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Dagbasi A, Warner J, Catterall V, Smith K, Crabtree DR, Carroll B, Frost G, Holliday A. Augmented gut hormone response to feeding in older adults exhibiting low appetite. Appetite 2024; 201:107415. [PMID: 38761969 DOI: 10.1016/j.appet.2024.107415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 04/25/2024] [Accepted: 05/09/2024] [Indexed: 05/20/2024]
Abstract
Age-related changes in gut hormones may play a role in anorexia of ageing. The aim of this study was to determine concentrations of ghrelin, PYY, and GLP-1 in older adults exhibiting an anorexia of ageing phenotype. Thirteen older adults with healthy appetite (OA-HA; 8f, 75 ± 7 years, 26.0 ± 3.2 kg m-2), fifteen older adults with low appetite (OA-LA; 10f, 72 ± 7 years, 23.6 ± 3.1 kg m-2), and twelve young adults (YA; 6f, 22 ± 2 years, 24.4 ± 2.0 kg m-2) completed the study. Healthy appetite and low appetite were determined based on BMI, habitual energy intake, self-reported appetite, and laboratory-assessed ad libitum lunch intake. Participants provided a fasted measure of subjective appetite and blood sample (0 min) before consuming a standardised breakfast (450 kcal). Appetite was measured and blood samples were drawn throughout a 240-min rest period. At 240 min, an ad libitum lunch meal was consumed. Relative intake at lunch (expressed as percentage of estimated total energy requirement) was lower for OA-LA (19.8 ± 7.7%) than YA (41.5 ± 9.2%, p < 0.001) and OA-HA (37.3 ± 10.0%, p < 0.001). Ghrelin suppression was greater for OA-LA (net AUC, -78719 ± 74788 pg mL-1·240min-1) than both YA (-23899 ± 27733 pg mL-1·240min-1, p = 0.016) and OA-HA (-21144 ± 31161 pg mL-1·240min-1, p = 0.009). There were trends for higher GLP-1 concentrations in OA-LA compared with YA at 90 min (8.85 ± 10.4 pM vs. 1.88 ± 4.63 pM, p = 0.073) and 180 min (5.00 ± 4.71 pM vs. 1.07 ± 2.83 pM, p = 0.065). There was a trend for a greater PYY response for OA-LA compared with OA-HA (net AUC p = 0.062). "Anorexigenic response score" - a composite score of gut hormone responses to feeding - showed greater anorexigenic response in OA-LA, compared with YA and OA-HA. No differences were seen in subjective appetite. These observations suggest augmented anorexigenic responses of gut hormones to feeding may be causal mechanisms of anorexia of ageing.
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Affiliation(s)
- Aygul Dagbasi
- Section of Nutrition, Imperial College London, 6th Floor Commonwealth Building, Hammersmith Hospital, London, UK
| | - Jordan Warner
- School of Biomedical, Nutritional, and Sport Science, Newcastle University, Newcastle Upon Tyne, UK
| | - Victoria Catterall
- School of Biomedical, Nutritional, and Sport Science, Newcastle University, Newcastle Upon Tyne, UK
| | - Kieran Smith
- Oxford Centre for Diabetes, Endocrinology and Metabolism, Churchill Hospital, University of Oxford, Oxford, UK
| | - Daniel R Crabtree
- The Rowett Institute, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
| | - Bernadette Carroll
- School of Biochemistry, University of Bristol, University Walk, Bristol, UK
| | - Gary Frost
- Section of Nutrition, Imperial College London, 6th Floor Commonwealth Building, Hammersmith Hospital, London, UK
| | - Adrian Holliday
- School of Biomedical, Nutritional, and Sport Science, Newcastle University, Newcastle Upon Tyne, UK; Human Nutrition and Exercise Research Centre, Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK.
