High protein vs high carbohydrate hypoenergetic diet for the treatment of obese hyperinsulinemic subjects.

OBJECTIVE: To test the hypothesis that hyperinsulinemic obese subjects would respond differently to changes in the composition of hypoenergetic diets. DESIGN: A 4-week randomized dietary intervention trial. SUBJECTS: Thirteen male obese hyperinsulinemic normoglycemic subjects were divided into two groups and fed hypoenergetic diets providing 80% of their resting energy expenditure (REE). One group received a high-protein diet (HP; 45% protein, 25% carbohydrates, and 30% fat as percent of dietary energy) and the other a high-carbohydrate diet (HC; 12% protein, 58% carbohydrates and 30% fat). MEASUREMENTS: Anthropometry, body composition, fasting serum insulin and lipids, and REE were performed before and after the feeding period. RESULTS: Weight loss was higher in the HP than HC group (8.3+/-0.7 vs 6.0+/-0.6 kg, P<0. 05). There was a decrease in body fat in both groups, whereas body water decreased significantly more in the HP group. REE decreased more in the HC than the HP group (-384.3+/-84.6 vs -132.3+/-51.0 kcal, P<0.05). Serum total cholesterol, triglycerides and LDL cholesterol decreased significantly to a similar extent in both diet groups, while HDL cholesterol was decreased significantly only in the HP group. Mean fasting insulin decreased significantly in both diet groups and reached the normal range only in the HP group. CONCLUSION: A low-carbohydrate (LC), HP hypoenergetic diet could be the diet composition of choice for a weight-reducing regimen in obese hyperinsulinemic subjects.

Insulin increases body fat despite control of food intake and physical activity.

The effect of experimentally induced hyperinsulinemia on body composition was studied in rats with food intakes precisely controlled by intragastric feeding and physical activity manipulated by sedation with chlordiazepoxide (CDP). Male Sprague-Dawley rats (n = 38) were fitted surgically with gastrostomy tubes. After 8 days the animals were divided into four groups. Group 1 received daily injections of protamine-zinc insulin; group 2 received daily injections of saline; group 3 received the same insulin doses as group 1 plus daily administration of CDP mixed with the diet; group 4 received daily injections of saline plus CDP in the diet. All groups were tubefed identical amounts of semiliquid diet via gastrostomy. Physical activity was measured by electronic monitor. After 4 wk the rats were killed. The insulin-treated groups (1 and 3) had significantly larger fat depots and larger mean fat cell size than the noninsulin-treated groups (2 and 4). This increase in fat occurred concurrently with a decrease in carcass protein and water. Physical activity, as measured, was unaltered by insulin but was significantly reduced by CDP. Treatment with CDP only increased the dorsal fat depot and liver weight but had no significant effect on total dissected fat depots and had a reductive effect on carcass protein. In conclusion insulin treatment enhanced the efficiency of conversion of energy intake into fat energy stores.

Overfeeding with medium-chain triglyceride diet results in diminished deposition of fat.

The study was designed to determine whether overfeeding rats with a diet containing medium-chain triglyceride (MCT) as the major fat source (45% of calories) would impede the expected gain in weight and body fat as compared to rats overfed with isocaloric amounts of diet containing long-chain triglyceride (LCT). For 6 wk rats were fed either MCT diet or LCT diet twice daily via a gastrostomy tube. MCT-fed rats gained 20% less weight (P less than 0.001) and possessed fat depots weighing 23% less (p less than 0.001) than LCT)-fed rats. Mean adipocyte size was smaller (p less than 0.005) in MCT- than in LCT-fed rats. Weights of carcass protein and water were similar for both groups as were concentrations of serum insulin and levels of physical activity. The decreased deposition of fat in the MCT-fed rats may have resulted from obligatory oxidation of MCT-derived fatty acids in the liver after being transported there via the portal vein, leaving almost no MCT derivatives for incorporation into body fat. MCT may have potential for dietary prevention of human obesity.