Thanks for the comments George. Was not aware Naude et al had been re-assessed by Harcombe & Noakes. I’m not a massive fan of meta-analysis studies as the heterogeneity within the studies included is often context specific and making definitive conclusions is therefore problematic.

Whilst I do not doubt your observations with the people you work with who are suffering from alcoholism, I would like to see such reported alcohol energy intakes scrutinised under study conditions where these intakes can be corroborated. As you would know, research has shown that self-reported food/drink consumption by those overweight or obese is grossly underestimated. I wonder in the same way if the reported caloric intakes reflect actual intakes or guesstimations from those suffering from alcohol abuse. It would certainly be challenging trying to get accurate data from self-reports if those that are highly intoxicated given the accompanying cognitive and memory deficits.

Most of the data I have reviewed shows that in general, insulin secretion decreases with concomitant weight/fat loss irrespective of dietary composition notwithstanding that a greater reduction is seen for low carb diets. Whilst I agree with you that all components of the diet influence this change, other lifestyle-related components also coalesce to have an impact; exercise, for example, has a prominient reducing effect whilst sedentarism or prolonged sitting tends to contribute to an increase (http://fitgreystrong.com/sitting-yourself-to-death/) independently of diet. I would also be interested to see if insulin elevation can accompany loss of fat mass. That would perhaps require, an intervention where a weight maintenance very-low carb diet phase (that aims to maximally decrease insulin at weight maintenance calories) is followed by an energy deficit higher carb diet (with physical activity and sedentary behaviour equally matched). I would also like to see an isoenergetic overfeeding study that compares protein-matched, very high-fat diet to a very high carb (also high in refined sugar) to ascertain if fat mass gain is independent of insulin production. My prediction is that insulin production would be different but fat mass gain would be the same. The other interesting aspect of this would be to see if such overfeeding affected the worsening of metabolic risk factors differentially i.e overfeeding fat is better than carb.