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Aukan MI, Coutinho S, Pedersen SA, Simpson MR, Martins C. Differences in gastrointestinal hormones and appetite ratings between individuals with and without obesity-A systematic review and meta-analysis. Obes Rev 2023; 24:e13531. [PMID: 36416279 PMCID: PMC10078575 DOI: 10.1111/obr.13531] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 08/26/2022] [Accepted: 10/27/2022] [Indexed: 11/24/2022]
Abstract
Determining if gastrointestinal (GI) hormone response to food intake differs between individuals with, and without, obesity may improve our understanding of obesity pathophysiology. A systematic review and meta-analysis of studies assessing the concentrations of GI hormones, as well as appetite ratings, following a test meal, in individuals with and without obesity was undertaken. Systematic searches were conducted in the databases MEDLINE, Embase, Cochrane Library, PsycINFO, Web of Science, and ClinicalTrials.gov. A total of 7514 unique articles were retrieved, 115 included in the systematic review, and 70 in the meta-analysis. The meta-analysis compared estimated standardized mean difference in GI hormones' concentration, as well as appetite ratings, between individuals with and without obesity. Basal and postprandial total ghrelin concentrations were lower in individuals with obesity compared with controls, and this was reflected by lower postprandial hunger ratings in the former. Individuals with obesity had a lower postprandial concentration of total peptide YY compared with controls, but no significant differences were found for glucagon-like peptide 1, cholecystokinin, or other appetite ratings. A large methodological and statistical heterogeneity among studies was found. More comprehensive studies are needed to understand if the differences observed are a cause or a consequence of obesity.
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Affiliation(s)
- Marthe Isaksen Aukan
- Obesity Research Group, Department of Clinical and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Centre of Obesity and Innovation (ObeCe), Clinic of Surgery, St. Olav University Hospital, Trondheim, Norway
| | - Silvia Coutinho
- Obesity Research Group, Department of Clinical and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Department of Public Health Nutrition at the Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo (UiO), Oslo, Norway
| | - Sindre Andre Pedersen
- Library Section for Research Support, Data and Analysis, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Melanie Rae Simpson
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway.,Clinical Research Unit Central Norway, St. Olavs Hospital, Trondheim, Norway
| | - Catia Martins
- Obesity Research Group, Department of Clinical and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Centre of Obesity and Innovation (ObeCe), Clinic of Surgery, St. Olav University Hospital, Trondheim, Norway.,Department of Nutrition Sciences, the University of Alabama at Birmingham (UAB), Birmingham, Alabama, USA
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2
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Differences in gastrointestinal hormones and appetite ratings among obesity classes. Appetite 2022; 171:105940. [DOI: 10.1016/j.appet.2022.105940] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 01/13/2022] [Accepted: 01/15/2022] [Indexed: 01/03/2023]
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Wikarek T, Kocełak P, Owczarek AJ, Chudek J, Olszanecka-Glinianowicz M. Effect of Dietary Macronutrients on Postprandial Glucagon and Insulin Release in Obese and Normal-Weight Women. Int J Endocrinol 2020; 2020:4603682. [PMID: 32411223 PMCID: PMC7210536 DOI: 10.1155/2020/4603682] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Revised: 03/10/2020] [Accepted: 03/30/2020] [Indexed: 11/17/2022] Open
Abstract
The aim of the study was to assess the effect of dietary macronutrients on circulating glucagon and insulin levels in obese and normal-weight women. Potentially, the impaired release of glucagon may proceed abnormal glucose metabolism in obese patients ahead of overt diabetes. In 20 insulin-sensitive women (11 obese and 9 normal-weight), plasma concentrations of insulin and glucagon levels were assessed before and after 3 different macronutrient test meals. AUCtotal insulin in the obese group was increased after protein and carbohydrates compared to fatty test meal consumption (3981 ± 2171 and 4869 ± 2784 vs. 2349 ± 1004 μIU∗h/m, p < 0.05, respectively), but without a difference between protein and carbohydrates ingestion. However, in the normal-weight group, AUCtotal insulin was increased after carbohydrates compared to fatty test meal ingestion (3929 ± 1719 vs. 2231 ± 509 μIU∗h/ml, p < 0.05) and similar after carbohydrate and protein as well as after fatty and protein test meals (3929 ± 1719 vs. 2231 ± 509 vs. 3046 ± 1406 μIU∗h/ml, respectively). However, AUCtotal insulin was significantly increased in obese compared to normal-weight women only after carbohydrate test meal ingestion (4869 ± 2784 vs. 3929 ± 1719 μIU∗h/ml, p < 0.05). AUCtotal glucagon was similar after carbohydrate, protein, and fatty test meals ingestion in obese and normal-weight women (921 ± 356 vs. 957 ± 368 vs. 926 ± 262 ng∗h/ml and 1196 ± 14 vs. 1360 ± 662 vs. 1792 ± 1176 ng∗h/ml, respectively). AUCtotal glucagon was significantly lower in obese than normal-weight women after a fatty meal (926 ± 262 vs. 1792 ± 1176 ng∗h/ml, p < 0.01). Postprandial glucagon secretion is not related to the macronutrient composition of the meal in normal-weight women since postprandial glucagon concentrations were stable and did not change after carbohydrate, protein, and fatty test meals. Lower glucagon secretion was observed in obese subjects after fatty meal consumption when compared to normal-weight subjects. Postprandial insulin profile was significantly higher after carbohydrate than fatty test meal intake in the obese group and did not differ between obese and normal-weight groups after carbohydrate, protein, and fatty test meals consumption. Impaired glucagon secretion after fatty meat suggests early pancreatic alpha-cell dysfunction, after a carbohydrate meal is a compensatory mechanism.
