Standardized Breakfast Research Articles

Effect of a Low-Fat Vegan Diet on Body Weight, Insulin Sensitivity, Postprandial Metabolism, and Intramyocellular and Hepatocellular Lipid Levels in Overweight Adults

Excess body weight and insulin resistance lead to type 2 diabetes and other major health problems. There is an urgent need for dietary interventions to address these conditions. To measure the effects of a low-fat vegan diet on body weight, insulin resistance, postprandial metabolism, and intramyocellular and hepatocellular lipid levels in overweight adults. This 16-week randomized clinical trial was conducted between January 2017 and February 2019 in Washington, DC. Of 3115 people who responded to flyers in medical offices and newspaper and radio advertisements, 244 met the participation criteria (age 25 to 75 years; body mass index of 28 to 40) after having been screened by telephone. Participants were randomized in a 1:1 ratio. The intervention group (n = 122) was asked to follow a low-fat vegan diet and the control group (n = 122) to make no diet changes for 16 weeks. At weeks 0 and 16, body weight was assessed using a calibrated scale. Body composition and visceral fat were measured by dual x-ray absorptiometry. Insulin resistance was assessed with the homeostasis model assessment index and the predicted insulin sensitivity index (PREDIM). Thermic effect of food was measured by indirect calorimetry over 3 hours after a standard liquid breakfast (720 kcal). In a subset of participants (n = 44), hepatocellular and intramyocellular lipids were quantified by proton magnetic resonance spectroscopy. Repeated measure analysis of variance was used for statistical analysis. Among the 244 participants in the study, 211 (87%) were female, 117 (48%) were White, and the mean (SD) age was 54.4 (11.6) years. Over the 16 weeks, body weight decreased in the intervention group by 5.9 kg (95% CI, 5.0-6.7 kg; P < .001). Thermic effect of food increased in the intervention group by 14.1% (95% CI, 6.5-20.4; P < .001). The homeostasis model assessment index decreased (-1.3; 95% CI, -2.2 to -0.3; P < .001) and PREDIM increased (0.9; 95% CI, 0.5-1.2; P < .001) in the intervention group. Hepatocellular lipid levels decreased in the intervention group by 34.4%, from a mean (SD) of 3.2% (2.9%) to 2.4% (2.2%) (P = .002), and intramyocellular lipid levels decreased by 10.4%, from a mean (SD) of 1.6 (1.1) to 1.5 (1.0) (P = .03). None of these variables changed significantly in the control group over the 16 weeks. The change in PREDIM correlated negatively with the change in body weight (r = -0.43; P < .001). Changes in hepatocellular and intramyocellular lipid levels correlated with changes in insulin resistance (both r = 0.51; P = .01). A low-fat plant-based dietary intervention reduces body weight by reducing energy intake and increasing postprandial metabolism. The changes are associated with reductions in hepatocellular and intramyocellular fat and increased insulin sensitivity. ClinicalTrials.gov Identifier: NCT02939638.

Effects of oral semaglutide on energy intake, food preference, appetite, control of eating and body weight in subjects with type 2 diabetes.

AimTo evaluate the effect of oral semaglutide on energy intake and appetite in subjects with type 2 diabetes (T2D).Materials and MethodsIn this randomized, double‐blind, placebo‐controlled, two‐period cross‐over trial, 15 subjects with T2D received 12 weeks of treatment with once‐daily oral semaglutide (4‐week dose escalation from 3 to 7 to 14 mg) followed by placebo, or vice versa. Energy intake was measured during an ad libitum lunch, evening meal and snack box after a standard breakfast. Appetite ratings were measured using a visual analogue scale after standard and fat‐rich breakfasts. Other assessments included eating and craving control (using the Control of Eating Questionnaire), and changes in body weight and composition.ResultsFollowing a standard breakfast, total daily ad libitum energy intake was significantly lower (38.9%) with oral semaglutide versus placebo in 13 evaluable subjects (estimated treatment difference, −5096.0 kJ; 95% CI –7000.0, −3192.1; P = .0001). After a fat‐rich breakfast, there were significant differences in favour of oral semaglutide versus placebo for measures of satiety, hunger and for overall appetite score, with no significant differences following a standard breakfast. Fewer food cravings and better eating control were seen with oral semaglutide versus placebo. Overall, mean body weight decreased by 2.7 kg with oral semaglutide and 0.1 kg with placebo, mostly attributable to body fat mass loss.ConclusionAfter 12 weeks of treatment, ad libitum energy intake was lower with oral semaglutide versus placebo, resulting in reduced body fat mass, and was associated with increased satiety and fullness after a fat‐rich breakfast, and improved eating control.Trial registration numberNCT02773381

