PMID- 37006572 OWN - NLM STAT- MEDLINE DCOM- 20230404 LR - 20231102 IS - 2296-2565 (Electronic) IS - 2296-2565 (Linking) VI - 11 DP - 2023 TI - Low carbohydrate intake correlates with trends of insulin resistance and metabolic acidosis in healthy lean individuals. PG - 1115333 LID - 10.3389/fpubh.2023.1115333 [doi] LID - 1115333 AB - INTRODUCTION: Both obesity and a poor diet are considered major risk factors for triggering insulin resistance syndrome (IRS) and the development of type 2 diabetes mellitus (T2DM). Owing to the impact of low-carbohydrate diets, such as the keto diet and the Atkins diet, on weight loss in individuals with obesity, these diets have become an effective strategy for a healthy lifestyle. However, the impact of the ketogenic diet on IRS in healthy individuals of a normal weight has been less well researched. This study presents a cross-sectional observational study that aimed to investigate the effect of low carbohydrate intake in healthy individuals of a normal weight with regard to glucose homeostasis, inflammatory, and metabolic parameters. METHODS: The study included 120 participants who were healthy, had a normal weight (BMI 25 kg/m(2)), and had no history of a major medical condition. Self-reported dietary intake and objective physical activity measured by accelerometry were tracked for 7 days. The participants were divided into three groups according to their dietary intake of carbohydrates: the low-carbohydrate (LC) group (those consuming <45% of their daily energy intake from carbohydrates), the recommended range of carbohydrate (RC) group (those consuming 45-65% of their daily energy intake from carbohydrates), and the high-carbohydrate (HC) group (those consuming more than 65% of their daily energy intake from carbohydrates). Blood samples were collected for the analysis of metabolic markers. HOMA of insulin resistance (HOMA-IR) and HOMA of beta-cell function (HOMA-beta), as well as C-peptide levels, were used for the evaluation of glucose homeostasis. RESULTS: Low carbohydrate intake (<45% of total energy) was found to significantly correlate with dysregulated glucose homeostasis as measured by elevations in HOMA-IR, HOMA-beta% assessment, and C-peptide levels. Low carbohydrate intake was also found to be coupled with lower serum bicarbonate and serum albumin levels, with an increased anion gap indicating metabolic acidosis. The elevation in C-peptide under low carbohydrate intake was found to be positively correlated with the secretion of IRS-related inflammatory markers, including FGF2, IP-10, IL-6, IL-17A, and MDC, but negatively correlated with IL-3. DISCUSSION: Overall, the findings of the study showed that, for the first time, low-carbohydrate intake in healthy individuals of a normal weight might lead to dysfunctional glucose homeostasis, increased metabolic acidosis, and the possibility of triggering inflammation by C-peptide elevation in plasma. CI - Copyright (c) 2023 Al-Reshed, Sindhu, Al Madhoun, Bahman, AlSaeed, Akhter, Malik, Alzaid, Al-Mulla and Ahmad. FAU - Al-Reshed, Fatema AU - Al-Reshed F AD - Immunology and Microbiology Department, Dasman Diabetes Institute, Kuwait City, Kuwait. FAU - Sindhu, Sardar AU - Sindhu S AD - Animal and Imaging Core Facility, Dasman Diabetes Institute, Kuwait City, Kuwait. FAU - Al Madhoun, Ashraf AU - Al Madhoun A AD - Animal and Imaging Core Facility, Dasman Diabetes Institute, Kuwait City, Kuwait. FAU - Bahman, Fatemah AU - Bahman F AD - Immunology and Microbiology Department, Dasman Diabetes Institute, Kuwait City, Kuwait. FAU - AlSaeed, Halemah AU - AlSaeed H AD - Immunology and Microbiology Department, Dasman Diabetes Institute, Kuwait City, Kuwait. FAU - Akhter, Nadeem AU - Akhter N AD - Immunology and Microbiology Department, Dasman Diabetes Institute, Kuwait City, Kuwait. FAU - Malik, Md Zubbair AU - Malik MZ AD - Genetics and Bioinformatics, Dasman Diabetes Institute, Dasman, Kuwait. FAU - Alzaid, Fawaz AU - Alzaid F AD - Institute Necker Enfants Malades (INEM), French Institute of Health and Medical Research (INSERM), Immunity and Metabolism of Diabetes (IMMEDIAB), Universite de Paris Cite, Paris, France. FAU - Al-Mulla, Fahd AU - Al-Mulla F AD - Genetics and Bioinformatics, Dasman Diabetes Institute, Dasman, Kuwait. FAU - Ahmad, Rasheed AU - Ahmad R AD - Immunology and Microbiology Department, Dasman Diabetes Institute, Kuwait City, Kuwait. LA - eng PT - Journal Article PT - Observational Study PT - Research Support, Non-U.S. Gov't DEP - 20230316 PL - Switzerland TA - Front Public Health JT - Frontiers in public health JID - 101616579 RN - 0 (Insulin) RN - 0 (C-Peptide) RN - 0 (Dietary Carbohydrates) RN - 0 (Blood Glucose) SB - IM MH - Humans MH - *Insulin Resistance MH - *Diabetes Mellitus, Type 2 MH - Insulin MH - Cross-Sectional Studies MH - C-Peptide MH - Dietary Carbohydrates MH - Blood Glucose/metabolism MH - *Metabolic Syndrome MH - Obesity MH - *Acidosis PMC - PMC10061153 OTO - NOTNLM OT - C-peptide OT - HOMA-IR OT - anion gap OT - inflammation OT - insulin resistance OT - low carbohydrate COIS- The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. EDAT- 2023/04/04 06:00 MHDA- 2023/04/04 06:42 PMCR- 2023/03/16 CRDT- 2023/04/03 03:48 PHST- 2022/12/03 00:00 [received] PHST- 2023/02/16 00:00 [accepted] PHST- 2023/04/04 06:42 [medline] PHST- 2023/04/03 03:48 [entrez] PHST- 2023/04/04 06:00 [pubmed] PHST- 2023/03/16 00:00 [pmc-release] AID - 10.3389/fpubh.2023.1115333 [doi] PST - epublish SO - Front Public Health. 2023 Mar 16;11:1115333. doi: 10.3389/fpubh.2023.1115333. eCollection 2023.