Dietary composition and weight loss: can we individualize dietary prescriptions according to insulin sensitivity or secretion status?

Authors: PITTAS, ANASTASIOS - T-NEMC ENDOCRINOLOGY; Roberts, Susan

Submitted to: Nutrition Reviews
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 4/10/2006
Publication Date: 10/1/2006
Citation: Pittas, A.G., Roberts, S. 2006. Dietary composition and weight loss: can we individualize dietary prescriptions according to insulin sensitivity or secretion status?. Nutrition Reviews. 64(10): 435-448.

Interpretive Summary: There is considerable uncertainty over whether any one dietary pattern broadly facilitates weight loss or maintenance of weight loss and current dietary guidelines recommend a spectrum of dietary composition for the general population. However, emerging evidence suggests that specific dietary compositions may work better for identifiable groups of overweight/obese individuals based on their individual metabolic status. We performed a systematic review of observational and intervention human studies to address the following questions: (1) Are baseline insulin sensitivity and insulin secretion associated with future weight change, and might these parameters affect individual responses to hypocaloric diets? (2) Is there an interaction between either insulin sensitivity or insulin secretion and the macronutrient composition of hypocaloric diets that influences adherence to a weight loss program? Current dietary guidelines recommend a spectrum of dietary composition for the general population, but emerging evidence suggests that specific dietary compositions may work better for identifiable groups of overweight/obese individuals based on their insulin dynamics. In particular, subject-specific insulin secretion status and perhaps insulin sensitivity may interact with diets that vary in glycemic load to influence the weight loss response to a hypocaloric diet. The results of this systematic review provide evidence that measurement of indices of insulin secretion or insulin sensitivity may help enhance weight loss success in overweight individuals through the use of targeted dietary recommendations specific for insulin secretion or sensitivity status.

Technical Abstract: There is considerable uncertainty over whether any one dietary pattern broadly facilitates weight loss or maintenance of weight loss, and current dietary guidelines recommend a spectrum of dietary composition for the general population. However, emerging evidence suggests that specific dietary compositions may work better for identifiable groups of overweight/obese individuals based on their individual metabolic status. In particular, characteristics of insulin dynamics, such as insulin sensitivity or insulin secretion status, may interact with diets that vary in macronutrient composition to influence the weight loss achieved with a hypocaloric diet.