Effect of macronutrient composition on short-term food intake and weight loss.

The purpose of this review is to describe the role of macronutrient composition on the suppression of short-term food intake (FI) and weight loss. The effects of macronutrient composition on short-term FI will be reviewed first, followed by a brief examination of longer-term clinical trials that vary in effects of dietary macronutrient composition on weight loss. The objectives were: 1) to examine the effect of macronutrient composition on the suppression of short-term FI, 2) to determine whether some macronutrient sources suppress FI beyond their provision of energy, 3) to assess the combined effects of macronutrients on FI and glycemic response, and 4) to determine whether knowledge of the effect of macronutrients on short-term FI has led to greater success in spontaneous weight loss, adherence to energy-restricted diets, and better weight maintenance after weight loss. Although knowledge of macronutrient composition on short-term FI regulation has advanced our understanding of the role of diet composition on energy balance, it has yet to lead to greater success in long-term weight loss and weight maintenance. It is clear from this review that many approaches based on manipulating dietary macronutrient composition can help people lose weight as long as they follow the diets. However, only by evaluating the interaction between the physiologic systems that govern FI and body weight may the benefits of dietary macronutrient composition be fully realized.

Pre-meal video game playing and a glucose preload suppress food intake in normal weight boys.

Increased food intake (FI) during television viewing has been reported in children, but it is unknown if this occurs following pre-meal video game playing (VGP). The objective was to determine the effect of pre-meal VGP for 30 min on subjective appetite and emotions, and FI in normal weight (NW) boys after a glucose or control preload. On four test mornings, NW boys (n = 19) received equally sweetened preloads of a non-caloric sucralose control or 50 g glucose in 250 mL of water, with or without VGP for 30 min. Food intake from an ad libitum pizza meal was measured immediately after. Subjective appetite was measured at 0, 15, 30, and 60 min. Subjective emotions were determined by visual analog scale at baseline and immediately before lunch. Both VGP (p = 0.023) and glucose (p <0.001) suppressed FI. Pre-meal VGP compared with no-VGP, and glucose compared with the non-caloric control, decreased FI by 59 and 170 kcal, respectively. Subjective average appetite increased to 30 min (p = 0.003), but was lower after glucose (p = 0.01) in both the VGP and no-VGP conditions compared with the control. Frustration and aggression scores increased after VGP (p <0.05), but did not correlate with FI. However, baseline and pre-meal happiness and excitement scores were inversely associated with FI. In conclusion, both pre-meal VGP and the glucose preload suppressed FI, supporting the roles of both physiologic and environmental factors in the regulation of short-term FI in 9- to 14-year-old NW boys.

Mechanism of action of whole milk and its components on glycemic control in healthy young men.

Milk reduces post-meal glycemia when consumed either before or within an ad libitum meal. The objective of this study was to compare the effect of each of the macronutrient components and their combination with whole milk on postprandial glycemia, glucoregulatory and gastrointestinal hormones and gastric emptying in healthy young men. In a randomized, crossover study, 12 males consumed beverages (500 ml) of whole milk (3.25% M.F.) (control), a simulated milk beverage based on milk macronutrients, complete milk protein (16 g), lactose (24 g) or milk fat (16 g). Whole and simulated milk was similar in lowering postprandial glycemia and slowing gastric emptying while increasing insulin, C-peptide, peptide tyrosine tyrosine (PYY) and cholecystokinin (CCK), but simulated milk resulted in higher (41%) glucagon-like peptide-1 (GLP-1) and lower (43%) ghrelin areas under the curve (AUC) than whole milk (P=.01 and P=.04, respectively). Whole and simulated milk lowered glucose (P=.0005) more than predicted by the sum of AUCs for their components. Adjusted for energy content, milks produced lower glucose and hormone responses than predicted from the sum of their components. The effect of protein/kcal on the AUCs was higher than fat/kcal for insulin, C-peptide, insulin secretion rate, GLP-1, CCK and paracetamol (P<.0001), but similar to lactose except for CCK and paracetamol, which were lower. The response in PYY and ghrelin was similar per unit of energy for each macronutrient. In conclusion, milk lowers postprandial glycemia by both insulin and insulin-independent mechanisms arising from interactions among its macronutrient components and energy content.

