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Amalie R Lanng Center for Clinical Metabolic Research, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark

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Lærke S Gasbjerg Center for Clinical Metabolic Research, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

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Natasha C Bergmann Center for Clinical Metabolic Research, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark

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Sigrid Bergmann Center for Clinical Metabolic Research, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark

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Mads M Helsted Center for Clinical Metabolic Research, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark

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Matthew P Gillum Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

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Bolette Hartmann Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

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Jens J Holst Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

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Tina Vilsbøll Center for Clinical Metabolic Research, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
Steno Diabetes Center Copenhagen, Gentofte, Denmark
Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

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Filip K Knop Center for Clinical Metabolic Research, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
Steno Diabetes Center Copenhagen, Gentofte, Denmark
Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

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important role in the regulation of plasma glucose concentrations. In humans, FGF21 is mainly secreted from the liver in response to fructose ( 16 ), high-carbohydrate diet ( 17 ) and oral alcohol ingestion ( 13 , 14 ). It is not known how alcohol mediates

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Benjamin G Challis Metabolic Research Laboratories, Wellcome Trust-MRC Institute of Metabolic Science, University of Cambridge and National Institute for Health Research Cambridge Biomedical Research Centre, Addenbrooke’s Hospital, Cambridge, UK
Wolfson Diabetes and Endocrine Centre, Addenbrooke’s Hospital, Cambridge, UK
IMED Biotech Unit, Clinical Discovery Unit, AstraZeneca, UK

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Andrew S Powlson Metabolic Research Laboratories, Wellcome Trust-MRC Institute of Metabolic Science, University of Cambridge and National Institute for Health Research Cambridge Biomedical Research Centre, Addenbrooke’s Hospital, Cambridge, UK
Wolfson Diabetes and Endocrine Centre, Addenbrooke’s Hospital, Cambridge, UK

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Ruth T Casey Wolfson Diabetes and Endocrine Centre, Addenbrooke’s Hospital, Cambridge, UK

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Carla Pearson Wolfson Diabetes and Endocrine Centre, Addenbrooke’s Hospital, Cambridge, UK

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Brian Y Lam Metabolic Research Laboratories, Wellcome Trust-MRC Institute of Metabolic Science, University of Cambridge and National Institute for Health Research Cambridge Biomedical Research Centre, Addenbrooke’s Hospital, Cambridge, UK

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Marcella Ma Metabolic Research Laboratories, Wellcome Trust-MRC Institute of Metabolic Science, University of Cambridge and National Institute for Health Research Cambridge Biomedical Research Centre, Addenbrooke’s Hospital, Cambridge, UK

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Deborah Pitfield Wolfson Diabetes and Endocrine Centre, Addenbrooke’s Hospital, Cambridge, UK

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Giles S H Yeo Metabolic Research Laboratories, Wellcome Trust-MRC Institute of Metabolic Science, University of Cambridge and National Institute for Health Research Cambridge Biomedical Research Centre, Addenbrooke’s Hospital, Cambridge, UK

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Edmund Godfrey Department of Radiology, Addenbrooke’s Hospital, Cambridge, UK

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Heok K Cheow Department of Radiology, Addenbrooke’s Hospital, Cambridge, UK
Department of Nuclear Medicine, Addenbrooke’s Hospital, Cambridge, UK

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V Krishna Chatterjee Metabolic Research Laboratories, Wellcome Trust-MRC Institute of Metabolic Science, University of Cambridge and National Institute for Health Research Cambridge Biomedical Research Centre, Addenbrooke’s Hospital, Cambridge, UK
Wolfson Diabetes and Endocrine Centre, Addenbrooke’s Hospital, Cambridge, UK

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Nicholas R Carroll Department of Radiology, Addenbrooke’s Hospital, Cambridge, UK

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Ashley Shaw Department of Radiology, Addenbrooke’s Hospital, Cambridge, UK

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John R Buscombe Department of Radiology, Addenbrooke’s Hospital, Cambridge, UK
Department of Nuclear Medicine, Addenbrooke’s Hospital, Cambridge, UK

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Helen L Simpson Department of Diabetes and Endocrinology, UCLH NHS Foundation Trust, London, UK

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realised with supplementary carbohydrates alone. Refractory hypoglycaemia may be successfully treated with adjunctive therapeutics including diazoxide, somatostatin analogues or mammalian target of rapamycin (mTOR) inhibitors ( 4 , 5 ). Although these

