Amino Acid Nitrogen Isotope Ratios Respond to Fish and Meat Intake in a 12-Week Inpatient Feeding Study of Men.

BACKGROUND: The natural abundance nitrogen stable isotope ratio (NIR) of whole tissue correlates with animal protein intakes, including meat and fish. Amino acid (AA) NIRs (NIRAAs) are more variable than the whole-tissue NIRs and may thus better differentiate among foods. OBJECTIVES: We evaluated whether NIRAAs were associated with intakes of fish and meat and whether these dietary associations were larger than with whole-tissue NIRs. METHODS: Men were recruited at the National Institute of Diabetes and Digestive and Kidney Diseases in Phoenix, Arizona, and randomly assigned to one of eight 12-wk inpatient dietary interventions, which varied the presence/absence of fish, meat, and sugar-sweetened beverages (SSBs) in all possible combinations. Fasting blood was drawn pre- and postintervention and plasma and RBC NIRAAs (free and protein-bound) were measured as secondary outcomes in 32 participants. Multivariable regression was used to determine responses of postintervention NIRAAs to dietary variables, and logistic regression was used to calculate receiver operating characteristic AUCs. RESULTS: Most plasma NIRAAs increased with fish and meat intakes, but to a greater extent with fish intake. The largest increase in response to fish intake was plasma NIRLeucine (ß = 2.19, SE = 0.26). The NIRThreonine decreased with both fish and meat intakes. Fewer RBC NIRAAs increased with fish intake, and only RBC NIRProline increased with meat intake. No plasma or RBC NIRAA responded to SSB intake. We identified fish intake with a high degree of accuracy using plasma NIRLeucine (corrected AUC, cAUC = 0.96) and NIRGlutamic acid/glutamine (cAUC = 0.93), and meat intake to a lower degree using plasma NIRProline (cAUC = 0.80) and RBC NIRProline (cAUC = 0.85). CONCLUSIONS: Plasma and RBC NIRAAs were associated with fish and meat intakes but were not superior to whole-tissue stable isotope biomarkers in identifying these intakes in a US diet. This trial is registered at www.clinicaltrials.gov as NCT01237093.

Short-term isocaloric manipulation of carbohydrate intake: effect on subsequent ad libitum energy intake.

BACKGROUND: Isocaloric manipulation of carbohydrate or fat intake could alter subsequent ad libitum food intake. METHODS: In a controlled inpatient study, we investigated whether isocaloric manipulation of carbohydrate or fat would alter subsequent ad libitum energy intake. Eighteen non-diabetic subjects (age range 19-53 years.; 15 M/3F; % body fat 38.5 ± 9.1 (mean ± SD)) were fed for 3 days an isocaloric high-carbohydrate diet (HC; 60% carbohydrate, 20% fat, 20% protein) and a high-fat diet (HF; 50% fat, 30% carbohydrate, 20% protein) in random order each followed by 3 days of ad libitum food intake. RESULTS: There were no differences in mean daily energy intake (EI) following each diet (HC vs. HF: 4,811 ± 1,190 vs. 4,823 ± 1,238 kcal/d; P = 0.7) or in the percent of weight maintenance energy needs (%EN-WM; 173 ± 41 vs. 173 ± 46%, P = 0.5). However, the individual difference in EI between the HF versus HC diet (ΔEI) both on day one and over the 3 days of each ad libitum period was negatively associated with % body fat (%BF) and waist circumference (day 1: ΔEI vs. %BF, r = -0.49, P = 0.04; mean day 1-3 kcal ΔEI vs. %BF, r = -0.66, P = 0.003, and ΔEI vs. waist, r = -0.65, P = 0.004). CONCLUSIONS: A short-term isocaloric HC diet did not result in overall lower EI compared with a HF diet in the same individuals. However, we did find that increasing body fat was associated with less decline in EI following the HC versus HF diet indicating that increasing adiposity is associated with altered regulation of EI in response to macronutrient changes.

Associations of plasma, RBCs, and hair carbon and nitrogen isotope ratios with fish, meat, and sugar-sweetened beverage intake in a 12-wk inpatient feeding study.

