title: Relationship of insulin dynamics to body composition and resting energy expenditure following weight loss.
abstract: OBJECTIVE
  To examine associations of baseline insulin dynamics with changes in body composition and resting energy expenditure (REE) following weight loss.
  
  
  METHODS
  Twenty-one participants with overweight or obesity achieved 10-15% weight loss and then received 3 weight loss maintenance diets (high-carbohydrate, moderate-carbohydrate, and low-carbohydrate) in random order, each for 4 weeks. Body composition was measured at baseline and after weight loss. Insulin 30 min after glucose consumption (insulin-30; insulin response), C-peptide deconvolution analysis, HOMA, hepatic insulin sensitivity (IS), and REE were assessed at baseline and after each maintenance diet.
  
  
  RESULTS
  Insulin-30, but not maximal insulin secretion, hepatic IS, or HOMA, predicted changes in fat mass (standardized β = 0.385, 1.7 kg difference between 10th and 90th centile of insulin-30, P = 0.04) after weight loss. Insulin-30 (β = -0.341, -312 kcal day(-1) , P = 0.008), maximal insulin secretion (β = -0.216, -95 kcal day(-1) , P = 0.0002), HOMA (β = -0.394, -350 kcal day(-1) , P = 0.002), and hepatic IS (β = 0.217, 225 kcal day(-1) , P = 0.0003) predicted change in REE during weight loss maintenance, independent of changes in body composition. The inverse relationship between insulin-30 and REE was substantially attenuated when the low-carbohydrate diet was consumed first.
  
  
  CONCLUSIONS
  These findings distinguish a novel phenotype, characterized by high insulin response, at risk for weight regain, and identify a dietary approach to ameliorate this risk.
authors.affiliation: Division of Gastroenterology, Hepatology and Nutrition, Boston Children's Hospital, Boston, Massachusetts, USA.|New Balance Foundation Obesity Prevention Center, Boston Children's Hospital, Boston, Massachusetts, USA.
authors.forename: Bridget M
authors.initials: BM
authors.lastname: Hron
authors.affiliation: New Balance Foundation Obesity Prevention Center, Boston Children's Hospital, Boston, Massachusetts, USA.|Division of Endocrinology, Boston Children's Hospital, Boston, Massachusetts, USA.
authors.forename: Cara B
authors.initials: CB
authors.lastname: Ebbeling
authors.affiliation: Clinical Research Center, Boston Children's Hospital, Boston, Massachusetts, USA.
authors.forename: Henry A
authors.initials: HA
authors.lastname: Feldman
authors.affiliation: New Balance Foundation Obesity Prevention Center, Boston Children's Hospital, Boston, Massachusetts, USA.|Division of Endocrinology, Boston Children's Hospital, Boston, Massachusetts, USA.
authors.forename: David S
authors.initials: DS
authors.lastname: Ludwig
mesh_terms: D000328:Adult; D001823:Body Composition / Q000502:physiology*; D001835:Body Weight; D002096:C-Peptide / Q000097:blood; D050528:Diet, Carbohydrate-Restricted; D004038:Diet, Reducing; D004734:Energy Metabolism / Q000502:physiology*; D005260:Female; D006801:Humans; D007328:Insulin / Q000378:metabolism*; D007333:Insulin Resistance; D008297:Male; D009765:Obesity / Q000178:diet therapy / Q000378:metabolism; D050177:Overweight / Q000178:diet therapy / Q000378:metabolism; D012146:Rest; D015431:Weight Loss / Q000502:physiology*; D055815:Young Adult
chemical_list: D002096:C-Peptide; D007328:Insulin