Acute effects of dry extract of ginger on energy expenditure in eutrophic women: A randomized clinical trial.

The thermic effect of food (TEF) is one of the components of total energy expenditure (TEE). Some bioactive compounds present in food could be useful to increase TEE. In this context, ginger has been extensively used as a thermogenic food despite no clear effect has been demonstrated yet. Herein, we evaluated the acute thermogenic effect of gingerol, a bioactive compound present in ginger, in healthy women. We carried out a randomized double-masked, cross-over and placebo-controlled clinical trial with 20 healthy eutrophic women. Anthropometric, body composition, indirect calorimetry and clinical variables were collected at baseline and throughout the intervention phase. A standardized breakfast was offered together with two dry extract of ginger capsules (5% gingerol) or a placebo (cellulose). Indirect calorimetry, blood pressure, heart rate, axillary temperature and blood collection were assessed at baseline and thereafter, at 30, 60, 120, 180 and 240min postprandial. The analyses were repeated with a minimum of seven days' washout period. Ginger intake did not increase the TEF of a standardized breakfast compared to the placebo. Oxygen consumption, respiratory quotient, blood pressure, heart rate, axillary temperature and metabolic profile were not different as well. Our data show that gingerol did not modify the acute TEF in healthy women. More studies in human subjects, using different concentrations of gingerol, administration methods and intervention type (chronic effect) are necessary to clarify the putative thermogenic effect of ginger. Registered at ClinicalTrials.gov (Thermogenic Effect of Ginger - NCT03089593).

Effects of potato resistant starch intake on insulin sensitivity, related metabolic markers and appetite ratings in men and women at risk for type 2 diabetes: a pilot cross-over randomised controlled trial.

BackgroundThe intake of certain types of resistant starch (RS) has been associated in some studies with increased whole‐body insulin sensitivity. This randomised, cross‐over pilot trial evaluated the effect of consuming cooked, then chilled potatoes, a source of RS, compared to isoenergetic, carbohydrate (CHO)‐containing control foods, on insulin sensitivity and related markers.MethodsNineteen adults with body mass index 27.0‐39.9 kg m−2 consumed 300 g day−1 RS‐enriched potatoes (approximately two potatoes; ~18 g RS) or CHO‐based control foods, as part of lunch, evening and snack meals, over a 24‐h period. After an overnight fast, insulin sensitivity, CHO metabolism markers, free fatty acids, breath hydrogen levels and appetite were assessed for up to 5 h after the intake of a standard breakfast. The primary endpoint was insulin sensitivity, assessed with the Matsuda index. P < 0.05 (one‐sided) was considered statistically significant.ResultsInsulin sensitivity was not significantly different between the potato and control conditions. The potato intervention resulted in higher postprandial breath hydrogen (P = 0.037), lower postprandial free fatty acid concentrations (P = 0.039) and lower fasting plasma glucose (P = 0.043) compared to the control condition. Fullness ratings were significantly lower after potato versus control (P = 0.002). No other significant effects were observed; however, there was a trend toward lower fasting insulin (P = 0.077) in the potato versus the control condition.ConclusionsThe results of this pilot study suggest RS‐enriched potatoes may have a favourable impact on carbohydrate metabolism and support the view that additional research in a larger study sample is warranted.

