Satiety Hormone Responses Research Articles

Metabolic and Gut Microbiota Responses to Sourdough Pasta Consumption in Overweight and Obese Adults.

Increasing consumer interest in fermented products has driven the emergence of a number of novel foods including shelf-stable sourdough pasta. This study comprehensively examined the impact of fermentation on the microbial composition of the culture, pasta, its subsequent effects on glycemic responses and gut microbiota in overweight men and women (>25 kg/m2) compared to a conventional, non-fermented pasta. Two, randomized crossover trials were performed. Study A examined acute feeding responses to each product wherein fasted participants completed a meal tolerance test comprised of 75 g of conventional or sourdough pasta to examine glycemic responses. Results showed enhanced gastric emptying with sourdough, but no difference in overall blood glucose, insulin or satiety hormone responses between the treatments. Study B consisted of three standard oral glucose tolerance tests as well as fecal collection for sequencing at baseline and following each pasta intervention (150 g or 2 serving/d for 5 days) followed by a 2-week washout period. Results showed no differential impact of either pasta treatment on glucose tolerance. Analysis of fecal bacterial and fungal (mycobiome) microbiota showed no change at the individual species or genus levels. However, fungi were adaptive following chronic pasta consumption with decreases in alpha diversity of fungi following sourdough, but not conventional pasta. This was accompanied by reductions in total fecal short chain fatty acid concentrations. In conclusion, sourdough fermentation did not change the overall glycemic properties of the pasta, incretin responses or bacterial gut microbiota, but appears to impact microbiome fungal community structure with chronic consumption.

Comparison of Glucose and Satiety Hormone Response to Oral Glucose vs. Two Mixed-Nutrient Meals in Rats.

The obesity epidemic is driving interest in identifying strategies that enhance appetite control by altering the secretion of hormones that regulate satiety and food intake. An appropriate nutrient stimulus, such as a meal or oral nutrient solution, is needed to elicit the secretion of satiety hormones in order to evaluate the impact of dietary and other interventions. Our objective was to compare the effects of oral glucose vs. mixed nutrients on plasma concentrations of glucose and appetite-regulating hormones to determine the most appropriate oral nutrient challenge to trigger robust hormone secretion. A 120 min oral glucose tolerance test (OGTT) was compared with two meal tolerance tests (MTT) of differing formulation to evaluate glucose and satiety hormone responses. Following overnight feed deprivation, male Sprague-Dawley rats were given one of three oral gavages with equal carbohydrate content (2 g CHO/kg) in the form of: (1) Dextrose, (2) Ensure®, or (3) Mixed Meal. A fourth group was given saline as a control. Blood was collected via tail snip and analyzed for glucose, insulin, GLP-1, GIP, PYY, amylin, leptin, and ghrelin. Dextrose resulted in the highest blood glucose at T15 (P = 0.014), while the mixed meal was significantly higher than saline from T30-T120 (P < 0.05). Insulin was higher at T15 with dextrose compared to saline (P = 0.031) and Ensure® (P = 0.033). GLP-1 tAUC was significantly higher with dextrose compared to mixed meal (P = 0.04) while GIP tAUC was higher with dextrose and mixed meal compared to saline (P < 0.05). Changes in tAUC for insulin, amylin, leptin, ghrelin, and PYY did not reach significance. Based on these findings, dextrose appears to provide a robust acute glycemic and hormone response and is therefore likely an appropriate oral solution to reproducibly test the impact of various dietary, surgical, or pharmacological interventions on glucose and satiety hormone response.

Acute Consumption of Resistant Starch Reduces Food Intake but Has No Effect on Appetite Ratings in Healthy Subjects.

Previous studies have shown the benefits of native banana starch (NBS) supplementation in improving glucose metabolism and reducing body weight (BW) in humans. However, the effect of this starch on appetite regulation is unknown. The aim of this study was to examine the effects of NBS rich resistant starch on subjective measurements of appetite, energy intake, and appetite hormones in healthy subjects. Postprandial glucose and insulin responses were also assessed. In a randomized, single-blind, crossover study, 28 healthy young subjects consumed a beverage containing either 40 g of NBS or 40 g of digestible corn starch (DCS) on two separate occasions. Effects on appetite were estimated using visual analogue scales (VAS) and satiety hormone responses. At the end of the intervention, participants were provided with a pre-weighed ad libitum homogeneous test meal. After a washout period of 1 week, subjects received the alternative treatment. NBS supplementation induced a reduction in food intake, glucose area under the curve (AUC)-180 min, and insulin AUC-180 min. However, there was no associated effect on the subjective appetite ratings or gut hormones. NBS supplementation may help to reduce meal size and control BW.

