The Influence of Higher Protein Intake and Greater Eating Frequency on Appetite Control in Overweight and Obese Men

The purpose of this study was to determine the effects of dietary protein intake and eating frequency on perceived appetite, satiety, and hormonal responses in overweight/obese men. Thirteen men (age 51 ± 4 years; BMI 31.3 ± 0.8 kg/m²) consumed eucaloric diets containing normal protein (79 ± 2 g protein/day; 14% of energy intake as protein) or higher protein (138 ± 3 g protein/day; 25% of energy intake as protein) equally divided among three eating occasions (3‐EO; every 4 h) or six eating occasions (6‐EO; every 2 h) on four separate days in randomized order. Hunger, fullness, plasma glucose, and hormonal responses were assessed throughout 11 h. No protein × eating frequency interactions were observed for any of the outcomes. Independent of eating frequency, higher protein led to greater daily fullness (P < 0.05) and peptide YY (PYY) concentrations (P < 0.05). In contrast, higher protein led to greater daily ghrelin concentrations (P < 0.05) vs. normal protein. Protein quantity did not influence daily hunger, glucose, or insulin concentrations. Independent of dietary protein, 6‐EO led to lower daily fullness (P < 0.05) and PYY concentrations (P < 0.05). The 6‐EO also led to lower glucose (P < 0.05) and insulin concentrations (P < 0.05) vs. 3‐EO. Although the hunger‐related perceived sensations and hormonal responses were conflicting, the fullness‐related responses were consistently greater with higher protein intake but lower with increased eating frequency. Collectively, these data suggest that higher protein intake promotes satiety and challenge the concept that increasing the number of eating occasions enhances satiety in overweight and obese men.     

Effects of acute and chronic protein intake on metabolism, appetite, and ghrelin during weight loss

Objective: This study evaluated the effects of acute and chronic consumption of higher dietary protein on energy expenditure, macronutrient use, appetite, and appetite‐regulating hormones during weight loss in women. Research Methods and Procedures: Thirty‐eight women chronically consuming a 750 kcal/d energy‐deficit diet with a protein content of 30% (higher protein‐chronic diet, HP‐CD, n = 21) or 18% (normal protein‐chronic diet, NP‐CD, n = 17) for 9 weeks were tested. On separate days, metabolic, appetite, and hormonal responses were measured over 4 hours when the women consumed a higher protein‐acute meal (HP‐AM) (30% of energy as protein) or a normal protein‐acute meal (NP‐AM) (18% of energy as protein). Results: With chronic diet groups combined, HP‐AM led to lower respiratory exchange ratio (0.829 ± 0.005 vs. 0.843 ± 0.008; p < 0.05), lower carbohydrate oxidation (p < 0.05), and higher fat oxidation (p < 0.05) compared with NP‐AM. HP‐AM also led to reduced self‐reported postprandial hunger (p < 0.001) and desire to eat (p < 0.001) and lower postprandial ghrelin (252 ± 16 vs. 274 ± 18 ng/mL · 240 minutes, p < 0.05) compared with NP‐AM. No differences in postprandial energy expenditure (PPEE) occurred between meals. When combining acute meals, respiratory exchange ratio was lower (p < 0.05) and protein oxidation (p < 0.001) was higher in the HP‐CD vs. NP‐CD. An acute meal‐by‐chronic diet interaction was observed with PPEE such that HP‐AM led to greater PPEE in the HP‐CD vs. NP‐CD (28.7 ± 2.7 vs. 19.9 ± 2.7 kcal/min for 195 minutes; p < 0.05). Conclusions: During weight loss, thermogenesis and protein use appear to be influenced by chronic protein intake, while appetite and ghrelin are more responsive to acute protein intake.     