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Prater MC, Guadagni AJ, Cooper JA. Postprandial appetite responses to a pecan enriched meal: A randomized crossover trial. Appetite 2024; 201:107598. [PMID: 38971424 DOI: 10.1016/j.appet.2024.107598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2024] [Revised: 06/26/2024] [Accepted: 07/03/2024] [Indexed: 07/08/2024]
Abstract
Longer-term pecan consumption has shown appetite-regulating effects as a part of a free-living diet, yet the physiologic appetite responses to a single pecan-containing meal are unclear. The purpose of this study was to compare the acute physiologic, subjective, and direct appetite responses of a pecan-containing meal to an energy- and macronutrient-matched control meal. This was an acute meal challenge study utilizing a double-blinded randomized crossover design with two periods. Participants were young, healthy adults (BMI: 22.9 ± 3.3 kg/m2, age: 22 ± 3 y) who consumed a meal containing either 68 g of pecans (PEC; 795 kcal) or an energy- and macronutrient-matched control meal (CON; 794 kcal) on separate testing days. At both testing visits, five postprandial blood draws, and visual analog scale (VAS) questionnaires (in-lab) were used to determine differences in peptide YY (PYY), ghrelin, and subjective appetite over a 4-h postprandial period. Participants also completed VAS questionnaires (at-home) and food records for the rest of the day after leaving the testing visits. Thirty-one out of thirty-two randomized participants completed the study. There was a greater overall postprandial PYY response (p < 0.001), and a greater suppression of postprandial ghrelin after time point 120 min (p < 0.001), with the PEC vs. CON meal. Further, there was a greater increase in subjective fullness (p = 0.001), and suppression of at-home overall appetite (p = 0.02), from time 240-780 min post-meal with PEC vs. CON meals. There were no differences in self-reported EI between meals or any other VAS measure. In conclusion, a pecan-containing breakfast shake produced more favorable physiologic and subjective improvements in appetite compared to an energy- and macronutrient-matched control meal. This trial is registered at clinicaltrials.gov (NCT05230212).
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Affiliation(s)
- M Catherine Prater
- Department of Nutritional Sciences, University of Georgia, Athens, GA, USA
| | - Alyssa J Guadagni
- Department of Nutritional Sciences, University of Georgia, Athens, GA, USA
| | - Jamie A Cooper
- Department of Kinesiology, University of Georgia, Athens, GA, USA.
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Smedegaard S, Kampmann U, Ovesen PG, Støvring H, Rittig N. Whey Protein Premeal Lowers Postprandial Glucose Concentrations in Adults Compared with Water-The Effect of Timing, Dose, and Metabolic Status: a Systematic Review and Meta-analysis. Am J Clin Nutr 2023; 118:391-405. [PMID: 37536867 DOI: 10.1016/j.ajcnut.2023.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 04/19/2023] [Accepted: 05/02/2023] [Indexed: 08/05/2023] Open
Abstract
BACKGROUND Serving whey protein before a meal in order to lower postprandial blood glucose concentrations is known as a premeal. The underlying mechanisms are only partly understood but may involve stimulation of glucagon-like peptide-1 (GLP-1), glucose-dependent insulinotropic polypeptide (GIP), and insulin secretion together with a slower gastric emptying rate. OBJECTIVES The objective of this systematic review and meta-analysis was to review all randomized clinical trials investigating premeals with whey protein in comparison with a nonactive comparator (control) that evaluated plasma glucose, GLP-1, GIP, insulin, and/or gastric emptying rate. Secondary aims included subgroup analyses on the timing and dose of the premeal together with the metabolic state of the participants [lean, obese, and type 2 diabetes mellitus (T2DM)]. METHODS We searched EMBASE, CENTRAL, PUBMED, and clinicaltrials.gov and found 16 randomized crossover trials with a total of 244 individuals. The last search was performed on 9 August, 2022. RESULTS Whey protein premeals lowered peak glucose concentration by -1.4 mmol/L [-1.9 mmol/L; -0.9 mmol/L], and the area under the curve for glucose was -0.9 standard deviation (SD) [-1.2 SD; -0.6 SD] compared with controls (high certainty). In association with these findings, whey protein premeals elevated GLP-1 (low certainty) and peak insulin (high certainty) concentrations and slowed gastric emptying rate (high certainty) compared with controls. Subgroup analyses showed a more pronounced and prolonged glucose-lowering effect in individuals with T2DM compared with participants without T2DM. The available evidence did not elucidate the role of GIP. The protein dose used varied between 4 and 55 g, and meta-regression analysis showed that the protein dose correlated with the glucose-lowering effects. CONCLUSIONS In conclusion, whey protein premeals lower postprandial blood glucose, reduce gastric emptying rate, and increase peak insulin. In addition, whey protein premeals may elevate plasma concentrations of GLP-1. Whey protein premeals may possess clinical potential, but the long-term effects await future clinical trials.