High Sensitivity of Aged Mice to Deoxynivalenol (Vomitoxin)-Induced Anorexia Corresponds to Elevated Proinflammatory Cytokine and Satiety Hormone Responses.

Deoxynivalenol (DON), a trichothecene mycotoxin that commonly contaminates cereal grains, is a public health concern because of its adverse effects on the gastrointestinal and immune systems. The objective of this study was to compare effects of DON on anorectic responses in aged (22 mos) and adult (3 mos) mice. Aged mice showed increased feed refusal with both acute i.p. (1 mg/kg and 5 mg/kg) and dietary (1, 2.5, 10 ppm) DON exposure in comparison to adult mice. In addition to greater suppression of food intake from dietary DON exposure, aged mice also exhibited greater but transient body weight suppression. When aged mice were acutely exposed to 1 mg/kg bw DON i.p., aged mice displayed elevated DON and DON3GlcA tissue levels and delayed clearance in comparison with adult mice. Acute DON exposure also elicited higher proinflammatory cytokine and satiety hormone responses in the plasma of the aged group compared with the adult group. Increased susceptibility to DON-induced anorexia in aged mice relative to adult mice suggests that advanced life stage could be a critical component in accurate human risk assessments for DON and other trichothecenes.

Effect of extended morning fasting upon ad libitum lunch intake and associated metabolic and hormonal responses in obese adults.

Background/Objectives:Breakfast omission is positively associated with obesity and increased risk of disease. However, little is known about the acute effects of extended morning fasting upon subsequent energy intake and associated metabolic/regulatory factors in obese adults.Subjects/Methods:In a randomised cross-over design, 24 obese men (n=8) and women (n=16) extended their overnight fast by omitting breakfast consumption or ingesting a typical carbohydrate-rich breakfast of 2183±393 kJ (521±94 kcal), before an ad libitum pasta lunch 3 h later. Blood samples were obtained throughout the day until 3 h post lunch and analysed for hormones implicated in appetite regulation, along with metabolic outcomes and subjective appetite measures.Results:Lunch intake was unaffected by extended morning fasting (difference=218 kJ, 95% confidence interval −54 kJ, 490 kJ; P=0.1) resulting in lower total intake in the fasting trial (difference=−1964 kJ, 95% confidence interval −1645 kJ, −2281 kJ; P<0.01). Systemic concentrations of peptide tyrosine–tyrosine and leptin were lower during the afternoon following morning fasting (P⩽0.06). Plasma-acylated ghrelin concentrations were also lower following the ad libitum lunch in the fasting trial (P<0.05) but this effect was not apparent for total ghrelin (P⩾0.1). Serum insulin concentrations were greater throughout the afternoon in the fasting trial (P=0.05), with plasma glucose also greater 1 h after lunch (P<0.01). Extended morning fasting did not result in greater appetite ratings after lunch, with some tendency for lower appetite 3 h post lunch (P=0.09).Conclusions:We demonstrate for the first time that, in obese adults, extended morning fasting does not cause compensatory intake during an ad libitum lunch nor does it increase appetite during the afternoon. Morning fasting reduced satiety hormone responses to a subsequent lunch meal but counterintuitively also reduced concentrations of the appetite-stimulating hormone-acylated ghrelin during the afternoon relative to lunch consumed after breakfast.

Postprandial effects of polydextrose on satiety hormone responses and subjective feelings of appetite in obese participants.