Food Form and Portion Size Affect Postprandial Appetite Sensations and Hormonal Responses in Healthy,Nonobese, Older Adults

Data are limited concerning the dietary factors that influence appetite control in older adults. This study examined the effects of food form and portion size on appetite in 43 older adults (age: 72 ± 1 years; BMI: 25.6 ± 0.3 kg/m²). Subjects were assigned to groups based on portion size of the test meal (12.5% (n = 18) vs. 25% (n = 25) of estimated energy need). Subjects randomly consumed, on two separate days, the respective solid or beverage test meal. Appetite sensations and hormonal responses were measured over 4 h. Main effects of food form (P < 0.05) and/or portion size (P < 0.05) were observed for each appetite sensation. Postprandial hunger and desire to eat were greater following beverage vs. solid meal (between 12.5% vs. 25%), whereas fullness was lower after beverage vs. solid meal (P < 0.05). Main effects of food form and/or portion size were observed for glucose, insulin, and ghrelin. Postprandial glucose and insulin concentrations were lower after beverage vs. solid meal (between 12.5% vs. 25%; all comparisons, P < 0.05) whereas beverage meal led to greater 4‐h ghrelin vs. solid meal (P = 0.09). No main effects were observed for glucagon‐like peptide‐1 (GLP‐1) or cholecystokinin (CCK). When adjusting for age, food form remained significant for postprandial hunger and fullness; portion size remained significant for postprandial glucose. Greater hunger and reduced satiety with accompanying glucose, insulin, and ghrelin following the beverage vs. solid meals, and to some extent, in smaller vs. larger portions suggest that appetite control is influenced by food form and portion size in older adults. These findings may enhance the development of appropriate dietary strategies that help to regulate energy balance.     

Higher protein intake preserves lean mass and satiety with weight loss in pre-obese and obese women

Objective: To examine the effects of dietary protein and obesity classification on energy‐restriction‐induced changes in weight, body composition, appetite, mood, and cardiovascular and kidney health. Research Methods and Procedures: Forty‐six women, ages 28 to 80, BMI 26 to 37 kg/m², followed a 12‐week 750‐kcal/d energy‐deficit diet containing higher protein (HP, 30% protein) or normal protein (NP, 18% protein) and were retrospectively subgrouped according to obesity classification [pre‐obese (POB), BMI = 26 to 29.9 kg/m²; obese (OB), BMI = 30 to 37 kg/m²). Results: All subjects lost weight, fat mass, and lean body mass (LBM; p < 0.001). With comparable weight loss, LBM losses were less in HP vs. NP (?1.5 ± 0.3 vs. ?2.8 ± 0.5 kg; p < 0.05) and POB vs. OB (?1.2 ± 0.3 vs. ?2.9 ± 0.4 kg; p < 0.005). The main effects of protein and obesity on LBM changes were independent and additive; POB‐HP lost less LBM vs. OB‐NP (p < 0.05). The energy‐restriction‐induced decline in satiety was less pronounced in HP vs. NP (p < 0.005). Perceived pleasure increased with HP and decreased with NP (p < 0.05). Lipid‐lipoprotein profile and blood pressure improved and kidney function minimally changed with energy restriction (p < 0.05), independently of protein intake. Discussion: Consuming a higher‐protein diet and accomplishing weight loss before becoming obese help women preserve LBM. Use of a higher‐protein diet also improves perceptions of satiety and pleasure during energy restriction.     

Effects of increased meal frequency on fat oxidation and perceived hunger

Objective:

Consuming smaller, more frequent meals is often advocated as a means of controlling body weight, but studies demonstrating a mechanistic effect of this practice on factors associated with body weight regulation are lacking. The purpose of this study was to compare the effect of consuming three (3M) vs. six meals (6M) per day on 24‐h fat oxidation and subjective ratings of hunger.

Design and Methods:

Lean (body mass index <25 kg/m²) subjects (7M, 8F) were studied in a whole‐room calorimeter on two occasions in a randomized cross‐over design. Subjects were provided isoenergetic, energy balanced diets with a 1‐ to 2‐week washout between conditions. Hunger, fullness, and “desire to eat” ratings were assessed throughout the day using visual analog scales and quantified as area under the curve (AUC).

Results:

There were no differences (P < 0.05) in 24‐h energy expenditure (8.7 ± 0.3 vs. 8.6 ± 0.3 mj d^?1), 24‐h respiratory quotient (0.85 ± 0.01 vs. 0.85 ± 0.01), or 24‐h fat oxidation (82 ± 6 vs. 80 ± 7 g day^‐1) between 3M and 6M, respectively. There was no difference in fullness 24‐h AUC, but hunger AUC (41850 ± 2255 vs. 36612 ± 2556 mm.24 h, P = 0.03) and “desire to eat” AUC (47061 ± 1791 vs. 41170 ± 2574 mm.24 h, P = 0.03) were greater during 6M than 3M.

