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Fernández-Verdejo R, Mey JT, Ravussin E. Effects of ketone bodies on energy expenditure, substrate utilization, and energy intake in humans. J Lipid Res 2023; 64:100442. [PMID: 37703994 PMCID: PMC10570604 DOI: 10.1016/j.jlr.2023.100442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 09/05/2023] [Accepted: 09/06/2023] [Indexed: 09/15/2023] Open
Abstract
The potential of ketogenic approaches to regulate energy balance has recently gained attention since ketones may influence both energy expenditure and energy intake. In this narrative review, we summarized the most relevant evidence about the role of ketosis on energy expenditure, substrate utilization, and energy intake in humans. We considered different strategies to induce ketosis, such as fasting, dietary manipulation, and exogenous ketone sources. In general, ketosis does not have a major influence on energy expenditure but promotes a shift in substrate utilization towards ketone body oxidation. The strategies to induce ketosis by reduction of dietary carbohydrate availability (e.g., ketogenic diets) do not independently influence energy intake, being thus equally effective for weight loss as diets with higher carbohydrate content. In contrast, the intake of medium-chain triglycerides and ketone esters induces ketosis and appears to increase energy expenditure and reduce energy intake in the context of high carbohydrate availability. These latter strategies lead to slightly enhanced weight loss. Unfortunately, distinguishing the effects of the various ketogenic strategies per se from the effects of other physiological responses is not possible with the available human data. Highly controlled, inpatient studies using targeted strategies to isolate the independent effects of ketones are required to adequately address this knowledge gap.
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Affiliation(s)
- Rodrigo Fernández-Verdejo
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, USA; Laboratorio de Fisiología del Ejercicio y Metabolismo (LABFEM), Escuela de Kinesiología, Facultad de Medicina, Universidad Finis Terrae, Santiago, Chile
| | - Jacob T Mey
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, USA
| | - Eric Ravussin
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, USA.
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BDNF and orexin-A response to aerobic exercise are moderated by the meal consumption before exercise in overweight men: Effect of high-carbohydrate, high-protein and high-fat meals. Sci Sports 2020. [DOI: 10.1016/j.scispo.2020.01.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Kohanmoo A, Faghih S, Akhlaghi M. Effect of short- and long-term protein consumption on appetite and appetite-regulating gastrointestinal hormones, a systematic review and meta-analysis of randomized controlled trials. Physiol Behav 2020; 226:113123. [PMID: 32768415 DOI: 10.1016/j.physbeh.2020.113123] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 08/02/2020] [Accepted: 08/03/2020] [Indexed: 01/21/2023]
Abstract
AIM High-protein diets are considered as useful diets for weight loss programs. We collected randomized controlled trials that evaluated the effect of protein on appetite and gastrointestinal hormones involved in appetite regulation. METHODS Trials were included if participants were healthy adults and isocaloric treatments were used in control and treatment arms. Random-effects model was used to calculate mean difference and 95% confidence intervals. RESULTS In total, 49 publications for acute and 19 articles for long-term effect of protein were included. In acute interventions, protein decreased hunger (-7 mm visual analogue scale (VAS), P<0.001), desire to eat (-5 mm, P = 0.045), and prospective food consumption (-5 mm, P = 0.001) and increased fullness (10 mm, P<0.001) and satiety (4 mm, P<0.001). There was also a decrease in ghrelin (-20 pg/ml, P<0.001) and increase in cholecystokinin (30 pg/ml, P<0.001) and glucagon-like peptide-1 (GLP-1) (21 ng/ml, P<0.001), but no change in gastric inhibitory polypeptide and peptide YY was observed. Appetite markers were affected by protein doses < 35 g but ghrelin, cholecystokinin, and GLP-1 changed significantly after doses ≥ 35 g. Long-term ingestion of protein did not affect these outcomes, except for GLP-1 which showed a significant decrease. CONCLUSION Results of this meta-analysis showed that acute ingestion of protein suppresses appetite, decreases ghrelin, and augments cholecystokinin and GLP-1. Results of long-term trials are inconclusive and further trials are required before a clear and sound conclusion on these trials could be made.
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Affiliation(s)
- Ali Kohanmoo
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Shiva Faghih
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Masoumeh Akhlaghi
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.
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Miki K, Kitada S, Miki M, Hui SP, Shrestha R, Yoshimura K, Tsujino K, Kagawa H, Oshitani Y, Kida H, Maekura R, Kangawa K. A phase II, open-label clinical trial on the combination therapy with medium-chain triglycerides and ghrelin in patients with chronic obstructive pulmonary disease. J Physiol Sci 2019; 69:969-979. [PMID: 31595463 PMCID: PMC10716959 DOI: 10.1007/s12576-019-00716-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Accepted: 09/19/2019] [Indexed: 12/20/2022]
Abstract
The aim of this study was to investigate the effect of activated ghrelin with dietary octanoic acids or medium-chain triglyceride (MCT) administration to underweight patient with chronic obstructive pulmonary disease (COPD). Eleven severe and very severe COPD patients received a 5-day treatment with edible MCT. Sequentially, 10 patients received a 3-week combination treatment with MCT and intravenous acyl ghrelin. Five-day MCT treatment increased endogenous acyl ghrelin (p = 0.0049), but the total ghrelin level was unchanged. MCT-ghrelin combination treatment improved the peak oxygen uptake (p = 0.0120) during whole treatment course. This effect was attributed to the resultant improvements in cardiac function by O2 pulse, and to the difference between inspired and expired oxygen concentration rather than minute ventilation. Addition of dietary MCT to ghrelin treatment improved the aerobic capacity of underweight COPD patients, likely by mechanisms of increased O2 delivery through improvements in primary cardiocirculatory and muscular crosstalk.