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Liza Haqq School of Science and Technology, University of New England, Armidale, New South Wales 2351, Australia

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James McFarlane School of Science and Technology, University of New England, Armidale, New South Wales 2351, Australia

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Gudrun Dieberg School of Science and Technology, University of New England, Armidale, New South Wales 2351, Australia

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Neil Smart School of Science and Technology, University of New England, Armidale, New South Wales 2351, Australia

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-selected pace No active intervention Totally 30 min/session, 3 days/week Curi (18) , Brazil To reduce daily intake by 500 kcal Carbohydrate, 50%; fat, 30% and protein, 20% 30 min walk, three self-weight resistance exercises (squats, sit-ups, push-ups and

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Michelle J Galvan Metabolic, Nutrition, and Exercise Research (MiNER) Laboratory, Department of Kinesiology, University of Texas at El Paso, El Paso, Texas, USA

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Michael J Sanchez Metabolic, Nutrition, and Exercise Research (MiNER) Laboratory, Department of Kinesiology, University of Texas at El Paso, El Paso, Texas, USA

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Andrew J McAinch Institute for Health and Sport (IHES), Victoria University, Melbourne, Victoria, Australia
Australian Institute for Musculoskeletal Science (AIMSS), Victoria University, Melbourne, Victoria, Australia

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Jeffrey D Covington Department of Pathology, University of Massachusetts Medical School, Worcester, Massachusetts, USA

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Jason B Boyle Metabolic, Nutrition, and Exercise Research (MiNER) Laboratory, Department of Kinesiology, University of Texas at El Paso, El Paso, Texas, USA

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Sudip Bajpeyi Metabolic, Nutrition, and Exercise Research (MiNER) Laboratory, Department of Kinesiology, University of Texas at El Paso, El Paso, Texas, USA

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. Figure 1 Study design. B, baseline testing; CHO, carbohydrate; D, day; DXA, dual-energy X-ray absorptiometry; Lac, blood lactate level; NMES, neuromuscular electrical stimulation; P, post-testing; S, screening; SD, standard diet. * Less than 24–36 h

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Taísa A R Vicente
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Ívina E S Rocha
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Roberto Salvatori Division of Endocrinology, Division of Endocrinology, National Research Council, Federal University of Sergipe, Aracaju, Sergipe 49060-100, Brazil

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Carla R P Oliveira
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Rossana M C Pereira
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Anita H O Souza
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Viviane C Campos
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Elenilde G Santos
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Rachel D C Araújo Diniz
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Eugênia H O Valença
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Carlos C Epitácio-Pereira
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Mario C P Oliveira
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Andrea Mari Division of Endocrinology, Division of Endocrinology, National Research Council, Federal University of Sergipe, Aracaju, Sergipe 49060-100, Brazil

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Manuel H Aguiar-Oliveira
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161 837 – 844 . ( doi:10.1530/EJE-09-0419 ). 7 Laron Z Avitzur Y Klinger B . Carbohydrate metabolism in primary growth hormone resistance (Laron syndrome) before and during insulin-like growth factor-I treatment . Metabolism 1995 44

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Srdjan Pandurevic Division of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy

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Ilaria Mancini Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy
Unit of Gynecology and Obstetrics, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Italy

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Dimitri Mitselman Division of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy

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Matteo Magagnoli Division of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy

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Rita Teglia Division of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy

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Roberta Fazzeri Division of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy

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Paola Dionese Division of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy

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Carolina Cecchetti Division of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy

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Massimiliamo Caprio Department of Human Sciences and Quality of Life Promotion, San Raffaele Roma Open University, Rome, Italy
Laboratory of Cardiovascular Endocrinology, IRCCS San Raffaele, Rome, Italy

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Costanzo Moretti Department of Systems Medicine, Unit of Endocrinology, University of Rome Tor Vergata, Rome, Italy

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Justyna Sicinska Dermatology Clinic of CSK MSWiA Hospital, Warsaw, Poland

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Alessandro Agostini Department of Experimental, Diagnostic, and Specialty Medicine, University of Bologna, Bologna, Italy

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Domenica Gazineo Teaching Hospital, S. Orsola Hospital, Bologna, Italy

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Lea Godino Teaching Hospital, S. Orsola Hospital, Bologna, Italy