Conclusion:

We conclude that increasing meal frequency from three to six per day has no significant effect on 24‐h fat oxidation, but may increase hunger and the desire to eat.

     

Vision and Eating Behavior in Obese Subjects

Objective: Vision is one of a number of factors influencing the amount of food consumed during a meal. The purpose of this study was to investigate the impact of vision on the microstructure of the eating behavior of obese subjects. Research Methods and Procedures: Eighteen obese subjects with a body mass index (mean ± SD) of 39.1 ± 6.3 kg/m² twice consumed a standardized test meal in excess, once with and once without a blindfold. The microstructure of the eating behavior was registered by VIKTOR, a computerized eating monitor. Subjective motivation to eat (i.e., desire to eat, hunger, satiety, and prospective consumption) was rated by visual analogue scales (VASs) before, immediately after, and then hourly up to 3 hours after the test meals. Results: The obese subjects ate 24% less food when blindfolded (359 ± 194 g vs. 472 ± 179 g; p < 0.01). Despite a smaller amount of food consumed when blindfolded, there were no significant differences with or without the blindfold for any of the VASs measuring subjective motivation to eat after test meals. Discussion: The importance of vision in regulating our eating behavior was demonstrated in this study. The obese subjects ate 24% less food blindfolded without feeling less full. Eating blindfolded could be tested as a didactic tool to make obese subjects aware of what factors affect the termination of eating.     

Dietary Restraint and Control Over “Wanting” Following Consumption of “Forbidden” Food

Eating behavior can be influenced by the rewarding value of food, i.e., “liking” and “wanting.” The objective of this study was to assess in normal‐weight dietary restrained (NR) vs. unrestrained (NU) eaters how rewarding value of food is affected by satiety, and by eating a nonhealthy perceived, dessert‐specific food vs. a healthy perceived, neutral food (chocolate mousse vs. cottage cheese). Subjects (24NR age = 25.0 ± 8.2 years, BMI = 22.3 ± 2.1 kg/m²; 26NU age = 24.8 ± 8.0 years, BMI = 22.1 ± 1.7 kg/m²) came to the university twice, fasted (randomized crossover design). Per test‐session “liking” and “wanting” for 72 items divided in six categories (bread, filling, drinks, dessert, sweets, stationery (placebo)) was measured, before and after consumption of chocolate mousse/cottage cheese, matched for energy content (5.6 kJ/g) and individual daily energy requirements (10%). Chocolate mousse was liked more than cottage cheese (P < 0.05). After consumption of chocolate mousse or cottage cheese, appetite and “liking” vs. placebo were decreased in NR and NU (P < 0.03), whereas “wanting” was only decreased in NR vs. NU (P ≤ 0.01). In NR vs. NU “wanting” was specifically decreased after chocolate mousse vs. cottage cheese; this decrease concerned especially “wanting” for bread and filling (P < 0.05). To conclude, despite similar decreases in appetite and “liking” after a meal in NR and NU, NR decrease “wanting” in contrast to NU. NR decrease “wanting” specifically for a nonhealthy perceived, “delicious,” dessert‐specific food vs. a nutritional identical, yet healthy perceived, slightly less “delicious,” “neutral” food. A healthy perceived food may thus impose greater risk for control of energy intake in NR.     

Short-term effects of a "health-at-every-size" approach on eating behaviors and appetite ratings

