Postprandial Satiety Research Articles

Effects of the consumption of algal biomass versus protein concentrate on postprandial satiety and metabolism

Algae are promising sources of nutritious and sustainable protein, but little is known about their metabolic health impact and acceptability as meal ingredients. This acute, randomized, controlled, five-way crossover trial compared whole algal biomasses and their corresponding protein concentrates to soy protein concentrate in terms of palatability, appetite, satiety, and metabolic response. Nineteen healthy Chinese males (21–50 years, 18.5–25.0 kg/m2) consumed noodle meals supplemented with 10 g of nori biomass/protein concentrate (NB/NC), Chlorella vulgaris biomass/protein concentrate (CB/CC) or soy protein concentrate control (CON) in randomized order. At regular intervals, blood samples were collected to measure biochemical markers, while gastrointestinal tolerance, palatability, and appetite were assessed using questionnaires and visual analog scales (VAS). Results indicated that algae-enriched meals were well-tolerated and comparable to soy in both visual appeal and smell, with NB and CC outperforming soy in aftertaste (p < 0.05). There were no significant differences between treatments in glucose, insulin, C-peptide, appetite/satiety, plasma ghrelin, and GLP-1. However, exploratory analysis of serum triglycerides revealed significant time × treatment effects (p < 0.004) and differences in incremental area under the curve (iAUC0–120,p = 0.0249). Our findings reveal that algal biomasses and protein concentrates are as comparable to soy protein concentrate in palatability, satiety, and metabolic outcomes, highlighting their potential as practical, sustainable, and nutritious ingredients.

EFFECTS OF CHEWING TIME OF HIGH PROTEIN MEAL ON SATIETY AND GLP-1 HORMONE

Background: Chewing or mastication process affects satiety as well as satiety regulating hormone Glucagon-like Peptide-1 (GLP-1). Proteins have the highest satiating effects among the macronutrients. This study explored the association of chewing with satiety and GLP-1 in participants consuming high-protein meal. Methods: Fifteen healthy volunteers, aged 25-35 years were enrolled through random sampling. Effects of chewing on postprandial satiety and plasma GLP-1 was examined through quasi-experimental study conducted in Khyber Medical University, Peshawar, from Jan to Mar 2023. Three visits were designed with one week wash-out period. Satiety and GLP-1 were compared among normal, fast, and slow chewing conditions, while providing high protein meal. Subjective satiety was assessed via visual analogue scale (VAS) and labelled magnitude scale (LMS), while serum GLP-1 levels were analysed through ELISA at baseline, 30, 120 and 240 min in each visit. Results: The participants had a mean chewing time of 793.66±311 second at normal rate. Mean chewing time was decreased to 496.60±135.82 second during fast chewing, while significantly increased to 1459.66±400.83 second during slow chewing. A comparison of satiety at different chewing rates revealed that slow chewing significantly reduced hunger and enhanced fullness (p&lt;0.05), relative to normal and fast chewing, at 240 minutes (p&lt;0.05). However, no significant difference was observed in plasma GLP-1 levels at any time intervals (p&gt;0.05). Conclusion: Satiety is significantly influenced by chewing and number of chews per bite of a high protein meal, whereas postprandial plasma GLP-1 levels show no significant differences across different chewing rates. Pak J Physiol 2024;20(2):31-35

Deacetylated Konjac Glucomannan with a Slower Hydration Rate Delays Rice Digestion and Weakens Appetite Response.

The physical characteristics of chyme during gastrointestinal digestion are considered to significantly affect nutrient digestion and absorption (such as glucose diffusion), which has an impact on postprandial satiety. The present study aims to analyze the hydration rate (HR) and rheological properties of deacetylated konjac glucomannan (DKGM) at different degrees and then explore their effects on rice texture, digestive properties, and the subjects' post-meal appetite. The present results show that, as the deacetylation degree (DD) of KGM increased, the intersection point of the viscoelastic modulus shifted to a high shear rate frequency, and as the swelling time of the DKGM was prolonged, its HR decreased significantly. The results of the in vitro gastrointestinal digestion tests show that the hardness and chewability of the rice in the fast-hydration group (MK1) were remarkably reduced. In contrast, the slow-hydration group (MK5) exhibited an outstanding ability to resist digestion. The kinetics of starch hydrolysis revealed that the HR of the rice in the fast-hydration group was 1.8 times faster than that of the slow-hydration group. Moreover, it was found that the subjects' appetite after the meal was highly related to the HR of the MK. Their hunger (p < 0.001), desire to eat (p < 0.001), and prospective food consumption (p < 0.001) were significantly inhibited in the slow-hydration group (MK5) compared to the control. This study explored the nutritional effects of the hydration properties derived from the DKGM, which may contribute to modifying the high glycemic index food and provide ideas for the fabrication of food with enhanced satiating capacity.