Sweet Taste Antagonist Lactisole Administered in Combination with Sucrose, But Not Glucose, Increases Energy Intake and Decreases Peripheral Serotonin in Male Subjects.

Knowledge regarding the involvement of sweetness perception on energy intake is scarce. Here, the impact of glucose and sucrose sweetness, beyond their caloric load, on subsequent food intake and biomarkers of satiation was evaluated by co-administration of the sweet taste receptor inhibitor lactisole. A total of 27 healthy, male subjects received solutions of either 10% glucose w/o 60 ppm lactisole or 10% sucrose w/o 60 ppm lactisole. Subsequent food intake from a standardized breakfast was evaluated 2 h after receiving the respective test solution. Changes in postprandial plasma concentrations of cholecystokinin, ghrelin, and serotonin were determined over a period of 120 min, as was the body temperature. Administration of lactisole to the sucrose solution increased the energy intake from the subsequent standardized breakfast by 12.9 ± 5.8% (p = 0.04), led to a decreased Δ AUC of the body core temperature by 46 ± 20% (p = 0.01), and time-dependently reduced Δ serotonin plasma concentrations (−16.9 ± 6.06 ng/mL vs. −0.56 ± 3.7 ng/mL after sucrose administration, p = 0.03). The present study shows that lactisole increases energy intake and decreases plasma serotonin concentrations as well as body core temperature induced by sucrose, but not glucose. This finding may be associated with the different binding affinities of sucrose and glucose to the sweet taste receptor.

Cognitive task performance under (combined) conditions of a metabolic and sensory stressor

Effects of stressors on cognitive task performance have primarily been studied in isolation, and little is known about the combined effects of two or more stressors. This study examined how a metabolic stressor (skipping breakfast) and a sensory stressor (noise) affect cognitive task performance in isolation and combined. In addition to performance, we collected physiological and subjective data to get insight in the underlying mechanisms. Twenty participants came to the lab twice, once after skipping breakfast, and once after a standardized breakfast. They performed runs of the 2-back task and the International Shopping List Task, which were alternately presented with and without noise. During the 2-back task, electrocardiography (ECG), electrodermal activity (EDA), and electroencephalography (EEG) were recorded. Subjective ratings on effort and stress were also collected. No interaction effects between the two stressors on cognitive performance were found. Skipping breakfast did not cause hypoglycemia, but resulted in subjective discomfort and a lower state of arousal (as indicated by lower heart rate and EDA). These may underly the trend for more missed responses on the 2-back task after breakfast skipping. Noise appeared to generate arousal and increased attention (reflected in higher EDA and P300) in accordance with higher experienced load and stress. This is consistent with less missed 2-back responses in noise conditions. The results indicate that individuals spent extra effort to maintain task performance in the presence of noise. We propose to use a model that, besides additional effort, takes the effect of stressors on performance into account.

Lower nocturnal blood glucose response to a potato-based mixed evening meal compared to rice in individuals with type 2 diabetes