Objective: To assess the effects of a “Health‐At‐Every‐Size” (HAES) intervention on eating behaviors and appetite ratings in 144 premenopausal overweight women. Research Methods and Procedures: Women were randomly assigned to one of the 3 groups: HAES group, social support (SS) group, and control group (N = 48 in each group). Interventions were conducted over a 4‐month period, and measurements were taken before and after this period. Eating behaviors (cognitive dietary restraint, disinhibition, and susceptibility to hunger) were evaluated by the Three‐Factor Eating Questionnaire. Appetite ratings (desire to eat, hunger, fullness, and prospective food consumption) were assessed by visual analogue scales before and after a standardized breakfast. Results: More important decreases in susceptibility to hunger and external hunger were observed in the HAES group when compared with the SS group (p = 0.05, for susceptibility to hunger) and the control group (p = 0.02 and p = 0.005, for susceptibility to hunger and external hunger, respectively). In addition, women from the HAES group had more important decreases in postprandial area under the curve for desire to eat (p = 0.02) and hunger (p = 0.04) when compared with the control group. The change in the desire to eat noted in the HAES group was also different from the one observed in SS group (p = 0.02). Women from the HAES group experienced significant weight loss at 4 months (?1.6 ± 2.5 kg, p < 0.0001), which did not differ significantly from the SS and control groups (p = 0.09). An increase in flexible restraint was significantly related to a greater weight loss in both HAES and SS groups (r = ?0.39, p < 0.01; and r = ?0.37, p < 0.05, respectively). A decrease in habitual susceptibility to disinhibition was also associated with a greater weight loss in HAES and control groups (r = 0.31, p < 0.05; and r = 0.44, p < 0.05, respectively). Discussion: These results suggest that a HAES intervention could have significant effects on eating behaviors and appetite ratings in premenopausal overweight women, when compared with an SS intervention or a control group.     

The effect of tesofensine on appetite sensations

Tesofensine (TE), an inhibitor of monoamine presynaptic reuptake, has produced twice the weight loss seen with currently marketed drugs. However, its long term effect on appetite in humans has not been studied. A multicentre phase II trial was divided into two parts (24 weeks each). Part 1 had a randomized, double‐blind, placebo‐controlled design and Part 2, an open‐labeled, single‐group, uncontrolled design. A drug‐free period (12 ± 3 weeks) separated them. In Part 1, participants (n = 158) were assigned to 0.25, 0.5 or 1.0 mg TE, or placebo. Completers of Part 1 were invited to participate in Part 2 (n = 113), during which they all received 0.5 or 1.0 mg TE. Appetite sensations and a composite satiety score (CSS = satiety + fullness + (100 − hunger) + (100 − prospective food consumption) were assessed. In Part 1 TE induced a dose‐dependent increase in CSS at week 12 that correlated with weight loss during the 24 weeks (r = 0.36, P < 0.0001). However, CSS diminished over time as weight loss progressed (e.g., for 1.0 mg; 52 ± 17 mm; 64 ± 13 mm; 55 ± 13 mm at baseline, week 12 and week 24, respectively). After drug withdrawal CSS returned to baseline values (50 ± 17 mm, in the whole sample.), despite the participants' reduced‐weight state (−7.2 ± 6.7 kg, P < 0.0001). The reintroduction of TE in Part 2 increased CSS again (56 ± 17 mm at week 60), regardless of initial treatment/weight loss. We postulate that enhanced satiety is involved in early weight loss. Whether the attenuated effect on appetite seen after 24 weeks is due to a counteracting effect in the weight reduced state or whether the appetite suppressing effect of TE per se diminishes over time is, however, still unclear.     

Effect of Fat Sources on Satiety

Objective: There are inconsistent reports on the satiety value of different fatty acids. This study compared the appetitive effects of two fat sources rich in monounsaturated fatty acids (peanut oil and canola oil) with a source rich in saturated fatty acids (butter). Research Methods and Procedures: After an overnight fast, lean participants completed a questionnaire eliciting information about hunger, fullness, desire to eat, and prospective consumption. They then consumed one of the preloads (muffins containing 40 g of each fat source or no fat) and 150 mL of water within 15 minutes. Questionnaires were completed again 30, 60, and 120 minutes after preload ingestion. Participants kept dietary records during the subsequent 24 hours. Results: Canola and peanut oil muffins resulted in higher fullness, and butter, canola, and peanut oil muffins resulted in lower hunger ratings 30, 60, and 120 minutes after preload ingestion compared with the fat‐free preload. No differences were observed among the fat‐containing loads. Although energy intake 24 hours after consumption of the preloads was also comparable on days the three fat‐containing loads were consumed, energy consumption after each study session was higher when the fat‐free muffins were provided. However, total energy intake, including the calories provided by the preloads, was similar across treatments. Discussion: These data do not support a differential satiety effect of fat sources rich in monounsaturated fatty acids relative to one rich in saturated fatty acids.     

