The Role of Carbohydrate Intake in Obesity: Implications For Diet and Weight Management
Abstract
Carbohydrates, the primary source of dietary energy, play a pivotal role in the development of obesity. Recent research has shifted focus from merely the quantity of carbohydrate intake to the quality, glycemic response, and timing. Excessive consumption of refined carbohydrates and sugar-sweetened beverages contributes to fat accumulation through mechanisms such as hyperinsulinemia, insulin resistance, and de novo lipogenesis. Furthermore, variations in carbohydrate metabolism among different populations—children, women, and specific ethnic groups—necessitate a personalized nutritional approach. While low-carbohydrate diets (e.g., ketogenic) offer short-term weight loss benefits, their long-term efficacy is comparable to high-carbohydrate diets if caloric intake is controlled. The integration of intermittent fasting, carbohydrate cycling, and microbiome-friendly dietary interventions reflects the evolving landscape of obesity management. Additionally, dietary fiber, whole grains, and low-GI foods provide metabolic advantages. Public health strategies must emphasize food quality, labeling reforms, and education to curb global obesity rates. This review highlights the biochemical, clinical, and policy-related aspects of carbohydrate intake in obesity, offering actionable insights for dietitians, clinicians, and researchers working on effective weight management strategies.
Keywords:
Carbohydrate intake, Obesity, Insulin resistance, Glycemic index, Dietary fiber, Low-carb diet, Metabolic syndrome, Personalized nutrition, public health policy, Weight management
References
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33. Akbaraly TN, Ferrie JE, Berr C, et al. Dietary pattern and depressive symptoms in middle age. Br J Psychiatry. 2009;195(5):408–13.
34. Rosinger A, Herrick K, Gahche J, Park S. Sugar-sweetened beverage consumption among U.S. youth. NCHS Data Brief. 2017;(271):1–8.
35. Malik VS, Hu FB. Fructose and cardiometabolic health. J Am Coll Cardiol. 2015;66(14):1615–24.
36. Ebbeling CB, Feldman HA, Klein GL, Wong JMW, Bielak L, Steltz SK, et al. Effects of a low carbohydrate diet on energy expenditure during weight loss maintenance: randomized trial. BMJ. 2018;363:k4583.
37. Kennedy ET, Bowman SA, Powell R. Dietary-fat intake in the US population. J Am Coll Nutr. 1999;18(3):207–12.
38. Drewnowski A. The cost of US foods as related to their nutritive value. Am J Clin Nutr. 2010;92(5):1181–8.
39. Willett WC, Stampfer MJ. Current evidence on healthy eating. Annu Rev Public Health. 2013;34:77–95.
40. WHO. Healthy diet. World Health Organization; 2020.
41. USDA. Dietary Guidelines for Americans 2020–2025. US Department of Health and Human Services; 2020.
42. Slavin JL, Lloyd B. Health benefits of fruits and vegetables. Adv Nutr. 2012;3(4):506–16.
43. Monteiro CA, Moubarac JC, Cannon G, Ng SW, Popkin B. Ultra-processed products are becoming dominant in the global food system. Obes Rev. 2013;14(S2):21–8.
44. TeMorenga L, Mallard S, Mann J. Dietary sugars and body weight: systematic review and meta-analyses of RCTs and cohort studies. BMJ. 2013;346:e7492.
45. Lim JS, Mietus-Snyder M, Valente A, Schwarz JM, Lustig RH. The role of fructose in the pathogenesis of NAFLD and the metabolic syndrome. Nat Rev Gastroenterol Hepatol. 2010;7(5):251–64.
2. Bray GA, Popkin BM. Dietary sugar and body weight: have we reached a crisis in the epidemic of obesity and diabetes? Health Aff. 2014;33(11):1747–53.
3. Feinman RD, Pogozelski WK, Astrup A, Bernstein RK, Fine EJ, Westman EC, et al. Dietary carbohydrate restriction as the first approach in diabetes management. Nutrients. 2015;7(6):2899–934.
