High and low carbohydrate and fat intakes: limits imposed by appetite and palatability and their implications for energy balance

Blundell, John; Stubbs, R. James

doi:10.1038/sj.ejcn.1600756

Cited by 82 publications

(51 citation statements)

References 105 publications

(136 reference statements)

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“…19,20 Short-term test meal studies with calorie for calorie comparisons suggest that carbohydrate is more satiating than fat and that overeating may be more likely with a high-fat diet because of the higher energy density and greater sensory pleasure. 21,22 The present study demonstrates that these potential differences produced by energy-fixed diets with various fat and carbohydrate contents do not translate into overall weight loss differences, but may contribute to explain why more subjects lost 410% of the initial body weight in the low-fat group. However, it is important to stress that the study duration of only 10 weeks was relatively short in the course of a weight management program, and diet palatability and tolerability might have more important influence on weight loss outcome in longterm studies.…”

Section: Nugenob Low-versus High-fat Diet M Petersen Et Almentioning

confidence: 69%

Randomized, multi-center trial of two hypo-energetic diets in obese subjects: high- versus low-fat content

Petersen¹,

Taylor

Saris

et al. 2005

Int J Obes

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Objective: To investigate whether a hypo-energetic low-fat diet is superior to a hypo-energetic high-fat diet for the treatment of obesity. Design: Open-label, 10-week dietary intervention comparing two hypo-energetic (À600 kcal/day) diets with a fat energy percent of 20-25 or 40-45. Subjects: Obese (BMI X30 kg/m 2 ) adult subjects (n ¼ 771), from eight European centers. Measurements: Body weight loss, dropout rates, proportion of subjects who lost more than 10% of initial body weight, blood lipid profile, insulin and glucose. Results: The dietary fat energy percent was 25% in the low-fat group and 40% in the high-fat group (mean difference: 16 (95% confidence interval (CI) 15-17)%). Average weight loss was 6.9 kg in the low-fat group and 6.6 kg in the high-fat group (mean difference: 0.3 (95% CI À0.2 to 0.8) kg). Dropout was 13.6% (n ¼ 53) in the low-fat group and 18.3% (n ¼ 70) in the high-fat group (P ¼ 0.001). Among completers, more subjects lost 410% in the low-fat group than in the high-fat group ((20.8%, n ¼ 70) versus (14.7%, n ¼ 46), P ¼ 0.02). Fasting plasma total, low-density lipoprotein-and high-density lipoprotein-cholesterol decreased in both groups, but more so in the low-fat group than in the high-fat group. Fasting plasma insulin and glucose were lowered equally by both diets. Conclusions: The low-fat diet produced similar mean weight loss as the high-fat diet, but resulted in more subjects losing 410% of initial body weight and fewer dropouts. Both diets produced favorable changes in fasting blood lipids, insulin and glucose.

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Section: Nugenob Low-versus High-fat Diet M Petersen Et Almentioning

confidence: 69%

Randomized, multi-center trial of two hypo-energetic diets in obese subjects: high- versus low-fat content

Petersen¹,

Taylor

Saris

et al. 2005

Int J Obes

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“…However, it is clear that feeding behaviour is influenced by both nutritional and non-nutritional factors. In addition, it appears that there is a good defence against development of underweight (in the absence of disease) (Garrow, 1988), but less good defence against development of overweight (Blundell and Stubbs, 1999), especially in an environment where the availability of abundant and varied food is coupled with limited physical activity. This defence needs to be very tight because deposition if only 1% of the lifetime cumulative energy intake were deposited in the reference male or female (equivalent to the dot by the side of Figure 3), it would double adult body weight and BMI, and adversely affect health.…”

Section: S55mentioning

confidence: 99%

Physiological aspects of energy metabolism and gastrointestinal effects of carbohydrates