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Affiliation(s)
- Stine Smedegaard
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark; Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark.
| | - Ulla Kampmann
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark; Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
| | - Per G Ovesen
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark; Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark; Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark
| | - Henrik Støvring
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
| | - Nikolaj Rittig
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark; Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark; Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
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Valicente VM, Peng CH, Pacheco KN, Lin L, Kielb EI, Dawoodani E, Abdollahi A, Mattes RD. Ultraprocessed Foods and Obesity Risk: A Critical Review of Reported Mechanisms. Adv Nutr 2023; 14:718-738. [PMID: 37080461 PMCID: PMC10334162 DOI: 10.1016/j.advnut.2023.04.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 04/02/2023] [Accepted: 04/14/2023] [Indexed: 04/22/2023] Open
Abstract
Epidemiologic evidence supports a positive association between ultraprocessed food (UPF) consumption and body mass index. This has led to recommendations to avoid UPFs despite very limited evidence establishing causality. Many mechanisms have been proposed, and this review critically aimed to evaluate selected possibilities for specificity, clarity, and consistency related to food choice (i.e., low cost, shelf-life, food packaging, hyperpalatability, and stimulation of hunger/suppression of fullness); food composition (i.e., macronutrients, food texture, added sugar, fat and salt, energy density, low-calorie sweeteners, and additives); and digestive processes (i.e., oral processing/eating rate, gastric emptying time, gastrointestinal transit time, and microbiome). For some purported mechanisms (e.g., fiber content, texture, gastric emptying, and intestinal transit time), data directly contrasting the effects of UPF and non-UPF intake on the indices of appetite, food intake, and adiposity are available and do not support a unique contribution of UPFs. In other instances, data are not available (e.g., microbiome and food additives) or are insufficient (e.g., packaging, food cost, shelf-life, macronutrient intake, and appetite stimulation) to judge the benefits versus the risks of UPF avoidance. There are yet other evoked mechanisms in which the preponderance of evidence indicates ingredients in UPFs actually moderate body weight (e.g., low-calorie sweetener use for weight management; beverage consumption as it dilutes energy density; and higher fat content because it reduces glycemic responses). Because avoidance of UPFs holds potential adverse effects (e.g., reduced diet quality, increased risk of food poisoning, and food wastage), it is imprudent to make recommendations regarding their role in diets before causality and plausible mechanisms have been verified.
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Affiliation(s)
- Vinicius M Valicente
- Department of Nutrition Science, Purdue University, West Lafayette, IN, United States
| | - Ching-Hsuan Peng
- Department of Speech, Language, and Hearing Sciences, Purdue University, West Lafayette, IN, United States
| | - Kathryn N Pacheco
- Department of Nutrition Science, Purdue University, West Lafayette, IN, United States
| | - Luotao Lin
- Department of Nutrition Science, Purdue University, West Lafayette, IN, United States
| | - Elizabeth I Kielb
- Department of Human Development and Family Studies, Purdue University, West Lafayette, IN, United States
| | - Elina Dawoodani
- Department of Nutrition Science, Purdue University, West Lafayette, IN, United States
| | - Afsoun Abdollahi
- Department of Nutrition Science, Purdue University, West Lafayette, IN, United States
| | - Richard D Mattes
- Department of Nutrition Science, Purdue University, West Lafayette, IN, United States.
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The effect of gastrointestinal bitter sensing on appetite regulation and energy intake: A systematic review. Appetite 2023; 180:106336. [PMID: 36216215 DOI: 10.1016/j.appet.2022.106336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 09/28/2022] [Accepted: 09/29/2022] [Indexed: 11/05/2022]
Abstract
Taste receptors are located on the epithelial surface throughout the alimentary canal to identify nutrients and potential toxins. In the oral cavity, the role of taste is to encourage or discourage ingestion, while in the gastrointestinal (GI) tract, the taste receptors help the body prepare for an appropriate response to the ingested foods. The GI sensing of bitter compounds may alter the secretion of appetite-related hormones thereby reducing food intake, which may have potential use for managing health outcomes. This systematic literature review investigated the acute effects of administering different bitter tasting compounds on circulating levels of selected GI hormones, subjective appetite, and energy intake in humans. A literature search was conducted using Medline, CINAHL and Web of Science databases. Of 290 articles identified, 16 met the inclusion criteria. Twelve studies assessed food intake; four of these found bitter administration decreased food intake and eight did not. Fourteen studies assessed subjective appetite; seven found bitter administration affected at least one measure of appetite and seven detected no significant changes. Nine studies included measures of GI hormones; no significant effects were found for changes in GLP-1, CCK or PYY. Four studies measured motilin and ghrelin and found mostly consistent changes in either food intake or subjective appetite. Overall, the data on food intake and subjective appetite were inconsistent, with only motilin and ghrelin responsive to post-oral bitter administration. There is limited consistent conclusive evidence that bitter compounds influence food intake, appetite or hormones with the reasons for this discussed within. SYSTEMATIC REVIEW REGISTRATION: CRD42021226102.