BackgroundDietary fibers are associated with enhanced satiety. However, the mechanism of different dietary fibers contributing to satiety-related gastrointestinal (GI) peptide release, especially in an obese population, is still poorly understood. Polydextrose (PDX), a water-soluble glucose polymer, has demonstrated its ability to reduce energy intake at a subsequent meal, but its mechanism of action requires further research. Also, there is limited evidence on its capacity to regulate subjective feelings of appetite. This study examines the effects of PDX on postprandial secretion of satiety-related GI peptides, short chain fatty acids (SCFAs), lactic acid, and subjective appetite ratings in obese participants.Methods18 non-diabetic, obese participants (42.0 y, 33.6 kg/m2) consumed a high-fat meal (4293 kJ, 36% from fat) with or without PDX (15 g) in an acute, multicenter, randomized, double-blind, placebo-controlled and crossover trial. Postprandial plasma concentrations of satiety-related peptides, namely ghrelin, cholecystokinin (CCK), glucagon-like peptide 1 (GLP-1), and peptide YY (PYY), as well as SCFAs and lactic acid were assessed. GI peptide, SCFA and lactate concentrations were then modeled using a linear mixed-effects model.The subjective feelings of hunger, satisfaction, and desire to eat were evaluated using visual analogue scales (VAS), which were analyzed as incremental areas under the curve (iAUC) during the satiation and satiety periods.ResultsWe found that PDX supplementation increased plasma GLP-1 levels more than the placebo treatment (P = 0.02). In the whole group, GLP-1 concentrations found in participants older than 40 years old were significantly lower (P = 0.01) as compared to those aged 40 years or less. There were no statistically significant differences in postprandial ghrelin, CCK, or PYY responses. The lactic acid concentrations were significantly (P = 0.01) decreased in the PDX group, while no significant changes in SCFAs were found. PDX reduced iAUC for hunger by 40% (P = 0.03) and marginally increased satisfaction by 22.5% (P = 0.08) during the post-meal satiety period.ConclusionPolydextrose increased the postprandial secretion of the satiety hormone GLP-1 and reduced hunger after a high-fat meal. PDX also reduced the elevated postprandial lactic acid levels in plasma. Therefore, PDX may offer an additional means to regulate inter-meal satiety and improve postprandial metabolism in obese participants.

Effect of soluble fiber dextrin on postprandial appetite and subsequent food intake in healthy adults

The effect of a newly developed soluble fiber dextrin on subjective appetite, satiety hormone response and food intake was investigated using a double blind, randomized cross‐over study. 41 healthy adults aged 24±4 years with a BMI of 23.4±2.5 kg/m2 ate a lunch meal with a test beverage that contained 0g, 10g or 20g fiber. Appetite questionnaires were completed and plasma samples collected immediately before, and at regular intervals following lunch. A snack was provided 150 minutes after lunch and the amount eaten recorded. Following the snack, subjective appetite was recorded each hour for the remainder of the day and food intake recorded using a food log. The consumption of the different test beverages had no effect on subjective appetite during the first 150 minutes after lunch or on food intake at the snack meal (p&gt;;0.05). However, after leaving the laboratory, subjective feelings of hunger, desire to eat and prospective consumption were significantly lower and fullness significantly higher over the rest of the day following the test beverage containing 20g fiber (p&lt;0.05). Plasma GIP was lower following the test beverage containing 20g fiber (p&lt;0.05), with no effect on plasma GLP‐1, ghrelin, CCK, PYY3–36, insulin or glucose (p&gt;;0.05). These results indicate that soluble fiber dextrin may promote satiety from 3 up to 8.5 hours after consumption.This study was funded by Tate and Lyle Health &amp; Nutrition Sciences.

Long-term results of a randomized clinical trial comparing Roux-en-Y gastric bypass with vertical banded gastroplasty

The long-term results of Roux-en-$\hbox{Y}$ gastric bypass (gastric bypass) and vertical banded gastroplasty (VBG) from randomized studies have not been described in detail. Patients were randomized to gastric bypass or VBG. Body mass index (BMI), body composition, eating habits and gastrointestinal hormones were reviewed after 6 years. The frequency of reoperation was assessed up to 10 years after surgery. Sixty-six (80 per cent) of the 82 subjects randomized were assessed for weight and BMI 6 years after surgery, 30 (81 per cent) in the gastric bypass group and 36 (80 per cent) in the VBG group. Intention-to-treat analysis demonstrated greater weight loss after gastric bypass compared with VBG, 6 years after surgery: BMI reduced from 41·8 (95 per cent confidence interval 41·3 to 42·3) to 30·3 (28·6 to 32·0) kg/m(2) for gastric bypass and from 42·3 (42·8 to 44·8) to 32·9 (31·3 to 34·5) kg/m(2) for VBG (P = 0·036). Gastric bypass caused a larger loss of fat mass (P = 0·026) and better preservation of lean tissue (P = 0·009). Patients having a gastric bypass had greater postprandial responses to the satiety hormones glucagon-like peptide 1 and peptide YY (P = 0·003 and P = 0·004 respectively). Ghrelin levels did not differ between the groups. Patients with a gastric bypass maintained a lower intake of fat compared with those having VBG (P = 0·013). Some 89 per cent of patients who initially had VBG had undergone, or were scheduled for, conversion to gastric bypass at latest follow-up. Gastric bypass was superior to VBG regarding weight loss, body composition, dietary composition and postprandial satiety hormone responses.

