Weight regain after low calorie diet: Long term pattern of blood sugar, serum lipids, ketone bodies and serum insulin levels

Abstract

4 years after controlled clinical treatment with a 1000 calorie mixed diet, 24 patients were reinvestigated to assess (1) whether the improved metabolism, as observed during therapy, is merely the result of starvation and (2) to what extent this improvement continues beyond the time of dietary treatment.-The following tests were carried out: Oral G.T.T. (100 g), immunoreactive insulin, free fatty acids, free glycerol. triglycerides, cholesterol, acetoacetate and beta-hyclroxy: butyrate.-12 patients had been able to maintain their weight or reduce further. They showed a slightly improved glucose tolerance and a more normal secretion kinetic for insulin release. However, 12 individuals who were found to have a 35% weight gain (Broca), returning almost to their initial weight, showed a decreased glucose tolerance compared with previous examination, while insulin levels were slightly elevated, with a typically delayed secretion. Both groups showed a weight-independent elevation of cholesterol and triglyceride levels and a marked decline of plasma FFA, free glycerol and ketone bodies. The parameters of lipid metabolism may possibly be influenced by the composition of the diet, while a change of weight after reduction primarily affects blood sugar levels and, to a lesser extent, insulin levels.

Gewichtsreduktion und Glucose-Intoleranz bei Adipositas

“…Dabei handelt es sich jedoch um Kurzzeitbeobachtungen, so daß kaum eine Differenzierung zwischen den Wirkungen der Abnahme des Körperfettes und der unterkalorischen Ernährung auf die Glucosetoleranz möglich war. Hewing und Mitarbeiter (14) konnten in einer Nachuntersuchung von 24 Patienten 4 Jahre nach Gewichtsreduktion den Langzeiteffekt des Gewichtsverhaltens auf den Nüchternblutzucker nachweisen. Die besondere Bedeutung des Gewichtsverhaltens für die Prognose der Glucose-Intoleranz fettsüchtiger Patienten über 5 Jahre wird in der vorliegenden Studie dokumentiert.…”