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Bertoli D, Steinkohl E, Mark EB, Brock C, Drewes AM, Frøkjaer JB. Quantification of gastric emptying with magnetic resonance imaging in healthy volunteers: A systematic review. Neurogastroenterol Motil 2022; 34:e14371. [PMID: 35340100 PMCID: PMC10078504 DOI: 10.1111/nmo.14371] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 02/17/2022] [Accepted: 03/14/2022] [Indexed: 02/06/2023]
Abstract
BACKGROUND Several magnetic resonance imaging (MRI) protocols have been used to assess gastric emptying (GE) with MRI. This systematic review summarizes the current literature on the topic. The aim was to provide an overview of the available imaging protocols and underline the items that appear most agreed upon and those that deserve further investigation. METHODS According to PRISMA guidelines, two independent reviewers conducted a systematic literature search with a pre-specified strategy in different databases. Peer-reviewed articles that utilized MRI techniques to assess GE in healthy volunteers (HVs) were included. The quality and the outcomes of the studies were reported and analyzed. KEY RESULTS The literature search yielded 30 studies (531 HVs, weighted mean age 27.4, weighted mean body mass index 23.0 kg/m2 ), T2-weighted sequences, balanced turbo field echo, and balanced gradient echo were evenly utilized, with volunteers in the supine position (74% of the studies). After overnight fasting, both liquid (56%) and mixed (44%) meals were equally utilized. Segmentation of the volumes was predominantly performed manually (63%) with a reported mean T50 ranging from 7 to 330 min. CONCLUSIONS & INFERENCES As observed in this systematic review, MRI is a flexible tool for assessing GE. Different protocols were analyzed, showing an equal capacity to assess the GE. However, many items in these protocols still require further investigation to obtain a common standard and increase this assessment quality.
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Affiliation(s)
- Davide Bertoli
- Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Emily Steinkohl
- Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.,Mech-Sense, Department of Radiology, Aalborg University Hospital, Aalborg, Denmark
| | - Esben Bolvig Mark
- Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital, Aalborg, Denmark.,Mech-Sense, Department of Radiology, Aalborg University Hospital, Aalborg, Denmark
| | - Christina Brock
- Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Asbjørn Mohr Drewes
- Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Jens Brøndum Frøkjaer
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.,Mech-Sense, Department of Radiology, Aalborg University Hospital, Aalborg, Denmark
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7
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Comparative Effects of Co-Ingesting Whey Protein and Glucose Alone and Combined on Blood Glucose, Plasma Insulin and Glucagon Concentrations in Younger and Older Men. Nutrients 2022; 14:nu14153111. [PMID: 35956288 PMCID: PMC9370714 DOI: 10.3390/nu14153111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 07/25/2022] [Accepted: 07/26/2022] [Indexed: 12/10/2022] Open
Abstract
The ingestion of dietary protein with, or before, carbohydrate may be a useful strategy to reduce postprandial hyperglycemia, but its effect in older people, who have an increased predisposition for type 2 diabetes, has not been clarified. Blood glucose, plasma insulin and glucagon concentrations were measured for 180 min following a drink containing either glucose (120 kcal), whey-protein (120 kcal), whey-protein plus glucose (240 kcal) or control (~2 kcal) in healthy younger (n = 10, 29 ± 2 years; 26.1 ± 0.4 kg/m2) and older men (n = 10, 78 ± 2 years; 27.3 ± 1.4 kg/m2). Mixed model analysis was used. In both age groups the co-ingestion of protein with glucose (i) markedly reduced the increase in blood glucose concentrations following glucose ingestion alone (p < 0.001) and (ii) had a synergistic effect on the increase in insulin concentrations (p = 0.002). Peak insulin concentrations after protein were unaffected by ageing, whereas insulin levels after glucose were lower in older than younger men (p < 0.05) and peak insulin concentrations were higher after glucose than protein in younger (p < 0.001) but not older men. Glucagon concentrations were unaffected by age. We conclude that the ability of whey-protein to reduce carbohydrate-induced postprandial hyperglycemia is retained in older men and that protein supplementation may be a useful strategy in the prevention and management of type 2 diabetes in older people.
