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Low-Carbohydrate Diet May Increase Energy Expenditure

NASHVILLE, Tenn – Lowering dietary carbohydrate intake could help in maintaining weight loss, new research suggests. Resultater fra et randomiseret…

NASHVILLE, Tenn – Lowering dietary carbohydrate intake could help in maintaining weight loss, new research suggests.

Resultater fra et randomiseret forsøg der sammenlignede metaboliske effekter af diets eller varierende kulhydrat-to-fat-forhold blev præsenteret November 14 her på Obesity Week 2018 by David S. Ludwig, MD, and Cara B. Ebbeling, MD, both of the New Balance Foundation Obesity Prevention Center, Boston Children‘s Hospital, and Harvard Medical School, Boston, Massachusetts. The findings were published simultaneously in BMJ .

The study found that lowering dietary carbohydrate increased energy expenditure during weight loss maintenance, especially among those with high insulin secretion. Men, de investigators’ brug af dobbeltmærket vand til måling af energiforbrug blev indkaldt i spørgsmålet under Obesity Week-symposium ved Kevin Hall, PhD, et seniorforsker ved National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland. [1

9659002] The Bottom Line, Symposium Chair and Obesity Society President Caroline M. Apovian, MD, Customs Medscape Medical News is, “We need to do more studies to show that this is actually the case. There’s controversy. .. This may mean that we have not yet figured out how to find out what each individual person needs to eat for better health. ”

The study tested the carbohydrate-insulin model of obesity, which states that the increased ratio of insulin-to-glucagon concentrations after consumption of a high-carbohydrate meal directs metabolic fuels away from oxidation and toward storage in adipose tissue. This process is thought to increase hunger and food cravings, lower energy expenditure, and predispose to weight gain, especially among people with high insulin secretion, Ludwig explained.

Prior studies have not found a difference in low-carbohydrate energy expenditure

De huidige studie heeft de effecten getroffen, en het was namelijk kort, maar minder dan 2 weken, zei hij. Maar het proces van aanpassen aan één of andere eetpatroon duurt langer dan dat. of diet varying in carbohydrate to fat ratio on energy expenditure during weight loss maintenance through 20 weeks in 164 adults with a body mass index of 25 kg / m 2 or higher who had lost at least 10% of their body weight during a 10-week run-in period using a diet containing 45% of total energy from carbohydrate, 30% from fat, and 25% from protein.

Participants were assigned to one of three weight maintenance diets varying by carbohydrate to fat ratio , all containing 20% ​​protein: high (60% carbohydrate, 20% fat), moderate (40% carbohydrate, 40% fat), or low (20% carbohydrate, 60% fat) for 20 weeks.

Total energy expenditure – measured by doubly labeled water – differed by diet in the intention-to-treat analysis ( P = .002), with a linear trend of 52 kcal / day for every 10% reduction in the contribution of carbohydrate two total energy intake.

The change in total energy expenditure was 91kcal / day greater in participants assigned to the moderate carbohydrate diet and 209kcal / day greater in those on the low carbohydrate diet compared to the high carbohydrate diet. [19659002] In de per protocolanalyse, die 120 deelnemers omvatte, waren de respectieve verschillen 131 kcal / dag en 278 kcal / dag.

Among the participants with the highest third of pre-weight loss insulin secretion, the difference between the low and high carbohydrate diet was 308 kcal / day in the intent-to-treat analysis and 478 kcal / day in the per protocol analysis [.004].

Both ghrelin and leptin were lower among those assigned to the low-versus high-carbohydrate diet ( P <.007 for both intention-to- treat and per protocol analyzes for ghrelin and P = .06 and P = .005, respectively for leptin).

Methodology Questioned

With doubly labeled water, both hydrogen and oxygen have been partially or completely replaced (labeled) with an uncommon isotope for tracing purposes. Hall said that, despite being considered the gold-standard method for measuring energy expenditure, the method is flawed for several reasons, including that it has not been validated during low-carbohydrate diets.

Hall also said that doubly labeled water “

Moreover, he noted that the method biases the results in favor of the low-carbohydrate diet by about 30 to 60 kcal / day through “loss of the deuterium isotope via de novo lipogenesis.”

And finally, Hall asserted, “Doubly labeled water expenditure differences need to be corroborated by proportionate measurements of energy intake and body composition changes.”

Ludwig rebutted on several of the technical points and concluded “post-hoc analyzes are highly speculative and very weak data to attack a gold standard method that has been used in a variety of dietary conditions to laugh for three decades. “

Apovian, who is professor of medicine and pediatrics at Boston University and director of the Center for Nutrition and Weight Management at the Boston Medical Center, Customs Medscape Medical News ,” We have a Studie viser, at lav-kulhydratdiettene giver dig mulighed for at øge din energiforbrug versus low-fat. There are some limitations … The answer may lie in genetics. “

Asked what doctors should tell patients who ask about which diet is best, she replied,” Whatever diet you feel you can adhere to is still the best diet. That’s all we know. “

BMJ. Published November 14, 2018 . Abstract

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