BACKGROUND: Naturally occurring carbon and nitrogen stable isotope ratios [13C/12C (CIR) and 15N/14N (NIR)] are promising dietary biomarkers. As these candidate biomarkers have long tissue residence times, long-term feeding studies are needed for their evaluation. OBJECTIVE: Our aim was to evaluate plasma, RBCs, and hair CIR and NIR as biomarkers of fish, meat, and sugar-sweetened beverage (SSB) intake in a 12-wk dietary intervention. METHODS: Thirty-two men (aged 46.2 ± 10.5 y; BMI: 27.2 ± 4.0 kg/m2) underwent a 12-wk inpatient dietary intervention at the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) in Phoenix, Arizona. The effects of fish, meat, and SSB intake on CIR and NIR were evaluated using a balanced factorial design, with each intake factor at 2 levels (present/absent) in a common, background diet (50% carbohydrate, 30% fat, 20% protein). Fasting blood samples were taken biweekly from baseline, and hair samples were collected at baseline and postintervention. Data were analyzed using multivariable regression. RESULTS: The postintervention CIR of plasma was elevated when diets included meat (ß = 0.89, 95% CI: 0.73,1.05) and SSBs (ß = 0.48, 95% CI: 0.32, 0.64). The postintervention NIR of plasma was elevated when diets included fish (ß = 0.85, 95% CI: 0.64, 1.05) and meat (ß = 0.61, 95% CI: 0.42, 0.8). Results were similar for RBCs and hair. Postintervention RBC CIR and NIR had strong associations with baseline, suggesting that turnover to the intervention diets was incomplete after 12 wk. Estimates of isotopic turnover rate further confirmed incomplete turnover of RBCs. CONCLUSIONS: CIR was associated with meat and SSBs, and more strongly with meat. NIR was associated with fish and meat, and more strongly with fish. Overall, CIR and NIR discriminated between dietary fish and meat, and to a lesser extent SSBs, indicating their potential utility as biomarkers of intake in US diets. Approaches to make these biomarkers more specific are needed. This trial was registered at clinicaltrials.gov as NCT01237093.

The 24-h carbohydrate oxidation rate in a human respiratory chamber predicts ad libitum food intake.

BACKGROUND: The 24-h respiratory quotient (24-h RQ) and 24-h carbohydrate balance (24-h CHO-Bal) are predictors of weight change. Whether these relations are mediated by the effects of substrate oxidation and balance on food intake is not known. OBJECTIVE: We tested whether substrate oxidation and balance predict future ad libitum food intake. DESIGN: Substrate oxidation and balance were measured in a respiratory chamber in 112 normoglycemic subjects (83 Pima Indians and 29 whites; 67 men and 45 women) in energy balance for 3 d before tests were performed. The subjects then self-selected their food ad libitum for the following 3 d. RESULTS: The 24-h RQ, 24-h carbohydrate oxidation (24-h CHO-Ox), and 24-h CHO-Bal in the respiratory chamber predicted subsequent ad libitum food intake over 3 d (as a percentage of weight maintenance energy needs; %EN-WM). The 24-h CHO-Ox explained 15% of the variance in %EN-WM. The weight change over the 3-d ad libitum period was associated positively with 24-h CHO-Ox and negatively with 24-h CHO-Bal in the chamber; these associations were no longer significant after adjustment for %EN-WM. CONCLUSION: Carbohydrate oxidation and balance predict subsequent ad libitum food intake and can influence short-term weight changes, which indicates that carbohydrate balance is a contributing metabolic factor affecting food intake.

Lack of relationship between calcium intake and body size in an obesity-prone population.

OBJECTIVE: Dietary calcium intake, especially from dairy products, may have a protective effect against obesity. This study aimed to determine if calcium intake is associated with body weight and adiposity in Pima Indians, an obesity-prone population. RESEARCH METHODS AND PROCEDURES: Subjects were 65 Pima Indian adults (35 men/30 women, age 33+/-8 years [mean+/-standard deviation]) participating in a study of eating behavior and 78 Pima Indian children (36 boys/42 girls, age 10.4+/-0.3 years) participating in a study of childhood obesity. Height and weight were measured, and body composition was determined by dual-energy x-ray absorptiometry. Food intake in adults was assessed using the Block 1998 Food Questionnaire; food intake in children was assessed using a 24-hour recall with parental assistance. RESULTS: In adults, mean energy intake was 3,163+/-1,037 kcal/day, mean percentage of energy from fat was 41%+/-7%, and calcium intake was 914+/-333 mg/day. In children, mean energy intake was 1,988+/-733 kcal/day, mean percentage of energy from fat was 36%+/-9%, and calcium intake was 637+/-352 mg/day, half the recommended daily intake for this age group. There were no significant associations between calcium intake and body weight (r=0.05, P=.71; r=0.04, P=.73), body fat (r=0.16, P=.19; r=0.12, P=.42), or body mass index (r=0.01, P=.97; r=0.04, P=.77) in either adults or children, respectively. DISCUSSION: One explanation for the lack of association between reported calcium intake and body size in Pima Indians may be that the high-fat, high-energy diet consumed by the population overwhelmed the "anti-obesigenic" effect of calcium. CONCLUSIONS: We were unable to find an association between calcium intake and body size or adiposity in Pima Indian adults and children. Although the essentiality of calcium to bone health is well established, the role of calcium and dairy product intake in obesity and weight management remains uncertain.

