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The carbohydrate-insulin model: a physiological perspective on the obesity pandemic.

Publication ,  Journal Article
Ludwig, DS; Aronne, LJ; Astrup, A; de Cabo, R; Cantley, LC; Friedman, MI; Heymsfield, SB; Johnson, JD; King, JC; Krauss, RM; Lieberman, DE ...
Published in: Am J Clin Nutr
December 1, 2021

According to a commonly held view, the obesity pandemic is caused by overconsumption of modern, highly palatable, energy-dense processed foods, exacerbated by a sedentary lifestyle. However, obesity rates remain at historic highs, despite a persistent focus on eating less and moving more, as guided by the energy balance model (EBM). This public health failure may arise from a fundamental limitation of the EBM itself. Conceptualizing obesity as a disorder of energy balance restates a principle of physics without considering the biological mechanisms that promote weight gain. An alternative paradigm, the carbohydrate-insulin model (CIM), proposes a reversal of causal direction. According to the CIM, increasing fat deposition in the body-resulting from the hormonal responses to a high-glycemic-load diet-drives positive energy balance. The CIM provides a conceptual framework with testable hypotheses for how various modifiable factors influence energy balance and fat storage. Rigorous research is needed to compare the validity of these 2 models, which have substantially different implications for obesity management, and to generate new models that best encompass the evidence.

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Published In

Am J Clin Nutr

DOI

EISSN

1938-3207

Publication Date

December 1, 2021

Volume

114

Issue

6

Start / End Page

1873 / 1885

Location

United States

Related Subject Headings

  • Pandemics
  • Obesity
  • Nutrition & Dietetics
  • Insulin
  • Humans
  • Energy Metabolism
  • Energy Intake
  • Dietary Fats
  • Dietary Carbohydrates
  • Carbohydrates
 

Citation

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Ludwig, D. S., Aronne, L. J., Astrup, A., de Cabo, R., Cantley, L. C., Friedman, M. I., … Ebbeling, C. B. (2021). The carbohydrate-insulin model: a physiological perspective on the obesity pandemic. Am J Clin Nutr, 114(6), 1873–1885. https://doi.org/10.1093/ajcn/nqab270
Ludwig, David S., Louis J. Aronne, Arne Astrup, Rafael de Cabo, Lewis C. Cantley, Mark I. Friedman, Steven B. Heymsfield, et al. “The carbohydrate-insulin model: a physiological perspective on the obesity pandemic.Am J Clin Nutr 114, no. 6 (December 1, 2021): 1873–85. https://doi.org/10.1093/ajcn/nqab270.
Ludwig DS, Aronne LJ, Astrup A, de Cabo R, Cantley LC, Friedman MI, et al. The carbohydrate-insulin model: a physiological perspective on the obesity pandemic. Am J Clin Nutr. 2021 Dec 1;114(6):1873–85.
Ludwig, David S., et al. “The carbohydrate-insulin model: a physiological perspective on the obesity pandemic.Am J Clin Nutr, vol. 114, no. 6, Dec. 2021, pp. 1873–85. Pubmed, doi:10.1093/ajcn/nqab270.
Ludwig DS, Aronne LJ, Astrup A, de Cabo R, Cantley LC, Friedman MI, Heymsfield SB, Johnson JD, King JC, Krauss RM, Lieberman DE, Taubes G, Volek JS, Westman EC, Willett WC, Yancy WS, Ebbeling CB. The carbohydrate-insulin model: a physiological perspective on the obesity pandemic. Am J Clin Nutr. 2021 Dec 1;114(6):1873–1885.
Journal cover image

Published In

Am J Clin Nutr

DOI

EISSN

1938-3207

Publication Date

December 1, 2021

Volume

114

Issue

6

Start / End Page

1873 / 1885

Location

United States

Related Subject Headings

  • Pandemics
  • Obesity
  • Nutrition & Dietetics
  • Insulin
  • Humans
  • Energy Metabolism
  • Energy Intake
  • Dietary Fats
  • Dietary Carbohydrates
  • Carbohydrates