Cumulative effect of obesity phenotypes on body weight and body mass index.

Obesity originates from an imbalance between energy intake and expenditure. Changes in energy intake components (satiation, postprandial satiety, emotional eating) and energy expenditure have been linked to obesity and are referred to as obesity phenotypes. We aim to study if these obesity phenotypes have a cumulative effect on body weight and body mass index (BMI). This is a cross-sectional study of adult patients with obesity (BMI > 30 kg/m2) who completed the validated tests to measure the obesity phenotypes. A total of 464 were included in this study. We defined higher calories to fullness during an ad libitum meal as abnormal satiation, accelerated time to half gastric emptying with scintigraphy as abnormal postprandial satiety, higher anxiety score on the Hospital Anxiety and Depression Scale as hedonic eating behavior, and decreased percentage of measured resting energy expenditure as abnormal energy expenditure. The primary analysis was done on the number of phenotypes ( ≤ 1 and ≥ 2) with body weight and BMI using an independent t-test. Our cohort included 464 patients (mean [SD] age 42.0 [10.9] years, 79% females, weight 111.2 [22.9] kg, BMI 38.9 [7.0] kg/m2). There were 294 patients who had ≤ 1 phenotype, and 170 patients with ≥ 2 phenotypes with no baseline demographical differences (i.e., age and sex). Having ≥ 2 phenotypes was associated with higher body weight (115 [25] kg vs. 109 [21] kg; p = 0.004), BMI (40 [8] kg/m2 vs. 38 [7] kg/m2; p = 0.02) and waist (118 [15] cm vs. 115 [13] cm; p = 0.04) and hip (129 [14] cm vs. 125 [13] cm; p = 0.01) circumferences compared to ≤ 1 phenotype. Obesity phenotypes are associated with an additive effect on the body weight and BMI. Patients who have multiple obesity phenotypes may require a more aggressive approach to enhance weight loss.

The Role of GLP-1, GIP, MCP-1 and IGFBP-7 Biomarkers in the Development of Metabolic Disorders: A Review and Predictive Analysis in the Context of Diabetes and Obesity.

Metabolic illnesses, including obesity and type 2 diabetes, have become worldwide epidemics that have an effect on public health. Clinical investigations and further exploration of these mechanisms could lead to innovative, effective, and personalized treatment strategies for individuals. It is important to screen biomarkers in previous studies to discover what is missing. Glucagon-like peptide-1's role in insulin secretion and glucose control highlights its diagnostic and therapeutic potential. Glucose-dependent insulinotropic peptide's influence on postprandial satiety and weight management signifies its importance in understanding metabolic processes. Monocyte chemoattractant protein-1's involvement in inflammation and insulin resistance underlines its value as a diagnostic marker. Insulin-like growth factor-binding protein-7's association with insulin sensitivity and kidney function presents it as a potential target for these diseases' management. In validating these biomarkers, it will be easier to reflect pathophysiological processes, and clinicians will be able to better assess disease severity, monitor disease progression, and tailor treatment strategies. The purpose of the study was to elucidate the significance of identifying novel biomarkers for type 2 diabetes mellitus and obesity, which can revolutionize early detection, risk assessment, and personalized treatment strategies. Standard literature searches of PubMed (MEDLINE), EMBASE, and Cochrane Library were conducted in the year 2023 to identify both original RCTs and recent systematic reviews that have explored the importance of identifying novel biomarkers for T2D and obesity. This search produced 1964 results, and then was reduced to randomized controlled trial and systematic reviews, producing 145 results and 44 results, respectively. Researchers have discovered potential associations between type 2 diabetes mellitus and obesity and the biomarkers glucagon-like peptide-1, glucose-dependent insulinotropic peptide, monocyte chemoattractant protein-1, and insulin-like growth factor-binding protein-7. Understanding the role of those biomarkers in disease pathogenesis offers hope for improving diagnostics, personalized treatment, and prevention strategies.

