Abstract
PurposeWe investigated the effects of the macronutrient composition of diets with differing satiety values on fasting appetite-related hormone concentrations after weight loss and examined whether the hormone secretion adapted to changes in body fat mass (FM) and fat-free mass (FFM) during the weight maintenance period (WM).MethodsEighty-two men and women with obesity underwent a 7-week very-low-energy diet (VLED) and were then randomised to a higher-satiety food (HSF) group or a lower-satiety food (LSF) group during 24-weeks of the WM. The groups consumed isoenergetic foods with different satiety ratings and macronutrient compositions.ResultsDuring the WM, the HSF group consumed more protein and dietary fibre and less fat than the LSF group, but the groups showed similar changes in body weight and fasting appetite-related hormones. In the whole study sample, VLED induced 12 kg (p < 0.001) weight loss. At the end of the WM, weight regain was 1.3 kg (p = 0.004), ghrelin concentration increased, whereas leptin, insulin, and glucose concentrations decreased compared to pre-VLED levels (p < 0.001 for all). Peptide YY did not differ from pre-VLED levels. Changes in ghrelin levels were inversely associated with changes in FFM during weeks 0–12 of the WM (p = 0.002), while changes in leptin and insulin levels were positively associated with changes in FM during weeks 0–12 (p = 0.015 and p = 0.038, respectively) and weeks 12–24 (p < 0.001 and p = 0.022) of the WM.ConclusionsThe macronutrient composition of an isoenergetic WM diet did not affect fasting appetite-related hormone concentrations. Leptin and insulin adjusted to the reduced FM, whereas ghrelin reflected FFM during the first months of the WM.Trial registrationisrctn.com, ID 67529475.
Highlights
According to the dynamic weight set point theory, the normal range of biological weight is elevated in people with obesity [1]
We found that weight loss increased fasting total plasma ghrelin concentrations and decreased fasting serum leptin and plasma insulin and glucose concentrations
We found no differences in these changes between the groups consuming isoenergetic weight maintenance diets with different predetermined satiety values and macronutrient compositions, mainly consisting of differences in protein (26 vs. 18 E%) and dietary fibre
Summary
According to the dynamic weight set point theory, the normal range of biological weight is elevated in people with obesity [1]. Reducing weight by dietary restriction results in counter-adaptive changes in physiological mechanisms involved in the regulation of appetite and energy balance [3]. These changes include an increase in the fasting concentration of orexigenic hormone ghrelin and a decrease in the fasting concentrations of anorexigenic hormones such as leptin, insulin, and peptide YY. Weight loss-induced alterations in the regulatory mechanisms have been related to increased feelings of hunger and decreased energy expenditure in some studies [7, 9] These physiological changes may be involved in constituting an energy gap in which the body’s energy requirements are lower than the hunger drive [3]. The negative energy balance and the loss of body mass could disrupt hormone secretion and unbalance its relation to the body’s energy reserves
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