2007

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The energy values of carbohydrates continue to be debated. This is because of the use of different energy systems, for example, combustible, digestible, metabolizable, and so on. Furthermore, ingested macronutrients may not be fully available to tissues, and the tissues themselves may not be able fully to oxidize substrates made available to them. Therefore, for certain carbohydrates, the discrepancies between combustible energy (cEI), digestible energy (DE), metabolizable energy (ME) and net metabolizable energy (NME) may be considerable. Three food energy systems are in use in food tables and for food labelling in different world regions based on selective interpretation of the digestive physiology and metabolism of food carbohydrates. This is clearly unsatisfactory and confusing to the consumer. While it has been suggested that an enormous amount of work would have to be undertaken to change the current ME system into an NME system, the additional changes may not be as great as anticipated. In experimental work, carbohydrate is high in the macronutrient hierarchy of satiation. However, studies of eating behaviour indicate that it does not unconditionally depend on the oxidation of one nutrient, and argue against the operation of a simple carbohydrate oxidation or storage model of feeding behaviour to the exclusion of other macronutrients. The site, rate and extent of carbohydrate digestion in, and absorption from the gut are key to understanding the many roles of carbohydrate, although the concept of digestibility has different meanings. Within the nutrition community, the characteristic patterns of digestion that occur in the small (upper) vs large (lower) bowel are known to impact in contrasting ways on metabolism, while in the discussion of the energy value of foods, digestibility is defined as the proportion of combustible energy that is absorbed over the entire length of the gastrointestinal tract. Carbohydrates that reach the large bowel are fermented to short-chain fatty acids. The exact amounts and types of carbohydrate that reach the caecum are unknown, but are probably between 20 and 40 g/day in countries with 'westernized' diets, whereas they may reach 50 g/day where traditional staples are largely cereal or diets are high in fruit and vegetables. Non-starch polysaccharides clearly affect bowel habit and so, to a lesser extent, does resistant starch. However, the short-chain carbohydrates, which are also found in breast milk, have little if any laxative role, although do effect the balance of the flora. This latter property has led to the term 'prebiotic', which is defined as the capacity to increase selectively the numbers of bifidobacteria and lactobacilli without growth of other genera. This now well-established physiological property has not so far led through to clear health benefits, but current studies are focused on their potential to prevent diarrhoeal illnesses, improve well-being and immunomodulation, particularly in atopic children and on increased calcium absorption.

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“…A large body of short-term studies on appetite and energy intake unequivocally show that fat is less satiating than carbohydrate and protein compared joule for joule, and that high fat foods are more likely to induce passive overconsumption and weight gain than low fat foods with higher contents of carbohydrate and protein. 10 High fat diets reduce energy output Diet induced thermogenesis following high fat diets is much lower than following high protein and high carbohydrate diets. 11 This is partly due to the lower cost of processing and of storing fat from the diet into the adipose tissue stores.…”

Section: Observational Studies Assessing the Association Between Dietmentioning

confidence: 99%

The role of dietary fat in the prevention and treatment of obesity. Efficacy and safety of low-fat diets

Astrup¹

2001

Int J Obes

119

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BACKGROUND: Does dietary fat play a central role in weight gain and development of obesity? Do low-fat diets have adverse effects on blood lipids? OBJECTIVE AND DESIGN: To answer these questions we have reviewed the evidence linking the dietary fat content to energy balance and obesity, and examined the efficacy and safety of ad libitum low fat, high carbohydrate=protein diets in the prevention and management of obesity. RESULTS: Physiological studies have provided insight into the mechanisms by which the macronutrients differ in their effect on energy balance: (1) energy from fat is less satiating than energy from carbohydrate, and a high fat=carbohydrate ratio in the diet promotes passive overconsumption, a positive energy balance and weight gain in susceptible individuals; (2) fat is more readily absorbed from the intestine and fecal energy loss is much lower with a high dietary fat=carbohydrate ratio; (3) carbohydrate is more thermogenic than fat and energy expenditure is lower during positive energy balance produced by a diet with a high fat=carbohydrate ratio than during positive energy balance produced by a diet with a low fat=carbohydrate ratio.Randomized intervention studies comparing low fat diets to normal fat diets show that low fat diets prevent weight gain in normal weight subjects and produce weight loss in overweight individuals. In our meta-analysis of ad libitum low fat interventions we included 16 trials involving 1728 individuals. The difference in weight loss between intervention and control groups was 2.5 kg (95% CI, 1.5 -3.5; P < 0.0001). Weight loss was positively related to pre-treatment body weight (r ¼ 0.52, P < 0.05) and to reduction in percentage energy as fat (0.37 kg=%, P < 0.005). Extrapolated to a body mass index (BMI) 30 kg=m 2 , and assuming a 10% reduction in dietary fat, the predicted weight loss would be 4.4 kg (95% CI, 2.0 -6.8 kg), which has been confirmed in subsequent studies. Newer studies have shown that replacing some carbohydrate with protein may enhance weight loss. CONCLUSION: The American Paradox, the observation that obesity prevalence is increasing despite a slight decrease in population dietary fat consumption, is easily explained by the concomitantly decreasing physical activity, which reduces fat requirements and counteracts the beneficial effect of a slight reduction in dietary fat.Low fat diets with a high content of complex carbohydrates and protein do not produce any adverse effect on cardiovascular risk factors when weight loss is allowed to occur, and they have been shown to decrease mortality among high risk subjects.

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High and low carbohydrate and fat intakes: limits imposed by appetite and palatability and their implications for energy balance

Cited by 82 publications

References 105 publications

Randomized, multi-center trial of two hypo-energetic diets in obese subjects: high- versus low-fat content

Randomized, multi-center trial of two hypo-energetic diets in obese subjects: high- versus low-fat content

Physiological aspects of energy metabolism and gastrointestinal effects of carbohydrates

The role of dietary fat in the prevention and treatment of obesity. Efficacy and safety of low-fat diets

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