Pre-meal water consumption reduces meal energy intake in older but not younger subjects

Objective: To determine whether the consumption of water 30 minutes before an ad libitum meal reduces meal energy intake in young and older adults. Research Methods and Procedures: Healthy, non‐obese young (n = 29; age, 21 to 35 years) and older (n = 21; age, 60 to 80 years) individuals were provided with an ad libitum lunch meal on two occasions. Thirty minutes before the lunch meals, subjects were given either a water preload (WP: 375 mL, women; 500 mL, men) or no preload (NP). Energy intake at the two lunch meals was measured. Visual analog scales were used to assess changes in hunger, fullness, and thirst during the meal studies. Results: There was no significant difference in meal energy intake between conditions in the young subjects (892 + 51 vs. 913 ± 54 kcal for NP and WP, respectively; p = 0.65). However, meal energy intake after the WP was significantly reduced relative to the NP condition in the older subjects (682 + 53 vs. 624 ± 56 kcal for NP and WP, respectively; p = 0.02). This effect was caused primarily by the reduction in meal energy intake after water consumption in older men. Hunger ratings were lower and fullness ratings were higher in older compared with younger adults (p < 0.01). Fullness ratings were higher in the WP condition compared with the NP condition for all subjects (p = 0.01). No age differences in thirst were detected during the test meals. Discussion: Under acute test meal conditions, pre‐meal water consumption reduces meal energy intake in older but not younger adults. Because older adults are at increased risk for overweight and obesity, intervention studies are needed to determine whether pre‐meal water consumption is an effective long‐term weight management strategy for the aging population.     

Feeding Frequency and Appetite in Lean and Obese Prepubertal Children

To determine the effect of feeding frequency on appetite in normal weight (NW) and obese (OB) prepubertal children, we carried out a prospective, randomized interventional study of 18 NW and 17 OB children ages 6–10. Children received three or five feedings in random order on separate days. Total calories, carbohydrate, protein, and fat composition on each day were equal. Two hours following the last feeding, children were offered ice cream ad lib. The major outcome variable was kilocalories ice cream consumed. A visual analog scale to assess fullness was also administered before consumption of ice cream. We observed that OB children consumed 73.0 ± 37.4 kcal more after five feedings than after three feedings whereas the NW children consumed 47.1 ± 27.8 kcal less. There was significant interaction between meal pattern and weight group indicating that this change in ice cream consumption differed significantly between groups (P = 0.014 by two‐factor analysis). Ice cream intake/kg was less in OB compared to NW subjects (P = 0.012). Fullness ratings before ice cream did not differ by meal pattern or weight group. However, pre‐ice cream fullness predicted ice cream intake in NW but not OB children. In summary, OB and NW children differed in appetite response to meal frequency. Our data suggest that: (i) satiety in OB children is related more to proximity of calories (larger supper) than to antecedent distribution of calories and; (ii) NW children may be more prone to restrict intake based on subjective fullness.     

Circadian Eating and Sleeping Patterns in the Night Eating Syndrome

Objective: To compare the eating and sleep‐wake patterns of persons with the night eating syndrome (NES) with those of matched control subjects. Research Methods and Procedures: Forty‐six overweight/obese NES subjects (mean age 43.3 ± 9.8 years; 32 women) and 43 similar controls (mean age 39.0 ± 11.0 years; 28 women) wore wrist actigraphs for 7 days and completed sleep and food diaries at home. Results: There was no difference between the total energy intake of the NES and the control subjects, but the pattern of energy intake differed greatly. Relative to control subjects, the temporal pattern of food intake of night eaters was delayed. Food intake after the evening meal, as a proportion of the 24‐hour intake, was more than 3‐fold greater in NES subjects than in controls (34.6 ± 10.1% vs. 10.0 ± 6.9%, p = 0.001). NES subjects had sleep onset, offset, and total sleep duration times comparable with those of controls. NES subjects reported more nocturnal awakenings than did controls (1.5 ± 1.0 per night vs. 0.5 ± 0.5; p < 0.001), and their actigraphically monitored arousals occurred earlier during sleep (at 128 minutes after sleep onset vs. 193 minutes, p = 0.01). NES subjects consumed food on 74% of the awakenings vs. 0% for the controls. Discussion: The pattern of cumulative energy intake of the night eaters suggests a phase delay in energy consumption relative to sleep‐wake times. NES may involve a dissociation of the circadian control of eating relative to sleep.     