Mechanism of action of pre-meal consumption of whey protein on glycemic control in young adults.

Whey protein (WP), when consumed in small amounts prior to a meal, improves post-meal glycemic control more than can be explained by insulin-dependent mechanisms alone. The objective of the study was to identify the mechanism of action of WP beyond insulin on the reduction of post-meal glycemia. In a randomized crossover study, healthy young men received preloads (300 ml) of WP (10 and 20 g), glucose (10 and 20 g) or water (control). Paracetamol (1.5 g) was added to the preloads to measure gastric emptying. Plasma concentrations of paracetamol, glucose, and ß-cell and gastrointestinal hormones were measured before preloads (baseline) and at intervals before (0-30 min) and after (50-230 min) a preset pizza meal (12 kcal/kg). Whey protein slowed pre-meal gastric emptying rate compared to the control and 10 g glucose (P<.0001), and induced lower pre-meal insulin and C-peptide than the glucose preloads (P<.0001). Glucose, but not WP, increased pre-meal plasma glucose concentrations (P<.0001). Both WP and glucose reduced post-meal glycemia (P=.0006) and resulted in similar CCK, amylin, ghrelin and GIP responses (P<.05). However, compared with glucose, WP resulted in higher post-meal GLP-1 and peptide tyrosine-tyrosine (PYY) and lower insulin concentrations, without altering insulin secretion and extraction rates. For the total duration of this study (0-230 min), WP resulted in lower mean plasma glucose, insulin and C-peptide, but higher GLP-1 and PYY concentrations than the glucose preloads. In conclusion, pre-meal consumption of WP lowers post-meal glycemia by both insulin-dependent and insulin-independent mechanisms.

Energy and macronutrient content of familiar beverages interact with pre-meal intervals to determine later food intake, appetite and glycemic response in young adults.

The objective was to compare the effects of pre-meal consumption of familiar beverages on appetite, food intake, and glycemic response in healthy young adults. Two short-term experiments compared the effect of consumption at 30 (experiment 1) or 120 min (experiment 2) before a pizza meal of isovolumetric amounts (500 mL) of water (0 kcal), soy beverage (200 kcal), 2% milk (260 kcal), 1% chocolate milk (340 kcal), orange juice (229 kcal) and cow's milk-based infant formula (368 kcal) on food intake and subjective appetite and blood glucose before and after a meal. Pre-meal ingestion of chocolate milk and infant formula reduced food intake compared to water at 30 min, however, beverage type did not affect food intake at 2h. Pre-meal blood glucose was higher after chocolate milk than other caloric beverages from 0 to 30 min (experiment 1), and after chocolate milk and orange juice from 0 to 120 min (experiment 2). Only milk reduced post-meal blood glucose in both experiments, suggesting that its effects were independent of meal-time energy intake. Combined pre- and post-meal blood glucose was lower after milk compared to chocolate milk and orange juice, but did not differ from other beverages. Thus, beverage calorie content and inter-meal intervals are primary determinants of food intake in the short-term, but macronutrient composition, especially protein content and composition, may play the greater role in glycemic control.

Milk proteins in the regulation of body weight, satiety, food intake and glycemia.

Consumption of dairy products and their milk proteins increase satiety and reduce food intake and blood glucose response when consumed alone or with carbohydrate. Dairy proteins are of interest because proteins are more satiating than either carbohydrate or fat, and they regulate food intake and metabolic functions by the combined actions of the intact protein, encrypted peptides and amino acids on gastrointestinal and central pathways. As shown in this review, milk proteins have physiologic functions that contribute to the maintenance of a healthy body weight and control of factors associated with the metabolic syndrome through their effects on mechanisms regulating food intake and blood glucose. More recent reports show that these benefits can be achieved within the range of usual consumption of dairy. In addition, recent research points to an intrinsic value of small amounts of milk protein or dairy consumed shortly before a meal to reduce the glycemic response to carbohydrate and that this is not at the cost of increased demand for insulin.

Relation between estimates of cornstarch digestibility by the Englyst in vitro method and glycemic response, subjective appetite, and short-term food intake in young men.