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Affiliation(s)
- Tomasz Wikarek
- Health Promotion and Obesity Management Unit, Department of Pathophysiology, Medical Faculty in Katowice, The Medical University of Silesia, Katowice, Poland
- Department of Gynecology and Obstetrics, Medical Faculty in Katowice, The Medical University of Silesia, Katowice, Poland
| | - Piotr Kocełak
- Health Promotion and Obesity Management Unit, Department of Pathophysiology, Medical Faculty in Katowice, The Medical University of Silesia, Katowice, Poland
| | - Aleksander J. Owczarek
- Department of Statistics, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia, Katowice, Poland
| | - Jerzy Chudek
- Pathophysiology Unit, Department of Pathophysiology, Medical Faculty in Katowice, The Medical University of Silesia, Katowice, Poland
- Department of Internal Medicine and Oncological Chemotherapy, Medical Faculty in Katowice, The Medical University of Silesia, Katowice, Poland
| | - Magdalena Olszanecka-Glinianowicz
- Health Promotion and Obesity Management Unit, Department of Pathophysiology, Medical Faculty in Katowice, The Medical University of Silesia, Katowice, Poland
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Cioffi I, Santarpia L, Vaccaro A, Naccarato M, Iacone R, Marra M, Contaldo F, Pasanisi F. Subjective palatability and appetite after gluten-free pasta: A pilot study. ACTA ALIMENTARIA 2019. [DOI: 10.1556/066.2019.0001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- I. Cioffi
- Internal Medicine and Clinical Nutrition Unit, Department of Clinical Medicine and Surgery, Federico II University Hospital, Pansini 5, 80131 Naples. Italy
| | - L. Santarpia
- Internal Medicine and Clinical Nutrition Unit, Department of Clinical Medicine and Surgery, Federico II University Hospital, Pansini 5, 80131 Naples. Italy
| | - A. Vaccaro
- Internal Medicine and Clinical Nutrition Unit, Department of Clinical Medicine and Surgery, Federico II University Hospital, Pansini 5, 80131 Naples. Italy
| | - M. Naccarato
- Internal Medicine and Clinical Nutrition Unit, Department of Clinical Medicine and Surgery, Federico II University Hospital, Pansini 5, 80131 Naples. Italy
| | - R. Iacone
- Internal Medicine and Clinical Nutrition Unit, Department of Clinical Medicine and Surgery, Federico II University Hospital, Pansini 5, 80131 Naples. Italy
| | - M. Marra
- Internal Medicine and Clinical Nutrition Unit, Department of Clinical Medicine and Surgery, Federico II University Hospital, Pansini 5, 80131 Naples. Italy
| | - F. Contaldo
- Interuniversity Center for Obesity and Eating disorders (CISRO), Department of Clinical Medicine and Surgery, Federico II University Hospital, Pansini 5, 80131 Naples. Italy
| | - F. Pasanisi
- Interuniversity Center for Obesity and Eating disorders (CISRO), Department of Clinical Medicine and Surgery, Federico II University Hospital, Pansini 5, 80131 Naples. Italy
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Chakraborty S, Halland M, Burton D, Desai A, Neja B, Low P, Singer W, Camilleri M, Zinsmeister AR, Bharucha AE. GI Dysfunctions in Diabetic Gastroenteropathy, Their Relationships With Symptoms, and Effects of a GLP-1 Antagonist. J Clin Endocrinol Metab 2019; 104:1967-1977. [PMID: 30358871 PMCID: PMC6467444 DOI: 10.1210/jc.2018-01623] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Accepted: 10/19/2018] [Indexed: 12/15/2022]
Abstract
CONTEXT Delayed gastric emptying (GE) is common but often asymptomatic in diabetes. The relationship between symptoms, glycemia, and neurohormonal functions, including glucagonlike peptide 1 (GLP-1), are unclear. OBJECTIVES To assess whether GE disturbances, symptoms during a GE study, and symptoms during enteral lipid infusion explain daily symptoms and whether GLP-1 mediates symptoms during enteral lipid infusion. DESIGN In this randomized controlled trial, GE, enteral lipid infusion, gastrointestinal (GI) symptoms during these assessments, autonomic functions, glycosylated hemoglobin (HbA1c), and daily GI symptoms (2-week Gastroparesis Cardinal Symptom Index diary) were evaluated. During enteral lipid infusion, participants received the GLP-1 antagonist exendin 9-39 or placebo. SETTING Single tertiary referral center. PARTICIPANTS 24 healthy controls and 40 patients with diabetic gastroenteropathy. MAIN OUTCOME MEASURES GE, symptoms during enteral lipid infusion, and the effect of exendin 9-39 on the latter. RESULTS In patients, GE was normal (55%), delayed (33%), or rapid (12%). During lipid infusion, GI symptoms tended to be greater (P = 0.06) in patients with diabetes mellitus (DM) than controls; exendin 9-39 did not affect symptoms. The HbA1c was inversely correlated with the mean symptom score during the GE study (r = -0.46, P = 0.003) and lipid infusion (r = -0.47, P < 0.01). GE and symptoms during GE study accounted for 40% and 32%, respectively, of the variance in daily symptom severity and quality of life. CONCLUSIONS In DM gastroenteropathy, GE and symptoms during a GE study explain daily symptoms. Symptoms during enteral lipid infusion were borderline increased but not reduced by a GLP-1 antagonist.