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Affiliation(s)
- Keisuke Miki
- Department of Respiratory Medicine, National Hospital Organization Osaka Toneyama Medical Center, 5-1-1 Toneyama, Toyonaka, Osaka, 560-8552, Japan.
| | - Seigo Kitada
- Department of Respiratory Medicine, National Hospital Organization Osaka Toneyama Medical Center, 5-1-1 Toneyama, Toyonaka, Osaka, 560-8552, Japan
| | - Mari Miki
- Department of Respiratory Medicine, National Hospital Organization Osaka Toneyama Medical Center, 5-1-1 Toneyama, Toyonaka, Osaka, 560-8552, Japan
| | - Shu-Ping Hui
- Faculty of Health Sciences, Hokkaido University, Kita 12, Nishi-5, Sapporo, Japan
| | - Rojeet Shrestha
- Faculty of Health Sciences, Hokkaido University, Kita 12, Nishi-5, Sapporo, Japan
| | - Kenji Yoshimura
- Department of Respiratory Medicine, National Hospital Organization Osaka Toneyama Medical Center, 5-1-1 Toneyama, Toyonaka, Osaka, 560-8552, Japan
| | - Kazuyuki Tsujino
- Department of Respiratory Medicine, National Hospital Organization Osaka Toneyama Medical Center, 5-1-1 Toneyama, Toyonaka, Osaka, 560-8552, Japan
| | - Hiroyuki Kagawa
- Department of Respiratory Medicine, National Hospital Organization Osaka Toneyama Medical Center, 5-1-1 Toneyama, Toyonaka, Osaka, 560-8552, Japan
| | - Yohei Oshitani
- Department of Respiratory Medicine, National Hospital Organization Osaka Toneyama Medical Center, 5-1-1 Toneyama, Toyonaka, Osaka, 560-8552, Japan
| | - Hiroshi Kida
- Department of Respiratory Medicine, National Hospital Organization Osaka Toneyama Medical Center, 5-1-1 Toneyama, Toyonaka, Osaka, 560-8552, Japan
| | - Ryoji Maekura
- Department of Respiratory Medicine, National Hospital Organization Osaka Toneyama Medical Center, 5-1-1 Toneyama, Toyonaka, Osaka, 560-8552, Japan
- Graduate School of Health Care Sciences, Jikei Institute, Miyahara 1-2-8, Yodogawa-ku, Osaka, Japan
| | - Kenji Kangawa
- National Cerebral and Cardiovascular Center Research Institute, 6-1, Kishibeshinmachi, Suita, Japan
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Tischmann L, Drummen M, Gatta-Cherifi B, Raben A, Fogelholm M, Hartmann B, Holst JJ, Matias I, Cota D, Mensink RP, Joris PJ, Westerterp-Plantenga MS, Adam TC. Effects of a High-Protein/Moderate-Carbohydrate Diet on Appetite, Gut Peptides, and Endocannabinoids-A Preview Study. Nutrients 2019; 11:E2269. [PMID: 31546629 PMCID: PMC6835833 DOI: 10.3390/nu11102269] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 09/18/2019] [Accepted: 09/19/2019] [Indexed: 12/17/2022] Open
Abstract
Favorable effects of a high-protein/moderate-carbohydrate (HP/MCHO) diet after weight loss on body weight management have been shown. To extend these findings, associations between perception of hunger and satiety with endocannabinoids, and with glucagon-like peptide-1 (GLP-1) and polypeptide YY (PYY) were assessed. At approximately 34 months after weight loss, 22 female and 16 male participants (mean age 64.5 ± 5.9 years; body mass index (BMI) 28.9 ± 3.9 kg/m2) completed a 48 h respiration chamber study. Participants were fed in energy balance with a HP/MCHO diet with 25%:45%:30% or a moderate-protein/high-carbohydrate (MP/HCHO) diet with 15%:55%:30% of energy from protein:carbohydrate:fat. Endocannabinoids and related compounds, relevant postprandial hormones (GLP-1, PYY), hunger, satiety, and ad libitum food intake were assessed. HP/MCHO versus MP/HCHO reduced hunger perception. The lower decremental area under the curve (dAUC) for hunger in the HP/MCHO diet (-56.6% compared to MP, p < 0.05) was associated with the higher AUC for 2-arachidonoylglycerol (2-AG) concentrations (p < 0.05). Hunger was inversely associated with PYY in the HP/MCHO group (r = -0.7, p < 0.01). Ad libitum food intake, homeostatic model assessment for insulin resistance (HOMA-IR) and incremental AUCs for gut peptides were not different between conditions. HP/MCHO versus MP/HCHO diet-induced reduction in hunger was present after 34 months weight maintenance in the post-obese state. HP/MCHO diet-induced decrease of hunger is suggested to interact with increased 2-AG and PYY concentrations.