Neuromodulation targeted to the prefrontal cortex induces changes in energy intake and weight loss in obesity.

OBJECTIVE: Obesity is associated with decreased activity in the prefrontal cortex. Transcranial direct current stimulation (tDCS) modifies cortical excitability and may facilitate improved control of eating. The energy intake (EI) and body weight in subjects who received cathodal versus sham (study 1) and subsequent anodal versus sham (study 2) tDCS aimed at the left dorsolateral prefrontal cortex (LDLPFC) were measured. METHODS: Nine (3m, 6f) healthy volunteers with obesity (94 ± 15 kg [M ± SD]; 42 ± 8 y) were admitted as inpatients for 9 days to participate in a double-blind, randomized, placebo-controlled crossover experiment. Study 1: following 5 days of a weight-maintaining diet, participants received cathodal or sham tDCS (2 mA, 40 min) on three consecutive mornings and then ate ad libitum from a computerized vending machine, which recorded EI. Weight was measured daily. Study 2: participants repeated the study, maintaining original assignment to active (this time anodal) and sham. RESULTS: Participants tended to consume fewer kilocalories per day (P = 0.07), significantly fewer kilocalories from soda (P = 0.02) and fat (P = 0.03), and had a greater % weight loss (P = 0.009) during anodal versus cathodal tDCS. CONCLUSIONS: The results indicated a role for the LDLPFC in obesity and food intake. This proof of concept study suggested, for the first time, the potential application of anodal tDCS to facilitate weight loss.

Negative relationship between fasting plasma ghrelin concentrations and ad libitum food intake.

Ghrelin is a novel GH secretagogue with orexigenic effects. We hypothesized that high fasting plasma ghrelin concentrations (FxGhr) might predict high ad libitum food intake. FxGhr were measured in 30 normoglycemic subjects: 15 Pima Indians (8 male/7 female; age, 32 +/- 7 yr; body weight, 87 +/- 21 kg; mean +/-sd) and 15 Caucasians (12 male/3 female, 36 +/- 8 yr, 94 +/- 26 kg) in energy balance for 3 d before testing. Subjects then self-selected their food ad libitum for the following 3 d. Mean daily energy intake (DEI) was calculated from the weight of foods consumed and expressed as a percent of weight maintenance energy needs. FxGhr were twice as high in Caucasians as in Pima Indians (103 +/- 53 vs. 52 +/- 18 fmol/ml, P < 0.001) and remained higher after adjustment for age, gender, and body weight (P < 0.0001). Neither DEI, nor percent of weight maintenance energy needs, nor percent of calories from fat differed between the races. In both groups, FxGhr were negatively correlated with DEI (r = -0.61, P = 0.01; r = -0.54, P = 0.04, respectively). These negative relationships were not explained by interindividual differences in age, gender, or body weight. This unexpected finding that low FxGhr predict ad libitum food intake suggests that the role of endogenous ghrelin in the regulation of energy homeostasis remains uncertain.

Soda consumption during ad libitum food intake predicts weight change.

Soda consumption may contribute to weight gain over time. Objective data were used to determine whether soda consumption predicts weight gain or changes in glucose regulation over time. Subjects without diabetes (128 men, 75 women; mean age 34.3±8.9 years; mean body mass index 32.5±7.4; mean percentage body fat 31.6%±8.6%) self-selected their food from an ad libitum vending machine system for 3 days. Mean daily energy intake was calculated from food weight. Energy consumed from soda was recorded as were food choices that were low in fat (<20% of calories from fat) or high in simple sugars (>30%). Food choices were expressed as percentage of daily energy intake. A subset of 85 subjects had measurement of follow-up weights and oral glucose tolerance (57 men, 28 women; mean follow-up time=2.5±2.1 years, range 6 months to 9.9 years). Energy consumed from soda was negatively related to age (r=-0.27, P=0.0001) and choosing low-fat foods (r=-0.35, P<0.0001), but positively associated with choosing solid foods high in simple sugars (r=0.45, P<0.0001) and overall average daily energy intake (r=0.46, P<0.0001). Energy intake from food alone did not differ between individuals who did and did not consume beverage calories (P=0.11). Total daily energy intake had no relationship with change in weight (P=0.29) or change in glucose regulation (P=0.38) over time. However, energy consumed from soda correlated with change in weight (r=0.21, P=0.04). This relationship was unchanged after adjusting for follow-up time and initial weight. Soda consumption is a marker for excess energy consumption and is associated with weight gain.