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Affiliation(s)
| | - Magnus Halland
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota
| | - Duane Burton
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota
| | - Anshuman Desai
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota
| | - Bridget Neja
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota
| | - Phillip Low
- Department of Neurology, Mayo Clinic, Rochester, Minnesota
| | | | - Michael Camilleri
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota
| | - Alan R Zinsmeister
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota
| | - Adil E Bharucha
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota
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Haddad E, Wien M, Oda K, Sabaté J. Postprandial gut hormone responses to Hass avocado meals and their association with visual analog scores in overweight adults: A randomized 3 × 3 crossover trial. Eat Behav 2018; 31:35-40. [PMID: 30096700 DOI: 10.1016/j.eatbeh.2018.08.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Revised: 08/01/2018] [Accepted: 08/02/2018] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To evaluate changes in postingestive gut hormone concentrations from the consumption of Hass avocado by addition or inclusion to lunch test meals, and to examine their association with measures of appetite sensation. METHODS A randomized 3 × 3 crossover study was conducted with 26 healthy overweight adults. Participants consumed one of three test meals: avocado-free control (C); isoenergic avocado inclusive (AI); and, energy increased avocado added (AA) one week apart. Ghrelin, peptide YY3-36 (PYY3-36), gastric inhibitory peptide (GIP) and glucagon-like peptide-1 (GLP-1) concentrations were measured at specific times before and following the test meals. Appetite sensations (Hunger, Fullness, Satisfied, Desire, How Much) were self-assessed using a visual analog scale (VAS) tool at matching time points and a Composite VAS score was computed. Mixed models and repeated measures analysis were used to compare differences among the test meals for VAS measurements and gut hormones, and their associations were evaluated using regression analysis. RESULTS A decrease in the 3-hour GLP-1 area under the curve (AUC) was observed in the AA meal compared to the C meal (P = 0.03). Negative associations were found for PYY3-36 and GIP for Hunger, Desire and How Much, and positive associations for Fullness, Satisfied and the Composite VAS score (all P < 0.001). For GLP-1, a negative association for Hunger and a positive association for Satisfied and the Composite VAS score (all P < 0.05) were noted. CONCLUSIONS Postprandial responses to PYY3-36, GIP and GLP-1 concentrations were associated with VAS measures and the Composite VAS score following consumption of test meals in overweight adults.
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Affiliation(s)
- Ella Haddad
- School of Public Health, Loma Linda University, Loma Linda, CA 92350, United States.
| | | | - Keiji Oda
- School of Public Health, Loma Linda University, Loma Linda, CA 92350, United States.
| | - Joan Sabaté
- School of Public Health, Loma Linda University, Loma Linda, CA 92350, United States.
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Giezenaar C, Lange K, Hausken T, Jones KL, Horowitz M, Chapman I, Soenen S. Acute Effects of Substitution, and Addition, of Carbohydrates and Fat to Protein on Gastric Emptying, Blood Glucose, Gut Hormones, Appetite, and Energy Intake. Nutrients 2018; 10:nu10101451. [PMID: 30301241 PMCID: PMC6213197 DOI: 10.3390/nu10101451] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 09/10/2018] [Accepted: 09/26/2018] [Indexed: 02/07/2023] Open
Abstract
Whey protein, when ingested on its own, load-dependently slows gastric emptying and stimulates gut hormone concentrations in healthy young men. The aim of this study was to determine the effects of substitution, and addition, of carbohydrate (dextrose) and fat (olive oil) to whey protein. In randomized, double-blind order, 13 healthy young men (age: 23 ± 1 years, body mass index: 24 ± 1 kg/m²) ingested a control drink (450 mL; ~2 kcal/'control') or iso-volumetric drinks containing protein/carbohydrate/fat: (i) 14 g/28 g/12.4 g (280 kcal/'M280'), (ii) 70 g/28 g/12.4 g (504kcal/'M504'), and (iii) 70 g/0 g/0 g (280 kcal/'P280'), on 4 separate study days. Gastric emptying (n = 11, 3D-ultrasonography), blood glucose, plasma insulin, ghrelin, cholecystokinin (CCK) and glucagon-like peptide-1 (GLP-1) concentrations (0⁻180 min), appetite (visual analogue scales), and ad-libitum buffet-meal energy intake (180⁻210 min) were determined. Substitution of protein with carbohydrate and fat was associated with faster gastric emptying (lower 50% emptying time (T50)), reduced suppression of ghrelin, and stimulation of GLP-1 (all P < 0.001); while the addition of carbohydrate and fat to protein did not affect gastric emptying or gut hormone responses significantly. Total energy intake (i.e., drink plus meal) was greater after all caloric drinks than control (P < 0.001). In conclusion, substitution of whey protein with dextrose and olive oil accelerated gastric emptying. Higher protein content of a mixed macronutrient drink increased gut hormone and insulin responses.
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Affiliation(s)
- Caroline Giezenaar
- Adelaide Medical School and National Health and Medical Research Council of Australia (NHMRC) Centre of Research Excellence (CRE) in Translating Nutritional Science to Good Health, The University of Adelaide, Adelaide 5000, Australia.
| | - Kylie Lange
- Adelaide Medical School and National Health and Medical Research Council of Australia (NHMRC) Centre of Research Excellence (CRE) in Translating Nutritional Science to Good Health, The University of Adelaide, Adelaide 5000, Australia.
| | - Trygve Hausken
- Department of Medicine, Haukeland University Hospital, 5021 Bergen, Norway.
| | - Karen L Jones
- Adelaide Medical School and National Health and Medical Research Council of Australia (NHMRC) Centre of Research Excellence (CRE) in Translating Nutritional Science to Good Health, The University of Adelaide, Adelaide 5000, Australia.
| | - Michael Horowitz
- Adelaide Medical School and National Health and Medical Research Council of Australia (NHMRC) Centre of Research Excellence (CRE) in Translating Nutritional Science to Good Health, The University of Adelaide, Adelaide 5000, Australia.
- Royal Adelaide Hospital, Adelaide 5000, Australia.
| | - Ian Chapman
- Adelaide Medical School and National Health and Medical Research Council of Australia (NHMRC) Centre of Research Excellence (CRE) in Translating Nutritional Science to Good Health, The University of Adelaide, Adelaide 5000, Australia.