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Affiliation(s)
- Lea Tischmann
- Department of Nutrition and Movement Sciences, Maastricht University Medical Centre, 6200 MD Maastricht, The Netherlands.
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, 6200 MD Maastricht, The Netherlands.
| | - Mathijs Drummen
- Department of Nutrition and Movement Sciences, Maastricht University Medical Centre, 6200 MD Maastricht, The Netherlands.
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, 6200 MD Maastricht, The Netherlands.
| | - Blandine Gatta-Cherifi
- Department of Endocrinology, University Hospital of Bordeaux, F-33607 Pessac, France.
- INSERM, Neurocentre Magendie, Physiopathologie de la Plasticité Neuronale, U1215, F-33000 Bordeaux, France.
- University of Bordeaux, Neurocentre Magendie, Physiopathologie de la Plasticité Neuronale, U1215, F-33000 Bordeaux, France.
| | - Anne Raben
- Department of Nutrition, Exercise and Sports, University of Copenhagen, DK1017 Copenhagen, Denmark.
| | - Mikael Fogelholm
- Department of Food and Environmental Sciences, University of Helsinki, FI-00014 Helsinki, Finland.
| | - Bolette Hartmann
- NNF Center of Basic Metabolic Research and Department of Biomedical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark.
| | - Jens J Holst
- NNF Center of Basic Metabolic Research and Department of Biomedical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark.
| | - Isabelle Matias
- INSERM, Neurocentre Magendie, Physiopathologie de la Plasticité Neuronale, U1215, F-33000 Bordeaux, France.
- University of Bordeaux, Neurocentre Magendie, Physiopathologie de la Plasticité Neuronale, U1215, F-33000 Bordeaux, France.
| | - Daniela Cota
- INSERM, Neurocentre Magendie, Physiopathologie de la Plasticité Neuronale, U1215, F-33000 Bordeaux, France.
- University of Bordeaux, Neurocentre Magendie, Physiopathologie de la Plasticité Neuronale, U1215, F-33000 Bordeaux, France.
| | - Ronald P Mensink
- Department of Nutrition and Movement Sciences, Maastricht University Medical Centre, 6200 MD Maastricht, The Netherlands.
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, 6200 MD Maastricht, The Netherlands.
| | - Peter J Joris
- Department of Nutrition and Movement Sciences, Maastricht University Medical Centre, 6200 MD Maastricht, The Netherlands.
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, 6200 MD Maastricht, The Netherlands.
| | - Margriet S Westerterp-Plantenga
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, 6200 MD Maastricht, The Netherlands.
| | - Tanja C Adam
- Department of Nutrition and Movement Sciences, Maastricht University Medical Centre, 6200 MD Maastricht, The Netherlands.
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, 6200 MD Maastricht, The Netherlands.
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Miron I, Dumitrascu DL. GASTROINTESTINAL MOTILITY DISORDERS IN OBESITY. ACTA ENDOCRINOLOGICA-BUCHAREST 2019; 15:497-504. [PMID: 32377248 DOI: 10.4183/aeb.2019.497] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The gastrointestinal (GI) motility, which is important for the digestion and absorption, may be altered in obesity. The aim of this review is to present the GI motility changes occurring in obesity, as well as their underlying mechanisms. We have conducted a systematic review of the published literature concerning GI motility and obesity and have described recent published data on the changes throughout the entire GI tract. Most recent discoveries include evidence supporting the increase of gastroesophageal reflux disease in obesity and inhibition of gastric motility. Intestinal transit of the distal small bowel generally slows down, ensuring enough time for digestion and absorption. Constipation is more frequent in obese patients than in those with a normal weight. The gut-brain axis plays an important role in the pathophysiology of GI motility disorders in obesity. This bidirectional communication is achieved by way of neurons, hormones, metabolites derived from intestinal microbiota and cytokines. The molecular mechanisms of GI motility changes in obesity are complex. Current data offer a starting point for further research needed to clarify the association of obesity with GI motility disorders.