Lentils based pasta affect satiation, satiety and food intake in healthy volunteers

Plant-based diets represent a valid strategy to improve human health and increase food sustainability. The availability of legume-based products, a good source of proteins and fibers, could help consumers to promote healthy dietary patterns. The aim of this study was to examine the impact of different legume-based pastas on energy intake and appetite in healthy volunteers. Four ad libitum (protocol 1) and iso-caloric pre-load meals (protocol 2) were tested using a randomized repeated measure design. The test meals consisted of lentils pasta (LP), chickpeas pasta (CP); durum wheat pasta (DWP) and gluten free pasta (GFP), served with tomato sauce. Protocol 1: the ad libitum lunch meal was consumed then EI registered. Protocol 2: subjective appetite was assessed by visual analogue scale before and after the pre-load meal for 2 h until an ad libitum buffet was served to assess EI. Twenty (age: 39.2 ± 8.41 years; BMI: 23.4 ± 3.4 kg/m2) and 40 (age: 42.6 ± 8.7 years; BMI: 23.8 ± 4.2 kg/m2) healthy subjects were respectively recruited for each protocol. ANCOVA analysis showed an overall effect of meals and sex on EI within meal and at the subsequent meal, resulting in a lower EI after LP compared to DWP (p < 0.05). Appetite sensations were significantly influenced solely after the pre-load meal, where repeated measures ANCOVA showed increased post-prandial satiety after LP and CP (p < 0.05) compared to DWP in females, whereas a reduction in desire to eat and higher fullness was found following LP compared to the other meals in both sexes (p < 0.05). Overall, lentil-based pasta seemed to acutely affect EI both within and at the subsequent meal, especially in females. Consumption of legume-based pasta might enhance legume intake by modulating appetite feelings and increasing food sustainability. However, further studies are needed to support these results in the long-term and considering different target populations.

Using the conditioned place preference paradigm to assess hunger in dairy calves: Preliminary results and methodological issues.

Dairy calves are typically fed restricted amounts of milk. Although feed restrictions are predicted to result in negative affective states, the relative aversiveness of 'hunger' remains largely unexplored in this species. Here, we investigated whether the conditioned place preference paradigm can be used to explore how calves feel when experiencing different levels of satiation. This paradigm provides insight into what animals remember from past experiences, the assumption being that individuals will prefer places associated with more pleasant or less unpleasant experiences. Sixteen Holstein calves were either fed a restricted (3L per meal totalling 6 L per day) or 'enhanced' milk allowance (ad libitum up to 6 L per meal totalling up to 12 L per day) in their home-pen. Calves were then placed in a conditioning pen for 4 h immediately after being fed their morning meal to allow them to develop an association between the pen and their state of post-prandial satiation. Calves were conditioned across four days with their satiation state alternating between days to allow them to develop an association between pen and satiation levels. On the 5th day, calves were individually allowed to roam freely between the two pens for 30 min. We expected that calves would prefer the pen where they previously experienced higher levels of satiation, but our results show no to limited effects of treatment. However, some methodological issues (colour and side bias) prevent us from drawing strong conclusions. We discuss reasons for these issues and potential solutions to avoid these in future studies.

Reversal of Conditioned Food Aversion Using a Cognitive Intervention: A Sham-Controlled, Randomized, Parallel Study

Background: Aversive conditioning weakens the gratifying value of a comfort meal. The aim was to determine the effect of a cognitive intervention to reverse aversive conditioning and restore hedonic postprandial response. Methods: This was a randomized, sham-controlled, single-blind, parallel study that was conducted on 12 healthy women (n = 6 in each group). The reward value of a comfort meal was measured on different days: at initial exposure, after aversive conditioning (administration of the same meal with a masked fat overload on the previous day) and after a cognitive intervention (disclosing the aversive conditioning paradigm in the test group vs. no explanation in the control group). The primary outcome, digestive wellbeing, was determined using graded scales at regular intervals before and after ingestion. Results: At initial exposure, the comfort meal produced a rewarding experience that was impaired using aversive conditioning; upon re-exposure to the original meal, the cognitive intervention increased meal wanting and liking; improved digestive wellbeing and mood; tended to reduce postprandial satiety, bloating/fullness; and abolished discomfort/pain, thereby restoring the hedonic value of the comfort meal. By contrast, sham intervention had no effects, and the postprandial sensations remained like the responses to the offending meal. Conclusion: In this proof-of-concept study, we demonstrate that in healthy women, a mild, short-term acquired aversion to a comfort meal can be reversed using a cognitive intervention. ClinicalTrials.gov ID: NCT05897411.