Guidelines for reducing postprandial blood glucose concentrations include avoiding high glycemic index (GI) foods, such as white potatoes. However, GI testing is often undertaken in the morning with foods consumed in isolation by non-clinical cohorts. We investigated the impact of potato preparation and consumption as part of a mixed-evening meal on postprandial and nocturnal glycemic responses, and postprandial insulin response, in individuals with Type 2 Diabetes Mellitus (T2DM). In a randomized, cross-over design, 24 males and females (age 58.3±9.3y; BMI: 31.7±6.8kg/m2) with T2DM (diet or metformin controlled) completed four experimental trials after consuming a standardized breakfast (25% daily energy intake (EI)) and lunch (35% EI). Dinner (40% EI) was consumed at 1800h being either: 1) boiled potato (BOIL); 2) roasted potato (ROAST); 3) boiled potato cooled for 24h (COOLED); or 4) basmati rice (CONTROL). Each meal contained 50% carbohydrate, 30% fat and 20% protein. Blood samples were collected prior to, immediately post meal and at 30-min intervals for a further 120min. A continuous glucose monitor was worn to assess nocturnal interstitial glucose concentrations. No differences were detected in postprandial venous glucose area under the curve (iAUC) between CONTROL and all three potato conditions. Postprandial insulin iAUC was greater following COOLED compared to CONTROL (P=0.003; 95% CI: 18.9-111.72 miU/mL). No significant differences between CONTROL and BOIL or ROAST were detected for postprandial insulin concentrations. All potato meals resulted in lower nocturnal glucose AUC than CONTROL (P<0.001; 95% CI 4.15-15.67mmol/L x h). Compared to an isoenergetic rice meal, boiled, roasted or boiled then cooled potato-based meals were not associated with unfavourable postprandial glucose responses or nocturnal glycemic control, and can be considered suitable for individuals with T2DM when consumed as part of a mixed-evening meal. Australian New Zealand Clinical Trials Registry https://www.anzctr.org.au/, ACTRN 12618000480280.

The intestinal microbiome is a co-determinant of the postprandial plasma glucose response.

Elevated postprandial plasma glucose is a risk factor for development of type 2 diabetes and cardiovascular disease. We hypothesized that the inter-individual postprandial plasma glucose response varies partly depending on the intestinal microbiome composition and function. We analyzed data from Danish adults (n = 106), who were self-reported healthy and attended the baseline visit of two previously reported randomized controlled cross-over trials within the Gut, Grain and Greens project. Plasma glucose concentrations at five time points were measured before and during three hours after a standardized breakfast. Based on these data, we devised machine learning algorithms integrating bio-clinical, as well as shotgun-sequencing-derived taxa and functional potentials of the intestinal microbiome to predict individual postprandial glucose excursions. In this post hoc study, we found microbial and clinical features, which predicted up to 48% of the inter-individual variance of postprandial plasma glucose responses (Pearson correlation coefficient of measured vs. predicted values, R = 0.69, 95% CI: 0.45 to 0.84, p<0.001). The features were age, fasting serum triglycerides, systolic blood pressure, BMI, fasting total serum cholesterol, abundance of Bifidobacterium genus, richness of metagenomics species and abundance of a metagenomic species annotated to Clostridiales at order level. A model based only on microbial features predicted up to 14% of the variance in postprandial plasma glucose excursions (R = 0.37, 95% CI: 0.02 to 0.64, p = 0.04). Adding fasting glycaemic measures to the model including microbial and bio-clinical features increased the predictive power to R = 0.78 (95% CI: 0.59 to 0.89, p<0.001), explaining more than 60% of the inter-individual variance of postprandial plasma glucose concentrations. The outcome of the study points to a potential role of the taxa and functional potentials of the intestinal microbiome. If validated in larger studies our findings may be included in future algorithms attempting to develop personalized nutrition, especially for prediction of individual blood glucose excursions in dys-glycaemic individuals.

The MEDGICarb-Study: Design of a multi-center randomized controlled trial to determine the differential health-promoting effects of low- and high-glycemic index Mediterranean-style eating patterns