- Royal Adelaide Hospital, Adelaide 5000, Australia.
| | - Stijn Soenen
- Adelaide Medical School and National Health and Medical Research Council of Australia (NHMRC) Centre of Research Excellence (CRE) in Translating Nutritional Science to Good Health, The University of Adelaide, Adelaide 5000, Australia.
- Royal Adelaide Hospital, Adelaide 5000, Australia.
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Giezenaar C, van der Burgh Y, Lange K, Hatzinikolas S, Hausken T, Jones KL, Horowitz M, Chapman I, Soenen S. Effects of Substitution, and Adding of Carbohydrate and Fat to Whey-Protein on Energy Intake, Appetite, Gastric Emptying, Glucose, Insulin, Ghrelin, CCK and GLP-1 in Healthy Older Men-A Randomized Controlled Trial. Nutrients 2018; 10:nu10020113. [PMID: 29360778 PMCID: PMC5852689 DOI: 10.3390/nu10020113] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Revised: 01/05/2018] [Accepted: 01/18/2018] [Indexed: 02/07/2023] Open
Abstract
Protein-rich supplements are used widely for the management of malnutrition in the elderly. We reported previously that the suppression of energy intake by whey protein is less in older than younger adults. The aim was to determine the effects of substitution, and adding of carbohydrate and fat to whey protein, on ad libitum energy intake from a buffet meal (180-210 min), gastric emptying (3D-ultrasonography), plasma gut hormone concentrations (0-180 min) and appetite (visual analogue scales), in healthy older men. In a randomized, double-blind order, 13 older men (75 ± 2 years) ingested drinks (~450 mL) containing: (i) 70 g whey protein (280 kcal; 'P280'); (ii) 14 g protein, 28 g carbohydrate, 12.4 g fat (280 kcal; 'M280'); (iii) 70 g protein, 28 g carbohydrate, 12.4 g fat (504 kcal; 'M504'); or (iv) control (~2 kcal). The caloric drinks, compared to a control, did not suppress appetite or energy intake; there was an increase in total energy intake (drink + meal, p < 0.05), which was increased most by the M504-drink. P280- and M504-drink ingestion were associated with slower a gastric-emptying time (n = 9), lower ghrelin, and higher cholecystokinin (CCK) and glucagon-like peptide-1 (GLP-1) than M280 (p < 0.05). Glucose and insulin were increased most by the mixed-macronutrient drinks (p < 0.05). In conclusion, energy intake was not suppressed, compared to a control, and particularly whey protein, affected gastric emptying and gut hormone responses.
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Affiliation(s)
- Caroline Giezenaar
- Discipline of Medicine and National Health and Medical Research Council of Australia (NHMRC) Centre of Research Excellence in Translating Nutritional Science to Good Health, Adelaide Medical School, Adelaide, SA 5000, Australia.
| | - Yonta van der Burgh
- Discipline of Medicine and National Health and Medical Research Council of Australia (NHMRC) Centre of Research Excellence in Translating Nutritional Science to Good Health, Adelaide Medical School, Adelaide, SA 5000, Australia.
| | - Kylie Lange
- Discipline of Medicine and National Health and Medical Research Council of Australia (NHMRC) Centre of Research Excellence in Translating Nutritional Science to Good Health, Adelaide Medical School, Adelaide, SA 5000, Australia.
| | - Seva Hatzinikolas
- Discipline of Medicine and National Health and Medical Research Council of Australia (NHMRC) Centre of Research Excellence in Translating Nutritional Science to Good Health, Adelaide Medical School, Adelaide, SA 5000, Australia.
| | - Trygve Hausken
- Department of Medicine, Haukeland University Hospital, 5021 Bergen, Norway.
| | - Karen L Jones
- Discipline of Medicine and National Health and Medical Research Council of Australia (NHMRC) Centre of Research Excellence in Translating Nutritional Science to Good Health, Adelaide Medical School, Adelaide, SA 5000, Australia.
| | - Michael Horowitz
- Discipline of Medicine and National Health and Medical Research Council of Australia (NHMRC) Centre of Research Excellence in Translating Nutritional Science to Good Health, Adelaide Medical School, Adelaide, SA 5000, Australia.
| | - Ian Chapman
- Discipline of Medicine and National Health and Medical Research Council of Australia (NHMRC) Centre of Research Excellence in Translating Nutritional Science to Good Health, Adelaide Medical School, Adelaide, SA 5000, Australia.
| | - Stijn Soenen
- Discipline of Medicine and National Health and Medical Research Council of Australia (NHMRC) Centre of Research Excellence in Translating Nutritional Science to Good Health, Adelaide Medical School, Adelaide, SA 5000, Australia.
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Efficacy of fibre additions to flatbread flour mixes for reducing post-meal glucose and insulin responses in healthy Indian subjects. Br J Nutr 2017; 117:386-394. [DOI: 10.1017/s0007114517000277] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
AbstractThe incidence of type 2 diabetes mellitus (T2DM) is increasing worldwide, including in developing countries, particularly in South Asia. Intakes of foods generating a high postprandial glucose (PPG) response have been positively associated with T2DM. As part of efforts to identify effective and feasible strategies to reduce the glycaemic impact of carbohydrate-rich staples, we previously found that addition of guar gum (GG) and chickpea flour (CPF) to wheat flour could significantly reduce the PPG response to flatbread products. On the basis of the results of an exploratory study with Caucasian subjects, we have now tested the effect of additions of specific combinations of CPF with low doses of GG to a flatbread flour mix for their impacts on PPG and postprandial insulin (PPI) responses in a South-Asian population. In a randomised, placebo-controlled full-cross-over design, fifty-six healthy Indian adults consumed flatbreads made with a commercial flatbread mix (100 % wheat flour) with no further additions (control) or incorporating 15 % CPF in combination with 2, 3 or 4 % GG. The flatbreads with CPF and 3 or 4 % GG significantly reduced PPG (both ≥15 % reduction in positive incremental AUC, P<0·01) and PPI (both ≥28 % reduction in total AUC, P<0·0001) compared with flatbreads made from control flour. These results confirm the efficacy and feasibility of the addition of CPF with GG to flatbread flour mixes to achieve significant reductions in both PPG and PPI in Indian subjects.
