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Obesity (Silver Spring). 2015 Nov;23(11):2216-22. doi: 10.1002/oby.21213. Epub 2015 Sep 16.

Relationship of insulin dynamics to body composition and resting energy expenditure following weight loss.

Author information

1
Division of Gastroenterology, Hepatology and Nutrition, Boston Children's Hospital, Boston, Massachusetts, USA.
2
New Balance Foundation Obesity Prevention Center, Boston Children's Hospital, Boston, Massachusetts, USA.
3
Division of Endocrinology, Boston Children's Hospital, Boston, Massachusetts, USA.
4
Clinical Research Center, Boston Children's Hospital, Boston, Massachusetts, USA.

Abstract

OBJECTIVE:

To examine associations of baseline insulin dynamics with changes in body composition and resting energy expenditure (REE) following weight loss.

METHODS:

Twenty-one participants with overweight or obesity achieved 10-15% weight loss and then received 3 weight loss maintenance diets (high-carbohydrate, moderate-carbohydrate, and low-carbohydrate) in random order, each for 4 weeks. Body composition was measured at baseline and after weight loss. Insulin 30 min after glucose consumption (insulin-30; insulin response), C-peptide deconvolution analysis, HOMA, hepatic insulin sensitivity (IS), and REE were assessed at baseline and after each maintenance diet.

RESULTS:

Insulin-30, but not maximal insulin secretion, hepatic IS, or HOMA, predicted changes in fat mass (standardized β = 0.385, 1.7 kg difference between 10th and 90th centile of insulin-30, P = 0.04) after weight loss. Insulin-30 (β = -0.341, -312 kcal day(-1) , P = 0.008), maximal insulin secretion (β = -0.216, -95 kcal day(-1) , P = 0.0002), HOMA (β = -0.394, -350 kcal day(-1) , P = 0.002), and hepatic IS (β = 0.217, 225 kcal day(-1) , P = 0.0003) predicted change in REE during weight loss maintenance, independent of changes in body composition. The inverse relationship between insulin-30 and REE was substantially attenuated when the low-carbohydrate diet was consumed first.

CONCLUSIONS:

These findings distinguish a novel phenotype, characterized by high insulin response, at risk for weight regain, and identify a dietary approach to ameliorate this risk.

PMID:
26373701
PMCID:
PMC4633340
DOI:
10.1002/oby.21213
[Indexed for MEDLINE]
Free PMC Article

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