Associations of Brain Reactivity to Food Cues with Weight Loss, Protein Intake and Dietary Restraint during the PREVIEW Intervention.

Mathijs Drummen,Gareth Stratton,Elke Dorenbos,Anne Raben,Margriet Westerterp-Plantenga,Tanja Adam,Anita Vreugdenhil

doi:10.3390/nu10111771

Mathijs Drummen, Gareth Stratton + Show 5 more

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https://doi.org/10.3390/nu10111771

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Abstract

The objective was to assess the effects of a weight loss and subsequent weight maintenance period comprising two diets differing in protein intake, on brain reward reactivity to visual food cues. Brain reward reactivity was assessed with functional magnetic resonance imaging in 27 overweight/obese individuals with impaired fasting glucose and/or impaired glucose tolerance (HOMA-IR: 3.7 ± 1.7; BMI: 31.8 ± 3.2 kg/m2; fasting glucose: 6.4 ± 0.6 mmol/L) before and after an 8-week low energy diet followed by a 2-year weight maintenance period, with either high protein (HP) or medium protein (MP) dietary guidelines. Brain reactivity and possible relationships with protein intake, anthropometrics, insulin resistance and eating behaviour were assessed. Brain reactivity, BMI, HOMA-IR and protein intake did not change differently between the groups during the intervention. In the whole group, protein intake during weight maintenance was negatively related to changes in high calorie images>low calorie images (H > L) brain activation in the superior/middle frontal gyrus and the inferior temporal gyrus (p < 0.005, corrected for multiple comparisons). H > L brain activation was positively associated with changes in body weight and body-fat percentage and inversely associated with changes in dietary restraint in multiple reward, gustatory and processing regions (p < 0.005, corrected for multiple comparisons). In conclusion, changes in food reward-related brain activation were inversely associated with protein intake and dietary restraint during weight maintenance after weight loss and positively associated with changes in body weight and body-fat percentage.

Highlights

Overweight and obesity are established risk factors for the development of type 2 diabetes (T2D) [1] and insulin resistance [2]
Insulin resistance, protein intake and physical activity (CPM), no differences were observed at baseline, nor in changes during the intervention between the groups
Protein intake during the weight maintenance period in the whole group was negatively related to changes in brain activation contrasting high-calorie with low-calorie images in regions associated with frontal control and visual processing

Summary

Introduction

Overweight and obesity are established risk factors for the development of type 2 diabetes (T2D) [1] and insulin resistance [2]. Comparing obese and normal-weight individuals, functional neuroimaging studies have reported increased anticipatory brain activation in response to visual food cues in gustatory and reward regions (including the striatum, insula, amygdala, orbitofrontal cortex and hippocampus) [6]. Further evidence comes from studies finding an inverse relationship between markers of peripheral insulin sensitivity and brain activation in response to food cues in brain reward regions [9,10] In line with these findings, we previously reported positive associations between insulin resistance and reactivity to food cues in the insula, anterior cingulate gyrus and nucleus accumbens in overweight and obese individuals with impaired fasting glucose and/or impaired glucose tolerance [11]. Given that insulin binds to receptors expressed on neurons in areas of reward processing [12], central insulin resistance may contribute to impaired reward signalling and a reduction in insulin resistance may help to normalize the reward response

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