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Affiliation(s)
- I Miron
- "Iuliu Hatieganu" University of Medicine and Pharmacy, 3 Medical Clinic, Cluj-Napoca, Romania
| | - D L Dumitrascu
- "Iuliu Hatieganu" Dept of Internal Medicine, Cluj-Napoca, Romania
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7
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Gwin JA, Maki KC, Leidy HJ. Increased Protein Consumption during the Day from an Energy-Restricted Diet Augments Satiety but Does Not Reduce Daily Fat or Carbohydrate Intake on a Free-Living Test Day in Overweight Women. J Nutr 2017; 147:2338-2346. [PMID: 29070709 PMCID: PMC6636664 DOI: 10.3945/jn.117.255554] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Revised: 07/26/2017] [Accepted: 09/26/2017] [Indexed: 11/14/2022] Open
Abstract
Background: Higher-protein (HP) energy-restriction diets improve weight management to a greater extent than normal-protein (NP) versions. Potential mechanisms of action with regard to assessment of eating behaviors across the day have not been widely examined during energy restriction.Objectives: The objectives of this study were to test whether the consumption of an HP energy-restriction diet reduces carbohydrate and fat intakes through improvements in daily appetite, satiety, and food cravings compared with NP versions and to test whether protein type within the NP diets alters protein-related satiety.Methods: Seventeen overweight women [mean ± SEM age: 36 ± 1 y; body mass index (kg/m2): 28.4 ± 0.1] completed a randomized, controlled-feeding crossover study. Participants were provided with the following ∼1250-kcal/d energy-restricted (-750-kcal/d deficit) diets, each for 6 d: HP [124 g protein/d; 60% from beef and 40% from plant sources (HP-BEEF)] or NP (48 g protein/d) that was protein-type matched (NP-BEEF) or unmatched [100% from plant-based sources (NP-PLANT)]. On day 6 of each diet period, participants completed a 12-h testing day containing repetitive appetite, satiety, and food-craving questionnaires. On day 7, the participants were asked to consume their protein requirement within each respective diet but were provided with a surplus of carbohydrate- and fat-rich foods to consume, ad libitum, at each eating occasion across the day. All outcomes reported were primary study outcomes.Results: The HP-BEEF diet reduced daily hunger by 16%, desire to eat by 15%, prospective food consumption by 14%, and fast-food cravings by 15% but increased daily fullness by 25% compared with the NP-BEEF and NP-PLANT diets (all P < 0.05). However, consuming more protein throughout the day did not reduce the energy consumed ad libitum from the fat- and carbohydrate-rich foods (HP-BEEF: 2000 ± 180 kcal/d; NP-BEEF: 2120 ± 190 kcal/d; NP-PLANT: 2070 ± 180 kcal/d). None of the outcomes differed between the NP-BEEF and NP-PLANT treatments.Conclusions: Although appetite control, satiety, and food cravings improved after an HP energy-restriction diet, increased protein consumption did not reduce carbohydrate and fat intakes throughout the free-living test day in overweight healthy women exposed to highly palatable foods. This trial was registered at clinicaltrials.gov as NCT02614729.
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Affiliation(s)
- Jess A Gwin
- Department of Nutrition Science, Purdue University, West Lafayette, IN; and
| | - Kevin C Maki
- Midwest Biomedical Research/Center for Metabolic and Cardiovascular Health; Glen Ellyn, IL
| | - Heather J Leidy
- Department of Nutrition Science, Purdue University, West Lafayette, IN; and
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Matu J, Deighton K, Ispoglou T, Shannon OM, Duckworth L. A high fat breakfast attenuates the suppression of appetite and acylated ghrelin during exercise at simulated altitude. Physiol Behav 2017; 179:353-360. [DOI: 10.1016/j.physbeh.2017.07.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Revised: 06/28/2017] [Accepted: 07/04/2017] [Indexed: 12/28/2022]
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9
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Gavrieli A, Mantzoros CS. Novel Molecules Regulating Energy Homeostasis: Physiology and Regulation by Macronutrient Intake and Weight Loss. Endocrinol Metab (Seoul) 2016; 31:361-372. [PMID: 27469065 PMCID: PMC5053046 DOI: 10.3803/enm.2016.31.3.361] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2016] [Revised: 06/29/2016] [Accepted: 07/07/2016] [Indexed: 12/13/2022] Open
Abstract
Excess energy intake, without a compensatory increase of energy expenditure, leads to obesity. Several molecules are involved in energy homeostasis regulation and new ones are being discovered constantly. Appetite regulating hormones such as ghrelin, peptide tyrosine-tyrosine and amylin or incretins such as the gastric inhibitory polypeptide have been studied extensively while other molecules such as fibroblast growth factor 21, chemerin, irisin, secreted frizzle-related protein-4, total bile acids, and heme oxygenase-1 have been linked to energy homeostasis regulation more recently and the specific role of each one of them has not been fully elucidated. This mini review focuses on the above mentioned molecules and discusses them in relation to their regulation by the macronutrient composition of the diet as well as diet-induced weight loss.
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Affiliation(s)
- Anna Gavrieli
- Department of Endocrinology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Christos S Mantzoros
- Department of Endocrinology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
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10
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Dougkas A, Östman E. Protein-Enriched Liquid Preloads Varying in Macronutrient Content Modulate Appetite and Appetite-Regulating Hormones in Healthy Adults. J Nutr 2016; 146:637-45. [PMID: 26791555 DOI: 10.3945/jn.115.217224] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Accepted: 12/11/2015] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Dietary protein is considered the most satiating macronutrient, yet there is little evidence on whether the effects observed are attributable to the protein or to the concomitant manipulation of carbohydrates and fat. OBJECTIVE The aim was to examine the effect of consumption of preloads varying in macronutrient content on appetite, energy intake, and biomarkers of satiety. METHODS Using a randomized, within-subjects, 2-level factorial design, 36 adults [mean ± SD age: 27 ± 5 y; body mass index (in kg/m(2)): 24.3 ± 1.6) received a breakfast consisting of 1 of 7 isovolumetric (670 mL) and isoenergetic (2100 kJ) liquid preloads matched for energy density and sensory properties but with different macronutrient composition (levels: 9%, 24%, or 40% of energy from protein combined with a carbohydrate-to-fat ratio of 0.4, 2, or 3.6, respectively). Appetite ratings and blood samples were collected and assessed at baseline and every 30 and 60 min, respectively, until a lunch test meal, which participants consumed ad libitum, was served 3.5 h after breakfast. RESULTS Prospective consumption was 12% lower after intake of the high-protein (40%)/3.6 carbohydrate:fat preload than after intake of the low-protein (9%)/0.4 carbohydrate:fat preload (P = 0.02) solely because of the increased protein, irrespective of the manipulation of the other macronutrients. Most appetite ratings tended to be suppressed (13%) with increasing protein content of the preloads (P < 0.06). Carbohydrate elicited greater increases in fullness and postprandial responses of glucose and insulin than did protein and fat. The glucose concentration was suppressed and glucagon-like peptide 1 increased more after intake of the high-protein (40%)/0.4 carbohydrate:fat preload than after the other preloads (P < 0.001). No statistically significant differences in postprandial ghrelin release or ad libitum energy intake at lunch were found. CONCLUSIONS By varying all 3 macronutrients simultaneously and in a systematically balanced manner, we found that protein had a more pronounced effect on suppressing appetite than did carbohydrates and fat. Modulating the nutritional profile of a meal by replacing fat with protein can influence appetite in healthy adults. This trial was registered at www.clinicaltrials.gov as NCT01849302.
