Acute Effects of Dietary Carbohydrate Restriction on Glycemia, Lipemia and Appetite Regulating Hormones in Normal-Weight to Obese Subjects.

Abstract

Postprandial responses to food are highly dependent on the macronutrient composition of the diet. We investigated the acute effects of transition from the recommended moderately high carbohydrate (HC) diet towards a carbohydrate-reduced high-protein (CRHP) diet on postprandial glycemia, insulinemia, lipemia, and appetite-regulating hormones in non-diabetic adults. Fourteen subjects, including five males (Mean ± SD: age 62 ± 6.5; BMI 32 ± 7.6 kg/m²; hemoglobin A1c (HbA1c) 40 ± 3.0 mmol/mol; HOMA2-IR 2.1 ± 0.9) were included in this randomized, cross-over study. Iso-caloric diets were consumed for two consecutive days with a median wash-out period of 21 days (range 2⁻8 weeks) between diets (macronutrient energy composition: CRHP/HC; 31%/54% carbohydrate, 29%/16% protein, 40%/30% fat). Postprandial glucose, insulin secretion rate (ISR), triglycerides (TGs), non-esterified fatty acids (NEFAs), and satiety ratings were assessed after ingestion of breakfast (Br) and lunch (Lu), and gut hormones and glucagon were assessed after ingestion of Br. Compared with the HC diet, the CRHP diet reduced peak glucose concentrations (Br 11%, p = 0.024; Lu 11%, p < 0.001), glucose excursions (Br 80%, p = 0.20; Lu 85%, p < 0.001), and ISR (Br 31%; Lu 64%, both p < 0.001) whereas CRHP, as compared with HC, increased glucagon-like peptide-1 (Br 27%, p = 0.015) and glucagon values (Br 249%, p < 0.001). NEFA and TG levels increased in the CRHP diet as compared with the HC diet after Br, but no difference was found after Lu (NEFA Br 22%, p < 0.01; TG Br 42%, p = 0.012). Beta-cell glucose sensitivity, insulin clearance, cholecystokinin values, and subjective satiety ratings were unaffected. It is possible to achieve a reduction in postprandial glycemia and insulin without a deleterious effect on beta-cell glucose sensitivity by substituting part of dietary carbohydrate with iso-caloric protein and fat in subjects without type 2 diabetes mellitus (T2DM). The metabolic effects are more pronounced after the second meal.

• Authors: Amirsalar Samkani, Mads J Skytte, Mads N Thomsen, Arne Astrup, Carolyn F Deacon, Jens J Holst, Sten Madsbad, Jens F Rehfeld, Thure Krarup, Steen B Haugaard
• Journal: Nutrients (Nutrients) Vol. 10 Issue 9 (Sep 12 2018) ISSN: 2072-6643 [Electronic] Switzerland
• PMID: 30213037 (Publication Type: Journal Article, Randomized Controlled Trial)

Chemical References

• Biomarkers
• Blood Glucose
• Gastrointestinal Hormones
• Glycated Hemoglobin A
• Insulin
• Lipids
• hemoglobin A1c protein, human

Topics

• Aged
• Appetite Regulation
• Biomarkers (blood)
• Blood Glucose (metabolism)
• Cross-Over Studies
• Denmark
• Diet, High-Protein Low-Carbohydrate
• Female
• Gastrointestinal Hormones (blood)
• Glycated Hemoglobin (metabolism)
• Humans
• Insulin (blood)
• Insulin-Secreting Cells (metabolism)
• Lipids (blood)
• Male
• Middle Aged
• Obesity (blood, diet therapy, physiopathology, psychology)
• Postprandial Period
• Satiety Response
• Time Factors
• Treatment Outcome