Measurement of,and Some Reasons for,Differences in Eating Habits Between Night and Day Workers

A questionnaire was designed to assess the following: why working people chose to eat or not to eat at a particular time of day; the factors that influenced the type of food eaten; and subjective responses to the meal (hunger before, enjoyment during, satiety afterward). Self-assessments were done every 3h during a typical week containing work and rest days, by one group of 50 day workers and another group of 43 night workers. During the night work hours compared to rest days, night workers evidenced a significantly altered food intake, with a greater frequency of cold rather than hot food (p < 0.001). The type and frequency of meals were influenced significantly more (p < 0.05) by habit and time availability and less by appetite. This pattern continued into the hours immediately after the night shift had ended. In day workers food intake during work hours, compared to rest days, was also influenced significantly more often (p < 0.05) by time availability than hunger, but less so than with night workers. Moreover, day workers were less dependent than night workers upon snacks (p = 0.01), and any significant differences from rest days did not continue beyond work hours. Not only did night workers change their eating habits during work days more than did day workers but also they looked forward to their meals significantly less (p < 0.001) and felt more bloated after consuming them (p < 0.05), such effects being present to some extent during their rest days also. These findings have clear implications for measures designed to ease eating problems that are commonly problematic in night workers.     

Appetite at "high altitude" [Operation Everest III (Comex-'97)]: a simulated ascent of Mount Everest.

We hypothesized that progressive loss of body mass during high-altitude sojourns is largely caused by decreased food intake, possibly due to hypobaric hypoxia. Therefore we assessed the effect of long-term hypobaric hypoxia per se on appetite in eight men who were exposed to a 31-day simulated stay at several altitudes up to the peak of Mt. Everest (8,848 m). Palatable food was provided ad libitum, and stresses such as cold exposure and exercise were avoided. At each altitude, body mass, energy, and macronutrient intake were measured; attitude toward eating and appetite profiles during and between meals were assessed by using questionnaires. Body mass reduction of an average of 5 +/- 2 kg was mainly due to a reduction in energy intake of 4.2 +/- 2 MJ/day (P < 0.01). At 5,000- and 6,000-m altitudes, subjects had hardly any acute mountain sickness symptoms and meal size reductions (P < 0.01) were related to a more rapid increase in satiety (P < 0.01). Meal frequency was increased from 4 +/- 1 to 7 +/- 1 eating occasions per day (P < 0. 01). At 7,000 m, when acute mountain sickness symptoms were present, uncoupling between hunger and desire to eat occurred and prevented a food intake necessary to meet energy balance requirements. On recovery, body mass was restored up to 63% after 4 days; this suggests physiological fluid retention with the return to sea level. We conclude that exposure to hypobaric hypoxia per se appears to be associated with a change in the attitude toward eating and with a decreased appetite and food intake.     

Decreased fasting serum glucogenic amino acids with a higher compared to normal protein diet during energy restriction in women: a randomized controlled trial

Dietary protein alters circulating amino acid (AAs) levels and higher protein intake (HP) is one means of losing weight. We examined 34 overweight and obese women (57 ± 4 years) during 6 months of energy restriction (7.3 ± 3.8% weight loss) divided into groups consuming either normal protein (NP; 18.6 energy% protein) or HP (24.3 energy% protein). There was a reduction in fasting serum glucogenic AAs (p = 0.015) that also associated with greater weight loss (p < 0.05) in the HP group, but not in the NP group. These findings have implications for nutrient prioritization during energy restriction.

