Impact of dietary glycemic challenge on fuel partitioning

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The ‘carbohydrate-insulin theory of obesity' is used to justify popular health claims stating that carbohydrates make you fat or a high glycemic load and consumption of sugar-sweetened beverages (SSBs) and breakfast skipping increase fat gain. According to this theory, the elevated postprandial insulin secretion to a high glycemic challenge is blamed as a causal mechanism by directing nutrients away from oxidation in muscle towards storage in adipose tissue. Scientific evidence is however largely disagreeing with an adverse effect of postprandial hyperinsulinemia on fuel partitioning. Possible reasons for this disagreement are differences in insulin sensitivity and energy balance. Diet-induced hyperinsulinemia may lead to a higher fat storage only at a positive energy balance. A shift in fuel partitioning towards fat storage requires improved or maintained insulin sensitivity in adipose tissue when compared with skeletal muscle. This may be the case during refeeding (after weight loss), physical inactivity or in metabolically healthy obese subjects (relative to insulin-resistant subjects). The adverse effect of a high-glycemic diet, SSBs consumption or breakfast skipping on body weight is likely due to increased energy consumption rather than to increased fat storage.

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