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von Gerichten J, Elnesr MH, Prollins JE, De Mel IA, Flanagan A, Johnston JD, Fielding BA, Short M. The [ 13 C]octanoic acid breath test for gastric emptying quantification: A focus on nutrition and modeling. Lipids 2022; 57:205-219. [PMID: 35799422 PMCID: PMC9546385 DOI: 10.1002/lipd.12352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 06/14/2022] [Accepted: 06/15/2022] [Indexed: 11/28/2022]
Abstract
Gastric emptying (GE) is the process of food being processed by the stomach and delivered to the small intestine where nutrients such as lipids are absorbed into the blood circulation. The combination of an easy and inexpensive method to measure GE such as the CO2 breath test using the stable isotope [13C]octanoic acid with semi‐mechanistic modeling could foster a wider application in nutritional studies to further understand the metabolic response to food. Here, we discuss the use of the [13C]octanoic acid breath test to label the solid phase of a meal, and the factors that influence GE to support mechanistic studies. Furthermore, we give an overview of existing mathematical models for the interpretation of the breath test data and how much nutritional studies could benefit from a physiological based pharmacokinetic model approach.
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Affiliation(s)
- Johanna von Gerichten
- Department of Nutritional Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - Marwan H Elnesr
- Department of Chemical and Process Engineering, Faculty of Engineering and Physical Sciences, University of Surrey, Guildford, UK
| | - Joe E Prollins
- Department of Chemical and Process Engineering, Faculty of Engineering and Physical Sciences, University of Surrey, Guildford, UK
| | - Ishanki A De Mel
- Department of Chemical and Process Engineering, Faculty of Engineering and Physical Sciences, University of Surrey, Guildford, UK
| | - Alan Flanagan
- Department of Nutritional Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK.,Section of Chronobiology, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - Jonathan D Johnston
- Section of Chronobiology, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - Barbara A Fielding
- Department of Nutritional Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - Michael Short
- Department of Chemical and Process Engineering, Faculty of Engineering and Physical Sciences, University of Surrey, Guildford, UK
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Lim JJ, Sequeira IR, Yip WCY, Lu LW, Barnett D, Cameron-Smith D, Poppitt SD. Postprandial glycine as a biomarker of satiety: A dose-rising randomised control trial of whey protein in overweight women. Appetite 2021; 169:105871. [PMID: 34915106 DOI: 10.1016/j.appet.2021.105871] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 11/29/2021] [Accepted: 12/12/2021] [Indexed: 01/09/2023]
Abstract
This study aimed to identify biomarkers of appetite response, modelled using a dose-rising whey protein preload intervention. Female participants (n = 24) with body mass index (BMI) between 23 and 40 kg/m2 consumed preload beverages (0 g protein water control, WC; 12.5 g low-dose protein, LP; or 50.0 g high-dose protein, HP) after an overnight fast, in a randomised cross over design. Repeated venous blood samples were collected to measure plasma biomarkers of appetite response, including glucose, glucoregulatory peptides, gut peptides, and amino acids (AAs). Appetite was assessed using Visual Analogue Scales (VAS) and ad libitum energy intake (EI). Dose-rising protein beverage significantly changed the postprandial trajectory of almost all biomarkers (treatment*time, p < 0.05), but did not suppress postprandial appetite (treatment*time, p > 0.05) or EI (ANOVA, p = 0.799). Circulating glycine had the strongest association with appetite response. Higher area under the curve (AUC0-240) glycine was associated with lower EI (p = 0.026, trend). Furthermore, circulating glycine was associated with decreased Hunger in all treatment groups, whereas the associations of glucose, alanine and amylin with appetite were dependent on treatment groups. Multivariate models, incorporating multiple biomarkers, improved the estimation of appetite response (marginal R2, range: 0.13-0.43). In conclusion, whilst glycine, both alone and within a multivariate model, can estimate appetite response to both water and whey protein beverage consumption, a large proportion of variance in appetite response remains unexplained. Most biomarkers, when assessed in isolation, are poor predictors of appetite response, and likely of utility only in combination with VAS and EI.
