Effects of Dietary Carbohydrate Content on Circulating Metabolic Fuel Availability in the Postprandial State - PubMed (original) (raw)

Effects of Dietary Carbohydrate Content on Circulating Metabolic Fuel Availability in the Postprandial State

Kim J Shimy et al. J Endocr Soc. 2020.

Abstract

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.

Keywords: beta-hydroxybutyrate; carbohydrate; fatty acids; glucose; insulin; obesity.

© Endocrine Society 2020.

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Figures

Figure 1:

Figure 1:

Participant flow diagram.

Figure 2:

Figure 2:

Total energy availability of metabolic fuels (glucose, beta-hydroxybutyrate, free fatty acids) excluding lactate, expressed as adjusted mean ± standard error (SE) in kcal/L, depicted over the 24-hour study period for high carbohydrate (HC), moderate carbohydrate (MC) and low carbohydrate (LC) diets. Postprandial time points (in minutes) and overnight periods are highlighted on the horizontal axis.

Figure 3:

Figure 3:

Postprandial total energy availability of metabolic fuels (glucose, beta-hydroxybutyrate, free fatty acids) excluding lactate, expressed as adjusted mean ± standard error (SE) in kcal/L. Postprandial energy availability for all 3 meals (dinner, breakfast, and lunch) were combined into a covariate-adjusted diet-specific mean for high carbohydrate (HC), moderate carbohydrate (MC), and low carbohydrate (LC) at each postprandial time point in minutes.

Figure 4:

Figure 4:

Mean postprandial energy availability of individual fuels are shown in panels A-D (A for glucose, B for beta hydroxybutyrate [BOHB], C for free fatty acids [FFA] and D for lactate). Postprandial energy availability is expressed as the adjusted mean in kcal/L ± standard error (SE) of values at dinner, breakfast, and snack, separated by test diet assignment (high carbohydrate [HC], moderate carbohydrate [MC], low carbohydrate [LC]). Mean concentrations for postprandial insulin, glucagon, and epinephrine are shown in panels E-G (E for insulin in uU/mL, F for glucagon in pg/mL, G for epinephrine in pg/mL). Hormonal concentrations are expressed as the adjusted mean ± standard error (SE) of values at dinner, breakfast, and snack, separated by test diet assignment.

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