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Alterations in carbohydrate metabolism in response to short-term dietary carbohydrate restriction

Divisions of ¹Kinesiology and ²Endocrinology and Metabolism, University of Michigan and Veterans Affairs Medical Center, Ann Arbor, Michigan

Submitted 22 February 2005 ; accepted in final form 25 March 2005

Dietary carbohydrate restriction (CR) presents a challenge to glucose homeostasis. Despite the popularity of CR diets, little is known regarding the metabolic effects of CR. The purpose of this study was to examine changes in whole body carbohydrate oxidation, glucose availability, endogenous glucose production, and peripheral glucose uptake after dietary CR, without the confounding influence of a negative energy balance. Postabsorptive rates of glucose appearance in plasma (R_a; i.e., endogenous glucose production) and disappearance from plasma (R_d; i.e., glucose uptake) were measured using isotope dilution methods after a conventional diet [60% carbohydrate (CHO), 30% fat, and 10% protein; kcals = 1.3 x resting energy expenditure (REE)] and after 2 days and 7 days of CR (5% CHO, 60% fat, and 35% protein; kcals = 1.3 x REE) in eight subjects (means ± SE; 29 ± 4 yr; BMI 24 ± 1 kg/m²) during a 9-day hospital visit. Postabsorptive plasma glucose concentration was reduced (P = 0.01) after 2 days but returned to prediet levels the next day and remained at euglycemic levels throughout the diet (5.1 ± 0.2, 4.3 ± 0.3, and 4.8 ± 0.4 mmol/l for prediet, 2 days and 7 days, respectively). Glucose R_a and glucose R_d were reduced to below prediet levels (9.8 ± 0.6 µmol·kg^–1·min^–1) after 2 days of CR (7.9 ± 0.3 µmol·kg^–1·min^–1) and remained suppressed after 7 days (8.3 ± 0.4 µmol·kg^–1·min^–1; both P < 0.001). A greater suppression in carbohydrate oxidation, compared with the reduction in glucose R_d, led to an increased (all P 0.05) rate of nonoxidative glucose disposal at 7 days (5.2 ± 0.5 µmol·kg^–1·min^–1), compared with 2 days (2.7 ± 0.5 µmol·kg^–1·min^–1) and prediet (1.6 ± 0.8 µmol·kg^–1·min^–1). In response to eucaloric CR, a marked increase in nonoxidative glucose disposal may help maintain systemic glucose availability.

hepatic glucose production; glucose uptake; high-fat diet; low-carbohydrate diet

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