Effects of calorie restriction and weight loss on glucose and insulin levels in obese humans.

The relative contributions of weight loss vs calorie restriction in the improvement of glucose tolerance in obese subjects has not been well studied. We measured fasting and stimulated glucose and insulin levels in seven obese subjects at 4 time periods: on a regular diet before weight loss, on a very low calorie ketogenic diet (VLCKD) after 4 days and after 6 weeks, and after 4 days back on a regular diet. Fasting glucose and insulin levels fell significantly after only 4 days of calorie restriction and did not change after 6 weeks. With return to a regular diet, these levels rose toward baseline even through body weight remained well below baseline. Stimulated glucose and insulin levels during an insulin tolerance test, intravenous glucose tolerance test, and standard meal demonstrated a similar pattern, although the changes due to either diet or weight loss were minimal. We conclude that calorie restriction has a greater effect on glucose and insulin levels than does weight loss in obese subjects who are losing weight.