The G-Index Diet: The Missing Link That Makes Permanent Weight Loss Possible

Work your way up to minutes of moderate-intensity aerobic activity, 75 minutes of vigorous-intensity aerobic activity, or an equivalent mix of the two each week. Strong scientific evidence shows that physical activity can help you maintain your weight over time.

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However, the exact amount of physical activity needed to do this is not clear since it varies greatly from person to person. It's possible that you may need to do more than the equivalent of minutes of moderate-intensity activity a week to maintain your weight. To lose weight and keep it off: You will need a high amount of physical activity unless you also adjust your diet and reduce the amount of calories you're eating and drinking.

Getting to and staying at a healthy weight requires both regular physical activity and a healthy eating plan. While performing the physical activity, if your breathing and heart rate is noticeably faster but you can still carry on a conversation — it's probably moderately intense. Your heart rate is increased substantially and you are breathing too hard and fast to have a conversation, it's probably vigorously intense.

The following table shows calories used in common physical activities at both moderate and vigorous levels. To help estimate the intensity of your physical activity, see Physical Activity for Everyone: Measuring Physical Activity Intensity. Getting Started with Physical Activity for a Healthy Weight If you've not been physically active in a while, you may be wondering how to get started again.

Lace up those sneakers and find some motivating ideas. Skip directly to search Skip directly to A to Z list Skip directly to navigation Skip directly to page options Skip directly to site content. Enter Email Address What's this? Physical Activity for a Healthy Weight. Recommend on Facebook Tweet Share Compartir.

On this Page Why is physical activity important?

The G-Index Diet: The Missing Link That Makes Permanent Weight Loss Possible by Richard N. Podell

How much physical activity do I need? How many calories are used in typical activities? Why is physical activity important? When losing weight, more physical activity increases the number of calories your body uses for energy or "burns off. Most weight loss occurs because of decreased caloric intake. The trial ended when at least participants completed at least 2 diets, as planned.

Participants lost an average of 1 kg of body weight from baseline to the end of each diet period, the same for each diet type. Urinary sodium and potassium excretion were similar during each diet period. In the morning after a to hour fast and during the fourth or fifth week of each dietary period, the participants were given breakfast, lunch, and dinner that had the food and nutrient composition of the assigned diet period. Blood was sampled before breakfast, usually at 8: See eTable 3 in Supplement 2 for data on glucose and insulin area under the curve and statistical testing. A self-selected subgroup of participants were included.

Carb indicates carbohydrate; GI, glycemic index. At the high dietary carbohydrate content, the low— compared with the high—glycemic index level significantly reduced insulin sensitivity from8.

The G-Index Diet: The Missing Link That Makes Permanent Weight Loss Possible

At the low carbohydrate content, the low— compared with the high—glycemic index level did not affect insulin sensitivity but increased fasting blood glucose level by 2. Mean glucose and insulin levels during the oral glucose tolerance test are shown in eFigure 2 in Supplement 2. The primary outcomes were systolic blood pressure, insulin sensitivity, and levels of low-density lipoprotein LDL cholesterol, high-density lipoprotein HDL cholesterol, and triglycerides. Diastolic blood pressure was a secondary outcome.

Additional data related to these outcomes are presented in Table 3 and eTable 3 in Supplement 2. Apolipoproteins and other lipid outcomes are in eTable 4. Glycemic index level did not affect HDL cholesterol level or systolic blood pressure or diastolic blood pressure. A low compared with a high dietary carbohydrate content did not affect insulin sensitivity at either the high— or the low—glycemic index level Figure 3 and Table 3. A low compared with a high dietary carbohydrate content significantly lowered plasma total triglycerides at both high— and the low—glycemic index levels.

There was no evidence of additive effects of glycemic index level and dietary carbohydrate content on any of the outcomes. A sensitivity analysis restricted to the participants who completed all 4 diets yielded results similar to the primary analyses eTable 5 in Supplement 2. Serious adverse events occurred in 7 participants: None were judged to be related to the study procedures. There were no unintended or unanticipated effects.

All 4 study diets were associated with lower systolic blood pressure by 7 to 9 mm Hg Table 3 and diastolic blood pressure by 4 to 6 mm Hg eTable 3 in Supplement 2.

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Paradoxically, the low—glycemic index, high-carbohydrate diet compared with the high—glycemic index, high-carbohydrate diet decreased insulin sensitivity and increased LDL cholesterol and LDL apolipoprotein B levels while other dietary factors that affect LDL levels such as saturated fat, cholesterol, and fiber were held constant. These findings are contrary to our hypotheses on glycemic index.