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Affiliation(s)
- Jia Jiet Lim
- Human Nutrition Unit, School of Biological Sciences, University of Auckland, Auckland, New Zealand; Riddet Institute, Palmerston North, New Zealand.
| | - Ivana R Sequeira
- Human Nutrition Unit, School of Biological Sciences, University of Auckland, Auckland, New Zealand; High Value Nutrition, National Science Challenge, Auckland, New Zealand
| | - Wilson C Y Yip
- Human Nutrition Unit, School of Biological Sciences, University of Auckland, Auckland, New Zealand; High Value Nutrition, National Science Challenge, Auckland, New Zealand
| | - Louise W Lu
- Human Nutrition Unit, School of Biological Sciences, University of Auckland, Auckland, New Zealand; High Value Nutrition, National Science Challenge, Auckland, New Zealand
| | - Daniel Barnett
- Department of Statistics, University of Auckland, Auckland, New Zealand
| | - David Cameron-Smith
- Riddet Institute, Palmerston North, New Zealand; Liggins Institute, University of Auckland, Auckland, New Zealand; Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
| | - Sally D Poppitt
- Human Nutrition Unit, School of Biological Sciences, University of Auckland, Auckland, New Zealand; Riddet Institute, Palmerston North, New Zealand; High Value Nutrition, National Science Challenge, Auckland, New Zealand; Department of Medicine, University of Auckland, Auckland, New Zealand
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10
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Giezenaar C, Oberoi A, Jones KL, Horowitz M, Chapman I, Soenen S. Effects of age on blood pressure and heart rate responses to whey protein in younger and older men. J Am Geriatr Soc 2021; 69:1291-1299. [PMID: 33675081 DOI: 10.1111/jgs.17083] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 01/10/2021] [Accepted: 01/14/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUND Postprandial falls in blood pressure (BP) are more common in older compared to younger individuals. The effects of protein compared to carbohydrates and fat on postprandial BP, and the relation to gastric emptying rates, are poorly studied. OBJECTIVES To determine the effects of a whey protein compared to a control drink on systolic BP (SBP) and diastolic BP (DBP), and heart rate (HR) in healthy younger and older men, and to relate these effects to gastric emptying. DESIGN A pooled analyses of two randomized, double-blind, cross-over studies. SETTING Two acute clinical intervention studies with identical study design. PARTICIPANTS Nineteen older (age: 74 ± 1 years, body mass index: 26 ± 1 kg/m2 ) and 13 younger (23 ± 1 years, 24 ± 1 kg/m2 ) healthy men. INTERVENTION A 70 g/280 kcal whey-protein or control (water with diet cordial, ~2 kcal) drink (450 ml). MEASUREMENTS BP and HR were assessed with an automated device immediately before and at 3-min intervals after drink ingestion (0-180 min). Gastric emptying of the drinks was measured using 3D ultrasonography (0-180 min). RESULTS Older versus younger men exhibited a greater fall in SBP (-23 ± 2 vs -15 ± 2 mmHg, p = 0.001) after whey-protein versus control, as BP did not change after the two drinks in younger men (p > 0.05). The nadir in SBP occurred later in the older than younger men (114 ± 11 vs 62 ± 14 min; p < 0.001), with SBP still apparently declining 180 min after whey-protein ingestion in the older men. The magnitude of the rise in HR was greater (p < 0.05) in the younger than older men. CONCLUSION Following ingestion of 70 g whey protein, healthy older men exhibited a sustained fall in BP, despite an increase in HR, whereas in younger men there was no change in BP. BP may need to be monitored after high protein meals in older people at risk of postprandial hypotension.
