scholarly journals Higher energy requirement during weight-loss maintenance on a low- versus high-carbohydrate diet: secondary analyses from a randomized controlled feeding study

2019 ◽  
Author(s):  
Cara B Ebbeling ◽  
Lisa Bielak ◽  
Paul R Lakin ◽  
Gloria L Klein ◽  
Julia MW Wong ◽  
...  
Keyword(s):  
Weight Loss ◽  
Energy Expenditure ◽  
Energy Requirement ◽  
Weight Loss Maintenance ◽  
Total Energy Expenditure ◽  
High Carbohydrate Diet ◽  
Doubly Labeled Water ◽  
Carbohydrate Diet ◽  
High Carbohydrate ◽  
Feeding Study

ABSTRACTBackgroundLonger-term feeding studies suggest that a low-carbohydrate diet increases energy expenditure, consistent with the carbohydrate-insulin model of obesity. However, the validity of methodology utilized in these studies, involving doubly-labeled water, has been questioned.ObjectiveThe aim of this study was to determine whether dietary energy requirement for weight-loss maintenance is higher on a low-versus high-carbohydrate diet.MethodsThe study reports secondary outcomes and exploratory analyses from a feeding study in which the primary outcome was total energy expenditure. After attaining a mean Run-in weight loss of 10.5%, 164 adults with pre-weight-loss BMI of ≥25 were randomly assigned to Test diets containing Low (20%), Moderate (40%) or High (60%) carbohydrate for 20 weeks. Calorie content of Test diets was adjusted to maintain individual body weight within 2 kg of the post-weight-loss value. In analyses by Intention-to-Treat (ITT, study completers, n=148) and Per Protocol (PP, those achieving the weight-loss maintenance target, n=110), we compared estimated energy requirement from 10 to 20 weeks on the Test diets using ANCOVA. Insulin secretion was assessed pre-weight-loss as insulin concentration 30 minutes following 75 grams oral glucose (Insulin-30).ResultsEstimated energy requirement was higher in the Low vs High group by models involving ITT (ranging from 181 [CI 8–353] to 223 [40–406] kcal/d; P≤0.04) and PP (ranging from 245 [43–446] to 295 [91–499] kcal/d; P≤0.02). This difference remained significant in sensitivity analyses accounting for change in adiposity and possible non-adherence. In observational analyses, pre-weight loss Insulin-30 predicted adverse change in body composition following weight loss.ConclusionsEnergy requirement was higher on a low-versus high-carbohydrate diet during weight-loss maintenance, commensurate with total energy expenditure. These data are consistent with the carbohydrate-insulin model and lend qualified support for the validity of the doubly-labeled water method with diets varying in macronutrient composition.

scholarly journals Energy Requirement Is Higher During Weight-Loss Maintenance in Adults Consuming a Low- Compared with High-Carbohydrate Diet

2020 ◽  
Vol 150 (8) ◽  
pp. 2009-2015 ◽  
Author(s):  
Cara B Ebbeling ◽  
Lisa Bielak ◽  
Paul R Lakin ◽  
Gloria L Klein ◽  
Julia M W Wong ◽  
...  
Keyword(s):  
Weight Loss ◽  
Energy Expenditure ◽  
Total Energy ◽  
Energy Requirement ◽  
Weight Loss Maintenance ◽  
High Carbohydrate Diet ◽  
Carbohydrate Diet ◽  
Low Carbohydrate Diet ◽  
High Carbohydrate ◽  
Low Carbohydrate

ABSTRACT Background Longer-term feeding studies suggest that a low-carbohydrate diet increases energy expenditure, consistent with the carbohydrate-insulin model of obesity. However, the validity of methodology utilized in these studies, involving doubly labeled water (DLW), has been questioned. Objective The aim of this study was to determine whether dietary energy requirement for weight-loss maintenance is higher on a low- compared with high-carbohydrate diet. Methods The study reports secondary outcomes from a feeding study in which the primary outcome was total energy expenditure (TEE). After attaining a mean Run-in weight loss of 10.5%, 164 adults (BMI ≥25 kg/m2; 70.1% women) were randomly assigned to Low-Carbohydrate (percentage of total energy from carbohydrate, fat, protein: 20/60/20), Moderate-Carbohydrate (40/40/20), or High-Carbohydrate (60/20/20) Test diets for 20 wk. Calorie content was adjusted to maintain individual body weight within ± 2 kg of the postweight-loss value. In analyses by intention-to-treat (ITT, completers, n = 148) and per protocol (PP, completers also achieving weight-loss maintenance, n = 110), we compared the estimated energy requirement (EER) from 10 to 20 wk of the Test diets using ANCOVA. Results Mean EER was higher in the Low- versus High-Carbohydrate group in models of varying covariate structure involving ITT [ranging from 181 (95% CI: 8–353) to 246 (64–427) kcal/d; P ≤0.04] and PP [ranging from 245 (43–446) to 323 (122–525) kcal/d; P ≤0.02]. This difference remained significant in sensitivity analyses accounting for change in adiposity and possible nonadherence. Conclusions Energy requirement was higher on a low- versus high-carbohydrate diet during weight-loss maintenance in adults, commensurate with TEE. These data are consistent with the carbohydrate-insulin model and lend qualified support for the validity of the DLW method with diets varying in macronutrient composition. This trial was registered at clinicaltrials.gov as NCT02068885.

