{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T16:28:03Z","timestamp":1790958483898,"version":"4.1.0"},"reference-count":39,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2018,9,14]],"date-time":"2018-09-14T00:00:00Z","timestamp":1536883200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100016441","name":"Physicians Committee for Responsible Medicine","doi-asserted-by":"publisher","award":["330068"],"award-info":[{"award-number":["330068"]}],"id":[{"id":"10.13039\/100016441","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>The effects of carbohydrates on body weight and insulin sensitivity are controversial. In this 16-week randomized clinical trial, we tested the role of a low-fat, plant-based diet on body weight, body composition and insulin resistance. As a part of this trial, we investigated the role of changes in carbohydrate intake on body composition and insulin resistance. Participants (n = 75) were randomized to follow a plant-based high-carbohydrate, low-fat (vegan) diet (n = 38) or to maintain their current diet (n = 37). Dual-energy X-ray absorptiometry was used to measure body composition. Insulin resistance was assessed with the Homeostasis Model Assessment (HOMA-IR) index. A repeated measure ANOVA model was used to test the between-group differences from baseline to 16 weeks. A linear regression model was used to test the relationship between carbohydrate intake, and body composition and insulin resistance. Weight decreased significantly in the vegan group (treatment effect \u22126.5 [95% CI \u22128.9 to \u22124.1] kg; Gxt, p &lt; 0.001). Fat mass was reduced in the vegan group (treatment effect \u22124.3 [95% CI \u22125.4 to \u22123.2] kg; Gxt, p &lt; 0.001). HOMA-IR was reduced significantly in the vegan group (treatment effect \u22121.0 [95% CI \u22121.2 to \u22120.8]; Gxt, p = 0.004). Changes in consumption of carbohydrate, as a percentage of energy, correlated negatively with changes in BMI (r = \u22120.53, p &lt; 0.001), fat mass (r = \u22120.55, p &lt; 0.001), volume of visceral fat (r = \u22120.35, p = 0.006), and HOMA (r = \u22120.27, p = 0.04). These associations remained significant after adjustment for energy intake. Changes in consumption of total and insoluble fiber correlated negatively with changes in BMI (r = \u22120.43, p &lt; 0.001; and r = \u22120.46, p &lt; 0.001, respectively), fat mass (r = \u22120.42, p &lt; 0.001; and r = \u22120.46, p &lt; 0.001, respectively), and volume of visceral fat (r = \u22120.29, p = 0.03; and r = \u22120.32, p = 0.01, respectively). The associations between total and insoluble fiber and changes in BMI and fat mass remained significant even after adjustment for energy intake. Increased carbohydrate and fiber intake, as part of a plant-based high-carbohydrate, low-fat diet, are associated with beneficial effects on weight, body composition, and insulin resistance.<\/jats:p>","DOI":"10.3390\/nu10091302","type":"journal-article","created":{"date-parts":[[2018,9,14]],"date-time":"2018-09-14T10:57:59Z","timestamp":1536922679000},"page":"1302","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":63,"title":["A Plant-Based High-Carbohydrate, Low-Fat Diet in Overweight Individuals in a 16-Week Randomized Clinical Trial: The Role of Carbohydrates"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0491-3993","authenticated-orcid":false,"given":"Hana","family":"Kahleova","sequence":"first","affiliation":[{"name":"Physicians Committee for Responsible Medicine, 5100 Wisconsin Ave, N.W. Ste.400, Washington, DC 20016, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Dort","sequence":"additional","affiliation":[{"name":"Physicians Committee for Responsible Medicine, 5100 Wisconsin Ave, N.W. Ste.400, Washington, DC 20016, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Holubkov","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Utah, Salt Lake City, UT 84132, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neal D.","family":"Barnard","sequence":"additional","affiliation":[{"name":"Physicians Committee for Responsible Medicine, 5100 Wisconsin Ave, N.W. Ste.400, Washington, DC 20016, USA"},{"name":"Adjunct Faculty, George Washington University School of Medicine and Health Sciences, Washington, DC 20016, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2018,9,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"NCD Risk Factor Collaboration (NCD-RisC) (2016). Trends in adult body-mass index in 200 countries from 1975 to 2014: A pooled analysis of 1698 population-based measurement studies with 19.2 million participants. Lancet, 387, 1377\u20131396.","DOI":"10.1016\/S0140-6736(16)30054-X"},{"key":"ref_2","unstructured":"GBD 2015 Risk Factors Collaborators (2016). Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990\u20132015: A systematic analysis for the Global Burden of Disease Study 2015. 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