4. Mozaffarian D, Hao T, Rimm EB, Willett WC, Hu FB. Changes in diet and lifestyle and long-term weight gain in women and men. N Engl J Med. 2011;364(25):2392–404.
5. Hall KD, Bemis T, Brychta R, Chen KY, Courville A, Crayner EJ, et al. Calorie for calorie, dietary fat restriction results in more body fat loss than carbohydrate restriction in people with obesity. Cell Metab. 2015;22(3):531–40.
6. Livesey G, Taylor R, Hulshof T, Howlett J. Glycemic response and health—a systematic review and meta-analysis. Am J Clin Nutr. 2008;87(1):258S–268S.
7. Jenkins DJA, Wolever TMS, Taylor RH. Glycemic index of foods: a physiological basis for carbohydrate exchange. Am J Clin Nutr. 1981;34(3):362–6.
8. Hu FB, Malik VS. Sugar-sweetened beverages and risk of obesity and type 2 diabetes: epidemiologic evidence. PhysiolBehav. 2010;100(1):47–54.
9. Ludwig DS. The glycemic index: physiological mechanisms relating to obesity, diabetes, and cardiovascular disease. JAMA. 2002;287(18):2414–23.
10. Johnson RJ, Segal MS, Sautin Y, Nakagawa T, Feig DI, Kang DH, et al. Potential role of sugar (fructose) in the epidemic of hypertension, obesity and the metabolic syndrome. Diabetes Care. 2007;30(7):1902–11.
11. Bray GA. Fructose: should we worry? Int J Obes. 2008;32(Suppl 7):S127–31.
12. Stanhope KL, Havel PJ. Fructose consumption: potential mechanisms for its effects to increase visceral adiposity and induce dyslipidemia and insulin resistance. Curr Opin Lipidol. 2008;19(1):16–24.
13. Malik VS, Schulze MB, Hu FB. Intake of sugar-sweetened beverages and weight gain: a systematic review. Am J Clin Nutr. 2006;84(2):274–88.
14. Volek JS, Sharman MJ, Forsythe CE. Modification of lipoproteins by very low-carbohydrate diets. J Nutr. 2005;135(6):1339–42.
15. Foster GD, Wyatt HR, Hill JO, McGuckin BG, Brill C, Mohammed BS, et al. A randomized trial of a low-carbohydrate diet for obesity. N Engl J Med. 2003;348(21):2082–90.
16. Sacks FM, Bray GA, Carey VJ, Smith SR, Ryan DH, Anton SD, et al. Comparison of weight-loss diets with different compositions of fat, protein, and carbohydrates. N Engl J Med. 2009;360(9):859–73.
17. Shai I, Schwarzfuchs D, Henkin Y, Shahar DR, Witkow S, Greenberg I, et al. Weight loss with a low-carbohydrate, Mediterranean, or low-fat diet. N Engl J Med. 2008;359(3):229–41.
18. De Souza RJ, Kendall CW, Jenkins DJ, et al. Effect of dietary glycemic index on body weight and blood lipids: a meta-analysis of randomized controlled trials. Am J Clin Nutr. 2006;84(6):1195–200.
19. Slavin JL. Dietary fiber and body weight. Nutrition. 2005;21(3):411–8.
20. Pereira MA, Ludwig DS. Dietary fiber and body-weight regulation: observations and mechanisms. Pediatr Clin. 2001;48(4):969–80.
21. Ludwig DS. The end of overeating. JAMA. 2009;301(15):1588–90.
22. Astrup A, Meinert Larsen T, Harper A. Atkins and other low-carbohydrate diets: hoax or an effective tool for weight loss? Lancet. 2004;364(9437):897–9.
23. Gardner CD, Kiazand A, Alhassan S, Kim S, Stafford RS, Balise RR, et al. Comparison of the Atkins, Zone, Ornish, and LEARN diets for change in weight and related risk factors among overweight premenopausal women. JAMA. 2007;297(9):969–77.
24. Arora T, Sharma R. Fermentation potential of the gut microbiome: implications for energy homeostasis and weight management. Nutr Rev. 2011;69(2):99–106.
