Sustained self-regulation of energy intake: initial hunger improves insulin sensitivity.

Mario Ciampolini,Lorenzo Borselli,Willem De Hahn,Riccardo Bianchi,Boudewijn De Pont,David Lovell-Smith,Angelo Pietrobelli,Massimiliano Sifone,Martine Van Weeren

doi:10.1155/2010/286952

Mario Ciampolini, Lorenzo Borselli + Show 7 more

Open Access

https://doi.org/10.1155/2010/286952

Copy DOI

Abstract

Background. Excessive energy intake has been implicated in diabetes, hypertension, coronary artery disease, and obesity. Dietary restraint has been unsuccessful as a method for the self-regulation of eating. Recognition of initial hunger (IH) is easily learned, can be validated by associated blood glucose (BG) concentration, and may improve insulin sensitivity. Objective. To investigate whether the initial hunger meal pattern (IHMP) is associated with improved insulin sensitivity over a 5-month period. Methods. Subjects were trained to recognize and validate sensations of IH, then adjust food intake so that initial hunger was present pre-meal at each meal time (IHMP). The purpose was to provide meal-by-meal subjective feedback for self-regulation of food intake. In a randomised trial, we measured blood glucose and calculated insulin sensitivity in 89 trained adults and 31 not-trained controls, before training in the IHMP and 5 months after training. Results. In trained subjects, significant decreases were found in insulin sensitivity index, insulin and BG peaks, glycated haemoglobin, mean pre-meal BG, standard deviation of diary BG (BG as recorded by subjects' 7-day diary), energy intake, BMI, and body weight when compared to control subjects. Conclusion. The IHMP improved insulin sensitivity and other cardiovascular risk factors over a 5-month period.

Highlights

In industrialised countries, most people regulate their energy expenditure poorly
Achieving the initial hunger meal pattern (IHMP) appeared to be difficult for 12 subjects who had high pretraining mean blood glucose (BG) concentrations or participated in heavy manual labour, especially in cold conditions
Some subjects may not have been faithful to the IHMP for all meals, we have included all those who completed the study in the final analysis, since it was our intention to treat them [30, 31]

Summary

Introduction

Most people regulate their energy expenditure poorly. Individual energy expenditure may differ up to 20-fold between resting conditions and high physical activity, but such differences have until now been weakly correlated to energy intake at subsequent meals [1]. Dietary regimes that attempt to restrain eating have been only marginally successful [3, 4] and the feasibility of self-regulation of energy intake regimes has been questioned [5]. A key reason for this lack of success may be that most dietary methods rely on weekly or monthly measurements of weight. These measurements provide no immediate feedback to dieters, who usually ingest food at least three times daily. To investigate whether the initial hunger meal pattern (IHMP) is associated with improved insulin sensitivity over a 5-month period. Subjects were trained to recognize and validate sensations of IH, adjust food intake so that initial hunger was present pre-meal at each meal time (IHMP). The IHMP improved insulin sensitivity and other cardiovascular risk factors over a 5-month period

Methods

Results

Discussion

Conclusion