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Affiliation(s)
- Anestis Dougkas
- Food for Health Science Center, Lund University, Lund, Sweden
| | - Elin Östman
- Food for Health Science Center, Lund University, Lund, Sweden
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11
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Leidy HJ, Clifton PM, Astrup A, Wycherley TP, Westerterp-Plantenga MS, Luscombe-Marsh ND, Woods SC, Mattes RD. The role of protein in weight loss and maintenance. Am J Clin Nutr 2015; 101:1320S-1329S. [PMID: 25926512 DOI: 10.3945/ajcn.114.084038] [Citation(s) in RCA: 249] [Impact Index Per Article: 27.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Over the past 20 y, higher-protein diets have been touted as a successful strategy to prevent or treat obesity through improvements in body weight management. These improvements are thought to be due, in part, to modulations in energy metabolism, appetite, and energy intake. Recent evidence also supports higher-protein diets for improvements in cardiometabolic risk factors. This article provides an overview of the literature that explores the mechanisms of action after acute protein consumption and the clinical health outcomes after consumption of long-term, higher-protein diets. Several meta-analyses of shorter-term, tightly controlled feeding studies showed greater weight loss, fat mass loss, and preservation of lean mass after higher-protein energy-restriction diets than after lower-protein energy-restriction diets. Reductions in triglycerides, blood pressure, and waist circumference were also reported. In addition, a review of the acute feeding trials confirms a modest satiety effect, including greater perceived fullness and elevated satiety hormones after higher-protein meals but does not support an effect on energy intake at the next eating occasion. Although shorter-term, tightly controlled feeding studies consistently identified benefits with increased protein consumption, longer-term studies produced limited and conflicting findings; nevertheless, a recent meta-analysis showed persistent benefits of a higher-protein weight-loss diet on body weight and fat mass. Dietary compliance appears to be the primary contributor to the discrepant findings because improvements in weight management were detected in those who adhered to the prescribed higher-protein regimen, whereas those who did not adhere to the diet had no marked improvements. Collectively, these data suggest that higher-protein diets that contain between 1.2 and 1.6 g protein · kg-1 · d-1 and potentially include meal-specific protein quantities of at least ∼25-30 g protein/meal provide improvements in appetite, body weight management, cardiometabolic risk factors, or all of these health outcomes; however, further strategies to increase dietary compliance with long-term dietary interventions are warranted.
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Affiliation(s)
- Heather J Leidy
- From the Department of Nutrition and Exercise Physiology, School of Medicine, University of Missouri; Columbia, MO (HJL); the Sansom Institute for Health Research, School of Pharmacy and Medical Sciences (PMC) and School of Population Health (TPW), University of South Australia, Adelaide, Australia; the Department of Nutrition, Exercise, and Sports, University of Copenhagen, Copenhagen, Denmark (AA); the Department of Human Biology, NUTRIM, Faculty of Health, Medicine, and Life Sciences, Maastricht University, Maastricht, The Netherlands (MSW-P); the Centre of Clinical Research Excellence in Nutritional Physiology, Interventions, and Outcomes, University of Adelaide, Adelaide, Australia (NDL-M and PMC); Preventative Health National Research Flagship, Commonwealth Scientific and Industrial Research Organization (CSIRO)-Animal, Food, and Health Sciences, Adelaide, Australia (NDL-M); the Department of Psychiatry and Behavioral Neuroscience; UC College of Medicine, University of Cincinnati, Cincinnati, OH (SCW); and the Department of Nutrition Science, College of Health and Human Sciences, Purdue University, West Lafayette, IN (RDM)
| | - Peter M Clifton
- From the Department of Nutrition and Exercise Physiology, School of Medicine, University of Missouri; Columbia, MO (HJL); the Sansom Institute for Health Research, School of Pharmacy and Medical Sciences (PMC) and School of Population Health (TPW), University of South Australia, Adelaide, Australia; the Department of Nutrition, Exercise, and Sports, University of Copenhagen, Copenhagen, Denmark (AA); the Department of Human Biology, NUTRIM, Faculty of Health, Medicine, and Life Sciences, Maastricht University, Maastricht, The Netherlands (MSW-P); the Centre of Clinical Research Excellence in Nutritional Physiology, Interventions, and Outcomes, University of Adelaide, Adelaide, Australia (NDL-M and PMC); Preventative Health National Research Flagship, Commonwealth Scientific and Industrial Research Organization (CSIRO)-Animal, Food, and Health Sciences, Adelaide, Australia (NDL-M); the Department of Psychiatry and Behavioral Neuroscience; UC College of Medicine, University of Cincinnati, Cincinnati, OH (SCW); and the Department of Nutrition Science, College of Health and Human Sciences, Purdue University, West Lafayette, IN (RDM)
| | - Arne Astrup