As we found previously in the OmniHeart trial, 8 the beneficial effects of the DASH diet can be improved modestly by reducing its carbohydrate content. Lowering the carbohydrate content and compensating the reduced calories with unsaturated fat and protein substantially lowered triglycerides and VLDL levels and slightly lowered diastolic blood pressure, confirming previously established findings. Thus, the new information in the present study is that composing a DASH-type diet with low—glycemic index foods compared with high—glycemic index foods does not improve CVD risk factors and may in fact reduce insulin sensitivity and increase LDL cholesterol.

We found that a low compared with a high glycemic index of a high-carbohydrate diet decreased insulin sensitivity measured by an oral glucose tolerance test. Fasting glucose level was higher on low—glycemic index than high—glycemic index dietary carbohydrate as previously reported. However, a low—glycemic index diet did not affect insulin sensitivity in other studies in which body weight either remained constant during the trial or decreased by a similar amount in the high— and low—glycemic index groups.

We chose a 5-week duration of the intervention feeding periods based on results of previous studies, which suggested that 5 weeks was sufficient to detect changes in our outcomes trial protocol in Supplement 1. A recent meta-analysis of 14 trials that had durations of at least 6 months found no effect of lowering glycemic index on lipids or fasting glucose, although fasting insulin was reduced.

This trial did not address the effect of glycemic index in a typical US diet. Rather we studied a low compared with a high glycemic index in a DASH-type diet. However, we do not attribute the null findings on glycemic index to the healthfulness or specific content of the DASH diet. For example, in several European studies 19 , 23 , 31 , 32 and one in Brazil, 22 the researchers gave or prescribed selected foods to the participants to use in their own diets instead of providing complete diets that differed from their usual diets.

In these studies, lowering glycemic index did not increase insulin sensitivity or improve blood pressure, HDL cholesterol level, or triglyceride level; LDL cholesterol level decreased in one of these studies 19 but did not change in the others. We showed in a subsample of the participants that the glycemic index values of individual foods computed from dietary tables, when assembled into meals, produced expected differences in blood glucose AUCi over 12 hours, a process variable, thus confirming previous results.

These results suggest that lowering glycemic index or lowering carbohydrates for breakfast, lunch, and dinner reduces blood glucose during 12 hours without any further reduction from lowering both together. Thus, the effects of these 2 changes in dietary carbohydrate were not additive, suggesting a plateau effect, as also found in a similar study.

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After we started this trial, reports of trials that involved glycemic index have accumulated. A meta-analysis of 28 trials found that lowering glycemic index did not affect HDL cholesterol or triglyceride levels and lowered LDL cholesterol level only if fiber content was also increased. There were no increases in foods or nutrients in the low—glycemic index, high-carbohydrate diet that have known effects to raise LDL levels.

In fact, the low—glycemic index, high-carbohydrate diet contained slightly less dietary cholesterol and more fiber than the other diets, but these differences would have lowered not raised LDL levels. Low—glycemic index diets did not lower blood pressure. We also did not study the influence of glycemic index on weight loss. Lowering glycemic index may improve weight loss 6 or maintenance 40 , 41 according to a meta-analysis 6 and some more recent clinical trials, 40 , 41 although others did not find an advantage of low—glycemic index diets. This trial oversampled black individuals because of their greater burden of type 2 diabetes and CVD that could be modifiable by dietary change.

The results were similar in black and white participants. The main dietary contrast of interest, high vs low glycemic index, included participants, exceeding the goal of However, the number of participants for each dietary contrast ranged from to Still, the precision of estimation of effects, as shown by the confidence intervals, was adequate for clinically relevant inference on the risk factors of interest.

The investigators were responsible for the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, and approval of the manuscript; and decision to submit the manuscript for publication. The funding agency provided critical review of the research grant application and the protocol and monitored the progress of the study. These companies were not involved in the design, execution, analysis, interpretation, or manuscript writing or critique.

Supplemental content at jama. Dr Sacks had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Acquisition, analysis, or interpretation of data: Drafting of the manuscript: Critical revision of the manuscript for important intellectual content: Administrative, technical, or material support: Conflict of Interest Disclosures: No other disclosures were reported.

We thank David S. We also thank the Frederick Church of the Brethren, Frederick, Maryland, which provided space for distribution of food to study participants. National Center for Biotechnology Information , U. Author manuscript; available in PMC Jun Sacks , MD, Vincent J.

