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High Glycemic Index Foods, Overeating, and Obesity
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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“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]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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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Snack food intake does not predict weight change among children and adolescents
Field, A. E., Austin, S. B., Gillman, M. W., ROSNER, B. A., Rockett, H. R. H., & Colditz, G. A. (2004) · International Journal of Obesity · doi:10.1038/sj.ijo.0802762 · Cited by 187
Glycaemic response to foods: Impact on satiety and long-term weight regulation
Bornet, F. R. J., Jardy-Gennetier, A.-E., Jacquet, N., & Stowell, J. (2007) · Appetite · doi:10.1016/j.appet.2007.04.006 · Cited by 182
Should obese patients be counselled to follow a low‐glycaemic index diet? No
Raben, A. (2002) · Obesity Reviews · doi:10.1046/j.1467-789x.2002.00080.x · Cited by 182
“All studies were performed in adults except for one (56).”
BackgroundInfluentialPinotti, L., Luciano, A., Ottoboni, M., Manoni, M., Ferrari, L., Marchis, D., & Tretola, M. (2021) · Journal of Cleaner Production · doi:10.1016/j.jclepro.2021.126290 · Cited by 180
“in humans (Holt et al., 1992; Lavin and Read, 1995; Ludwig et al., 1999) have suggested that the ingestion of high-GI meals increases hunger and promotes overeating in subsequent meals compared to low-GI meals, which is a positive effect in terms of pig nutrition.”
BackgroundKoh-Banerjee, P., & Rimm, E. B. (2003) · Proceedings of The Nutrition Society · doi:10.1079/pns2002232 · Cited by 181
“In addition, the high-GI meal resulted in higher serum insulin levels, lower plasma glucagon levels, lower post-absorptive plasma glucose and serum fatty acid levels, and elevated plasma adrenaline (Ludwig et al. 1999a).”
BackgroundInfluentialGastrointestinal Effects of Oat Bran and Oat Gum: A Review
Mälkki, Y., & Virtanen, E. (2001) · LWT · doi:10.1006/fstl.2001.0795 · Cited by 178
Liu, S., & Manson, J. E. (2001) · Current Opinion in Lipidology · doi:10.1097/00041433-200108000-00005 · Cited by 172
Dietary Determinants of Energy Intake and Weight Regulation in Healthy Adults
McCrory, M. A., Fuss, P., Saltzman, E. J., & Roberts, S. B. (2000) · Journal of Nutrition · doi:10.1093/jn/130.2.276s · Cited by 172
Self-citationThe Pediatric Obesity Epidemic: Causes and Controversies
Slyper, A. H. (2004) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2003-031449 · Cited by 174
“(98) demonstrated in obese adolescents that voluntary food intake after breakfast and lunch was higher after high-glycemic-index meals compared with isocaloric medium-glycemic-index meals, whereas medium-glycemic meals resulted in a higher food intake than isocaloric low-glycemic-index meals.”
BackgroundThe anorexia of aging in humans.
Hays, N., & Roberts, S. (2006) · Physiology and Behavior · doi:10.1016/j.physbeh.2006.05.029 · Cited by 184
Self-citationIs There an Association Between Sweetened Beverages and Adiposity?
Bachman, C., Baranowski, T., & Nicklas, T. A. (2006) · Nutrition Reviews · doi:10.1111/j.1753-4887.2006.tb00199.x · Cited by 167
Effect of Glycemic Carbohydrates on Short-term Satiety and Food Intake
Anderson, G. H., & Woodend, D. (2003) · Nutrition Reviews · doi:10.1301/nr.2003.may.s17-s26 · Cited by 166
Pittas, A. G., Das, S. K., Hajduk, C. L., Golden, J., Saltzman, E., Stark, P. C., Greenberg, A. S., & Roberts, S. B. (2005) · Diabetes Care · doi:10.2337/diacare.28.12.2939 · Cited by 163
“High– glycemic load diets also lead to other postprandial metabolic changes, including a lower glucose nadir and increase in counterregulatory hormones that may explain increased hunger and increased energy intake in the postabsorptive period, presumably leading to weight gain over time (32).”