Food label accuracy of common snack foods.

UNLABELLED: Nutrition labels have raised awareness of the energetic value of foods, and represent for many a pivotal guideline to regulate food intake. However, recent data have created doubts on label accuracy. OBJECTIVE: We tested label accuracy for energy and macronutrient content of prepackaged energy-dense snack food products. We measured "true" caloric content of 24 popular snack food products in the U.S. and determined macronutrient content in 10 selected items. DESIGN AND METHODS: Bomb calorimetry and food factors were used to estimate energy content. Macronutrient content was determined according to Official Methods of Analysis. Calorimetric measurements were performed in our metabolic laboratory between April 20th and May 18th and macronutrient content was measured between September 28th and October 7th of 2010. RESULTS AND CONCLUSION: Serving size, by weight, exceeded label statements by 1.2% [median] (25th percentile -1.4, 75th percentile 4.3, P = 0.10). When differences in serving size were accounted for, metabolizable calories were 6.8 kcal (0.5, 23.5, P = 0.0003) or 4.3% (0.2, 13.7, P = 0.001) higher than the label statement. In a small convenience sample of the tested snack foods, carbohydrate content exceeded label statements by 7.7% (0.8, 16.7, P = 0.01); however fat and protein content were not significantly different from label statements (-12.8% [-38.6, 9.6], P = 0.23; 6.1% [-6.1, 17.5], P = 0.32). Carbohydrate content explained 40% and serving size an additional 55% of the excess calories. Among a convenience sample of energy-dense snack foods, caloric content is higher than stated on the nutrition labels, but overall well within FDA limits. This discrepancy may be explained by inaccurate carbohydrate content and serving size.

Higher 24-h respiratory quotient and higher spontaneous physical activity in nighttime eaters.

We have previously shown that a higher 24-h respiratory quotient (24-h RQ) predicts greater ad-libitum food intake and that nighttime eaters (NE) ingested more calories during an in-patient food intake study and gained more weight over time. We investigated whether 24-h RQ was higher in individuals who exhibited nighttime eating behavior. Healthy nondiabetic Pima Indians (PI; n = 97, 54 male/43 female) and whites (W; n = 32, 22 male/10 female) were admitted to our Clinical Research Unit. After 3 days of a weight maintaining diet, 24-h energy expenditure (24-h EE), 24-h RQ, rates of carbohydrate (CHOX) and lipid oxidation (LIPOX), and spontaneous physical activity (SPA) were measured in a metabolic chamber whereas volunteers were in energy balance and unable to consume excess calories. Individuals subsequently ate ad libitum from a computerized vending machine for 3 days with amount and timing of food intake recorded. Fifty-five individuals (36%; 39 PI, 16 W) were NE, who ate between 11 PM and 5 AM on at least one of the 3 days on the vending machines. There were no differences in BMI or percentage body fat between NE and non-NE. After adjusting for age, sex, race, fat-free mass, fat mass, and energy balance, NE had a higher 24-h RQ (P = 0.01), higher CHOX (P = 0.009), and lower LIPOX (P = 0.03) and higher 24-h SPA (P = 0.04) compared to non-NE. There were no differences in adjusted 24-h EE or sleep RQ between the groups. Individuals with nighttime eating behavior have higher 24-h RQ, higher CHOX and lower LIPOX, a phenotype associated with increased food intake and weight gain.

Reproducibility of ad libitum energy intake with the use of a computerized vending machine system.