P03-045-23 Effects of Blackberry Consumption on Postprandial Satiety, Glucose, Anxiety, and Skin Health

P03-045-23 Effects of Blackberry Consumption on Postprandial Satiety, Glucose, Anxiety, and Skin Health

Phenotype tailored lifestyle intervention on weight loss and cardiometabolic risk factors in adults with obesity: a single-centre, non-randomised, proof-of-concept study

Lifestyle interventions for weight loss are currently not individualised to underlying pathophysiology and behavioral traits in obesity. We aim to compare the outcome of a standard lifestyle intervention (SLI) to phenotype-tailored lifestyle interventions (PLI) on weight loss, cardiometabolic risk factors and physiologic variables contributing to obesity. This 12-week, single-centre non-randomised proof-of-concept clinical trial including men and women aged 18-65 years with a body mass index (BMI) greater than 30 without history of any bariatric procedure, and current use of any medication known to affect weight. Participants lived anywhere in the United States, and underwent in-person testing in Rochester, MN at a teaching hospital. All participants completed in-person phenotype testing at baseline and after 12 weeks. Participants were assigned to their intervention based on their period of enrollment. In the first phase, participants were assigned to SLI with a low-calorie diet (LCD), moderate physical activity, and weekly behavioral therapy sessions. In the second phase, other participants were assigned to PLI according to phenotype: abnormal satiation (time-restricted volumetric LCD); abnormal postprandial satiety (LCD with pre-meal protein supplementation); emotional eating (LCD with intensive behavioral therapy); and abnormal resting energy expenditure (LCD with post-workout protein supplementation and high-intensity interval training). The primary outcome was total body weight loss in kg at 12 weeks using multiple imputation for missing data. Linear models estimated the association of study group allocation and study endpoints adjusting for age, sex, and baseline weight. This study was registered with ClinicalTrials.gov, NCT04073394. Between July 2020 and August 2021, 211 participants were screened, and 165 were assigned to one of the two treatments in the two phases: 81 SLI (mean [SD] age 42.9 [12] years; 79% women; BMI 38.0 [6.0]) and 84 PLI (age 44.8 [12.2] years; 83% women; BMI 38.7 [6.9]); 146 completed the 12-week programs. The weight loss was-7.4kg (95%CI,-8.8,-6.0) with PLI vs.-4.3kg (95%CI,-5.8,-2.7) with SLI (difference,-3.1kg [95%CI,-5.1 to-1.1]; P=0.004). No adverse events were reported in any group. Phenotype-tailored lifestyle interventions may result in significant weight loss, but a randomised controlled trial is required to confirm causality. Mayo Clinic; NIH (K23-DK114460).

Combined effect of eating speed instructions and food texture modification on eating rate, appetite and later food intake

Modifying food texture and eating slowly each reduce appetite and energy intake. No study has evaluated the effect of combining these measures to slow eating speed and determine the effect on appetite. The aim of this study was to investigate whether there is a combined effect of manipulating oral processing behaviours (OPBs) in this manner on self-reported satiety and subsequent food intake. A 2 × 2 design was used with four breakfast conditions in total. Twenty-four participants attended four study visits where they were asked to consume one of two isocaloric fixed-portion breakfasts differing in texture: 1) granola with milk and 2) yogurt with muesli and conserve. Participants consumed each breakfast twice, with verbal instructions to chew slowly at one visit and at a normal rate at another. Consumption was video-recorded to behaviourally code OPBs. Participants completed visual analogue scales of self-reported appetite measures at the beginning of the test session, immediately prior to and immediately after breakfast consumption. They also completed a food diary documenting food intake for the remainder of the day. The breakfast designed to be eaten slowest (the harder-textured meal with instructions to eat slowly) was eaten at a slower rate, with a greater number of chews per bite and a slower bite rate (p < 0.001) compared to the other meals. No differences were observed between the breakfast conditions on subjective measures of post-prandial satiety, or subsequent energy or macronutrient consumption. Results of this study highlight that combined effects of texture and instructions are most effective at reducing eating rate, though eating slower was not shown to enhance post-meal satiety. Reduced eating speed has previously been shown to reduce ad-libitum energy intake. Future research should consider combined approaches to reduce eating speed, to mitigate the risk of overconsumption within meals.