Acute and second-meal effects of peanuts on glycaemic response and appetite in obese women with high type 2 diabetes risk: a randomised cross-over clinical trial

Nut consumption is associated with a reduced risk of type 2 diabetes mellitus (T2DM). The aim of the present study was to assess the effects of adding peanuts (whole or peanut butter) on first (0-240 min)- and second (240-490 min)-meal glucose metabolism and selected gut satiety hormone responses, appetite ratings and food intake in obese women with high T2DM risk. A group of fifteen women participated in a randomised cross-over clinical trial in which 42·5 g of whole peanuts without skins (WP), peanut butter (PB) or no peanuts (control) were added to a 75 g available carbohydrate-matched breakfast meal. Postprandial concentrations (0-490 min) of glucose, insulin, NEFA, glucagon-like peptide-1 (GLP-1), peptide YY (PYY), cholecystokinin (CCK), appetitive sensations and food intake were assessed after breakfast treatments and a standard lunch. Postprandial NEFA incremental AUC (IAUC) (0-240 min) and glucose IAUC (240-490 min) responses were lower for the PB breakfast compared with the control breakfast. Insulin concentrations were higher at 120 and 370 min after the PB consumption than after the control consumption. Desire-to-eat ratings were lower, while PYY, GLP-1 and CCK concentrations were higher after the PB intake compared with the control intake. WP led to similar but non-significant effects. The addition of PB to breakfast moderated postprandial glucose and NEFA concentrations, enhanced gut satiety hormone secretion and reduced the desire to eat. The greater bioaccessibility of the lipid component in PB is probably responsible for the observed incremental post-ingestive responses between the nut forms. Inclusion of PB, and probably WP, to breakfast may help to moderate glucose concentrations and appetite in obese women.

Within subject variation of satiety hormone responses to a standard lunch

BackgroundInsulin (Ins), leptin (Lep), GLP‐1, and glucagon (Glg) are known regulators of glucose metabolism and food intake, but reproducibility in response to a meal challenge is not well characterized. We assessed within‐subject variation of these hormones in 14 young adult women.MethodsSubjects were studied on 2 days during the follicular phase of the menstrual cycle. On test days blood was drawn at 20, 35, 50, 65 &amp; 125 min after a standard lunch meal. Meso Scale Discovery assay system was used to measure the hormones in a multiplexed sandwich immunoassay.ResultsAnalysis of variance revealed that there were no differences between test days for all 4 hormones. Correlations between values for test days 1 &amp; 2 were significant for Ins (r = 0.68; p &lt; 0.0001), Lep (r = 0.86; p &lt; 0.0001) and GLP‐1 (r = 0.97; p &lt; 0.0001) but not for Glg (r = 0.18; p = 0.143). Mean within‐subject variation (% of mean value at each time point) was 42, 37, 48, and 87 for Ins, Lep, GLP‐1 and Glg, respectively. Averaging values for 5 time points, to represent postprandial response, reduced within‐subject variation to 30, 37, 23, and 35% of mean value, respectively.DiscussionDespite controlled test meals, we observed large within‐subject variation that was partly reduced by using summary measures. Other contributors to variation may include pre‐test diet intake, environmental influences, or analytical error. Funding: USDA CSREES 2009‐35215‐05364.

