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Postprandial levels of GLP-1, GIP and glucagon after 2 years of weight loss with a Paleolithic diet: A randomised controlled trial in healthy obese women

Journal article
Authors J. Otten
M. Ryberg
C. Mellberg
T. Andersson
E. Chorell
B. Lindahl
Christel Larsson
J. J. Holst
T. Olsson
Published in European Journal of Endocrinology
Volume 180
Issue 6
Pages 417-427
ISSN 0804-4643
Publication year 2019
Published at Department of Food and Nutrition, and Sport Science
Pages 417-427
Language en
Keywords 3 hydroxybutyric acid, fatty acid, gastric inhibitory polypeptide, glucagon, glucagon like peptide 1, glucose, incretin, insulin, biological marker, adult, Article, body weight, body weight loss, caloric intake, caloric restriction, carbohydrate intake, carboxy terminal sequence, comparative study, controlled study, diet therapy, dietary compliance, dual energy X ray absorptiometry, fat intake, fat mass, female, gas chromatography, glucose blood level, human, insulin blood level, major clinical study, middle aged, nitrogen urine level, obese patient, obesity, oral glucose tolerance test, paleolithic diet, postmenopause, postprandial state, priority journal, protein intake, randomized controlled trial, treatment outcome, aged, blood, physiology, Biomarkers, Diet, Paleolithic, Energy Intake, Glucagon-Like Peptide 1, Humans, Postprandial Period, Weight Loss
Subject categories Endocrinology and Diabetes


Objective: To investigate how weight loss by different diets impacts postp randial levels of glucagon-like peptide 1 (GLP-1), glucose-dependent insulinotropic polypeptide (GIP) and glucagon. Methods: In this single-centre, parallel group 2-year trial, 70 healthy postmenopausal obese women were randomised to the Paleolithic diet or a healthy control diet based on Nordic Nutrition Recommendations. Both diets were without calorie restriction. The primary outcome was the change in fat mass. Here, secondary analyses on GLP-1, GIP and glucagon measured during an OGTT are described. Results: In the Paleolithic diet group, mean weight loss compared to ba seline was 11% at 6 months and 10% at 24 months. In the control diet group, mean weight loss was 6% a fter 6 and 24 months (P = 0.0001 and P = 0.049 for the comparison between groups at 6 and 24 months respectively). Compared to baseline, the mean incremental area under the curve (iAUC) for GLP-1 increased by 34 and 45% after 6 and 24 months in the Paleolithic diet group and increased by 59% after 24 months in the control diet group. The mean iAUC for GIP increased only in the Paleolithic diet group. The area under the curve (AUC) for glucagon increas ed during the first 6 months in both groups. The fasting glucagon increase correlated with the β-hydroxybutyrate increase. Conclusions: Weight loss caused an increase in postprandial GLP-1 levels and a further rise occurred during weight maintenance. Postprandial GIP levels increased only after the Paleolithic diet. Reduced postprandial glucagon suppression may be caused by a catabolic state. © 2019 European Society of Endocrinology Printed in Great Britain.

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