The complex pattern of the effects of prolonged frequent exercise on appetite control, and implications for obesity

From a public health perspective, much of the interest in the relationship between exercise and appetite rests on the implications for energy balance and obesity. Energy balance reflects a dynamic 2-way interaction between energy expenditure (EE) and energy intake (EI). Physical activity and exercise, and appetite are the behavioural components of EE and EI, respectively. Beyond EE, exercise is a powerful and complex physiological stimulus acting on several bodily systems. There are multiple effects of frequent and prolonged exercise on appetite which include inter alia an increase in fasting hunger, an enhancement of post-prandial satiety, a modulation of the hedonic responses to food and improvements in eating behaviour traits. These lead to variable adjustments in EI and in a reduction in the susceptibility to overconsumption. Frequent and prolonged physical activity and exercise behaviour can strengthen and sensitise the appetite control system, whilst physical inactivity and sedentariness (low level of EE) fails to downregulate EI and can permit overconsumption. Not all of the effects of exercise operate uniformly to drive appetite in the same direction. The complexity of the interaction between EE and EI means that the effects of prolonged exercise are characterised by substantial individual heterogeneity. This leads to variable effects on energy balance and body mass.

Association Between Food Intake and Gastrointestinal Symptoms in Patients With Obesity.

Hunger, satiation, postprandial satiety, and hedonic eating constitute key food intake parameters. We aim to study whether these symptoms are associated with gastrointestinal symptoms (GIS) in patients with obesity. This is a cross-sectional study of patients with obesity. Patients completed the following validated biomarkers and questionnaires: hunger was measured via visual analog scale (100 mm) following a standard meal, satiation was measured via ad libitum meal (calories to fullness; kcal), postprandial satiety was measured via gastric emptying scintigraphy (T1/2; mins), and hedonic eating was measured via the Hospital Anxiety and Depression Scale questionnaire. Participants completed the abridged Bowel Disease Questionnaire to evaluate their GIS. We calculated the odds ratios (ORs) adjusted for sex, weight, and age between food intake parameters <25th or >75th percentile observed in a prior cohort of 450 participants with obesity and GIS. A total of 274 participants (41 ± 10 [SD] years, 75% females, body mass index 39 ± 8 kg/m2) were included in the analysis. Increased hunger was associated with a lower prevalence of lumpy stools (OR = 0.18, P = .02). Satiation was associated with abdominal pain/discomfort (relieved by defecation [OR = 2.4, P = .02] or associated with change in stool consistency [OR = 2.92, P < .01]), loose/watery stools (OR = 2.09, P = .02), and bloating (OR = 2.49, P < .01). Abnormal postprandial satiety was associated with bloating (OR = 2.26, P < .01) and loose/watery stools (OR = 1.84, P = .04). Hedonic eating was associated with abdominal pain/discomfort with stool frequency change (OR = 2.4, P = .02), >3 bowel movements per day (OR = 1.93, P = .048), bloating (OR = 2.49, P = .01), abdominal pain after meals >1 per month (OR = 4.24, P < .01), and nausea >1 per week (OR = 4.51, P < .01). Alterations in hunger, satiation, postprandial satiety, and hedonic eating are associated with GIS in patients with obesity.

Assessing the Effect of Plant-Based Mince on Fullness and Post-Prandial Satiety in Healthy Male Subjects.

This study aimed to assess the effect of substituting plant-based mince for beef mince in a standard pasta meal on the amount consumed and on objective and subjective measures of post-prandial satiety. Healthy, adult males (n = 24) consumed a pasta lunch meal containing either plant-based or beef mince at separate visits, and the amount consumed measured at each visit. Perceptions of hunger, fullness and satisfaction were recorded and blood samples collected before and for 3 h after eating, when a buffet meal was provided. Participants consumed 586 kJ less of the pasta meal prepared with plant-based mince compared to beef mince (p < 0.05). Energy intake at the buffet meal and measures of fullness, satiety and satisfaction after the pasta meal were not different between plant and beef mince (p > 0.05). Post-prandial Glucagon-Like Peptide-1 (GLP-1), but not insulin or leptin concentrations, were lower after the plant-based pasta meal (p < 0.05). Our results suggest that the pasta meal containing plant-based mince was more satiating than an equivalent meal prepared with beef mince, and that this was not associated with greater energy intake at a subsequent meal occasion. Further studies that evaluate the longer-term effects of replacing meat with plant-based mince on energy intakes and explore the mechanisms underlying the lower consumption of the plant-based mince meal would be valuable.