scholarly journals Effects of a low carbohydrate diet on energy expenditure during weight loss maintenance: randomized trial

BMJ ◽  
2018 ◽  
pp. k4583 ◽  
Author(s):  
Cara B Ebbeling ◽  
Henry A Feldman ◽  
Gloria L Klein ◽  
Julia M W Wong ◽  
Lisa Bielak ◽  
...  
Keyword(s):  
Weight Loss ◽  
Energy Expenditure ◽  
Total Energy ◽  
Total Energy Expenditure ◽  
Carbohydrate Diet ◽  
Intention To Treat ◽  
Low Carbohydrate Diet ◽  
High Carbohydrate ◽  
Low Carbohydrate ◽  
Treat Analysis

AbstractObjectiveTo determine the effects of diets varying in carbohydrate to fat ratio on total energy expenditure.DesignRandomized trial.SettingMulticenter collaboration at US two sites, August 2014 to May 2017.Participants164 adults aged 18-65 years with a body mass index of 25 or more.InterventionsAfter 12% (within 2%) weight loss on a run-in diet, participants were randomly assigned to one of three test diets according to carbohydrate content (high, 60%, n=54; moderate, 40%, n=53; or low, 20%, n=57) for 20 weeks. Test diets were controlled for protein and were energy adjusted to maintain weight loss within 2 kg. To test for effect modification predicted by the carbohydrate-insulin model, the sample was divided into thirds of pre-weight loss insulin secretion (insulin concentration 30 minutes after oral glucose).Main outcome measuresThe primary outcome was total energy expenditure, measured with doubly labeled water, by intention-to-treat analysis. Per protocol analysis included participants who maintained target weight loss, potentially providing a more precise effect estimate. Secondary outcomes were resting energy expenditure, measures of physical activity, and levels of the metabolic hormones leptin and ghrelin.ResultsTotal energy expenditure differed by diet in the intention-to-treat analysis (n=162, P=0.002), with a linear trend of 52 kcal/d (95% confidence interval 23 to 82) for every 10% decrease in the contribution of carbohydrate to total energy intake (1 kcal=4.18 kJ=0.00418 MJ). Change in total energy expenditure was 91 kcal/d (95% confidence interval −29 to 210) greater in participants assigned to the moderate carbohydrate diet and 209 kcal/d (91 to 326) greater in those assigned to the low carbohydrate diet compared with the high carbohydrate diet. In the per protocol analysis (n=120, P<0.001), the respective differences were 131 kcal/d (−6 to 267) and 278 kcal/d (144 to 411). Among participants in the highest third of pre-weight loss insulin secretion, the difference between the low and high carbohydrate diet was 308 kcal/d in the intention-to-treat analysis and 478 kcal/d in the per protocol analysis (P<0.004). Ghrelin was significantly lower in participants assigned to the low carbohydrate diet compared with those assigned to the high carbohydrate diet (both analyses). Leptin was also significantly lower in participants assigned to the low carbohydrate diet (per protocol).ConclusionsConsistent with the carbohydrate-insulin model, 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.Trial registrationClinicalTrials.govNCT02068885.

Diets Varying in Carbohydrate Content Differentially Alter Brain Activity in Homeostatic and Reward Regions in Adults

2021 ◽  
Author(s):  
Laura M Holsen ◽  
W Scott Hoge ◽  
Belinda S Lennerz ◽  
Hilâl Cerit ◽  
Taryn Hye ◽  
...  
Keyword(s):  
Weight Loss ◽  
Insulin Secretion ◽  
Total Energy ◽  
Brain Activity ◽  
Weight Loss Maintenance ◽  
Brain Regions ◽  
High Carbohydrate Diet ◽  
Carbohydrate Content ◽  
Carbohydrate Diet ◽  
High Carbohydrate