Self-citationDietary composition and physiologic adaptations to energy restriction
Agus, M. S. D., SWAIN, J. F., Larson, C. L., Eckert, E. A., & Ludwig, D. S. (2000) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/71.4.901 · Cited by 163
Self-citationDye, B. A., Shenkin, J. D., Ogden, C. L., Marshall, T. A., Levy, S. M., & Kanellis, M. J. (2004) · The Journal of the American Dental Association · doi:10.14219/jada.archive.2004.0021 · Cited by 161
Higgins, K., & Mattes, R. D. (2018) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/nqy381 · Cited by 172
Dietary hyperglycemia, glycemic index and metabolic retinal diseases
Chiu, C., & Taylor, A. (2010) · Progress in Retinal and Eye Research · doi:10.1016/j.preteyeres.2010.09.001 · Cited by 166
“, 1988) and the counter-regulatory responses (Jenkins et al., 1990; Ludwig et al., 1999).”
InfluentialChildhood obesity: are we missing the big picture?
Maziak, W., Ward, K. D., & Stockton, M. B. (2007) · Obesity Reviews · doi:10.1111/j.1467-789x.2007.00376.x · Cited by 156
“Energy-dense food is not only associated with obesity and increased risk of cardiovascular disease and type 2 diabetes, but there is also evidence that such food can reduce satiety and increase appetite, leading to overeating in adolescents (18,19).”
BackgroundHow Lifestyle Factors Affect Cognitive and Executive Function and the Ability to Learn in Children
Jirout, J. J., LoCasale‐Crouch, J., Turnbull, K. L. P., Gu, Y., Mateus, M. C., Garzione, S., Evans, T. M., WELTMAN, A. L., & Kranz, S. (2019) · Nutrients · doi:10.3390/nu11081953 · Cited by 192
“Data indicate that high GI foods cause individuals to eat more [52], likely because the drop in blood glucose in reaction to insulin release, and the removal of glucose from the blood stream, triggers a strong hunger signal.”
BackgroundShould obese patients be counselled to follow a low‐glycaemic index diet? Yes
Pawlak, D. B., Ebbeling, C. B., & Ludwig, D. S. (2002) · Obesity Reviews · doi:10.1046/j.1467-789x.2002.00079.x · Cited by 152
“Along this line, subjects ate significantly more after high compared to low GI meals, and ad libitum energy consumption was strongly predicted by the plasma blood glucose nadir (36).”
BackgroundSelf-citationDietary Approaches to the Treatment of Obesity
Makris, A., & Foster, G. D. (2011) · Psychiatric Clinics of North America · doi:10.1016/j.psc.2011.08.004 · Cited by 154
“Ludwig et al [46] compared the effects of three isocaloric breakfasts varying in GI on subsequent food intake and a variety of metabolic parameters, including glycemic response.”
BackgroundMethodNutritional management in children and adolescents with diabetes
Smart, C. E., Vliet, E. A.-V., & Waldron, S. (2009) · Pediatric Diabetes · doi:10.1111/j.1399-5448.2009.00572.x · Cited by 150
“Physical activity may also help lower lipids in adolescents with diabetes (B) (88) • An interdisciplinary approach including a physician, nurse practitioner or diabetes nurse educator, dietician, mental health provider and exercise physiologist (if possible) is recommended (E) (89) • It would be sensible to consider t…”
BackgroundPi-Sunyer, X. (2002) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/76/1.290s · Cited by 408
Pregnancy-related Weight Gain-A Link to Obesity?
Siega‐Riz, A. M., Evenson, K. R., & Dole, N. (2004) · Nutrition Reviews · doi:10.1111/j.1753-4887.2004.tb00079.x · Cited by 143
Metadata
- 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)
- 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
- 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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