25. Turnbaugh PJ, Ley RE, Mahowald MA, Magrini V, Mardis ER, Gordon JI. An obesity-associated gut microbiome with increased capacity for energy harvest. Nature. 2006;444(7122):1027–31.
26. Zeevi D, Korem T, Zmora N, Israeli D, Rothschild D, Weinberger A, et al. Personalized nutrition by prediction of glycemic responses. Cell. 2015;163(5):1079–94.
27. DiNicolantonio JJ, O'Keefe JH, Lucan SC. Added fructose: a principal driver of type 2 diabetes mellitus and its consequences. Mayo Clin Proc. 2015;90(3):372–81.
28. Ludwig DS, Ebbeling CB. The carbohydrate-insulin model of obesity: beyond “calories in, calories out”. JAMA Intern Med. 2018;178(8):1098–103.
29. Mechanick JI, Farkouh ME, Newman JD, Garvey WT. Cardiometabolic-based chronic disease, part 1: a new taxonomy for etiological classification. J Clin Endocrinol Metab. 2020;105(3):E867–E882.
30. Buse JB, Wexler DJ, Tsapas A, et al. 2019 update to: Management of hyperglycemia in type 2 diabetes. Diabetes Care. 2020;43(2):487–93.
31. Micha R, Peñalvo JL, Cudhea F, Imamura F, Rehm CD, Mozaffarian D. Association between dietary factors and mortality from heart disease, stroke, and type 2 diabetes in the United States. JAMA. 2017;317(9):912–24.
32. Nettleton JA, Steffen LM, Mayer-Davis EJ, et al. Dietary patterns are associated with biochemical markers of inflammation and endothelial activation in the Multi-Ethnic Study of Atherosclerosis (MESA). Am J Clin Nutr. 2006;83(6):1369–79.
33. Akbaraly TN, Ferrie JE, Berr C, et al. Dietary pattern and depressive symptoms in middle age. Br J Psychiatry. 2009;195(5):408–13.
34. Rosinger A, Herrick K, Gahche J, Park S. Sugar-sweetened beverage consumption among U.S. youth. NCHS Data Brief. 2017;(271):1–8.
35. Malik VS, Hu FB. Fructose and cardiometabolic health. J Am Coll Cardiol. 2015;66(14):1615–24.
36. Ebbeling CB, Feldman HA, Klein GL, Wong JMW, Bielak L, Steltz SK, et al. Effects of a low carbohydrate diet on energy expenditure during weight loss maintenance: randomized trial. BMJ. 2018;363:k4583.
37. Kennedy ET, Bowman SA, Powell R. Dietary-fat intake in the US population. J Am Coll Nutr. 1999;18(3):207–12.
38. Drewnowski A. The cost of US foods as related to their nutritive value. Am J Clin Nutr. 2010;92(5):1181–8.
39. Willett WC, Stampfer MJ. Current evidence on healthy eating. Annu Rev Public Health. 2013;34:77–95.
40. WHO. Healthy diet. World Health Organization; 2020.
41. USDA. Dietary Guidelines for Americans 2020–2025. US Department of Health and Human Services; 2020.
42. Slavin JL, Lloyd B. Health benefits of fruits and vegetables. Adv Nutr. 2012;3(4):506–16.
43. Monteiro CA, Moubarac JC, Cannon G, Ng SW, Popkin B. Ultra-processed products are becoming dominant in the global food system. Obes Rev. 2013;14(S2):21–8.
44. TeMorenga L, Mallard S, Mann J. Dietary sugars and body weight: systematic review and meta-analyses of RCTs and cohort studies. BMJ. 2013;346:e7492.
45. Lim JS, Mietus-Snyder M, Valente A, Schwarz JM, Lustig RH. The role of fructose in the pathogenesis of NAFLD and the metabolic syndrome. Nat Rev Gastroenterol Hepatol. 2010;7(5):251–64.
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M, P., K, V., D, R., Patibandla, J., & A, S. (2025). The Role of Carbohydrate Intake in Obesity: Implications For Diet and Weight Management. Journal of Integral Sciences, 8(3), 16-21. https://doi.org/10.37022/jis.v8i3.111
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