- From the Department of Nutrition and Exercise Physiology, School of Medicine, University of Missouri; Columbia, MO (HJL); the Sansom Institute for Health Research, School of Pharmacy and Medical Sciences (PMC) and School of Population Health (TPW), University of South Australia, Adelaide, Australia; the Department of Nutrition, Exercise, and Sports, University of Copenhagen, Copenhagen, Denmark (AA); the Department of Human Biology, NUTRIM, Faculty of Health, Medicine, and Life Sciences, Maastricht University, Maastricht, The Netherlands (MSW-P); the Centre of Clinical Research Excellence in Nutritional Physiology, Interventions, and Outcomes, University of Adelaide, Adelaide, Australia (NDL-M and PMC); Preventative Health National Research Flagship, Commonwealth Scientific and Industrial Research Organization (CSIRO)-Animal, Food, and Health Sciences, Adelaide, Australia (NDL-M); the Department of Psychiatry and Behavioral Neuroscience; UC College of Medicine, University of Cincinnati, Cincinnati, OH (SCW); and the Department of Nutrition Science, College of Health and Human Sciences, Purdue University, West Lafayette, IN (RDM)
| | - Thomas P Wycherley
- From the Department of Nutrition and Exercise Physiology, School of Medicine, University of Missouri; Columbia, MO (HJL); the Sansom Institute for Health Research, School of Pharmacy and Medical Sciences (PMC) and School of Population Health (TPW), University of South Australia, Adelaide, Australia; the Department of Nutrition, Exercise, and Sports, University of Copenhagen, Copenhagen, Denmark (AA); the Department of Human Biology, NUTRIM, Faculty of Health, Medicine, and Life Sciences, Maastricht University, Maastricht, The Netherlands (MSW-P); the Centre of Clinical Research Excellence in Nutritional Physiology, Interventions, and Outcomes, University of Adelaide, Adelaide, Australia (NDL-M and PMC); Preventative Health National Research Flagship, Commonwealth Scientific and Industrial Research Organization (CSIRO)-Animal, Food, and Health Sciences, Adelaide, Australia (NDL-M); the Department of Psychiatry and Behavioral Neuroscience; UC College of Medicine, University of Cincinnati, Cincinnati, OH (SCW); and the Department of Nutrition Science, College of Health and Human Sciences, Purdue University, West Lafayette, IN (RDM)
| | - Margriet S Westerterp-Plantenga
- From the Department of Nutrition and Exercise Physiology, School of Medicine, University of Missouri; Columbia, MO (HJL); the Sansom Institute for Health Research, School of Pharmacy and Medical Sciences (PMC) and School of Population Health (TPW), University of South Australia, Adelaide, Australia; the Department of Nutrition, Exercise, and Sports, University of Copenhagen, Copenhagen, Denmark (AA); the Department of Human Biology, NUTRIM, Faculty of Health, Medicine, and Life Sciences, Maastricht University, Maastricht, The Netherlands (MSW-P); the Centre of Clinical Research Excellence in Nutritional Physiology, Interventions, and Outcomes, University of Adelaide, Adelaide, Australia (NDL-M and PMC); Preventative Health National Research Flagship, Commonwealth Scientific and Industrial Research Organization (CSIRO)-Animal, Food, and Health Sciences, Adelaide, Australia (NDL-M); the Department of Psychiatry and Behavioral Neuroscience; UC College of Medicine, University of Cincinnati, Cincinnati, OH (SCW); and the Department of Nutrition Science, College of Health and Human Sciences, Purdue University, West Lafayette, IN (RDM)
| | - Natalie D Luscombe-Marsh
- From the Department of Nutrition and Exercise Physiology, School of Medicine, University of Missouri; Columbia, MO (HJL); the Sansom Institute for Health Research, School of Pharmacy and Medical Sciences (PMC) and School of Population Health (TPW), University of South Australia, Adelaide, Australia; the Department of Nutrition, Exercise, and Sports, University of Copenhagen, Copenhagen, Denmark (AA); the Department of Human Biology, NUTRIM, Faculty of Health, Medicine, and Life Sciences, Maastricht University, Maastricht, The Netherlands (MSW-P); the Centre of Clinical Research Excellence in Nutritional Physiology, Interventions, and Outcomes, University of Adelaide, Adelaide, Australia (NDL-M and PMC); Preventative Health National Research Flagship, Commonwealth Scientific and Industrial Research Organization (CSIRO)-Animal, Food, and Health Sciences, Adelaide, Australia (NDL-M); the Department of Psychiatry and Behavioral Neuroscience; UC College of Medicine, University of Cincinnati, Cincinnati, OH (SCW); and the Department of Nutrition Science, College of Health and Human Sciences, Purdue University, West Lafayette, IN (RDM)
| | - Stephen C Woods
- From the Department of Nutrition and Exercise Physiology, School of Medicine, University of Missouri; Columbia, MO (HJL); the Sansom Institute for Health Research, School of Pharmacy and Medical Sciences (PMC) and School of Population Health (TPW), University of South Australia, Adelaide, Australia; the Department of Nutrition, Exercise, and Sports, University of Copenhagen, Copenhagen, Denmark (AA); the Department of Human Biology, NUTRIM, Faculty of Health, Medicine, and Life Sciences, Maastricht University, Maastricht, The Netherlands (MSW-P); the Centre of Clinical Research Excellence in Nutritional Physiology, Interventions, and Outcomes, University of Adelaide, Adelaide, Australia (NDL-M and PMC); Preventative Health National Research Flagship, Commonwealth Scientific and Industrial Research Organization (CSIRO)-Animal, Food, and Health Sciences, Adelaide, Australia (NDL-M); the Department of Psychiatry and Behavioral Neuroscience; UC College of Medicine, University of Cincinnati, Cincinnati, OH (SCW); and the Department of Nutrition Science, College of Health and Human Sciences, Purdue University, West Lafayette, IN (RDM)
