A Diet with Carbohydrates Eaten Primarily at Dinner: An Innovative, Nutritional Approach to End the Vicious Cycle of Abdominal Obesity

Sustained weight reduction is needed in order to end the "vicious cycle" of abdominal obesity-a known risk factor for diabetes and coronary heart disease. However, most obese subjects fail to maintain long-term diets; they regain lost body weight and develop metabolic syndrome. Adipose tissue itself contributes to weight cycling and metabolic pathology, since it functions as an endocrine organ. Fat cells synthesize and secrete adipocytokines that regulate hunger and satiety, as well as adipocytokines that impact insulin resistance, the metabolic syndrome, and inflammation. The idea to study the effect of a low-calorie diet with carbohydrates eaten primarily at dinner came about after analyzing results from research in Muslim populations during Ramadan. For the month of Ramadan, Muslims fast during the day and consume a carbohydrate-rich meal after sundown. This dramatically modifies the diurnal pattern of leptin secretion. Our experimental diet improved the diurnal secretion patterns of the "satiety hormone," leptin, the "hunger hormone," ghrelin, and adiponectin-"the link between abdominal obesity, insulin resistance and the metabolic syndrome." Lower hunger scores and greater improvements in anthropometric, biochemical, and inflammatory parameters were observed compared to controls. We believe that this novel nutritional approach should be considered as a first line of treatment, prior to pharmaceutical or surgical interventions.