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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This research was supported by the Intramural Research Program of the NIH, National Institute of Diabetes and Digestive and Kidney Diseases.
I have received funding from the Nutrition Science Initiative to investigate the effects of ketogenic diets on human energy expenditure. I also have a patent pending on a method of personalized dynamic feedback control of body weight (US Patent Application No 13/754058; assigned to the National Institutes of Health).
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Hall, K. A review of the carbohydrate–insulin model of obesity. Eur J Clin Nutr 71, 323–326 (2017). https://doi.org/10.1038/ejcn.2016.260
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