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de la Iglesia R, Loria-Kohen V, Zulet MA, Martinez JA, Reglero G, Ramirez de Molina A. Dietary Strategies Implicated in the Prevention and Treatment of Metabolic Syndrome. Int J Mol Sci 2016; 17:E1877. [PMID: 27834920 PMCID: PMC5133877 DOI: 10.3390/ijms17111877] [Citation(s) in RCA: 105] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Revised: 10/07/2016] [Accepted: 10/31/2016] [Indexed: 02/06/2023] Open
Abstract
Metabolic syndrome (MetS) is established as the combination of central obesity and different metabolic disturbances, such as insulin resistance, hypertension and dyslipidemia. This cluster of factors affects approximately 10%-50% of adults worldwide and the prevalence has been increasing in epidemic proportions over the last years. Thus, dietary strategies to treat this heterogenic disease are under continuous study. In this sense, diets based on negative-energy-balance, the Mediterranean dietary pattern, n-3 fatty acids, total antioxidant capacity and meal frequency have been suggested as effective approaches to treat MetS. Furthermore, the type and percentage of carbohydrates, the glycemic index or glycemic load, and dietary fiber content are some of the most relevant aspects related to insulin resistance and impaired glucose tolerance, which are important co-morbidities of MetS. Finally, new studies focused on the molecular action of specific nutritional bioactive compounds with positive effects on the MetS are currently an objective of scientific research worldwide. The present review summarizes some of the most relevant dietary approaches and bioactive compounds employed in the treatment of the MetS to date.
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Affiliation(s)
- Rocio de la Iglesia
- GENYAL Platform on Nutrition and Health, IMDEA Food Institute, CEI UAM + CSIC, 28049 Madrid, Spain.
| | - Viviana Loria-Kohen
- GENYAL Platform on Nutrition and Health, IMDEA Food Institute, CEI UAM + CSIC, 28049 Madrid, Spain.
| | - Maria Angeles Zulet
- Department of Nutrition, Food Science and Physiology, University of Navarra, 31008 Pamplona, Spain.
- CIBER Fisiopatología de la Obesidad y la Nutrición (CIBERobn), 28029 Madrid, Spain.
| | - Jose Alfredo Martinez
- Department of Nutrition, Food Science and Physiology, University of Navarra, 31008 Pamplona, Spain.
- CIBER Fisiopatología de la Obesidad y la Nutrición (CIBERobn), 28029 Madrid, Spain.
| | - Guillermo Reglero
- GENYAL Platform on Nutrition and Health, IMDEA Food Institute, CEI UAM + CSIC, 28049 Madrid, Spain.
| | - Ana Ramirez de Molina
- GENYAL Platform on Nutrition and Health, IMDEA Food Institute, CEI UAM + CSIC, 28049 Madrid, Spain.
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11
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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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Wang S, Yang L, Lu J, Mu Y. High-protein breakfast promotes weight loss by suppressing subsequent food intake and regulating appetite hormones in obese Chinese adolescents. Horm Res Paediatr 2015; 83:19-25. [PMID: 24923232 DOI: 10.1159/000362168] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2014] [Accepted: 03/04/2014] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE A high-protein diet may decrease food intake through regulating satiety and appetite hormones and can be an effective strategy for weight loss. Few studies exist on obese Chinese adolescents. METHODS AND MATERIALS 156 obese Chinese adolescents were enrolled and randomly assigned to one of two isoenergetic breakfasts, either with egg or steamed bread. Subsequent lunchtime food intake was recorded 4 h later. Appetite was assessed with a visual analog scale. Anorexigenic hormones peptide YY (PYY), glucagon-like peptide-1 (GLP-1) and orexigenic hormone ghrelin were determined with radioimmunoassay at 0, 30, and 180 min. Body weight was recorded. The tests were repeated 3 months later. Analysis was performed between two tests and then two groups. Pearson's correlation was used for association analysis. RESULTS Subsequent lunchtime food intake and body weight were decreased while satiety was increased in subjects on an egg breakfast, which is associated with an increase of serum PYY and GLP-1 (p < 0.001, respectively). There were strong correlations between weight loss, appetite, subsequent food intake and changes of appetite hormones. CONCLUSION A high-protein breakfast promotes weight loss in obese Chinese adolescents, possibly through its regulation of satiety, subsequent food intake and appetite hormones.