ABSTRACT Background Obesity has one of the highest refractory rates of all chronic diseases, in part because weight loss induced by calorie restriction, the first-line treatment for obesity, elicits biological adaptations that promote weight regain. Although acute feeding trials suggest a role for macronutrient composition in modifying brain activity related to hunger and satiety, relevance of these findings to weight-loss maintenance has not been studied. Objectives We investigated effects of weight-loss maintenance diets varying in macronutrient content on regional cerebral blood flow (rCBF) in brain regions involved in hunger and reward. Methods In conjunction with a randomized controlled feeding trial, we investigated the effects of weight-loss maintenance diets varying in carbohydrate content [high, 60% of total energy: n = 20; 6 men/14 women; mean age: 32.5 y; mean BMI (in kg/m 2): 27.4; moderate, 40% of total energy: n = 22; 10 men/12 women; mean age: 32.5 y; mean BMI: 29.0; low, 20% of total energy: n = 28; 12 men/16 women; mean age: 33.2 y; mean BMI: 27.7] on rCBF in brain regions involved in hunger and reward preprandial and 4 h postprandial after 14–20 wk on the diets. The primary outcome was rCBF in the nucleus accumbens (NAcc) at 4 h postprandial; the secondary outcome was preprandial rCBF in the hypothalamus. Results Consistent with a priori hypothesis, at 4 h postprandial, NAcc rCBF was 43% higher in adults assigned to the high- compared with low-carbohydrate diet {P[family-wise error (FWE)-corrected] &lt; 0.05}. Preprandial hypothalamus rCBF was 41% higher on high-carbohydrate diet [P(FWE-corrected) &lt; 0.001]. Exploratory analyses revealed that elevated rCBF on high-carbohydrate diet was not specific to prandial state: preprandial NAcc rCBF [P(FWE-corrected) &lt; 0.001] and 4 h postprandial rCBF in hypothalamus [P(FWE-corrected) &lt; 0.001]. Insulin secretion predicted differential postprandial activation of the NAcc by diet. Conclusions We report significant differences in rCBF in adults assigned to diets varying in carbohydrate content for several months, which appear to be partially associated with insulin secretion. These findings suggest that chronic intake of a high-carbohydrate diet may affect brain reward and homeostatic activity in ways that could impede weight-loss maintenance. This trial was registered at clinicaltrials.gov as NCT02300857.

24-hour energy expenditure and sympathetic activity in postobese women consuming a high-carbohydrate diet

1992 ◽  
Vol 262 (3) ◽  
pp. E282-E288 ◽  
Author(s):  
A. Astrup ◽  
B. Buemann ◽  
N. J. Christensen ◽  
J. Madsen
Keyword(s):  
Heart Rate ◽  
Energy Expenditure ◽  
High Carbohydrate Diet ◽  
Control Group ◽  
Plasma Norepinephrine ◽  
Dietary Carbohydrate ◽  
Obese Women ◽  
Carbohydrate Diet ◽  
High Carbohydrate ◽  
Before And After

It has been suggested that the energy expenditure (EE) of formerly obese subjects (postobese) is highly susceptible to the dietary carbohydrate content and that a high dietary carbohydrate-to-fat ratio may increase their 24-h EE. We studied eight obese women before and after weight normalization (postobese state) and compared them with eight matched controls. Twenty-four hour EE, substrate oxidations, and 24-h heart rate were measured in respiratory chambers on a fixed physical program, while the postobese and controls were in macronutrient balance on a high-carbohydrate diet. Mean 24-h EE decreased from the obese to the postobese state (P less than 0.01), but it remained higher in the postobese women than in the controls (8,292 +/- 153 vs. 7,646 +/- 190 kJ/day, P = 0.01). The higher EE in the postobese group was entirely covered by a 22% higher carbohydrate oxidation (P = 0.006). The mean 24-h heart rate, as measured by telemetry, was also higher in the postobese group than in the control group (74 vs. 66 beats/min, P less than 0.03). Plasma norepinephrine (NE) concentrations were greater by 50% in the postobese as compared with the controls (P = 0.004), and differences in plasma NE concentrations entirely accounted for the group difference in 24-h EE and heart rate between postobese and controls, as analyzed by stepwise regression analysis. We conclude that postobese women on a high-carbohydrate-low-fat diet have an enhanced sympathetic nervous system activity, which is responsible for the higher 24-h EE and heart rate. These findings may have implications for understanding the pathophysiology and for the treatment of obesity.

scholarly journals Relationship between Measured Aerobic Capacity and Total Energy Expenditure Obtained by Doubly Labeled Water in Community-Dwelling Healthy Adults Aged 81-94y: A Preliminary Study

2021 ◽  
Author(s):  
Jun Yasukata ◽  
Yosuke Yamada ◽  
Hiroyuki Sagayama ◽  
Yasuki Higaki ◽  
Hiroaki Tanaka
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Energy Expenditure ◽  
Total Energy ◽  
Aerobic Capacity ◽  
Energy Requirement ◽  
Total Energy Expenditure ◽  
Community Dwelling ◽  
Activity Level ◽  
Doubly Labeled Water

Adequate energy intake is critical for the healthy longevity of older adults, and the estimated energy requirement is determined by total energy expenditure (TEE). We aimed to identify the relationship between measured aerobic capacity and TEE, activity energy expenditure (AEE) or physical activity level (PAL) with the doubly labeled water (DLW) methods in the advanced older adults. A total of 12 physically independent older adults (10 males and 2 females) aged between 81 to 94 years participated in this study. Aerobic capacity was evaluated according to the lactate threshold (LT). TEE under free-living conditions was assessed using the DLW method, and self-reported physical activity was obtained through the Japanese version of the International Physical Activity Questionnaire (IPAQ). LT was significantly positively correlated with TEE, AEE, and PAL after adjustment for age and sex (&rho;= 0.77 (P&lt;0.01), 0.86 (p&lt;0.01), and 0.86 (p&lt;0.01), respectively). We found the LT as an aerobic capacity is positively and independently correlated with TEE, AEE or PAL. The present results suggest that maintaining aerobic capacity is an important factor for preventing frailty, although further research is needed to multisite studies and many samples.

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