A low carbohydrate diet promotes weight maintenance.
Many people who lose weight intentionally struggle to maintain their lower weight. In the carbohydrate-insulin model of obesity, a high glycemic load increases the blood insulin-to-glucagon ratio, which results in increased hunger, lower energy expenditure, and weight gain. To test this model, researchers examined the effects on total-energy (kcal/day) expenditure of three diets with different carbohydrate-to-fat ratios.
Researchers randomized 164 adults (body-mass index, ≥25 kg/m2) to high-, moderate-, or low-carbohydrate diets (60%, 40%, and 20% carbohydrates, respectively) with inverse proportions of fat (20%, 40%, and 60% fats, respectively). Diets had a fixed amount of protein (20%), and total energy intakes to maintain weight loss. After 20 weeks, intent-to-treat analysis showed higher total energy expenditure in the moderate- and low-carbohydrate groups (mean, 91 kcal/day and 209 kcal/day, respectively). The effect of the low-carb diet on improving total energy expenditure was even greater in the subgroup of people whose pre–weight loss insulin levels were in the highest tertile. Blood levels of ghrelin and leptin, hormones that promote weight gain, were significantly lower in the low-carb group.
The authors concluded that “lowering dietary carbohydrate increased energy expenditure during weight loss maintenance. This metabolic effect may improve the success of obesity treatment, especially among those with high insulin secretion”.
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Source: NEJM Journal Watch and BMJ
