The carbohydrate-insulin model: a physiological perspective on the obesity pandemic
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The carbohydrate-insulin model: a physiological perspective on the obesity pandemic. / Ludwig, David S; Aronne, Louis J; Astrup, Arne; de Cabo, Rafael; Cantley, Lewis C; Friedman, Mark I; Heymsfield, Steven B; Johnson, James D; King, Janet C; Krauss, Ronald M; Lieberman, Daniel E; Taubes, Gary; Volek, Jeff S; Westman, Eric C; Willett, Walter C; Yancy, William S; Ebbeling, Cara B.
In: American Journal of Clinical Nutrition, Vol. 114, No. 6, 2021, p. 1873-1885.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - The carbohydrate-insulin model: a physiological perspective on the obesity pandemic
AU - Ludwig, David S
AU - Aronne, Louis J
AU - Astrup, Arne
AU - de Cabo, Rafael
AU - Cantley, Lewis C
AU - Friedman, Mark I
AU - Heymsfield, Steven B
AU - Johnson, James D
AU - King, Janet C
AU - Krauss, Ronald M
AU - Lieberman, Daniel E
AU - Taubes, Gary
AU - Volek, Jeff S
AU - Westman, Eric C
AU - Willett, Walter C
AU - Yancy, William S
AU - Ebbeling, Cara B
N1 - © The Author(s) 2021. Published by Oxford University Press on behalf of the American Society for Nutrition.
PY - 2021
Y1 - 2021
N2 - According to a commonly held view, the obesity pandemic is caused by overconsumption of modern, highly palatable, energy-dense processed foods, exacerbated by a sedentary lifestyle. However, obesity rates remain at historic highs, despite a persistent focus on eating less and moving more, as guided by the energy balance model (EBM). This public health failure may arise from a fundamental limitation of the EBM itself. Conceptualizing obesity as a disorder of energy balance restates a principle of physics without considering the biological mechanisms that promote weight gain. An alternative paradigm, the carbohydrate-insulin model (CIM), proposes a reversal of causal direction. According to the CIM, increasing fat deposition in the body-resulting from the hormonal responses to a high-glycemic-load diet-drives positive energy balance. The CIM provides a conceptual framework with testable hypotheses for how various modifiable factors influence energy balance and fat storage. 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.
AB - According to a commonly held view, the obesity pandemic is caused by overconsumption of modern, highly palatable, energy-dense processed foods, exacerbated by a sedentary lifestyle. However, obesity rates remain at historic highs, despite a persistent focus on eating less and moving more, as guided by the energy balance model (EBM). This public health failure may arise from a fundamental limitation of the EBM itself. Conceptualizing obesity as a disorder of energy balance restates a principle of physics without considering the biological mechanisms that promote weight gain. An alternative paradigm, the carbohydrate-insulin model (CIM), proposes a reversal of causal direction. According to the CIM, increasing fat deposition in the body-resulting from the hormonal responses to a high-glycemic-load diet-drives positive energy balance. The CIM provides a conceptual framework with testable hypotheses for how various modifiable factors influence energy balance and fat storage. 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.
KW - Faculty of Science
KW - Obesity
KW - Weight loss
KW - Dietary carbohydrate
KW - Energy balance
KW - Macronutrients
KW - Endocrinology
KW - Insulin
KW - Glucagon
KW - Incretins
KW - Scholarly discourse
U2 - 10.1093/ajcn/nqab270
DO - 10.1093/ajcn/nqab270
M3 - Journal article
C2 - 34515299
VL - 114
SP - 1873
EP - 1885
JO - American Journal of Clinical Nutrition
JF - American Journal of Clinical Nutrition
SN - 0002-9165
IS - 6
ER -
ID: 279686631