A review of the carbohydrate–insulin model of obesity

  title={A review of the carbohydrate–insulin model of obesity},
  author={K D Hall},
  journal={European Journal of Clinical Nutrition},
  • K. D. Hall
  • Published 2017
  • Biology
  • European Journal of Clinical Nutrition
The carbohydrate–insulin model of obesity theorizes that diets high in carbohydrate are particularly fattening due to their propensity to elevate insulin secretion. Insulin directs the partitioning of energy toward storage as fat in adipose tissue and away from oxidation by metabolically active tissues and purportedly results in a perceived state of cellular internal starvation. In response, hunger and appetite increases and metabolism is suppressed, thereby promoting the positive energy… 

Low-carbohydrate diets and cardiometabolic health: the importance of carbohydrate quality over quantity.

Assessing the evidence for the role of carbohydrate quantity vs quality in cardiometabolic health reflects the current shift in dietary guidance that allows for flexibility in the proportion of macronutrients in the diet, with a focus on quality over quantity and dietary patterns over single nutrients.

The Carbohydrate-Insulin Model of Obesity: Beyond “Calories In, Calories Out”

The principles of a low-glycemic load diet offer a practical alternative to the conventional focus on dietary fat and calorie restriction and provide a conceptual framework for understanding how many dietary and nondietary exposures might alter hormones, metabolism, and adipocyte biology in ways that could predispose to obesity.

The carbohydrate-insulin model: a physiological perspective on the obesity pandemic

Rigorous research is needed to compare the validity of these 2 models, which have substantially different implications for obesity management, and to generate new models that best encompass the evidence.

Competing paradigms of obesity pathogenesis: energy balance versus carbohydrate-insulin models

Robust contrasts in how the EBM and CIM view obesity pathophysiology are highlighted and deficiencies in the E BM that impede paradigm testing and refinement are considered.

"Calories in, calories out" and macronutrient intake: the hope, hype, and science of calories.

  • S. HowellR. Kones
  • Medicine
    American journal of physiology. Endocrinology and metabolism
  • 2017
Results from a number of sources refute both the theory and effectiveness of the carbohydrate-insulin hypothesis, and indicate that energy balance is not materially changed during isocaloric substitution of dietary fats for carbohydrates.

Ketogenic Diet and Glucose Control

The Ketogenic diet includes very low-carbohydrate and high fat and is known to be effective for weight loss in a short period of time and there is a lack of evidence with respect to recommending this diet as nutrition therapy for diabetics.

Excess insulin and hypoxia, linkages to obesity and type 2 diabetes

A series of analyses of a national dataset is presented to demonstrate the mediating role of insulin and oxygen for obesity and the implications and applicability of this knowledge for preventing and managing obesity and obesity-related chronic conditions.

Restoration of metabolic tempo through time-restricted eating (TRE) as the preventive measure for metabolic diseases

There is no study confirming that TRE could prevent the development of common metabolic diseases in healthy subjects after long-term implementation, but the gap of knowledge warrants future investigation.

Overweight and diabetes prevention: is a low-carbohydrate–high-fat diet recommendable?

  • F. Brouns
  • Medicine
    European Journal of Nutrition
  • 2018
A narrative review highlights recent metabolic and clinical outcomes of studies as well as practical feasibility of low LCHF diets, and concludes that lifestyle intervention in people at high risk of developing type 2 diabetes, while maintaining a relative carbohydrate-rich diet, results in long-term prevention of progression to type 1 diabetes and is generally seen as safe.



Energy expenditure and body composition changes after an isocaloric ketogenic diet in overweight and obese men.

The isocaloric KD was not accompanied by increased body fat loss but was associated with relatively small increases in EE that were near the limits of detection with the use of state-of-the-art technology.

Failure to increase lipid oxidation in response to increasing dietary fat content in formerly obese women.

Independent of energy balance, an increase in dietary fat content to 50% fat energy results in preferential fat storage, impaired suppression of carbohydrate oxidation, and reduction of 24-h EE in postobese women.

Fat and carbohydrate balances during adaptation to a high-fat.

Both baseline insulin concentration and f1.gif" BORDER="0">O(2)max during treadmill exercise predict fat balance during the shift to a high-fat diet under isoenergetic conditions.

Low-carbohydrate nutrition and metabolism.

The persistence of an epidemic of obesity and type 2 diabetes suggests that new nutritional strategies are needed if the epidemic is to be overcome. A promising nutritional approach suggested by this

Fat and carbohydrate overfeeding in humans: different effects on energy storage.

Excess dietary fat leads to greater fat accumulation than does excess dietary carbohydrate, and the difference was greatest early in the overfeeding period.

The role of protein in weight loss and maintenance.

Data suggest that higher-protein diets that contain between 1.2 and 1.6 g protein · kg-1 · d-1 and potentially include meal-specific protein quantities of at least ∼25-30 g protein/meal provide improvements in appetite, body weight management, cardiometabolic risk factors, or all of these health outcomes; however, further strategies to increase dietary compliance with long-term dietary interventions are warranted.

Effects of Dietary Fat and Carbohydrate Exchange on Human Energy Metabolism

The results suggest that a low-fat diet would be beneficial in the treatment of obesity, especially if subjects have a restrained type of eating behaviour.

Changes in fat oxidation in response to a high-fat diet.

When in energy balance, lean subjects are capable of adjusting fat oxidation to fat intake within 7 d of when dietary fat content is increased.

Effects of short-term carbohydrate or fat overfeeding on energy expenditure and plasma leptin concentrations in healthy female subjects

CHO OF, but not FAT OF, increases energy expenditure and leptin concentration, suggesting that leptin is not involved in the stimulation of energy metabolism during overfeeding.