The $12M NuSI/Ludwig Study ~ Part III: Some "Early" Lessons

SUMMARY

Continuing on with discussion of:

Effects of a low carbohydrate diet on energy expenditure during weight loss maintenance: randomized trial

In Part I, I discussed some issues with methodology, largely focusing on the reduced Run-In Phase that probably compromised the results irreparably.

In Part II, I highlighted a critical issue with the Run-In Stage, the objective of which was to create a somewhat homogeneous”reduced weight state” to test various diets in maintenance of the state.

Finally, since randomization into the various test diets occurred after weight loss (PWL) randomization to maintenance evaluation diet wouldn’t influence the effects of various BSL (pre-weight loss baseline) measures on the Run-In outcome — target = 12 percent ± 2 percent weight loss — on a normal composition diet for all:  45% Carb / 30% Fat / 25% Protein.

The researchers seem to have made minimal adjustments, if any, during the Run-In Weight reduction in order to create a uniform outcome.  Rather, the result was a wide assortment of weight loss (5.6 to 16.0%, roughly 10.5% ± 5 percent ). 

Thus we have an”accidental” test-within-a-test of the CIH/TWICHOO from those”early” results.

In the long run, I provide these scatter plots for all 105 subjects who successfully completed the study, for whom complete data for insulin measures and energy expenditure were available at all time points.

The Carb-Insulin Hypothesis (aka TWICHOO) forecasts that weight loss will vary inversely with insulin levels:  The higher the insulin levels, the lower the weight loss.  The Run-In Stage data supports no such relationship (indeed, if anything, absolute weight loss was higher for those with higher baseline insulin steps.

Meanwhile, differences in weight loss are easily explained by variation in caloric deficit throughout the calorie restricted Run-In due to coarse estimation of baseline energy expenditure (vs. rigorous measure).

This post expands on some relationships of baseline (BSL) and post-weight loss (PWL) steps as detected during the weight loss part of the Run-In Phase.


Bottom Line:  Baseline insulin status appears to be irrelevant to weight loss on a”high carb” calorie-restricted diet.  



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