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Nutrients. 2019 Mar 11;11(3). pii: E586. doi: 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.

Author information

1
Department of Nutrition, Exercise and Sports, Faculty of Sciences, University of Copenhagen, Rolighedsvej 26, 1958 Frederiksberg, Denmark. madsfiil@nexs.ku.dk.
2
Pennington Biomedical Research Center of the Louisiana State University System, Baton Rouge, LA 70803, USA. George.Bray@pbrc.edu.
3
Gelesis, Boston, MA 02116, USA. yzohar@gelesis.com.
4
Gelesis, Boston, MA 02116, USA. lurban@gelesis.com.
5
Pennington Biomedical Research Center of the Louisiana State University System, Baton Rouge, LA 70803, USA. Derek.Miketinas@pbrc.edu.
6
School of Nutrition and Food Sciences, Texas Woman's University, Denton, TX 76204, USA. Derek.Miketinas@pbrc.edu.
7
Pennington Biomedical Research Center of the Louisiana State University System, Baton Rouge, LA 70803, USA. WilliaDA@pbrc.edu.
8
Pennington Biomedical Research Center of the Louisiana State University System, Baton Rouge, LA 70803, USA. ryandh@pbrc.edu.
9
Pennington Biomedical Research Center of the Louisiana State University System, Baton Rouge, LA 70803, USA. Jennifer.Rood@pbrc.edu.
10
Pennington Biomedical Research Center of the Louisiana State University System, Baton Rouge, LA 70803, USA. Catherine.Champagne@pbrc.edu.
11
Nutrition Department, Harvard T.H Chan School of Public Health and Department of Medicine, Harvard Medical School, Boston, MA 02115, USA. fsacks@hsph.harvard.edu.
12
Department of Nutrition, Exercise and Sports, Faculty of Sciences, University of Copenhagen, Rolighedsvej 26, 1958 Frederiksberg, Denmark. ast@nexs.ku.dk.

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.

KEYWORDS:

clinical nutrition; diet; glucose; insulin; macronutrient composition; weight

PMID:
30861997
PMCID:
PMC6470525
DOI:
10.3390/nu11030586
[Indexed for MEDLINE]
Free PMC Article

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