Physical Activity for a Healthy Weight

Carey , PhD, Cheryl A. Author information Copyright and License information Disclaimer. The publisher's final edited version of this article is available at JAMA.

See other articles in PMC that cite the published article. Associated Data Supplementary Materials supplement. Participants Eligibility criteria were age 30 years or older; systolic blood pressure to mm Hg and diastolic, 70 to 99 mm Hg; and body mass index BMI 25 or higher calculated as weight in kilograms divided by height in meters squared. Open in a separate window. Controlled Diet Intervention Eligible participants began an 8-day run-in phase during which each study diet was given for 2 days.

Measurements The 5 primary outcomes were insulin sensitivity; systolic blood pressure; and low-density lipoprotein LDL cholesterol, high-density lipoprotein HDL cholesterol, and triglyceride levels.

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Analysis Plan The diet contrasts pertaining to the effect of glycemic index were high glycemic index vs low glycemic index in the setting of high total carbohydrate intake and separately in the setting of low total carbohydrate intake. Results One hundred sixty-three participants completed at least 2 diets and were included in the analysis of outcomes Figure 1.

Effect of the Study Diets on Blood Glucose and Insulin Levels Over 12 Hours In the morning after a to hour fast and during the fourth or fifth week of each dietary period, the participants were given breakfast, lunch, and dinner that had the food and nutrient composition of the assigned diet period. Effect of Low Compared With High Glycemic Index of Dietary Carbohydrate At the high dietary carbohydrate content, the low— compared with the high—glycemic index level significantly reduced insulin sensitivity from8.

Effect of Study Diets on Main Outcomes The primary outcomes were systolic blood pressure, insulin sensitivity, and levels of low-density lipoprotein LDL cholesterol, high-density lipoprotein HDL cholesterol, and triglycerides. Therefore, mean differences reported in the text do not exactly match the differences between means in this table. Number providing outcome measures for each pair of diets: High carbohydrate, high glycemic index and high carbohydrate, low glycemic index: High carbohydrate, high glycemic index and low carbohydrate, high glycemic index: High carbohydrate, high glycemic index and low carbohydrate, low glycemic index: High carbohydrate, low glycemic index and low carbohydrate, low glycemic index: Low carbohydrate, high glycemic index and low carbohydrate, low glycemic index: Effect of Amount of Carbohydrate A low compared with a high dietary carbohydrate content did not affect insulin sensitivity at either the high— or the low—glycemic index level Figure 3 and Table 3.

Changes From Baseline All 4 study diets were associated with lower systolic blood pressure by 7 to 9 mm Hg Table 3 and diastolic blood pressure by 4 to 6 mm Hg eTable 3 in Supplement 2. Conclusions In this 5-week controlled feeding study, diets with low glycemic index of dietary carbohydrate, compared with high glycemic index of dietary carbohydrate, did not result in improvements in insulin sensitivity, lipid levels, or systolic blood pressure. Supplementary Material supplement Click here to view. Footnotes Supplemental content at jama. Study concept and design: Am J Clin Nutr.

International tables of glycemic index and glycemic load values: The Canadian Trial of Carbohydrates in Diabetes CCD , a 1-y controlled trial of low-glycemic-index dietary carbohydrate in type 2 diabetes: Effect of the glycemic index of carbohydrates on day-long 10 h profiles of plasma glucose, insulin, cholecystokinin and ghrelin. Eur J Clin Nutr. Continuous glucose monitoring to assess the ecologic validity of dietary glycemic index and glycemic load. Glycemic response and health: A clinical trial of the effects of dietary patterns on blood pressure.

N Engl J Med. OmniHeart Collaborative Research Group. Effects of protein, monounsaturated fat, and carbohydrate intake on blood pressure and serum lipids: Mediterranean diet, traditional risk factors, and the rate of cardiovascular complications after myocardial infarction: Primary prevention of cardiovascular disease with a Mediterranean diet. Dietary glycemic load, carbohydrate, sugar, and colorectal cancer risk in men and women.

Cancer Epidemiol Biomarkers Prev. Evaluation of the overall efficacy of the Omron office digital blood pressure HEM monitor in adults. Insulin sensitivity indices obtained from oral glucose tolerance testing: Acute metabolic response to high-carbohydrate, high-starch meals compared with moderate-carbohydrate, low-starch meals in subjects with type 2 diabetes.