · 10.1542/peds.103.3.e26

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  • 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 [39]

  • The brain perceives the decrease in metabolic fuel concentration as indicating that critical tissues are deprived of energy and may respond with a counter-regulatory hormone response.

    “The brain perceives this signal as indicating that critical tissues (e.g., liver) (24) are deprived of energy—a state of “cellular semistarvation” as it has been termed (42)—and may respond to the metabolic challenge with a counter-regulatory hormone response (39).”

    From The carbohydrate-insulin model: A physiological perspective on the obesity pandemic (2021) · cites this paper as [39]

  • 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 [39]

  • The blood glucose nadir after a high-GI meal is expected at 4 h.

    “Neuroimaging was performed at 4 h after the test meal, when the blood glucose nadir after the high-GI meal was expected (14), by using a GE 3Tesla whole-body scanner (GE Healthcare).”

    From Effects of dietary glycemic index on brain regions related to reward and craving in men (2013) · cites this paper as [14]

  • The decline in blood glucose (and other metabolic fuels) in the late postprandial period after a high-GI meal constitutes a powerful homeostatic hunger signal.

    “The decline in blood glucose (and other metabolic fuels) (13,14) in the late postprandial period after a high-GI meal would not only constitute a powerful homeostatic hunger signal (15)”

    From Effects of dietary glycemic index on brain regions related to reward and craving in men (2013) · cites this paper as [14]

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Authors
Ludwig, D. S., Majzoub, J. A., Al-Zahrani, A., Dallal, G. E., Blanco, I., & Roberts, S. B.
Affiliations
  • Children's Hospital (TN)
  • From the Division of Endocrinology, Department of Medicine, Children's Hospital, and
  • Tufts University (US)
ORCID
Venue
Pediatrics
Publisher
American Academy of Pediatrics (AAP)
Published
1999-03-01
Volume
103
Issue
3
Pages
e26-e26
ISSN
  • 0031-4005 (ISSN-L)
  • 1098-4275
DOI
10.1542/peds.103.3.e26
OpenAlex
W2164074129
Cited by
699
References
54
Citations by year
2026: 4 · 2025: 9 · 2024: 12 · 2023: 12 · 2022: 12 · 2021: 21 · 2020: 19 · 2019: 17 · 2018: 15 · 2017: 18 · 2016: 26 · 2015: 33 · 2014: 29 · 2013: 28 · 2012: 31
FWCI
9.34
Type
journal article
Language
en
Open access
closed
Locations
  • PEDIATRICS (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Institutes of Health (5k08dk002440-02)
  • National Institute of Diabetes and Digestive and Kidney Diseases (K08 DK 02440)
  • National Center for Research Resources (M01 RR 02635, 2M01 RR02172, M01RR002635, M01RR002172)
Topics
  • Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Regulation of Appetite and Obesity
  • Health Sciences › Nursing › Nutrition and Dietetics › Food composition and properties
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diet, Metabolism, and Disease
Keywords
glycemic index, obesity, overeating, voluntary food intake, energy metabolism, insulin, glucagon, epinephrine, plasma glucose, serum fatty acids, body weight regulation, adolescent boys, diet composition
MeSH terms
Adolescent, Blood Glucose, Energy Intake, Dietary Carbohydrates, Humans, Hunger, Insulin, Male, Obesity, Regression Analysis, Cross-Over Studies, Dietary Sucrose, Area Under Curve

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