Satiety scores and satiety hormone response after sucrose-sweetened soft drink compared with isocaloric semi-skimmed milk and with non-caloric soft drink: a controlled trial

Observational studies indicate that sugar-sweetened soft drinks (SSSD) may promote obesity, among other factors, owing to low-satiating effects. The effect of energy in drinks on appetite is still unclear. We examined the effect of two isocaloric, but macronutrient, different beverages (SSSD versus semi-skimmed milk) and two non-energy-containing beverages (aspartame-sweetened soft drink (ASSD) and water) on appetite, appetite-regulating hormones and energy intake (EI). In all, 24 obese individuals were included in a crossover trial. Each subject was served either 500 ml of SSSD (regular cola: 900 kJ), semi-skimmed milk (950 kJ), ASSD (diet cola: 7.5 kJ), or water. Subjective appetite scores, ghrelin, GLP-1, and GIP concentrations were measured at baseline and continuously 4-h post intake. Ad libitum EI was measured 4 h after intake of the test drinks. Milk induced greater subjective fullness and less hunger than regular cola (P<0.05). Also, milk led to 31% higher GLP-1 (95% CI: 20, 44; P<0.01) and 45% higher GIP (95% CI: 23, 72; P<0.01) concentrations compared with SSSD. Ghrelin was equally 20% lower after milk and SSSD compared with water. The total EI (ad libitum EI+EI from the drink) was higher after the energy-containing drinks compared with diet cola and water (P<0.01). Milk increased appetite scores and GLP-1 and GIP responses compared with SSSD. The energy containing beverages were not compensated by decreased EI at the following meal, emphasizing the risk of generating a positive energy balance by consuming energy containing beverages. Furthermore, there were no indications of ASSD increased appetite or EI compared with water.

Acute effects of pistachio consumption on postprandial glucose and insulin levels, oxidative stress, gut satiety hormone responses and endothelial function

BackgroundNut consumption has been found to decrease risk of CHD, to improve control of type 2 diabetes and to promote healthy body weights, possibly related to their favorable fat, protein and antioxidant profiles. Previous studies have demonstrated that pistachios when included in meals decrease the postprandial glycemic response of carbohydrate foods.Methods20 subjects, 40–65y, BMI&gt;30kg/m2, with metabolic syndrome as defined by NCEP ATP III guidelines were recruited. Each subject participated in a total of 5 breakfast study meals over 5–10wks. Study meal order was randomized and were consumed after an overnight fast. Meal 1 was a control meal of white bread (50g available CHO). Meals 2 (white bread, butter and cheese) and 3 (white bread plus 3oz pistachios) had similar macronutrient profiles. Meals 4 (white bread) and 5 (3oz pistachios alone) had the same amount of available CHO (12g). Capillary finger‐prick and venous blood samples were taken and subjective satiety measures via a visual analogue scale were assessed along with endothelial function over the 3h study periods. Differences were assessed by least squares means with a Tukey adjustment for multiple comparisons.

Weight loss during oligofructose supplementation is associated with decreased ghrelin and increased peptide YY in overweight and obese adults

Background: Rodent studies show that oligofructose promotes weight loss, stimulates satiety hormone secretion, reduces energy intake, and improves lipid profiles.Objective: Our objective was to examine the effects of oligofructose supplementation on body weight and satiety hormone concentrations in overweight and obese adults.Design: This study was a randomized, double-blind, placebo-controlled trial. Forty-eight otherwise healthy adults with a body mass index (in kg/m2) > 25 were randomly assigned to receive 21 g oligofructose/d or a placebo (maltodextrin) for 12 wk. Body composition (by dual-energy X-ray absorptiometry); meal tolerance tests, including satiety hormone response; food intake; and subjective appetite ratings were determined.Results: There was a reduction in body weight of 1.03 ± 0.43 kg with oligofructose supplementation, whereas the control group experienced an increase in body weight of 0.45 ± 0.31 kg over 12 wk (P = 0.01). A lower area under the curve (AUC) for ghrelin (P = 0.004) and a higher AUC for peptide YY (PYY) with oligofructose (P = 0.03) coincided with a reduction in self-reported caloric intake (P ≤ 0.05). Glucose decreased in the oligofructose group and increased in the control group between initial and final tests (P ≤ 0.05). Insulin concentrations mirrored this pattern (P ≤ 0.05). Oligofructose supplementation did not affect plasma active glucagon-like peptide 1 secretion. According to a visual analog scale designed to assess side effects, oligofructose was well tolerated.Conclusions: Independent of other lifestyle changes, oligofructose supplementation has the potential to promote weight loss and improve glucose regulation in overweight adults. Suppressed ghrelin and enhanced PYY may contribute in part to the reduction in energy intake. The trial was registered at clinicaltrials.gov as NCT00522353.