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Affiliation(s)
- Caroline Giezenaar
- Riddet Institute, Massey University, Palmerston North, New Zealand
- NHMRC Centre of Research Excellence in Translating Nutritional Science to Good Health, Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia
| | - Avneet Oberoi
- NHMRC Centre of Research Excellence in Translating Nutritional Science to Good Health, Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia
| | - Karen L Jones
- NHMRC Centre of Research Excellence in Translating Nutritional Science to Good Health, Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia
- Endocrine and Metabolic Unit, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Michael Horowitz
- NHMRC Centre of Research Excellence in Translating Nutritional Science to Good Health, Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia
- Endocrine and Metabolic Unit, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Ian Chapman
- NHMRC Centre of Research Excellence in Translating Nutritional Science to Good Health, Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia
- Endocrine and Metabolic Unit, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Stijn Soenen
- NHMRC Centre of Research Excellence in Translating Nutritional Science to Good Health, Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia
- Faculty of Health Sciences & Medicine, Bond University, Gold Coast, Queensland, Australia
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Chapman I, Oberoi A, Giezenaar C, Soenen S. Rational Use of Protein Supplements in the Elderly-Relevance of Gastrointestinal Mechanisms. Nutrients 2021; 13:nu13041227. [PMID: 33917734 PMCID: PMC8068133 DOI: 10.3390/nu13041227] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 03/25/2021] [Accepted: 04/01/2021] [Indexed: 02/07/2023] Open
Abstract
Protein supplements are increasingly used by older people to maintain nutrition and prevent or treat loss of muscle function. Daily protein requirements in older people are in the range of 1.2 gm/kg/day or higher. Many older adults do not consume this much protein and are likely to benefit from higher consumption. Protein supplements are probably best taken twice daily, if possible soon after exercise, in doses that achieve protein intakes of 30 gm or more per episode. It is probably not important to give these supplements between meals, as we have shown no suppressive effects of 30 gm whey drinks, and little if any suppression of 70 gm given to older subjects at varying time intervals from meals. Many gastrointestinal mechanisms controlling food intake change with age, but their contributions to changes in responses to protein are not yet well understood. There may be benefits in giving the supplement with rather than between meals, to achieve protein intakes above the effective anabolic threshold with lower supplement doses, and have favourable effects on food-induced blood glucose increases in older people with, or at risk of developing, type 2 diabetes mellitus; combined protein and glucose drinks lower blood glucose compared with glucose alone in older people.
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Affiliation(s)
- Ian Chapman
- Adelaide Medical School and Centre of Research Excellence (C.R.E.) in Translating Nutritional Science to Good Health, The University of Adelaide, Royal Adelaide Hospital, Adelaide, SA 5000, Australia; (I.C.); (A.O.)
| | - Avneet Oberoi
- Adelaide Medical School and Centre of Research Excellence (C.R.E.) in Translating Nutritional Science to Good Health, The University of Adelaide, Royal Adelaide Hospital, Adelaide, SA 5000, Australia; (I.C.); (A.O.)
| | - Caroline Giezenaar
- Riddett Institute, Massey University, Palmerston North 9430, New Zealand;
| | - Stijn Soenen
- Faculty of Health Sciences and Medicine, Bond University, Robina, QLD 4226, Australia
- Correspondence: ; Tel.: +61-07-55595-1390
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Gastric Sensory and Motor Functions and Energy Intake in Health and Obesity-Therapeutic Implications. Nutrients 2021; 13:nu13041158. [PMID: 33915747 PMCID: PMC8065811 DOI: 10.3390/nu13041158] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 03/18/2021] [Accepted: 03/26/2021] [Indexed: 01/19/2023] Open
Abstract
Sensory and motor functions of the stomach, including gastric emptying and accommodation, have significant effects on energy consumption and appetite. Obesity is characterized by energy imbalance; altered gastric functions, such as rapid gastric emptying and large fasting gastric volume in obesity, may result in increased food intake prior to reaching usual fullness and increased appetite. Thus, many different interventions for obesity, including different diets, anti-obesity medications, bariatric endoscopy, and surgery, alter gastric functions and gastrointestinal motility. In this review, we focus on the role of the gastric and intestinal functions in food intake, pathophysiology of obesity, and obesity management.