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Affiliation(s)
- Shaoyun Wang
- Department of Endocrinology, Chinese PLA General Hospital, Chinese PLA Medical College, Beijing, PR China
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13
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Ohlsson B, Höglund P, Roth B, Darwiche G. Modification of a traditional breakfast leads to increased satiety along with attenuated plasma increments of glucose, C-peptide, insulin, and glucose-dependent insulinotropic polypeptide in humans. Nutr Res 2015; 36:359-368. [PMID: 27001281 DOI: 10.1016/j.nutres.2015.12.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Revised: 12/02/2015] [Accepted: 12/04/2015] [Indexed: 12/24/2022]
Abstract
Our hypothesis was that carbohydrate, fat, and protein contents of meals affect satiety, glucose homeostasis, and hormone secretion. The objectives of this crossover trial were to examine satiety, glycemic-insulinemic response, and plasma peptide levels in response to 2 different recommended diabetes diets with equivalent energy content. One traditional reference breakfast and one test breakfast, with lower carbohydrate and higher fat and protein content, were randomly administered to healthy volunteers (8 men, 12 women). Blood samples were collected, and satiety was scored on a visual analog scale before and 3 hours after meals. Plasma glucose was measured, and levels of C-peptide, ghrelin, glucagon, glucagon-like peptide-1, glucose-dependent insulinotropic polypeptide (GIP), insulin, plasminogen activator inhibitor-1, and adipokines were analyzed by Luminex. Greater satiety, visual analog scale, and total and delta area under the curve (P < .001), and lower glucose postprandial peak (max) and change from baseline (dmax; P < .001) were observed after test meal compared with reference meal. Postprandial increments of C-peptide, insulin, and GIP were suppressed after test meal compared with reference meal (total delta area under the curve [P = .03, .006, and .004], delta area under the curve [P = .006, .003, and .02], max [P = .01, .007, and .002], and dmax [P = .004, .008, and .007], respectively). Concentrations of other peptides were similar between meals. A lower carbohydrate and higher fat and protein content provides greater satiety and attenuation of C-peptide, glucose, insulin, and GIP responses compared with the reference breakfast but does not affect adipokines, ghrelin, glucagon, glucagon-like peptide-1, and plasminogen activator inhibitor-1.
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Affiliation(s)
- Bodil Ohlsson
- Department of Clinical Sciences, Division of Internal Medicine, Skåne University Hospital, Malmö, Lund University, Lund, Sweden.
| | - Peter Höglund
- Department of Laboratory Medicine, Division of Clinical Chemistry & Pharmacology, Skåne University Hospital, Lund, Lund University, Lund, Sweden
| | - Bodil Roth
- Department of Clinical Sciences, Division of Internal Medicine, Skåne University Hospital, Malmö, Lund University, Lund, Sweden
| | - Gassan Darwiche
- Department of Clinical Sciences, Division of Internal Medicine, Skåne University Hospital, Malmö, Lund University, Lund, Sweden
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Hutchison AT, Feinle-Bisset C, Fitzgerald PCE, Standfield S, Horowitz M, Clifton PM, Luscombe-Marsh ND. Comparative effects of intraduodenal whey protein hydrolysate on antropyloroduodenal motility, gut hormones, glycemia, appetite, and energy intake in lean and obese men. Am J Clin Nutr 2015; 102:1323-31. [PMID: 26561615 DOI: 10.3945/ajcn.115.114538] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Accepted: 09/16/2015] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND In lean individuals, intraduodenal protein and lipid modulate gastrointestinal motor and hormone functions and reduce energy intake in a load-dependent manner; protein also stimulates insulin, with modest effects on reducing blood glucose. The effect of intraduodenal lipid on gastrointestinal motor and hormone responses is diminished in obesity; whether the effects of protein are also attenuated remains unclear. OBJECTIVES The objectives of this study were to characterize the load-dependent effects of intraduodenal whey protein hydrolysate on antropyloroduodenal pressures, gut hormones, glycemia, appetite, and energy intake in obese subjects and to compare the responses to the higher protein load with those in lean subjects. DESIGN We measured antropyloroduodenal pressures, plasma cholecystokinin (CCK), glucagon-like peptide 1 (GLP-1), glucose-dependent insulinotropic polypeptide (GIP), glucagon, insulin, blood glucose, appetite, and energy intake in 12 nondiabetic obese men on 3 separate occasions, in a double-blind, randomized order, during 60-min intraduodenal infusions of hydrolyzed whey protein at either 0 (saline control), 1.5, or 3 kcal/min. Twelve age-matched lean individuals received a 3-kcal/min infusion only. Immediately after the infusions, energy intake from a buffet lunch was quantified. RESULTS In obese subjects, protein suppressed antral and duodenal pressures; stimulated plasma CCK, GLP-1, GIP, insulin, and glucagon (all r > 0.57, P < 0.01); and tended to reduce energy intake (r = -10.38, P = 0.057) in a dose-dependent manner. In response to the 3-kcal/min protein load, antropyloroduodenal pressures, CCK, GLP-1, and glucagon did not differ between lean and obese subjects. Insulin release was greater, and GIP release less, in obese than in lean subjects (both P < 0.05), whereas the reduction in glucose was comparable. Energy intake tended to be higher in obese subjects (P = 0.08). CONCLUSIONS The gastrointestinal effects of hydrolyzed whey protein remain relatively intact in obesity; however, the observed changes in insulin and GIP suggest early disturbances in the insulin-incretin axis. This study was registered at www.anzctr.org.au as ACTRN 12612000203853.