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Ignacio Sajoux Epigenomics in Endocrinology and Nutrition Group, Instituto de Investigacion Sanitaria (IDIS), Complejo Hospitalario Universitario de Santiago (CHUS/SERGAS), Spain
Medical Department Pronokal Group, Barcelona, Spain

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Flaminia Fanelli Division of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy

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Cristina M Meriggiola Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy
Unit of Gynecology and Obstetrics, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Italy

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Uberto Pagotto Division of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy

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Alessandra Gambineri Division of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy

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phase consisted of three steps of 600–800 kcal/day with high-biological-value protein preparations obtained from cow’s milk, soy, eggs, green peas, and cereals, <50 g daily of carbohydrates from vegetables, and 10 g of olive oil per day. In step 1, which

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Angelica Amorim Amato Department of Pharmaceutical Sciences, University of Brasilia, Brasilia, Brazil
Department of Developmental and Cell Biology, University of California, Irvine, California, USA

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Hailey Brit Wheeler Department of Developmental and Cell Biology, University of California, Irvine, California, USA

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Bruce Blumberg Department of Developmental and Cell Biology, University of California, Irvine, California, USA
Department of Pharmaceutical Sciences, University of California, Irvine, California, USA
Department of Biomedical Engineering, University of California, Irvine, California, USA

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consumed seems to be more important than the total number of calories. Recent studies reported that the glycemic load of carbohydrate calories consumed (high vs low glycemic load) was a more important predictor of weight gain than was the total number of

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L Bahler Internal Medicine, Academic Medical Center, Amsterdam, The Netherlands

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H J Verberne Nuclear Medicine, Academic Medical Center, Amsterdam, The Netherlands

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E Brakema Internal Medicine, Academic Medical Center, Amsterdam, The Netherlands

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R Tepaske Intensive Care Medicine, Academic Medical Center, Amsterdam, The Netherlands

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J Booij Nuclear Medicine, Academic Medical Center, Amsterdam, The Netherlands

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J B Hoekstra Internal Medicine, Academic Medical Center, Amsterdam, The Netherlands

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F Holleman Internal Medicine, Academic Medical Center, Amsterdam, The Netherlands

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results of the OGTT ( 24 ). Furthermore, carbohydrate intake preceding the OGTT might also influence the results of the OGTT ( 25 ). This study has several limitations. Due to the relative small sample size, external influences have a relatively large

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Alice S Ryan VA Maryland Health Care System, Division of Endocrinology, Research Service, Division of Gerontology and Geriatric Medicine, Department of Medicine, Baltimore Veterans Affairs Medical Center, 10 North Greene Street GRECC (BT/18/GR), Baltimore, Maryland 21201, USA

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John C McLenithan VA Maryland Health Care System, Division of Endocrinology, Research Service, Division of Gerontology and Geriatric Medicine, Department of Medicine, Baltimore Veterans Affairs Medical Center, 10 North Greene Street GRECC (BT/18/GR), Baltimore, Maryland 21201, USA

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Gretchen M Zietowski VA Maryland Health Care System, Division of Endocrinology, Research Service, Division of Gerontology and Geriatric Medicine, Department of Medicine, Baltimore Veterans Affairs Medical Center, 10 North Greene Street GRECC (BT/18/GR), Baltimore, Maryland 21201, USA

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-thigh was used to quantify muscle area, total fat area, and low-density lean tissue of the thigh (11) . Metabolic testing To control intake of nutrient before the metabolic studies, all subjects were provided with a eucaloric diet (50–55% carbohydrate, 15

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Julia Otten Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden

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Andreas Stomby Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
Region Jönköping County, Jönköping, Sweden

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Maria Waling Department of Food, Nutrition and Culinary Science, Umeå University, Umeå, Sweden

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Elin Chorell Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden

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Mats Ryberg Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden

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Michael Svensson Department of Community Medicine and Rehabilitation, Section for Sports Medicine, Umeå University, Umeå Sweden

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Jens Juul Holst NNF Center for Basic Metabolic Research and Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark

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Tommy Olsson Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden

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included 70 g turkey, one boiled egg (ca 50 g), one banana (ca 105 g), half an apple with peel (ca 30 g), and cashew nuts without salt (25 g). The meal contained 419 kcal with 34%E carbohydrates, 41%E fat, and 25%E protein. Of the total protein content of

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