Energy balance
In crossover diet studies without washout periods, the order of macronutrient manipulation (specifically Low Carbohydrate vs. Low Fat) significantly affects energy balance and body composition outcomes due to carryover effects from gut adaptations.
If you are designing or interpreting a nutrition study that switches between two diets without a break, the order matters. Starting with a high-volume, high-fiber diet (like a Low Carb diet in this study) before switching to a lower-volume diet can lead to significantly greater weight loss than the reverse order, likely because the gut adapts to the volume/fiber of the first diet, reducing intake in the second. For individuals, this suggests that the sequence of dietary changes might impact long-term adherence and results, though this specific mechanism (gut adaptation to mass) is most relevant in controlled settings.
Subjects randomized to LCLF lost 2.9 ± 1.1 kg more body weight (p < 0.001) and 1.5 ± 0.6 kg more body fat (p = 0.03) than the LFLC group likely because the LCLF group consumed 922 ± 304 kcal/d less than the LFLC group (p = 0.0024). Reduced energy intake in LCLF vs LFLC was driven by the last two weeks (-1610 ± 306 kcal/d; p<0.00001) perhaps due to carryover effects of gut adaptations over the first two weeks arising from large differences in the mass of food (1295 ± 209 g/d; p<0.00001) and fiber intake (58 ± 5 g/d; p<0.00001).
Why this rating
Randomized crossover inpatient feeding study (gold standard for nutrition), but it is a secondary analysis of existing trials and the paper is a preprint.
Source
Diet order affects energy balance in randomized crossover feeding studies that vary in macronutrients but not ultra-processing
Christina M. Sciarrillo et al. · medRxiv · 2023
DOI 10.1101/2023.10.03.23296501
Related findings · Energy balance
- Achieving a total body weight loss of 10-15% (or >10-15 kg) through Total Diet Replacement (TDR) induces remission of Type 2 Diabetes in individuals with short-duration disease.Strong
- Bariatric surgery is superior to medical management alone for inducing significant long-term weight loss, remission of type 2 diabetes, and reduction in mortality for patients with BMI ≥ 40 or ≥ 35 with comorbidities.Strong
- Achieving type 2 diabetes remission requires significant weight loss (≥15 kg) via major caloric restriction, independent of macronutrient composition.Strong
This is one finding among thousands. Every one is graded and traced to its source, so you can see what the evidence actually supports. Browse the research →