     

RCT of a High‐protein Diet on Hunger Motivation and Weight‐loss in Obese Children: An Extension and Replication

This study aimed to evaluate the weight loss and hunger motivation effects of an energy‐restricted high‐protein (HP) diet in overweight and obese children. In total, 95 overweight and obese children attended an 8‐week (maximum) program of physical activity, reduced‐energy intake, and behavior change education. Children were randomly assigned to one of two isoenergetic diets (standard (SP): 15% protein; HP: 25% protein), based on individually estimated energy requirements. Anthropometry and body composition were assessed at the start and end of the program and appetite and mood ratings completed on the first 3 consecutive weekdays of each week children attended camp. The HP diet had no greater effect on weight loss, body composition, or changes in appetite or mood when compared to the SP diet. Overall, campers lost 5.2 ± 3.0 kg in body weight and reduced their BMI standard deviation score (sds) by 0.25. Ratings of desire to eat increased significantly over the duration of the intervention, irrespective of diet. This is the third time we have reported an increase in hunger motivation in weight‐loss campers and replicates our previous failure to block this with a higher protein diet. Further work is warranted into the management of hunger motivation as a result of negative energy balance.     

Normal vs. high‐protein weight loss diets in men: Effects on body composition and indices of metabolic syndrome

Objective:

This study assessed the effectiveness of a prescribed weight‐loss diet with 0.8 versus 1.4 g protein·kg^?1 day^?1 on changes in weight, body composition, indices of metabolic syndrome, and resting energy expenditure (REE) in overweight and obese men.

Design and Methods:

Men were randomized to groups that consumed diets containing 750 kcal day^?1 less than daily energy needs for weight maintenance with either normal protein (NP, n = 21) or higher protein (HP, n = 22) content for 12 weeks. The macronutrient distributions of the NP and HP diets were 25:60:15, and 25:50:25 percent energy from fat, carbohydrate, and protein, respectively. Assessments were made pre and post intervention. The subjects were retrospectively subgrouped into overweight and obese groups.

Results and Conclusion:

Both diet groups lost comparable body weight and fat. The HP group lost less lean body mass than the NP group (?1.9 ± 0.3 vs. ?3.0 ± 0.4 kg). The effects of protein and BMI status on lean body mass loss were additive. The reductions in total cholesterol, HDL‐C, triacylglycerol, glucose, and insulin, along with LDL‐C, total cholesterol‐to‐HDL‐C ratio, and HOMA‐IR, were not statistically different between NP and HP. Likewise, macronutrient distributions of the diet did not affect the reductions in REE, and blood pressure. In conclusion, energy restriction effectively improves multiple clinical indicators of cardiovascular health and glucose control, and consumption of a higher‐protein diet and accomplishing weight loss when overweight versus obese help men preserve lean body mass over a short period of time.

     

Low-dose pramlintide reduced food intake and meal duration in healthy, normal-weight subjects

Objective: We previously reported that a single preprandial injection (120 μg) of pramlintide, an analog of the β‐cell hormone amylin, reduced ad libitum food intake in obese subjects. To further characterize the meal‐related effects of amylin signaling in humans, we studied a lower pramlintide dose (30 μg) in normal‐weight subjects. Research Methods and Procedures: In a randomized, double‐blind, placebo‐controlled, cross‐over study, 15 healthy men (age, 24 ± 7 years; BMI, 22.2 ± 1.8 kg/m²) underwent a standardized buffet meal test on two occasions. After an overnight fast, subjects received a single subcutaneous injection of pramlintide (30 μg) or placebo, followed immediately by a standardized pre‐load meal. After 1 hour, subjects were offered an ad libitum buffet meal, and total caloric intake and meal duration were measured. Results: Compared with placebo, pramlintide reduced total caloric intake (1411 ± 94 vs. 1190 ± 117 kcal; Δ, ?221 ± 101 kcal; ?14 ± 9%; p = 0.05) and meal duration (36 ± 2 vs. 31 ± 3 minutes; Δ, ?5.1 ± 1.4 minutes; p < 0.005). Visual analog scale profiles of hunger trended lower and fullness higher during the first hour after pramlintide administration. In response to the buffet, hunger and fullness changed to a similar degree after pramlintide and placebo, despite subjects on pramlintide consuming 14% fewer kilocalories. Visual analog scale nausea ratings remained near baseline, without differences between treatments. Plasma peptide YY, cholecystokinin, and ghrelin concentrations did not differ with treatment, whereas glucagon‐like peptide‐1 concentrations after meals were lower in response to pramlintide than to placebo. Discussion: These observations add support to the concept that amylin agonism may have a role in human appetite control.