| | - Richard D Mattes
- From the Department of Nutrition and Exercise Physiology, School of Medicine, University of Missouri; Columbia, MO (HJL); the Sansom Institute for Health Research, School of Pharmacy and Medical Sciences (PMC) and School of Population Health (TPW), University of South Australia, Adelaide, Australia; the Department of Nutrition, Exercise, and Sports, University of Copenhagen, Copenhagen, Denmark (AA); the Department of Human Biology, NUTRIM, Faculty of Health, Medicine, and Life Sciences, Maastricht University, Maastricht, The Netherlands (MSW-P); the Centre of Clinical Research Excellence in Nutritional Physiology, Interventions, and Outcomes, University of Adelaide, Adelaide, Australia (NDL-M and PMC); Preventative Health National Research Flagship, Commonwealth Scientific and Industrial Research Organization (CSIRO)-Animal, Food, and Health Sciences, Adelaide, Australia (NDL-M); the Department of Psychiatry and Behavioral Neuroscience; UC College of Medicine, University of Cincinnati, Cincinnati, OH (SCW); and the Department of Nutrition Science, College of Health and Human Sciences, Purdue University, West Lafayette, IN (RDM)
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12
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The role of gastrointestinal hormones in the pathogenesis of obesity and type 2 diabetes. GASTROENTEROLOGY REVIEW 2014; 9:69-76. [PMID: 25061485 PMCID: PMC4108747 DOI: 10.5114/pg.2014.42498] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2011] [Revised: 02/05/2012] [Accepted: 04/10/2012] [Indexed: 12/25/2022]
Abstract
Obesity, influencing the increase of incidence of type 2 diabetes, cardiovascular complications and cancer is a growing medical problem worldwide. The feelings of hunger and satiety are stimulated by the “gut-brain axis”, where a crucial role is played by gastrointestinal hormones: glucagon-like peptide 1, glucose-dependent insulinotropic polypeptide, pancreatic polypeptide, peptide YY, oxyntomodulin, cholecystokinin and ghrelin. These hormones affect not only the functioning of the digestive tract, but also might have effects on insulin secretion and are mediators which affect brain areas involved in the regulation of food intake. The effect of their actions can be antagonistic as well as an additive or synergistic, and their secretion is dependent on many factors, such as dietary nutrients or the energy state of the body. Changes in circulating gut hormones concentrations result in activation of various pathways primarily within the hypothalamus and brain stem areas, which modulate feeding behaviour and a number of metabolic processes.
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13
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Acute effects of high-protein versus normal-protein isocaloric meals on satiety and ghrelin. Eur J Nutr 2013; 53:493-500. [DOI: 10.1007/s00394-013-0552-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2013] [Accepted: 06/18/2013] [Indexed: 10/26/2022]
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14
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Stadlbauer U, Arnold M, Weber E, Langhans W. Possible mechanisms of circulating PYY-induced satiation in male rats. Endocrinology 2013; 154:193-204. [PMID: 23239815 DOI: 10.1210/en.2012-1956] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Peptide tyrosine-tyrosine (PYY) is implicated in eating control, but the site(s) and mechanism(s) of its action remain uncertain. We tested acute effects of intrameal hepatic portal vein (HPV) PYY(3-36) infusions on eating in adult, male rats and measured HPV and jugular vein (JV) plasma levels of PYY in response to a solid, mixed-nutrient meal. We also examined the effects of HPV PYY(3-36) infusions on JV plasma levels, flavor acceptance, and neuronal activation. Intrameal HPV PYY(3-36) infusions [1 and 3 nmol/kg body weight (BW)] selectively reduced (P < 0.05) ongoing meal size. HPV PYY levels increased (P < 0.05) during a chow (12.5 kcal) or an isocaloric high-fat meal. JV PYY levels were generally lower than HPV levels but also increased in response to the chow meal. HPV PYY(3-36) infusion (1 nmol/kg BW) caused a greater increase in JV PYY than a meal, but neither 1 nor 3 nmol/kg BW PYY(3-36) caused conditioned flavor avoidance. HPV PYY(3-36) (1 nmol/kg BW) increased the number of c-Fos-expressing cells in the nucleus tractus solitarii, the hypothalamic arcuate and paraventricular nuclei, the central area of the amygdala, and the nucleus accumbens but not in the area postrema and parabrachial nucleus. These data show that HPV infusions of PYY(3-36) inhibit eating in rats without causing avoidance, and they identify some brain areas that might be involved. Endogenous PYY may induce satiation by acting directly in the brain, but further studies should examine whether PYY(3-36) administrations that mimic the meal-induced increase in plasma PYY are sufficient to inhibit eating.
