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Nutrients 2019, 11(3), 586; https://doi.org/10.3390/nu11030586

Pretreatment Fasting Glucose and Insulin as Determinants of Weight Loss on Diets Varying in Macronutrients and Dietary Fibers—The POUNDS LOST Study

1
Department of Nutrition, Exercise and Sports, Faculty of Sciences, University of Copenhagen, Rolighedsvej 26, 1958 Frederiksberg, Denmark
2
Pennington Biomedical Research Center of the Louisiana State University System, Baton Rouge, LA 70803, USA
3
Gelesis, Boston, MA 02116, USA
4
School of Nutrition and Food Sciences, Texas Woman’s University, Denton, TX 76204, USA
5
Nutrition Department, Harvard T.H Chan School of Public Health and Department of Medicine, Harvard Medical School, Boston, MA 02115, USA
*
Author to whom correspondence should be addressed.
Received: 28 January 2019 / Revised: 4 March 2019 / Accepted: 6 March 2019 / Published: 11 March 2019
(This article belongs to the Special Issue Personalized Nutrition)
Full-Text   |   PDF [706 KB, uploaded 15 March 2019]   |  

Abstract

Efforts to identify a preferable diet for weight management based on macronutrient composition have largely failed, but recent evidence suggests that satiety effects of carbohydrates may depend on the individual’s insulin-mediated cellular glucose uptake. Therefore, using data from the POUNDS LOST trial, pre-treatment fasting plasma glucose (FPG), fasting insulin (FI), and homeostatic model assessment of insulin resistance (HOMA-IR) were studied as prognostic markers of long-term weight loss in four diets differing in carbohydrate, fat, and protein content, while assessing the role of dietary fiber intake. Subjects with FPG <100 mg/dL lost 2.6 (95% CI 0.9;4.4, p = 0.003) kg more on the low-fat/high-protein (n = 132) compared to the low-fat/average-protein diet (n = 136). Subjects with HOMA-IR ≥4 lost 3.6 (95% CI 0.2;7.1, p = 0.038) kg more body weight on the high-fat/high-protein (n = 35) compared to high-fat/average-protein diet (n = 33). Regardless of the randomized diet, subjects with prediabetes and FI below the median lost 5.6 kg (95% CI 0.6;10.6, p = 0.030) more when consuming ≥35 g (n = 15) compared to <35 g dietary fiber/10 MJ (n = 16). Overall, subjects with normal glycemia lost most on the low-fat/high-protein diet, subjects with high HOMA-IR lost most on the high-fat/high protein diet, and subjects with prediabetes and low FI had particular benefit from dietary fiber in the diet. View Full-Text
Keywords: glucose; insulin; weight; diet; macronutrient composition; clinical nutrition glucose; insulin; weight; diet; macronutrient composition; clinical nutrition
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Hjorth, M.F.; Bray, G.A.; Zohar, Y.; Urban, L.; Miketinas, D.C.; Williamson, D.A.; Ryan, D.H.; Rood, J.; Champagne, C.M.; Sacks, F.M.; Astrup, A. Pretreatment Fasting Glucose and Insulin as Determinants of Weight Loss on Diets Varying in Macronutrients and Dietary Fibers—The POUNDS LOST Study. Nutrients 2019, 11, 586.

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