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Oberoi A, Giezenaar C, Clames A, Bøhler K, Lange K, Horowitz M, Jones KL, Chapman I, Soenen S. Whey Protein Drink Ingestion before Breakfast Suppressed Energy Intake at Breakfast and Lunch, but Not during Dinner, and Was Less Suppressed in Healthy Older than Younger Men. Nutrients 2020; 12:nu12113318. [PMID: 33138061 PMCID: PMC7693940 DOI: 10.3390/nu12113318] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 10/24/2020] [Accepted: 10/27/2020] [Indexed: 02/07/2023] Open
Abstract
Ageing is associated with changes in feeding behavior. We have reported that there is suppression of energy intake three hours after whey protein drink ingestion in young, but not older, men. This study aimed to determine these effects over a time period of 9 h. Fifteen younger (27 ± 1 years, 25.8 ± 0.7 kg/m2) and 15 older (75 ± 2 years, 26.6 ± 0.8 kg/m2) healthy men were studied on three occasions on which they received, in a randomized order, a 30 g/120 kcal, 70 g/280 kcal whey-protein, or control (~2 kcal) drink. Ad-libitum energy intake (sum of breakfast, lunch, and dinner) was suppressed in a protein load responsive fashion (P = 0.001). Suppression was minimal at breakfast, substantial at lunch (~-16%, P = 0.001), no longer present by dinner, and was less in older than younger men (-3 ± 4% vs. -8 ± 4%, P = 0.027). Cumulative protein intake was increased in the younger and older men (+20% and +42%, P < 0.001). Visual analogue scale ratings of fullness were higher and desire to eat and prospective food consumption were lower after protein vs. control, and these effects were smaller in older vs. younger men (interaction effect P < 0.05). These findings support the use of whey-protein drink supplements in older people who aim to increase their protein intake without decreasing their overall energy intake.
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Affiliation(s)
- Avneet Oberoi
- Adelaide Medical School and Centre of Research Excellence in Translating Nutritional Science to Good Health, The University of Adelaide, Adelaide, Royal Adelaide Hospital, Adelaide, SA 5000, South-Australia, Australia; (A.O.); (A.C.); (K.B.); (K.L.); (M.H.); (K.L.J.); (I.C.)
| | - Caroline Giezenaar
- Riddet Institute, Massey University, Palmerston North 9430, New Zealand;
| | - Alina Clames
- Adelaide Medical School and Centre of Research Excellence in Translating Nutritional Science to Good Health, The University of Adelaide, Adelaide, Royal Adelaide Hospital, Adelaide, SA 5000, South-Australia, Australia; (A.O.); (A.C.); (K.B.); (K.L.); (M.H.); (K.L.J.); (I.C.)
| | - Kristine Bøhler
- Adelaide Medical School and Centre of Research Excellence in Translating Nutritional Science to Good Health, The University of Adelaide, Adelaide, Royal Adelaide Hospital, Adelaide, SA 5000, South-Australia, Australia; (A.O.); (A.C.); (K.B.); (K.L.); (M.H.); (K.L.J.); (I.C.)
| | - Kylie Lange
- Adelaide Medical School and Centre of Research Excellence in Translating Nutritional Science to Good Health, The University of Adelaide, Adelaide, Royal Adelaide Hospital, Adelaide, SA 5000, South-Australia, Australia; (A.O.); (A.C.); (K.B.); (K.L.); (M.H.); (K.L.J.); (I.C.)
| | - Michael Horowitz
- Adelaide Medical School and Centre of Research Excellence in Translating Nutritional Science to Good Health, The University of Adelaide, Adelaide, Royal Adelaide Hospital, Adelaide, SA 5000, South-Australia, Australia; (A.O.); (A.C.); (K.B.); (K.L.); (M.H.); (K.L.J.); (I.C.)
| | - Karen L. Jones
- Adelaide Medical School and Centre of Research Excellence in Translating Nutritional Science to Good Health, The University of Adelaide, Adelaide, Royal Adelaide Hospital, Adelaide, SA 5000, South-Australia, Australia; (A.O.); (A.C.); (K.B.); (K.L.); (M.H.); (K.L.J.); (I.C.)
| | - Ian Chapman
- Adelaide Medical School and Centre of Research Excellence in Translating Nutritional Science to Good Health, The University of Adelaide, Adelaide, Royal Adelaide Hospital, Adelaide, SA 5000, South-Australia, Australia; (A.O.); (A.C.); (K.B.); (K.L.); (M.H.); (K.L.J.); (I.C.)
| | - Stijn Soenen
- Adelaide Medical School and Centre of Research Excellence in Translating Nutritional Science to Good Health, The University of Adelaide, Adelaide, Royal Adelaide Hospital, Adelaide, SA 5000, South-Australia, Australia; (A.O.); (A.C.); (K.B.); (K.L.); (M.H.); (K.L.J.); (I.C.)
- Faculty of Health Sciences & Medicine, Bond University, Gold Coast 4229, Queensland, Australia
- Correspondence: ; Tel.: +61-487-333-418
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