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Affiliation(s)
- Amy T Hutchison
- University of Adelaide Discipline of Medicine and National Health and Medical Research Council of Australia Centre of Research Excellence in Translating Nutritional Science to Good Health, University of Adelaide, Adelaide, Australia
| | - Christine Feinle-Bisset
- University of Adelaide Discipline of Medicine and National Health and Medical Research Council of Australia Centre of Research Excellence in Translating Nutritional Science to Good Health, University of Adelaide, Adelaide, Australia
| | - Penelope C E Fitzgerald
- University of Adelaide Discipline of Medicine and National Health and Medical Research Council of Australia Centre of Research Excellence in Translating Nutritional Science to Good Health, University of Adelaide, Adelaide, Australia
| | - Scott Standfield
- University of Adelaide Discipline of Medicine and National Health and Medical Research Council of Australia Centre of Research Excellence in Translating Nutritional Science to Good Health, University of Adelaide, Adelaide, Australia
| | - Michael Horowitz
- University of Adelaide Discipline of Medicine and National Health and Medical Research Council of Australia Centre of Research Excellence in Translating Nutritional Science to Good Health, University of Adelaide, Adelaide, Australia
| | - Peter M Clifton
- University of Adelaide Discipline of Medicine and National Health and Medical Research Council of Australia Centre of Research Excellence in Translating Nutritional Science to Good Health, University of Adelaide, Adelaide, Australia; School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, Australia; and
| | - Natalie D Luscombe-Marsh
- University of Adelaide Discipline of Medicine and National Health and Medical Research Council of Australia Centre of Research Excellence in Translating Nutritional Science to Good Health, University of Adelaide, Adelaide, Australia; Commonwealth Scientific and Industrial Research Organization, Animal, Food and Health Sciences, Adelaide, Australia
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15
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de Mello AH, Prá M, Cardoso LC, de Bona Schraiber R, Rezin GT. Incretin-based therapies for obesity treatment. Metabolism 2015; 64:967-81. [PMID: 26072135 DOI: 10.1016/j.metabol.2015.05.012] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Revised: 05/18/2015] [Accepted: 05/21/2015] [Indexed: 12/19/2022]
Abstract
Currently, obesity and its associated complications are considered major public health problems worldwide. Because the causes are multifactorial and complex, different treatment methods are used, which include diet and exercise, as well as the use of drugs, although they can have adverse side effects. A new target for the treatment of obesity may be the incretin system, which consists of hormones that seem to contribute to weight loss. In this sense, some studies have shown a relationship between weight loss and drugs related to incretin system, including glucagon-like peptide-1 (GLP-1) agonists and dipeptidyl peptidase-4 (DPP-4) inhibitors. The objective of this review is to summarize the association between the incretin system and obesity treatment.
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Affiliation(s)
- Aline Haas de Mello
- Laboratory of Clinical and Experimental Pathophysiology. Postgraduate Program in Health Sciences at University of Southern Santa Catarina at Tubarão, Santa Catarina, Brazil
| | - Morgana Prá
- Laboratory of Clinical and Experimental Pathophysiology. Postgraduate Program in Health Sciences at University of Southern Santa Catarina at Tubarão, Santa Catarina, Brazil
| | - Larissa Colonetti Cardoso
- Laboratory of Clinical and Experimental Pathophysiology. Postgraduate Program in Health Sciences at University of Southern Santa Catarina at Tubarão, Santa Catarina, Brazil
| | - Rosiane de Bona Schraiber
- Laboratory of Clinical and Experimental Pathophysiology. Postgraduate Program in Health Sciences at University of Southern Santa Catarina at Tubarão, Santa Catarina, Brazil
| | - Gislaine Tezza Rezin
- Laboratory of Clinical and Experimental Pathophysiology. Postgraduate Program in Health Sciences at University of Southern Santa Catarina at Tubarão, Santa Catarina, Brazil; Clinical Research Center at Hospital Nossa Senhora da Conceição, Santa Catarina, Brazil.
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Viljakainen H, Andersson-Assarsson JC, Armenio M, Pekkinen M, Pettersson M, Valta H, Lipsanen-Nyman M, Mäkitie O, Lindstrand A. Low Copy Number of the AMY1 Locus Is Associated with Early-Onset Female Obesity in Finland. PLoS One 2015; 10:e0131883. [PMID: 26132294 PMCID: PMC4489572 DOI: 10.1371/journal.pone.0131883] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2015] [Accepted: 06/08/2015] [Indexed: 12/25/2022] Open
Abstract
Background The salivary α-amylase locus (AMY1) is located in a highly polymorphic multi allelic copy number variable chromosomal region. A recent report identified an association between AMY1 copy numbers and BMI in common obesity. The present study investigated the relationship between AMY1 copy number, BMI and serum amylase in childhood-onset obesity. Patients Sixty-one subjects with a history of childhood-onset obesity (mean age 19.1 years, 54% males) and 71 matched controls (19.8 yrs, 45% males) were included. All anthropometric measures were greater in the obese; their mean BMI was 40 kg/m2 (range 25-62 kg/m2) compared with 23 kg/m2 in the controls (15-32 kg/m2). Results Mean AMY1 copy numbers did not differ between the obese and control subjects, but gender differences were observed; obese men showed the highest and obese women the lowest number of AMY1 copies (p=0.045). Further, only in affected females, AMY1 copy number correlated significantly with whole body fat percent (r=-0.512, p=0.013) and BMI (r=-0.416, p=0.025). Finally, a clear linear association between AMY1 copy number and serum salivary amylase was observed in all subgroups but again differences existed between obese males and females. Conclusions In conclusion, our findings suggest that AMY1 copy number differences play a role in childhood-onset obesity but the effect differs between males and females. Further studies in larger cohorts are needed to confirm these observations.
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Affiliation(s)
- Heli Viljakainen
- Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Johanna C Andersson-Assarsson
- Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Center for Cardiovascular and Metabolic Research, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Miriam Armenio
- Department of Molecular Medicine and Surgery, and Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
| | | | - Maria Pettersson
- Department of Molecular Medicine and Surgery, and Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Helena Valta
- Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Marita Lipsanen-Nyman
- Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Outi Mäkitie
- Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Department of Molecular Medicine and Surgery, and Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
- Folkhälsan Institute of Genetics, Helsinki, Finland
- Department of Clinical Genetics, Karolinska University Hospital, Stockholm, Sweden
| | - Anna Lindstrand
- Department of Molecular Medicine and Surgery, and Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Clinical Genetics, Karolinska University Hospital, Stockholm, Sweden
- * E-mail:
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Postprandial glucagon-like peptide-1 secretion is increased during the progression of glucose intolerance and obesity in high-fat/high-sucrose diet-fed rats. Br J Nutr 2015; 113:1477-88. [PMID: 25827219 DOI: 10.1017/s0007114515000550] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Glucagon-like peptide-1 (GLP-1) is secreted by distal enteroendocrine cells in response to luminal nutrients, and exerts insulinotropic and anorexigenic effects. Although GLP-1 secretory responses under established obese or diabetic conditions have been studied, it has not been investigated whether or how postprandial GLP-1 responses were affected during the progression of diet-induced obesity. In the present study, a meal tolerance test was performed every week in rats fed a high-fat and high-sucrose (HF/HS) diet to evaluate postprandial glycaemic, insulin and GLP-1 responses. In addition, gastric emptying was assessed by the acetaminophen method. After 8 weeks of HF/HS treatment, portal vein and intestinal mucosa were collected to examine GLP-1 production. Postprandial glucose in response to normal meal ingestion was increased in the HF/HS group within 2 weeks, and its elevation gradually returned close to that of the control group until day 50. Slower postprandial gastric emptying was observed in the HF/HS group on days 6, 13 and 34. Postprandial GLP-1 and insulin responses were increased in the HF/HS group at 7 weeks. Higher portal GLP-1 and insulin levels were observed in the HF/HS group, but mucosal gut hormone mRNA levels were unchanged. These results revealed that the postprandial GLP-1 response to meal ingestion is enhanced during the progression of diet-induced glucose intolerance and obesity in rats. The boosted postprandial GLP-1 secretion by chronic HF/HS diet treatment suggests increased sensitivity to luminal nutrients in the gut, and this may slow the establishment of glucose intolerance and obesity.
