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Caloric restriction improves glycemic control via the adiponectin-ceramide axis in non-obese men and women: the CALERIE™ 2 randomized controlled trial.

Nature communications2026-07-10PubMed
Total: 85.5Rigor: 9Innovation: 9Journal: 9Clinical: 6

Summary

In a 24-month randomized trial in non-obese adults, caloric restriction improved glycemic control and implicated the adiponectin–ceramide axis as a key mediator. Findings suggest that changes in adiponectin and bioactive ceramides track metabolic benefits of CR in humans.

Key Findings

  • Caloric restriction over 24 months improved glycemic control in non-obese adults.
  • The adiponectin–ceramide axis emerged as a mechanistic mediator of CR’s metabolic benefits.
  • Trial registration NCT00427193; non-blinded design with biomarker profiling.

Clinical Implications

Supports mechanistically informed lifestyle counseling by highlighting adiponectin–ceramide signaling as a potential biomarker axis to monitor or target during caloric restriction interventions.

Why It Matters

Provides human RCT evidence linking a defined lipid-hormonal axis to the metabolic benefits of caloric restriction, advancing mechanistic understanding with translational potential.

Limitations

  • Non-blinded design may introduce behavioral and ascertainment biases.
  • Generalizability may be limited to non-obese adults engaged in a structured CR program.

Future Directions

Validate the adiponectin–ceramide axis as a monitoring biomarker and explore pharmacologic modulation of ceramide metabolism to mimic CR benefits.

Study Information

Study Type
RCT
Research Domain
Pathophysiology
Evidence Level
I - Randomized controlled trial with extended follow-up providing high internal validity.
Study Design
OTHER