Pretreatment fasting glucose and insulin as determinants of weight loss on diets varying in macronutrients and dietary fibers - The POUNDS LOST Study

Research output: Contribution to journalJournal articleResearchpeer-review


  • Hjorth, Mads Fiil
  • George A Bray
  • Yishai Zohar
  • Lorien Urban
  • Derek C Miketinas
  • Donald A Williamson
  • Donna H Ryan
  • Jennifer Rood
  • Catherine M Champagne
  • Frank M Sacks
  • Arne Astrup

Efforts to identify a preferable diet for weight management based on macronutrient composition have largely failed, but recent evidence suggests that satiety effects of carbohydrates may depend on the individual's insulin-mediated cellular glucose uptake. Therefore, using data from the POUNDS LOST trial, pre-treatment fasting plasma glucose (FPG), fasting insulin (FI), and homeostatic model assessment of insulin resistance (HOMA-IR) were studied as prognostic markers of long-term weight loss in four diets differing in carbohydrate, fat, and protein content, while assessing the role of dietary fiber intake. Subjects with FPG <100 mg/dL lost 2.6 (95% CI 0.9;4.4, p = 0.003) kg more on the low-fat/high-protein (n = 132) compared to the low-fat/average-protein diet (n = 136). Subjects with HOMA-IR ≥4 lost 3.6 (95% CI 0.2;7.1, p = 0.038) kg more body weight on the high-fat/high-protein (n = 35) compared to high-fat/average-protein diet (n = 33). Regardless of the randomized diet, subjects with prediabetes and FI below the median lost 5.6 kg (95% CI 0.6;10.6, p = 0.030) more when consuming ≥35 g (n = 15) compared to <35 g dietary fiber/10 MJ (n = 16). Overall, subjects with normal glycemia lost most on the low-fat/high-protein diet, subjects with high HOMA-IR lost most on the high-fat/high protein diet, and subjects with prediabetes and low FI had particular benefit from dietary fiber in the diet.

Original languageEnglish
Article number586
Issue number3
Number of pages12
Publication statusPublished - 2019

    Research areas

  • Faculty of Science - Glucose, Insulin, Weight, Diet, Macronutrient composition, Clinical nutrition

Number of downloads are based on statistics from Google Scholar and

No data available

ID: 214867950