Research paper
Ludwig DS, Ebbeling CB. The Carbohydrate-Insulin Model of Obesity: Beyond “Calories In, Calories Out.” JAMA Internal Medicine. 2018;178(8):1098-1103. doi:10.1001/jamainternmed.2018.2933
Why we cite it
This paper formalizes the carbohydrate-insulin model (CIM) as a comprehensive alternative to the “calories in, calories out” framework, integrating evidence from animal, genetic, behavioral, and feeding studies. It is cited by 11 live companion pages and 3 knowledge files (measured 2026-09-02, card 6NM98H) (7 references total). The unique contribution is the three-part rebuttal of common CIM objections (overeating causation, glucose levels in established obesity, lean high-carbohydrate populations) and the integration of bi-directional Mendelian Randomization evidence, which the authors read as favouring insulin secretion → BMI over the reverse (corrected 2026-09-10 from ”establishing causal directionality”: establish does not occur in the paper, which calls the method ”potentially free from confounding”).
DOI: 10.1001/jamainternmed.2018.2933 · PubMed 29971406 · Publisher