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Classification of obesity targeted personalized dietary weight loss management based on carbohydrate tolerance

European Journal of Clinical Nutrition volume 72, pages 1300–1304 (2018)Cite this article

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There is a huge variability in weight loss responses to diets in overweight and obese individuals, and 3–6 months weight loss on a low-fat or a low-carb diet typically varies from a gain of few kg to a 15–20 kg weight loss. Efforts to develop pretreatment prognostic markers to identify the obese patients who will benefit from a particular weight loss have been unsuccessful. The lack of identifiable biological predictors has been interpreted as being due to differences in dietary adherence and psychosocial factors, and some yet unknown factors (genes, epigenetics, pollutants, etc.) [1]. Moreover, randomized controlled trials (RCT) comparing diets differing in macronutrient content, e.g., low-fat, low-carb, or high protein, have not identified one diet that is substantially superior to others. This has led to the view that all calories are equal, and that focus should be on using willpower and practical tools to reduce caloric intake.

However, recent discoveries have shown that the large variability in weight loss response observed in obese individuals prescribed the same diet is partly due to alterations in the mechanisms linking glucose metabolism to appetite control, and that prevalent physiological alterations in glucose metabolism are responsible for powerful differences in responsiveness to carbohydrate intake ranging from induction of marked satiety signals to almost absent satiety effect. The discovery of this interplay between glucose metabolism and diet composition has opened a novel clinical management strategy that can improve dietary weight loss in overweight, obese, and diabetic individuals.

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Authors and Affiliations

  1. Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark

    Arne Astrup & Mads F. Hjorth

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  1. Arne Astrup
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  2. Mads F. Hjorth
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Correspondence to Arne Astrup.

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Conflict of interest

AA and MFH are co-inventers on a pending provisional patent application on the use of biomarkers for prediction of weight-loss responses, and co-founders/owners of the University of Copenhagen spin-out company Personalized Weight Management Research Consortium ApS (Gluco-diet.dk). AA is consultant or a member of advisory boards for Basic Research, USA; Beachbody, USA; BioCare Copenhagen, Denmark; Gelesis, USA; Groupe Éthique et Santé, France; McCain Foods Limited, USA; Nestlé Research Center, Switzerland; and Weight Watchers, USA. AA and MFH are co-authors of a number of diet/cookery books, including personalized nutrition for weight loss, published in several languages.

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Astrup, A., Hjorth, M.F. Classification of obesity targeted personalized dietary weight loss management based on carbohydrate tolerance. Eur J Clin Nutr 72, 1300–1304 (2018). https://doi.org/10.1038/s41430-018-0227-6

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