BACKGROUND: Starch composition and rate of digestion are determinants of blood glucose concentrations and food intake (FI). OBJECTIVE: Our objective was to describe relations between estimates of digestibility of starches by the in vitro Englyst method and their effect on blood glucose concentrations, subjective appetite, and FI in young men. DESIGN: Subjects consumed 5 soups containing 50 g maltodextrin, whole-grain, high-amylose, regular cornstarch, or no added starch at 1-wk intervals. Ad libitum FI was measured at 30 min (experiment 1) or 120 min (experiment 2) later, which were the estimated times of digestion of a rapidly digestible starch (RDS) and slowly digestible starch, respectively. Blood glucose concentrations and appetite were measured pre- and postmeal. RESULTS: At 30 min, FI was reduced by maltodextrin only [86% RDS, 12% resistant starch (RS); P < 0.05], but at 120 min FI was reduced by whole-grain (24% RDS, 66% RS), high-amylose corn (40% RDS, 48% RS), and regular corn (27% RDS, 39% RS) (P < 0.0001). The premeal blood glucose concentration at 30 and 120 min was highest and lowest after maltodextrin treatment, respectively (P < 0.0001). After the meal, the blood glucose area under the curve at 30 min was lower after all starch treatments (P < 0.05), but at 120 min the blood glucose area under the curve was lower only after the regular cornstarch treatment (P < 0.05). Premeal appetite decreased by all treatments (P < 0.05). CONCLUSION: The in vitro estimates of starch digestibility by the Englyst method predicted the effects of starch composition on blood glucose concentrations and FI in young men 30 and 120 min after consumption. This trial was registered at clinicaltrials.gov as NCT00980941 for experiment 1 and NCT00988689 for experiment 2.

Effect of premeal consumption of whey protein and its hydrolysate on food intake and postmeal glycemia and insulin responses in young adults.

BACKGROUND: Dairy protein ingestion before a meal reduces food intake and, when consumed with carbohydrate, reduces blood glucose. OBJECTIVE: The objective was to describe the effect of whey protein (WP) or its hydrolysate (WPH) when consumed before a meal on food intake, pre- and postmeal satiety, and concentrations of blood glucose and insulin in healthy young adults. DESIGN: Two randomized crossover studies were conducted. WP (10-40 g) in 300 mL water was provided in experiment 1, and WP (5-40 g) and WPH (10 g) in 300 mL water were provided in experiment 2. At 30 min after consumption, the subjects were fed an ad libitum pizza meal (experiment 1) or a preset pizza meal (12 kcal/kg, experiment 2). Satiety, blood glucose, and insulin were measured at baseline and at intervals both before and after the meals. RESULTS: In experiment 1, 20-40 g WP suppressed food intake (P < 0.0001) and 10-40 g WP reduced postmeal blood glucose concentrations and the area under the curve (AUC) (P < 0.05). In experiment 2, 10-40 g WP, but not WPH, reduced postmeal blood glucose AUC and insulin AUC in a dose-dependent manner (P < 0.05). The ratio of cumulative blood glucose to insulin AUCs (0-170 min) was reduced by > or =10 g WP but not by 10 g WPH. CONCLUSIONS: WP consumed before a meal reduces food intake, postmeal blood glucose and insulin, and the ratio of cumulative blood glucose to insulin AUCs in a dose-dependent manner. Intact WP, but not WPH, contributes to blood glucose control by both insulin-dependent and insulin-independent mechanisms. This trial was registered at clinicaltrials.gov as NCT00988377 and NCT00988182.

Reduced energy intake at breakfast is not compensated for at lunch if a high-insoluble-fiber cereal replaces a low-fiber cereal.