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Responses in gut hormones and hunger to diets with either high protein or a mixture of protein plus free amino acids supplied under weight-loss conditions. Br J Nutr 2015; 113:1254-70. [PMID: 25809236 DOI: 10.1017/s0007114515000069] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
High-protein diets are an effective means for weight loss (WL), but the mechanisms are unclear. One hypothesis relates to the release of gut hormones by either protein or amino acids (AA). The present study involved overweight and obese male volunteers (n 18, mean BMI 36·8 kg/m2) who consumed a maintenance diet for 7 d followed by fully randomised 10 d treatments with three iso-energetic WL diets, i.e. with either normal protein (NP, 15% of energy) or high protein (HP, 30%) or with a combination of protein and free AA, each 15% of energy (NPAA). Psychometric ratings of appetite were recorded hourly. On day 10, plasma samples were taken at 30 min intervals over two consecutive 5 h periods (covering post-breakfast and post-lunch) and analysed for AA, glucose and hormones (insulin, total glucose-dependent insulinotropic peptide, active ghrelin and total peptide YY (PYY)) plus leucine kinetics (first 5 h only). Composite hunger was 16% lower for the HP diet than for the NP diet (P<0·01) in the 5 h period after both meals. Plasma essential AA concentrations were greatest within 60 min of each meal for the NPAA diet, but remained elevated for 3-5 h after the HP diet. The three WL diets showed no difference for either fasting concentrations or the postprandial net incremental AUC (net AUCi) for insulin, ghrelin or PYY. No strong correlations were observed between composite hunger scores and net AUCi for either AA or gut peptides. Regulation of hunger may involve subtle interactions, and a range of signals may need to be integrated to produce the overall response.
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L-glutamine and whole protein restore first-phase insulin response and increase glucagon-like peptide-1 in type 2 diabetes patients. Nutrients 2015; 7:2101-8. [PMID: 25811109 PMCID: PMC4425133 DOI: 10.3390/nu7042101] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Revised: 03/10/2015] [Accepted: 03/12/2015] [Indexed: 11/16/2022] Open
Abstract
L-glutamine triggers glucagon-like peptide-1 (GLP-1) release from L cells in vitro and when ingested pre-meal, decreases postprandial glycaemia and increases circulating insulin and GLP-1 in type 2 diabetes (T2D) patients. We aimed to evaluate the effect of oral L-glutamine, compared with whole protein low in glutamine, on insulin response in well-controlled T2D patients. In a randomized study with a crossover design, T2D patients (n = 10, 6 men) aged 65.1 ± 5.8, with glycosylated hemoglobin (HbA1c) 6.6% ± 0.7% (48 ± 8 mmol/mol), received oral L-glutamine (25 g), protein (25 g) or water, followed by an intravenous glucose bolus (0.3 g/kg) and hyperglycemic glucose clamp for 2 h. Blood was frequently collected for analyses of glucose, serum insulin and plasma total and active GLP-1 and area under the curve of glucose, insulin, total and active GLP-1 excursions calculated. Treatments were tested 1-2 weeks apart. Both L-glutamine and protein increased first-phase insulin response (p ≤ 0.02). Protein (p = 0.05), but not L-glutamine (p = 0.2), increased second-phase insulin response. Total GLP-1 was increased by both L-glutamine and protein (p ≤ 0.02). We conclude that oral L-glutamine and whole protein are similarly effective in restoring first-phase insulin response in T2D patients. Larger studies are required to further investigate the utility of similar approaches in improving insulin response in diabetes.
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Abstract
PURPOSE OF REVIEW Diets that induce negative energy balance continue to be the cornerstone of obesity management. However, long-term volitional reduction in energy intake is challenging. Functional foods that enhance satiety may have an important practical application in increasing compliance to weight loss diets and thereby promoting sustained weight loss. Here, we present recent advances in identifying common foods that increase satiety. RECENT FINDINGS Protein induces satiety in the short term. There is no clear evidence to indicate superiority of a specific protein source over the other. Low-fat dairy products, eggs, and legumes enhance satiety. Although energy dense, nuts have some satiety-inducing effect, when included in the diet by isocaloric replacement of usual foods. Satiety induced by dietary fiber sources, such as oats and rye, are well documented, but these sensations do not always translate into reductions in energy intake or body weight. SUMMARY Several foods and food groups show promising potential in inducing satiety. However, it is important to recognize that the short-term effect of a food may not always translate into greater weight loss in the long term. Long-term clinical studies are needed to demonstrate the utility of a food in promoting weight loss.
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Affiliation(s)
- Candida Rebello
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, Louisiana, USA
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