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Affiliation(s)
- Ulrike Stadlbauer
- Swiss Federal Institute of Technology Zurich, Schorenstrasse 16, 8603 Schwerzenbach, Switzerland.
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15
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Mager DR, Mazurak V, Rodriguez-Dimitrescu C, Vine D, Jetha M, Ball G, Yap J. A meal high in saturated fat evokes postprandial dyslipemia, hyperinsulinemia, and altered lipoprotein expression in obese children with and without nonalcoholic fatty liver disease. JPEN J Parenter Enteral Nutr 2012; 37:517-28. [PMID: 23223552 DOI: 10.1177/0148607112467820] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Hyperinsulinemia and altered lipid and lipoprotein metabolism induced by fast-food diets may contribute to nonalcoholic fatty liver disease (NAFLD). We hypothesized that a high saturated fat (SFA) meal would evoke prolonged postprandial lipemia and hyperinsulinemia, increased inflammation, and altered lipoprotein expression in obese children with NAFLD when compared with healthy children. METHODS We prospectively studied 31 children (NAFLD, 13.1 ± 2.6 years, n = 11; age-matched obese, 14.3 ± 1.7 years, n = 9; lean, 13.6 ± 2.6 years, n = 11) following consumption of a high SFA (18.8%) meal. Prior to and at 1, 3, and 6 hours after meal consumption, blood was collected for analysis of alanine aminotransferase (ALT); aspartate aminotransferase (AST); γ-glutamyltransferase; leptin; C-reactive protein; (fasting) insulin; glucose; triglycerides (TGs); total, high-density lipoprotein, and low-density lipoprotein cholesterol; adiponectin; nonesterified fatty acids (NEFAs); inflammatory markers (TNF-α, IL-6, IL-10); apolipoproteins-B48, B100, and CIII; and fatty acid (FA) composition of TG fractions. RESULTS Children with NAFLD had significantly higher fasting levels of ALT (87 ± 54 U/L), AST (52 ± 33.5 U/L), and apolipoprotein-CIII (20.6 ± 11.3 mg/dL) with postprandial hyperinsulinemia (iAUC insulin: 225 ± 207 [NAFLD] vs 113 ± 73 [obese] vs 47 ± 19.9 [lean] mU/L-h; P < .001); suppression of NEFA (iAUC-NEFA: 1.7 ± 0.9 [NAFLD] vs 0.6 ± 0.3 [obese] vs 1 ± 0.7 [lean] mEq/L-h); and prolonged elevations in apolipoprotein-B48 3-6 hours after meal consumption when compared with obese and lean controls (P < .05). CONCLUSION A meal high in saturated fat evokes postprandial dyslipemia, hyperinsulinemia, and altered lipoprotein expression in obese children with and without NAFLD.
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Affiliation(s)
- Diana R Mager
- Department of Agriculture, Food, and Nutritional Science, 4-126 Li Ka Shing Centre for Research Innovation, University of Alberta, Edmonton, AB T6G OK2, Canada.
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16
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Mitchell S, Welch-Burke T, Dumitrescu L, Lomenick JP, Murdock DG, Crawford DC, Summar M. Peptide tyrosine tyrosine levels are increased in patients with urea cycle disorders. Mol Genet Metab 2012; 106:39-42. [PMID: 22459207 PMCID: PMC3336020 DOI: 10.1016/j.ymgme.2012.02.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2012] [Accepted: 02/14/2012] [Indexed: 11/25/2022]
Abstract
Nutritional management is essential for patients with inborn errors of metabolism, such as urea cycle disorders (UCDs). Lack of appetite is common in these patients and can lead to underconsumption of calories, catabolism, and subsequently loss of metabolic control. The etiology of anorexia in these patients is largely unexplored. The neuroendocrine hormone peptide tyrosine tyrosine (PYY), secreted postprandially from endocrine cells of the ileum and colon, induces feelings of satiety and decreases food intake. While plasma PYY levels have been characterized in a number of populations, they have not been examined in UCD patients. In a retrospective study, plasma PYY concentrations were measured in UCD (n=42) patients and controls (n=28) via an ELISA to determine if levels of this anorexigenic hormone are altered in this patient population. Median PYY levels were significantly higher in UCD patients compared to controls (p=3.5×10(-5)). Body mass index was significantly associated with increased PYY levels in controls (p=0.02), while UCD diagnosis subtype was associated with PYY levels (p=1×10(-3)) in cases. Median PYY levels were significantly lower in ornithine carbamoyltransferase deficient patients compared with all other UCD subtypes (p=9×10(-3)), but significantly higher compared to controls (p=1.6×10(-3)). Overall, this study demonstrates that UCD cases have increased PYY levels compared to controls, suggesting that regulation of PYY may be altered in these patients. These observations may lead to a better understanding of the development of anorexia in UCD patients.
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Affiliation(s)
- Sabrina Mitchell
- Center for Human Genetics Research, Vanderbilt University Medical Center, Nashville, TN 37232, USA.
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