BACKGROUND: In cohort studies, insoluble fiber has been associated with a reduced risk of obesity and diabetes; however, compared with soluble fiber, its role in the regulation of short-term food intake (FI) and satiety has received little attention. OBJECTIVE: Our aim was to compare the effects of a high-insoluble-fiber (HF) cereal with a low-fiber (LF) cereal on FI, subjective appetite (SA), and plasma glucose (PG) in healthy individuals. DESIGN: Males and females (n = 32) were randomly assigned to consume 60 g of either HF (26 g insoluble fiber, 120 kcal) or LF (1 g fiber, 217 kcal) breakfast cereal. Pre- and postlunch SA and PG were measured regularly for 4 h, and ad libitum FI was measured at 3 h. RESULTS: The prelunch SA area under the curve did not differ between the 2 cereals, but when expressed as change in appetite per kilocalorie of cereal, HF suppressed SA more than did LF (-17.6 +/- 1.8 compared with -10.0 +/- 1.1 mm . min . kcal(-)(1), respectively; P < 0.01). Lunchtime FI did not differ between cereals, but cumulative energy intake (cereal + lunch) was lower after the HF than after the LF cereal (1330 +/- 57 compared with 1422 +/- 66 kcal, respectively; P = 0.01). The prelunch PG area under the curve (P < 0.0001) and the immediate postlunch PG (P = 0.01) were lower after HF cereal consumption. CONCLUSIONS: An HF breakfast cereal contributes to a cumulative reduction in breakfast and lunch energy intake, possibly due to its high satiety value per kilocalorie. A short-term benefit of the HF cereal, compared with LF cereal, was lower PG concentration before and immediately after lunch.

Effects of glucose-to-fructose ratios in solutions on subjective satiety, food intake, and satiety hormones in young men.

BACKGROUND: The greater prevalence of obesity and the metabolic syndrome in the past 35 y has been attributed to the replacement of sucrose in the food supply with high-fructose corn syrup (HFCS). OBJECTIVE: Two experiments were conducted to determine the effect of solutions containing sucrose, HFCS, or various ratios of glucose to fructose (G:F) on food intake (FI), average appetite (AA), blood glucose (BG), plasma insulin, ghrelin, and uric acid (UA) in men. DESIGN: Sugar solutions (300 kcal/300 mL) were (in %) G20:F80, HFCS 55 (G45:F55), sucrose, and G80:F20 (experiment 1, n = 12) and G20:F80, G35:F65, G50:F50, sucrose, and G80:F20 (experiment 2, n = 19). The controls were a sweet energy-free control (experiment 1) and water (both experiments). Solutions were provided in a repeated-measures design. AA, BG, and FI were measured in all subjects. Hormonal responses and UA were measured in 7 subjects in experiment 2. Measurements were taken from baseline to 75 min. FI was measured at 80 min. RESULTS: Sucrose and HFCS (experiment 1) and sucrose and G50:F50 (experiment 2) had similar effects on all dependent measures. All sugar solutions similarly reduced the AA area under the curve (AUC). FI and plasma UA concentrations were significantly (P < 0.05) lower after high-glucose solutions than after low-glucose solutions. The lower FI was associated with a greater BG AUC (P < 0.05) and smaller AA and ghrelin AUCs (P < 0.01). Insulin and BG AUCs were positively associated (P < 0.001). CONCLUSION: Sucrose, HFCS, and G50:F50 solutions do not differ significantly in their short-term effects on subjective and physiologic measures of satiety, UA, and FI at a subsequent meal.

Whey proteins in the regulation of food intake and satiety.

Whey protein has potential as a functional food component to contribute to the regulation of body weight by providing satiety signals that affect both short-term and long-term food intake regulation. Because whey is an inexpensive source of high nutritional quality protein, the utilization of whey as a physiologically functional food ingredient for weight management is of current interest. At present, the role of individual whey proteins and peptides in contributing to food intake regulation has not been fully defined. However, Whey protein reduces short-term food intake relative to placebo, carbohydrate and other proteins. Whey protein affects satiation and satiety by the actions of: (1) whey protein fractions per se; (2) bioactive peptides; (3) amino-acids released after digestion; (4) combined action of whey protein and/or peptides and/or amino acids with other milk constituents. Whey ingestion activates many components of the food intake regulatory system. Whey protein is insulinotropic, and whey-born peptides affect the renin-angiotensin system. Therefore whey protein has potential as physiologically functional food component for persons with obesity and its co-morbidities (hypertension, type II diabetes, hyper- and dislipidemia). It remains unclear, however, if the favourable effects of whey on food intake, subjective satiety and intake regulatory mechanisms in humans are obtained from usual serving sizes of dairy products. The effects described have been observed in short-term experiments and when whey is consumed in much higher amounts.