Review

European Journal of Clinical Nutrition (2017) 71, 323–326; doi:10.1038/ejcn.2016.260; published online 11 January 2017

There is a Corrigendum (3 May 2017) associated with this article.

A review of the carbohydrate–insulin model of obesity

K D Hall1

1National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, USA

Correspondence: Dr KD Hall, National Institute of Diabetes and Digestive and Kidney Diseases, 12A South Drive, Room 4007, Bethesda 20892, MD, USA. E-mail: kevinh@niddk.nih.gov

Received 15 September 2016; Accepted 10 October 2016
Advance online publication 11 January 2017

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Abstract

The carbohydrate–insulin model of obesity theorizes that diets high in carbohydrate are particularly fattening due to their propensity to elevate insulin secretion. Insulin directs the partitioning of energy toward storage as fat in adipose tissue and away from oxidation by metabolically active tissues and purportedly results in a perceived state of cellular internal starvation. In response, hunger and appetite increases and metabolism is suppressed, thereby promoting the positive energy balance associated with the development of obesity. Several logical consequences of this carbohydrate–insulin model of obesity were recently investigated in a pair of carefully controlled inpatient feeding studies whose results failed to support key model predictions. Therefore, important aspects of carbohydrate–insulin model have been experimentally falsified suggesting that the model is too simplistic. This review describes the current state of the carbohydrate–insulin model and the implications of its recent experimental tests.

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