Effects of meals on objective and subjective measures of daytime sleepiness.

Effects of recent food ingestion on daytime sleepiness were assessed in 16 subjects (8 men and 8 women) who were each studied on two occasions, 28 days apart. On each occasion, subjects ate a high-fat low-carbohydrate (CHO) (fat/CHO energy ratio 54:41) meal and an isoenergetic low-fat high-CHO meal (fat/CHO energy ratio 7:88) 4 h apart in a counterbalanced order. Sleepiness was measured at 2-hr intervals by using the Multiple Sleep Latency Test and the Akerstedt electroencephalograph sleepiness test. To control for circadian factors, one group (4 men, 4 women) ate the meals 2 h later than did the other group of subjects. There were no differences in sleepiness according to the composition of the meal. Sleepiness in the Multiple Sleep Latency Test was significantly greater 1.5 h after the meals were eaten than before (F 11.37; df 1,15; P = 0.004). Sleepiness was also enhanced in the Akerstedt sleepiness test 3 h 20 min after the meals. The results suggest that the meals induced an enhancement in sleepiness that was not solely due to circadian rhythms.

Influences of fat, energy, and time of day on mood and performance.

Paired studies testing the effects of lower energy high-fat, low-CHO meals (3181 kJ, fat:CHO energy ratio 54:41) and higher energy low-fat, high-CHO meals (3599 kJ, fat:CHO energy ratio 7:88) were conducted in 18 healthy males. The meals were eaten at 1030 h by group A (nine subjects) and 1230 h by group B (nine subjects). Subjective lassitude increased following ingestion of all four meals, but there was little change in performance. In addition, group A, but not group B, felt significantly less vigorous, imaginative, and antagonistic, and significantly more dreamy, feeble, and fatigued after the lower energy high-fat, low-CHO meal than after the higher energy low-fat, high-CHO meal. These results suggest that in the morning, fat exerts a greater depression on alertness and mood than carbohydrate irrespective of a reduction in energy content, but this effect varies according to the time at which food is eaten, and is less evident at lunch time.

The influence of food on pain perception in healthy human volunteers.

The aim of this study was to investigate if food could reduce pain perception in a group of 16 healthy human volunteers (8 male and 8 female), and to explore the differential effects of macronutrient composition on the response to cold-induced pain. All subjects underwent the cold pressor test (CPT) on 3 occasions in a counterbalanced order, before and after administration of isoenergetic high-fat low-carbohydrate (CHO) and high-CHO low-fat meals, and when no meal was given. The CPT was carried out 4 times on each test day, once before the meal, and 0.5, 1.5, and 2.5 h after the meal, and at the equivalent times on the day when no food was given. Radial pulse and blood pressure measurements and visual analogue scales of mood/emotional state were carried out before and after each CPT. Mean pain scores were significantly reduced following both meals compared with the no-food condition. The maximum reduction in pain occurred 1.5 h after ingestion, and a significantly greater effect was exerted by the high-fat low-CHO meal compared with the high-CHO low-fat meal. These results demonstrate that food, particularly when rich in fat, significantly reduces the pain induced by the cold pressor stimulus in healthy human subjects.

Influences of fat and carbohydrate on postprandial sleepiness, mood, and hormones.

Paired studies were conducted in 18 healthy volunteers (9 men, 9 women) to investigate whether differences in mood and daytime sleepiness induced by high-fat-low-carbohydrate (CHO) and low-fat-high-CHO morning meals were associated with specific hormonal responses. Plasma insulin concentrations were significantly higher after low-fat-high-CHO meals, and cholecystokinin (CCK) concentrations were significantly higher after high-fat-low-CHO meals. Subjects tended to feel more sleepy and less awake 2-3 h after the high-fat-low-CHO meal, and ratings of fatigue were significantly greater 3 h after the high-fat-low-CHO meal than after the low-fat-high-CHO meal. The results of the present study are consistent with the hypothesis that there is an association between the lassitude experienced after a meal and the release of CCK.

Effects of carbohydrate and lipid on resting energy expenditure, heart rate, sleepiness, and mood.