Acute postprandial gut hormone, leptin, glucose and insulin responses to resistant starch in obese children: a single blind crossover study

IntroductionResistant starch (RS) has beneficial effects on postprandial glucose metabolism in both animals and adults. Hitherto, there have been no studies in children of the acute metabolic and hormonal effects...

Dietary Gamma-Aminobutyric Acid (GABA) Induces Satiation by Enhancing the Postprandial Activation of Vagal Afferent Nerves.

Gamma-aminobutyric acid (GABA) is present in the mammalian brain as the main inhibitory neurotransmitter and in foods. It is widely used as a supplement that regulates brain function through stress-reducing and sleep-enhancing effects. However, its underlying mechanisms remain poorly understood, as it is reportedly unable to cross the blood–brain barrier. Here, we explored whether a single peroral administration of GABA affects feeding behavior as an evaluation of brain function and the involvement of vagal afferent nerves. Peroral GABA at 20 and 200 mg/kg immediately before refeeding suppressed short-term food intake without aversive behaviors in mice. However, GABA administration 30 min before refeeding demonstrated no effects. A rise in circulating GABA concentrations by the peroral administration of 200 mg/kg GABA was similar to that by the intraperitoneal injection of 20 mg/kg GABA, which did not alter feeding. The feeding suppression by peroral GABA was blunted by the denervation of vagal afferents. Unexpectedly, peroral GABA alone did not alter vagal afferent activities histologically. The coadministration of a liquid diet and GABA potentiated the postprandial activation of vagal afferents, thereby enhancing postprandial satiation. In conclusion, dietary GABA activates vagal afferents in collaboration with meals or meal-evoked factors and regulates brain function including feeding behavior.

Efficacy of Acupuncture Treatment for Postprandial Distress Syndrome: A Systematic Review and Meta-Analysis.

Objective This systematic review and meta-analysis was conducted to assess the efficacy of acupuncture treatment for postprandial distress syndrome (PDS). Methods Search the Web of Science, the Cochrane Library, PubMed, and Embase databases with acupuncture randomized controlled trials for the treatment of patients with PDS. Strictly according to inclusion and exclusion quality assessment standards, the qualified ones are used to study the optimum extraction and data by two independent reviewers. Stata 15.0 software was used for meta-analysis. Result We initially identified 63 studies, of which five (1253 participants) were eventually included in our analysis. There were 643 cases in the experimental group and 610 cases in the control group. Acupuncture had a significant effect on the total therapeutic effect (OTE) at week 4 (OR 4.74, 95% CI 02.88-7.83, Z = 6.10, P = 0 < 0.05). Significantly improved NDI (Nepean dyspepsia index) scores of PDS patients at week 4 (SMD 0.61, 95% CI 0.48 to 0.74). Significantly improved NDI scores in PDS patients at week 16 (SMD 0.49, 95% CI 0.27 to 0.71). After acupuncture treatment, the SID (dyspepsia symptom index) score of PDS patients decreased significantly at week 4 (SMD-0.52, 95% CI -0.73 to -0.32) and week 16 (SMD-0.59, 95% CI -0.81 to -0.36). Postprandial satiety scores (SMD-0.63, 95% CI -0.76 to -0.50) and early satiety scores (SMD-0.51, 95% CI -0.64 to -0.37) were also significantly lower at week 4 after acupuncture. Conclusion This study highlighted that the acupuncture could significantly improve the overall therapeutic effect of PDS patients, alleviate the symptoms of postprandial fullness and early satiety, and improve the quality of life of patients. Our results supported that acupuncture was an effective therapeutic strategy for postprandial distress syndrome.