Effect of Pistachios on Postprandial Glucose and Insulin Levels and Gut Satiety Hormone Responses.

BackgroundNut consumption is associated with reduced risk of CHD and type 2 diabetes and healthy body weights. Previous studies demonstrated that pistachios decrease the postprandial glycemic response of carbohydrate foods.ObjectiveTo assess the effect of pistachios on postprandial serum insulin/glucose levels and gut satiety hormone responses.MethodsFasted subjects (9M, 6F) consumed 3 different meals in random order. Test meals, with similar macronutrient profiles, consisted of white bread (WB) plus 2oz of pistachios, and; WB plus butter and cheese. The control meal was WB. Capillary finger‐prick and venous blood samples were taken and subjective satiety measures via a visual analogue scale were assessed over 3 hours.ResultsCompared to the control, peak postprandial glucose concentration was reduced in both test meals while plasma insulin was not different. However, GIP iAUC for WB was significantly lower than for the test meals. GLP‐1 levels were consistently higher after WB+Pistachio meal compared to other meals and GLP‐1 iAUC of both WB+Pistachio and WB+Cheese meals were significantly higher than WB control meal. Despite absence of changes in VAS satiety scores, several hunger markers were increased over the first hour in the control meal.ConclusionReducing postprandial glycemia and altering gut hormones may be further mechanisms by which pistachios contribute to health.

The Effects of Pistachios on Postprandial Glucose and Insulin Levels, Gut Satiety Hormones and Measures of Oxidative Stress

Background: Nuts are associated with a reduced risk of CHD and Type 2 Diabetes possibly relating to their favorable fat, protein and antioxidant profiles. Moreover, nuts have also been shown to reduce serum LDL‐C. Previous studies have demonstrated that pistachios decreased the postprandial glycemic response of white bread in a dose‐dependent manner and attenuated the glucose excursions of common carbohydrate foods when consumed with 2oz of pistachios.Objective: To assess the effect of pistachios on postprandial serum insulin levels, gut satiety hormone responses and measures of tissue oxidative stress.Methods: After an overnight fast, 15 healthy subjects consumed 2 iso‐caloric test meals and 1 control meal in a randomized fashion, each separated by 1 week. Test meals, with similar macronutrient profiles, consisted of white bread (97g) plus 2oz of pistachios; white bread (97g) plus butter (14g) and cheese (68g). The control meal was white bread. Capillary finger‐prick and venous blood samples were taken and subjective satiety measures via a visual analogue scale were assessed over 3 hours. The relative glycemic and insulinemic responses were assessed by calculating the incremental area under the 3h curve (IAUC).Results: Differences are assessed by least squares means with a Tukey adjustment for multiple comparisons. To be presented.Funding Support: Western Pistachio Association

The effect of a high fat and high carbohydrate meal on satiety hormone response and subjective hunger in humans

The effect of macronutrient content on postprandial hormonal release and subjective hunger was investigated in 10 male subjects. In random order, subjects either continued an overnight fast or were given a meal high in carbohydrate (CHO) or fat Blood samples and subjective hunger ratings were recorded 30 minutes preprandial and at 30, 90, and 210 minutes postprandial. Following the CHO meal, postprandial levels of insulin, C-peptide, and amylin were significantly greater (all: P<0.001) and GLP-1 had a non-significant increase when compared to fat. Following the fat meal, glucagon and GLP-1 increased significantly compared to the CHO meal (both: P<0.001). Whilst hormonal responses were different following the CHO and fat meal, postprandial subjective hunger ratings did not significantly differ. In both meal protocols, “fullness” was associated with plasma GLP-1 (r = 0.84, P<0.01), glucagon (r = −0.80, P<0.01), and C-peptide (r = −0.65, P<0.05). “Hunger” was related to GLP-1 (r = − 0.84, P<0.01) and C-peptide (r = 0.77, P<0.01), whereas “desire to eat” was solely correlated to GLP-1 (r = −0.85, P<0.01)). In conclusion, although a single meal high in CHO or fat produced differing postprandial hormonal responses, subjective hunger was not affected. It appears that there are varying degrees of hormonal action that can influence subjective hunger, suggesting that when different macronutrients are consumed distinct combinations of hormones are released. However, these varying hormonal combinations seem to affect subjective hunger similarly. Funded by AHFMR and CIHR.