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Nutrients 2018, 10(9), 1285; https://doi.org/10.3390/nu10091285

Acute Effects of Dietary Carbohydrate Restriction on Glycemia, Lipemia and Appetite Regulating Hormones in Normal-Weight to Obese Subjects

1
Department of Endocrinology, Copenhagen University Hospital, Bispebjerg, DK-2400 Copenhagen NV, Denmark
2
Department of Nutrition, Exercise and Sports, University of Copenhagen, DK-1017 Copenhagen K, Denmark
3
Endocrinology Research Section, Department of Biomedical Sciences, University of Copenhagen, DK-1017 Copenhagen K, Denmark
4
Section for Translational Physiology, NNF Center for Basic Metabolic Research, University of Copenhagen, DK-1017 Copenhagen K, Denmark
5
Department of Endocrinology, Copenhagen University Hospital, Amager Hvidovre, DK-2650 Hvidovre, Denmark
6
Department of Clinical Biochemistry, Copenhagen University Hospital, Rigshospitalet, DK-2100 Copenhagen, Denmark
7
Department of Internal Medicine, Copenhagen University Hospital, Amager Hvidovre, DK-2650 Hvidovre, Denmark
*
Author to whom correspondence should be addressed.
Received: 26 August 2018 / Revised: 7 September 2018 / Accepted: 10 September 2018 / Published: 12 September 2018
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Abstract

Postprandial responses to food are highly dependent on the macronutrient composition of the diet. We investigated the acute effects of transition from the recommended moderately high carbohydrate (HC) diet towards a carbohydrate-reduced high-protein (CRHP) diet on postprandial glycemia, insulinemia, lipemia, and appetite-regulating hormones in non-diabetic adults. Fourteen subjects, including five males (Mean ± SD: age 62 ± 6.5; BMI 32 ± 7.6 kg/m2; hemoglobin A1c (HbA1c) 40 ± 3.0 mmol/mol; HOMA2-IR 2.1 ± 0.9) were included in this randomized, cross-over study. Iso-caloric diets were consumed for two consecutive days with a median wash-out period of 21 days (range 2–8 weeks) between diets (macronutrient energy composition: CRHP/HC; 31%/54% carbohydrate, 29%/16% protein, 40%/30% fat). Postprandial glucose, insulin secretion rate (ISR), triglycerides (TGs), non-esterified fatty acids (NEFAs), and satiety ratings were assessed after ingestion of breakfast (Br) and lunch (Lu), and gut hormones and glucagon were assessed after ingestion of Br. Compared with the HC diet, the CRHP diet reduced peak glucose concentrations (Br 11%, p = 0.024; Lu 11%, p < 0.001), glucose excursions (Br 80%, p = 0.20; Lu 85%, p < 0.001), and ISR (Br 31%; Lu 64%, both p < 0.001) whereas CRHP, as compared with HC, increased glucagon-like peptide-1 (Br 27%, p = 0.015) and glucagon values (Br 249%, p < 0.001). NEFA and TG levels increased in the CRHP diet as compared with the HC diet after Br, but no difference was found after Lu (NEFA Br 22%, p < 0.01; TG Br 42%, p = 0.012). Beta-cell glucose sensitivity, insulin clearance, cholecystokinin values, and subjective satiety ratings were unaffected. It is possible to achieve a reduction in postprandial glycemia and insulin without a deleterious effect on beta-cell glucose sensitivity by substituting part of dietary carbohydrate with iso-caloric protein and fat in subjects without type 2 diabetes mellitus (T2DM). The metabolic effects are more pronounced after the second meal. View Full-Text
Keywords: carbohydrate reduction; postprandial glucose metabolism; second-meal effect carbohydrate reduction; postprandial glucose metabolism; second-meal effect
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).
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Samkani, A.; Skytte, M.J.; Thomsen, M.N.; Astrup, A.; Deacon, C.F.; Holst, J.J.; Madsbad, S.; Rehfeld, J.F.; Krarup, T.; Haugaard, S.B. Acute Effects of Dietary Carbohydrate Restriction on Glycemia, Lipemia and Appetite Regulating Hormones in Normal-Weight to Obese Subjects. Nutrients 2018, 10, 1285.

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