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45 obese subjects were fed a high-carbohydrate, relatively low-fat, or a low-carbohydrate, relatively high-fat 1,000-calorie (4.14MJ) formula diet. The diet provided for an isoenergetic substitution of 170 g of carbohydrates for 75 g of fat. Weight reduction up to day 30 was significantly higher in the subjects on the carbohydrate-restricted diet. There were no significant differences between the water and electrolyte balances. The mean total weight reduction achieved on the high-carbohydrate diet was 9.8 ± 4.5 kg with a mean daily weight loss of 298 ± 80 g, while the corresponding values on the carbohydrate-restricted diet were 14 ± 7.2 kg and 362 ± 91 g/day, respectively.

The effect of the carbohydrate patterns of threc isocaloric mixed breakfasts on the postprandial concentrations of plasma glucose,-insulin,-growth hormone and free fatty acids in normal man. Intern.

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The metabolism of fructose in isolatcd perfused livers from fasting rats was affected by sulfonylureas (0.5 and 2.5 mM) as folIows: 1. Net formation of glucose and ketone bodies was reduced by tolbutamide and chlorpropamide, while net production of lactate plus pyruvate was enhanced. 2. Hepatic oxygen uptake was reduced by the sulfonylurea drugs. 3. Surface fluorescence of reduced pyridine nucleotides decreased while surface fluorescence of flavine nucleotides increascd, indicating a more oxidized state of the mitochondrial compartment. 4. None of these effects could be observed with carboxy-tolbutamide, the non-hypoglycemic metabolite of tolbutamide. 5. Within the freeze clamped tissue of livers perfused in a recirculating system, glibenclamide (0.002 mM) did reduce the contents of ATP, ADP and several triose phosphates. A shift in the 3-hydroxybutyrate/acetoacetate ratio towards oxidation associated with an unchanged lacatate/pyruvate ratio confirmed a more oxidized state of the mitochondrial compartment, as indicated by the fluorescence tracings. 6. It is suggested that sulfonylureas affect hepatic metabolism by reducing mitochondrial A TPproduction, possibly by impairing pyruvate transport through the mitochondrial membrane. In addition the known inhibitory effect of sulfonylureas on intrahepatic Iipolysis does contribute to the observed effects.

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