Zhizhu Kuanzhong Capsule in treating patients with functional dyspepsia postprandial distress syndrome: study protocol for a multicenter, randomized, double-blind, placebo-controlled, parallel-group clinical trial

BackgroundFunctional dyspepsia (FD) is one of the most common functional gastrointestinal disorders. Based on the various symptoms present in patients with functional dyspepsia postprandial distress syndrome (FD-PDS), routine agents such as acid suppressants, prokinetic drugs, and centrally acting drugs, offer limited treatment choices with potential side effects. As a preliminary clinical trial showed that the marketed product Zhizhu Kuanzhong Capsule (ZZKZ) can improve symptoms in FD-PDS patients, our study aims to provide further evidence on the clinical efficacy and safety of ZZKZ in the treatment of patients with FD-PDS.MethodsIn this multicenter, randomized, patient- and investigator-blinded, placebo-controlled, parallel-group clinical trial, we will recruit patients with FD-PDS from 18 hospitals in China and Australia. The trial will enroll patients with FD-PDS based on the Rome IV diagnostic criteria. A total of 480 eligible patients will be randomized 1:1 into either ZZKZ or placebo group with 8 weeks of treatment and 4 weeks of follow-up. The primary endpoint will be measured by a self-rated Visual Analogue Score (VAS) for the degree of discomfort with both symptoms of postprandial fullness and early satiation, recorded once a day and 7 days a week. The primary analysis will aim to compare the response rate for FD-PDS VAS score between the groups before and after 8 weeks of treatment with an alpha level of 0.05 (2-sided).DiscussionThis trial aims to strengthen the evidence for the efficacy and safety of ZZKZ, a marketed product, in treating FD-PDS. Compared to the previous clinical trial that targeted FD-PDS, this trial will have an 8-week double-blind treatment period to investigate the effect of long-term mediation through comparison with the placebo group.Trial registrationClinicalTrials.gov NCT03825692. Registered on 28 January 2019

Acute Effects of Split Pea-Enriched White Pan Bread on Postprandial Glycemic and Satiety Responses in Healthy Volunteers-A Randomized Crossover Trial.

Pulse consumption has been associated with reduced postprandial glucose response (PPGR) and improved satiety. The objective of this study was (i) to investigate the effects of fortifying white pan bread with split yellow pea (Pisum sativum L.) flour on PPGR and appetite-related sensations, and (ii) to determine whether Revtech heat processing of pea flour alters the postprandial effects. A randomized controlled crossover trial was performed with 24 healthy adults. Participants consumed 50 g available carbohydrate from bread containing 20% pea flour that was untreated (USYP), Revtech processed at 140 °C with no steam (RT0%), Revtech processed at 140 °C with 10% steam (RT10%), or a control bread with 100% white wheat flour (100%W). Blood samples were analyzed for glucose and plasma insulin at 0, 15, 30, 45, 60, 90, and 120 min post-meal. Appetite sensations and product acceptability were measured using visual analogue and 9-point hedonic scales. Results showed no significant difference in the postprandial glucose and insulin responses of different bread treatments. However, pea-containing variants resulted in 18% higher fullness and 16–18% lower hunger, desire to eat, and prospective food consumption ratings compared to 100% W. No differences in the aroma, flavor, color, and overall acceptability of different bread products were observed. This trial supports using pea flour as a value-added ingredient to improve the short-term appetite-related sensations of white pan bread without affecting the overall acceptability.

Does a Higher Protein Diet Promote Satiety and Weight Loss Independent of Carbohydrate Content? An 8-Week Low-Energy Diet (LED) Intervention.

Both higher protein (HP) and lower carbohydrate (LC) diets may promote satiety and enhance body weight (BW) loss. This study investigated whether HP can promote these outcomes independent of carbohydrate (CHO) content. 121 women with obesity (BW: 95.1 ± 13.0 kg, BMI: 35.4 ± 3.9 kg/m2) were randomised to either HP (1.2 g/kg BW) or normal protein (NP, 0.8 g/kg BW) diets, in combination with either LC (28 en%) or normal CHO (NC, 40 en%) diets. A low-energy diet partial diet replacement (LEDpdr) regime was used for 8 weeks, where participants consumed fixed-energy meal replacements plus one ad libitum meal daily. Four-day dietary records showed that daily energy intake (EI) was similar between groups (p = 0.744), but the difference in protein and CHO between groups was lower than expected. Following multiple imputation (completion rate 77%), decrease in mean BW, fat mass (FM) and fat-free mass (FFM) at Week 8 in all was 7.5 ± 0.7 kg (p < 0.001), 5.7 ± 0.5 kg (p < 0.001), and 1.4 ± 0.7 kg (p = 0.054) respectively, but with no significant difference between diet groups. LC (CHO×Week, p < 0.05), but not HP, significantly promoted postprandial satiety during a preload challenge. Improvements in blood biomarkers were unrelated to LEDpdr macronutrient composition. In conclusion, HP did not promote satiety and BW loss compared to NP LEDpdr, irrespective of CHO content.