Effect of whey protein and a free amino acid mixture simulating whey protein on measures of satiety in normal-weight women.

Dietary protein is considered more satiating than carbohydrate, and whey protein is more satiating than other protein sources. The purported satiating effect of whey protein may be due to direct effects of the unique mixture of proteins in whey, due to the effects of peptides released upon digestion and/or its amino acid composition. The objective of the present study was to compare the satiating effects of intact whey protein isolate (WPI) or a free amino acid mixture (AAM) simulating the amino acid composition of the WPI. A single-blind completely randomised block design included twenty, healthy, adult women (age 24·2 (sem 0·8) years) of normal weight (BMI 22·7 (sem 0·4) kg/m2). Following consumption of isoenergetic (approximately 1800 kJ) preload meals enriched (52 g amino acid equivalent) with WPI or AAM, consumption of an ad libitum test meal 120 min later and subjective feelings of appetite using visual analogue scales (VAS) were determined. There were no significant differences (P=0·24) in the ad libitum test meal intakes between the WPI (268·5 (sem 27·3) g) and the AAM (238·4 (sem 22·7) g) preload meals. Subjective VAS ratings of appetite did not differ significantly between the WPI and the AAM preload meals (P>0·05). Intact whey protein and a free AAM simulating the whey protein showed similar effects on satiety. This suggests that the satiating effect of whey protein may be related to its specific amino acid composition.

The challenge of long-term tetrahydrobiopterin (BH4) therapy in phenylketonuria: Effects on metabolic control, nutritional habits and nutrient supply.

BACKGROUND AND AIMS: BH4-sensitive phenylketonuria (PKU) patients relax their phenylalanine (Phe) restricted diet due to increased Phe tolerance, while keeping dried blood Phe concentrations with in the therapeutic range. We aimed to investigate metabolic control, eating habits and nutrient supply under long-term BH4-therapy. PATIENTS AND METHODS: Retrospective analysis of mean dried blood Phe concentrations and their variability, food and nutrient intake in BH4-sensitive patients (n = 8, 3f, age 6.0-16.6 y) under classical dietary treatment for one year and during the three years after initiation of BH4. RESULTS: Phe concentrations of BH4-sensitve PKU patients remained within therapeutic range throughout the observation period, independent of therapeutic regime. Under BH4, Phe tolerance increased significantly (493.2 ± 161.8 mg/d under classical diet vs 2021.93 ± 897.4 mg/d two years under BH4; P = 0.004). Variability of Phe concentrations remained unchanged (mean SD; P = 1.000). Patients adjust their food choice and significantly increased their intake of cereals, potatoes, dairy products and meat (P = 0.019, P = 0.016, P = 0.016 and P = 0.016, respectively). Under diet changes after implementation of BH4 a drop in micronutrient intake (vitamin D, folic acid, iron, calcium, iodine) could be revealed (P = 0.005, P < 0.001, P = 0.004, P = 0.001, P = 0.003, respectively). CONCLUSIONS: BH4-sensitive PKU patients can achieve good metabolic control under an adjuvant BH4- or a BH4 monotherapy. The liberalized diet under BH4 seems to jeopardize the quality of patients' nutrition, and these patients require close follow-up and special nutrition education to minimize the risk for imbalanced diet and nutrient deficiencies.