The effects of gastric infusions of fat and carbohydrate on physiological and psychological measures were compared using a within subject design in 9 healthy subjects (6 males). Each subject received isovolaemic rapid gastric infusions of sucrose solution (100% energy carbohydrate), lipid emulsion (100% energy fat, 20% Intralipid), and a non-nutrient control (0.9% saline) in a randomised order. Nutrient infusions were isoenergetic, containing one-third of an individual subject's estimated daily energy requirements (mean, 3227 kJ; range, 2479-3971 kJ). Measures of heart rate (HR), energy expenditure (EE), mood, and sleepiness were collected before the infusions and every 0.5 h for 3.5 h. Mean postingestive HR, EE, and satiation were significantly greater after the nutrient infusions than after the control. Sucrose induced a rapid increase in HR and EE, whereas lipid had a lesser and more delayed effect. Thirty minutes after the gastric infusions, HR and EE were significantly higher after the sucrose than after the lipid and saline. Hedonic tone was greater and tension lower after the saline and sucrose infusions than after the lipid infusion. From 3 to 3.5 h after ingestion, subjects felt significantly more sleepy after the lipid infusion than they did at these times after the saline infusion, and significantly more dreamy after the lipid infusion than they did after the sucrose infusion. In conclusion, the presence of lipid and sucrose in the intestine induces significant and differing physiological and psychological effects, which are independent of cognitive and orosensory influences.

Effects of a specific CCK-A antagonist, Loxiglumide, on postprandial mood and sleepiness.

Previous studies have demonstrated that feelings of sleepiness increase after ingestion of a fat-rich meal. The aim of the study was to test the hypothesis that postprandial sleepiness is mediated by cholecystokinin (CCK) acting on CCK-A receptors. A double-blind crossover study was conducted. Twelve male volunteers ate a high-fat morning meal [54% energy fat, 41% energy carbohydrate (CHO)]. On one day they received an i.v. infusion of Loxiglumide, a CCK-A receptor antagonist (30 mg/kg/h for 10 min then 10 mg/kg/h for 3 h 10 min). On another day the protocol was repeated except a saline placebo infusion was given at similar rates as the Loxiglumide, starting 20 min before the meal. Subjects' mood and sleepiness were monitored throughout using questionnaires and performance tasks. The results indicate that ratings of vigour were significantly lower during the Loxiglumide infusion than during the saline infusion, [F(1,10) = 6.65; p = 0.027]. Subjects who were infused with Loxiglumide on their first test day felt significantly (p < 0.05) more fatigued, sleepy and tense and less vigorous, less efficient and had lower energetic arousal during the Loxiglumide infusion than during the saline infusion. In conclusion, the results suggest that the postprandial decline in feelings of alertness after a fat-rich meal is not mediated solely by CCK acting through CCK-A receptors.

Influences of dietary and intraduodenal lipid on alertness, mood, and sustained concentration.

The effects of intraduodenal and dietary lipid on alertness, mood and performance in a task requiring sustained attention were investigated in two studies. The first experiment compared the effect of duodenal infusion of either 100 g/l Intralipid (8.36 kJ/min) or isotonic saline (9 g NaCl/l) in paired studies carried out on two non-consecutive days on five male volunteers. Two consecutive 3 h infusions, one of lipid, the other saline, were given blind on each day using a crossover design. Analysis of variance indicated that lipid significantly reduced alertness (P < 0.05) and affected the speed and accuracy of performance in a sustained attention task (P < 0.05). A second experiment compared the effects on eight male volunteers of two isoenergetic lunches of similar appearance, taste and protein content but differing fat and carbohydrate (CHO) contents (fat energy:CHO, 64:18 v. 7:76). Alertness was lower (P < 0.05) and responses to stimuli in a sustained attention task were slower after the high-fat meal than after the low-fat meal (P < 0.05). In conclusion, infusion of lipid into the small intestine, and the substitution of fat for carbohydrate while keeping energy and protein constant in a lunch, both cause an enhanced postprandial decline in alertness and concentration. This may be related to the presence of lipid in the small intestine.

Alterations in mood after changing to a low-fat diet.

The effects on mood of reducing dietary fat while keeping the energy constant were examined in ten male and ten female healthy volunteers aged between 20 and 37 years. Each volunteer consumed a diet containing 41% energy as fat for 1 month. For the second month half of the subjects changed to a low-fat diet (25% energy from fat) and the remainder continued to eat the diet containing 41% energy from fat. Changes in mood and blood lipid concentrations were assessed before, during and at the end of the study. Profile of mood states (POMS) ratings of anger-hostility significantly increased in the intervention group after 1 month on the low-fat diet, while during the same period there was a slight decline in anger-hostility in the control subjects (group F 6.72; df 1.14; P = 0.021). Tension-anxiety ratings declined in the control group consuming the higher fat diet but did not change in the group consuming the low-fat diet (group F 6.34; df 1.14; P = 0.025). There was a decline in fasting concentrations of HDL-cholesterol after the low-fat diet and a small increase in subjects consuming the medium-fat diet (group F 4.96; df 1.12; P = 0.046), but no significant changes in concentrations of total serum cholesterol, LDL-cholesterol or triacylglycerol were observed. The results suggest that a change in dietary fat content from 41 to 25% energy may have adverse effects on mood. The alterations in mood appear to be unrelated to changes in fasting plasma cholesterol concentrations.