Effect of the once-daily human GLP-1 analogue liraglutide on appetite, energy intake, energy expenditure and gastric emptying in type 2 diabetes.

AIMS: Liraglutide reduces bodyweight in patients with type 2 diabetes mellitus (T2DM). This study aimed to investigate the mechanisms underlying this effect. METHODS: The comparative effects of liraglutide, glimepiride and placebo on energy intake, appetite, nausea, gastric emptying, antral distension, bodyweight, gastrointestinal hormones, fasting plasma glucose and resting energy expenditure (REE), were assessed in subjects with T2DM randomised to treatment A (liraglutide-placebo), B (placebo-glimepiride) or C (glimepiride-liraglutide). Assessments were performed at the end of each 4-week treatment period. RESULTS: Energy intake was less (NS) with liraglutide vs placebo and glimepiride, and 24-h REE was higher (NS) with liraglutide vs placebo and glimepiride. Fasting hunger was less (p=0.01) with liraglutide vs placebo and glimepiride, and meal duration was shorter with liraglutide (p=0.002) vs placebo. Paracetamol AUC(0-60 min) and C(max) were less (p<0.01) and fasting peptide YY was lower (p ≤ 0.001) after liraglutide vs placebo and glimepiride. Bodyweight reductions of 1.3 and 2.0 kg were observed with liraglutide vs placebo and glimepiride (p<0.001). There were no differences on antral distension, nausea, or other gastro-intestinal hormones. CONCLUSION: Liraglutide caused decreased gastric emptying and increased reduction in bodyweight. The mechanisms of the liraglutide-induced weight-loss may involve a combined effect on energy intake and energy expenditure.

Effects of PYY1-36 and PYY3-36 on appetite, energy intake, energy expenditure, glucose and fat metabolism in obese and lean subjects.

Peptide YY (PYY)(3-36) has been shown to produce dramatic reductions in energy intake (EI), but no human data exist regarding energy expenditure (EE), glucose and fat metabolism. Nothing is known regarding PYY1-36. To compare effects of PYY(1-36) and PYY(3-36) on appetite, EI, EE, insulin, glucose and free fatty acids (FFA) concentrations, 12 lean and 12 obese males participated in a blinded, randomized, crossover study with 90-min infusions of saline, 0.8 pmol x kg(-1) x min(-1) PYY(1-36) and PYY(3-36). Only four participants completed PYY(3-36) infusions because of nausea. Subsequently, six lean and eight obese participants completed 0.2 pmol x kg(-1) x min(-1) PYY(3-36) and 1.6 pmol x kg(-1) x min(-1) PYY(1-36) infusions. PYY(3-36) [corrected] produced [corrected] lower ratings of well-being and [corrected] increases in heart rate, [corrected] FFA, and [corrected] postprandial [corrected] insulin concentrations. Furthermore, high-dose [corrected] PYY(3-36) (0.8 [corrected] pmol x kg(-1) x min(-1)) produced decreased [corrected] EI and increased postprandial [corrected] glucose concentrations and tendency to reduced EE [corrected]

Effects of different dietary fat types on postprandial appetite and energy expenditure.

OBJECTIVE: Observational studies suggest that monounsaturated (MUFA) and trans fatty acids (TRANS) are more fattening than polyunsaturated fatty acids (PUFA). Therefore, the aim of this study was to investigate the acute effect of intake of PUFA, MUFA, or TRANS on appetite and energy expenditure (EE). RESEARCH METHODS AND PROCEDURES: Three test meals were randomly given in a cross-over design to 19 overweight (BMI: 26.8 +/- 0.4 kg/m2), young (25.2 +/- 0.7 years) men. The fat-rich breakfasts (0.8 g fat/kg body weight, 60% energy from fat) varied only in the source of C:18-fat. EE was measured continuously in a respiration chamber, and appetite sensations were rated by visual analog scales before and every 30 minutes, for 5 hours, after the meal. After 5 hours, an ad libitum meal was served, and energy intake was registered. Sensory evaluations of all meals were given using visual analog scales. Data were analyzed by two-way ANOVA. RESULTS: There were no differences in basal or postprandial values of appetite ratings and EE, in subsequent ad libitum energy intake, or in the sensory evaluation of the test meals among the 3 test days. DISCUSSION: Giving acutely large amounts of MUFA, PUFA, or TRANS did not impose any differences in appetite and EE in overweight humans. However, studies with extended protocols and other subject groups are warranted to investigate the long-term effect of dietary fat quality on the regulation of energy balance and body weight.