BACKGROUND: Accurate assessment of energy intake is difficult but critical for the evaluation of eating behavior and intervention effects. Consequently, methods to assess ad libitum energy intake under controlled conditions have been developed. OBJECTIVE: Our objective was to evaluate the reproducibility of ad libitum energy intake with the use of a computerized vending machine system. DESIGN: Twelve individuals (mean + or - SD: 36 + or - 8 y old; 41 + or - 8% body fat) consumed a weight-maintaining diet for 3 d; subsequently, they self-selected all food with the use of a computerized vending machine system for an additional 3 d. Mean daily energy intake was calculated from the actual weight of foods consumed and expressed as a percentage of weight-maintenance energy needs (%WMEN). Subjects repeated the study multiple times during 2 y. The within-person reproducibility of energy intake was determined through the calculation of the intraclass correlation coefficients (ICCs) between visits. RESULTS: Daily energy intake for all subjects was 5020 + or - 1753 kcal during visit 1 and 4855 + or - 1615 kcal during visit 2. There were no significant associations between energy intake and body weight, body mass index, or percentage body fat while subjects used the vending machines, which indicates that intake was not driven by body size or need. Despite overconsumption (%WMEN = 181 + or - 57%), the reproducibility of intake between visits, whether expressed as daily energy intake (ICC = 0.90), %WMEN (ICC = 0.86), weight of food consumed (ICC = 0.87), or fat intake (g/d; ICC = 0.87), was highly significant (P < 0.0001). CONCLUSION: Although ad libitum energy intake exceeded %WMEN, the within-person reliability of this intake across multiple visits was high, which makes this a reproducible method for the measurement of ad libitum intake in subjects who reside in a research unit. This trial was registered at clinicaltrials.gov as NCT00342732.

Maternal influence, not diabetic intrauterine environment, predicts children's energy intake.

Offspring of women with diabetes during pregnancy are at increased risk of accelerated weight gain and diabetes, effects partly mediated by the in utero environment. Whether differences in energy intake can explain this increased risk is unknown. We compared diet composition, eating patterns, and physiological responses to a mixed meal in 63 nondiabetic children whose mothers developed diabetes either before (offspring of diabetic mothers, ODMs, n = 31, age 9.2 +/- 1.7 years, mean +/- s.d.) or after (offspring of prediabetic mothers, OPDMs, n = 32, 9.6 +/- 1.3 years) the pregnancy. After consuming a standardized diet for 3 days, participants ate ad libitum from a computer-operated vending machine stocked with foods they had rated favorably on a food preferences questionnaire. Mothers and children always ate together. A subset of 35 children underwent a meal test with blood draws to measure insulin and glucose. Children's energy intake was associated with age, sex, and percent body fat, and strongly with mother's energy intake (r = 0.57, P < 0.0001). After adjustment for these variables, there were no differences between ODM and OPDM in energy intake or diet composition. The insulin area under the curve (AUC) following the meal test was significantly correlated with total energy intake but not after adjustment for the above covariates. Differences in energy intake were not observed between ODM and OPDM. Mother's energy intake was a significant predictor of children's energy intake. These findings indicate that in this subset of children in a controlled in-patient setting, maternal influence may outweigh intrauterine effects on energy intake.

Nighttime eating: commonly observed and related to weight gain in an inpatient food intake study.

BACKGROUND: Nighttime food intake has rarely been studied in inpatient settings and only one study observed a relation between self-reported nighttime eating and weight gain. OBJECTIVE: We investigated the prevalence of nighttime eating and its effect on weight change. DESIGN: Healthy nondiabetic Pima Indians (n = 117; 67 M, 50 F) and whites (n = 43; 29 M, 13 F) were admitted to a clinical research unit. After consuming a standardized diet for 3 d, participants ate ad libitum from a computer-operated vending machine that recorded the time of food selection. Energy intake was calculated as mean kcal/d. Follow-up weight was available for 94 volunteers. RESULTS: Fifty-five subjects (36%) were nighttime eaters (NEs; persons who ate between 2300 and 0500 on > or =1 of the 3 d). Prevalence was similar among whites and Pima Indians (37% and 35%, respectively). There were no significant differences in body mass index or percentage body fat between NEs and non-NEs. NEs consumed more calories per day (4758) than did non-NEs (4244; P = 0.02), but the percentage of calories from macronutrients did not differ. NEs consumed approximately 15% (690 kcal) of their daily energy during nighttime episodes. After control for baseline weight and follow-up time (x +/- SD: 3.4 +/- 1.8 y), NEs (n = 29) gained more weight (6.2 kg) than did non-NEs (n = 65; 1.7 kg; P = 0.03). CONCLUSIONS: Nighttime eating was common, and it predicted weight gain. It remains to be determined whether this behavior indicates abnormal sleep patterns leading to nighttime wakefulness and food intake in those prone to weight gain.