Meals with similar energy densities but rich in protein, fat, carbohydrate, or alcohol have different effects on energy expenditure and substrate metabolism but not on appetite and energy intake.

BACKGROUND: It has been suggested that the satiating power of the 4 macronutrients follows the oxidation hierarchy: alcohol > protein > carbohydrate > fat. However, the experimental evidence for this is still scarce. OBJECTIVE: The goal was to investigate the effects on appetite, energy intake and expenditure, and substrate metabolism of meals rich in 1 of the 4 macronutrients. DESIGN: Subjective appetite sensations, ad libitum food intake, energy expenditure, substrate metabolism, and hormone concentrations were measured for 5 h after breakfast meals with similar energy density and fiber contents but rich in either protein (32% of energy), carbohydrate (65% of energy), fat (65% of energy), or alcohol (23% of energy). Subjects were normal-weight, healthy women (n = 9) and men (n = 10) studied in a crossover design. RESULTS: There were no significant differences in hunger or satiety sensations or in ad libitum energy intake after the 4 meals. Diet-induced thermogenesis was larger after the alcohol meal (by 27%; P < 0.01), whereas protein produced an intermediary response (17%; NS) compared with carbohydrate and fat (meal effect: P < 0.01). After the alcohol meal, fat oxidation and leptin concentrations were greatly suppressed (meal effects, P < 0.0001 and P < 0.05) and triacylglycerol concentrations were as high as after the fat meal. CONCLUSION: Intake of an alcohol-rich meal stimulates energy expenditure but suppresses fat oxidation and leptin more than do isoenergetically dense meals rich in protein, carbohydrate, or fat. Despite differences in substrate metabolism and hormone concentrations, satiety and ad libitum energy intake were not significantly different between meals. Our data, therefore, do not support the proposed relation between the macronutrient oxidation hierarchy and the satiety hierarchy.

Effect of 3 modified fats and a conventional fat on appetite, energy intake, energy expenditure, and substrate oxidation in healthy men.

BACKGROUND: Different dietary fats are metabolized differently in humans and may influence energy expenditure, substrate oxidation, appetite regulation, and body weight regulation. OBJECTIVE: We examined the short-term effects of 4 triacylglycerols (test fats) on subjective appetite, ad libitum energy intake, meal-induced thermogenesis, and postprandial substrate oxidation. DESIGN: Eleven healthy, normal-weight men (mean age: 25.1 +/- 0.5 y) consumed 4 different test fats [conventional fat (rapeseed oil) and 3 modified fats (lipase-structured fat, chemically structured fat, and physically mixed fat)] in a randomized, double-blind, crossover design. RESULTS: No significant differences in appetite sensations or ad libitum energy intakes were observed between the 4 test fats. Overall, the 4 fats exerted different effects on energy expenditure (meal effect: P < 0.01) and substrate oxidation (interaction between meal and time: P < 0.05). In post hoc tests, the 3 modified fats resulted in significantly higher postprandial energy expenditure and fat oxidation than did the conventional fat (P < 0.008, Bonferroni adjusted); no significant differences were observed between the 3 modified fats. CONCLUSIONS: Structured fats do not change short-term postprandial appetite sensations or ad libitum energy intakes but do result in higher postprandial energy expenditure and fat oxidation than do conventional fats and hence promote negative energy and fat balance. In humans, a physically mixed fat (trioctanoate + rapeseed oil) is metabolized as quickly as are structured fats. The position of medium-chain fatty acids on the glycerol backbone of triacylglycerols does not seem to affect energy expenditure or appetite.