Adults with central adiposity and other features of the metabolic syndrome have a markedly elevated risk of developing type 2 diabetes (T2D) and cardiovascular disease (CVD). A Mediterranean-style healthy eating pattern (MED-HEP) and consumption of foods with a lower glycemic index (GI) are potential dietary approaches to curb the T2D and CVD epidemic. However, experimental evidence of the effectiveness of MED-HEP and of the contribution of GI towards improving indices of glucose homeostasis, especially among non-diabetic people, are lacking. Therefore, we developed the MedGI-Carb trial, a multi-center (Italy, Sweden, and United States) intervention in adults with at least two components of the metabolic syndrome (elevated waist circumference + one other component) that aims to improve markers of glucose homeostasis through dietary modification. All participants were randomized to consume an isocaloric high- or low-GI MED-HEP for 12 weeks. We hypothesized that indexes of insulinemia (primary outcome: postprandial insulin and glucose after standardized breakfast and lunch; secondary outcomes: fasting plasma glucose and insulin, HbA1c, 24-h continuous glucose monitoring) would be improved more with the low-GI versus the high-GI MED-HEP. Additionally, we hypothesized that consumption of a MED-HEP would improve other markers of cardiometabolic health and well-being (fasting blood pressure, fasting lipid profile, sleep quality, satiety, global metabolic alterations in the plasma metabolome, changes in the gut microbiota, subjective health and well-being), with no difference between groups. Collectively, the design of MEDGI-Carb allows several different research questions to be explored. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT03410719.

An Afternoon Hummus Snack Affects Diet Quality, Appetite, and Glycemic Control in Healthy Adults

ABSTRACTBackgroundSnacking continues to be a major component in the dietary patterns of most Americans despite conflicting evidence surrounding snacking healthfulness. Low-sugar, highly nutritive snacks, such as hummus, can lead to improvements in diet quality, appetite, and glycemic control.ObjectivesThe purpose of the study was to examine the effects of afternoon snacking on diet quality, appetite, and glycemic control in healthy adults.MethodsThirty-nine adults (age: 26 ± 1 y; BMI: 24.4 ± 0.5 kg/m2) randomly completed the following afternoon snack patterns for 6 d/pattern: hummus and pretzels [HUMMUS; 240 kcal; 6 g protein, 31 g carbohydrate (2 g sugar), 11 g fat]; granola bars [BARS; 240 kcal; 4 g protein, 38 g carbohydrate (16 g sugar), 9 g fat]; or no snacking (NO SNACK). On day 7 of each pattern, a standardized breakfast and lunch were provided. The respective snack was provided to participants 3 h after lunch, and appetite, satiety, and mood questionnaires were completed throughout the afternoon. At 3 h postsnack, a standardized dinner was consumed, and an evening snack cooler was provided to be consumed, ad libitum at home, throughout the evening. Lastly, 24 h continuous glucose monitoring was performed.ResultsHUMMUS reduced subsequent snacking on desserts by ∼20% compared with NO SNACK (P = 0.001) and BARS (P < 0.001). HUMMUS led to greater dietary compensation compared with BARS (122 ± 31% compared with 72 ± 32%, respectively; P < 0.05). HUMMUS reduced indices of appetite (i.e., hunger, desire to eat, and prospective food consumption) by ∼70% compared with NO SNACK (all P < 0.05), whereas BARS did not. Additionally, satiety was ∼30% greater following HUMMUS and BARS compared with NO SNACK (both P < 0.005) with no differences between snacks. Lastly, HUMMUS reduced afternoon blood glucose concentrations by ∼5% compared with BARS (P < 0.05).ConclusionsAcute consumption of a low-sugar, afternoon hummus snack improved diet quality and selected indices of appetite, satiety, and glycemic control in healthy adults. Long-term trials assessing the effects of hummus snacking on health outcomes are warranted.

Extending the Overnight Fast: Sex Differences in Acute Metabolic Responses to Breakfast.

Fasting for over 24 h is associated with worsening glucose tolerance, but the effect of extending the overnight fast period (a form of time-restricted feeding) on acute metabolic responses and insulin sensitivity is unclear. The aim of this pilot study was to determine the acute impact of an increased fasting period on postprandial glycaemia, insulinemia, and acute insulin sensitivity responses to a standard meal. Twenty-four lean, young, healthy adults (12 males, 12 females) consumed a standard breakfast after an overnight fast of 12, 14, and 16 h. Each fast duration was repeated on three separate occasions (3 × 3) in random order. Postprandial glucose and insulin responses were measured at regular intervals over 2 h and quantified as incremental area under the curve (iAUC). Insulin sensitivity was determined by homeostatic modelling assessment (HOMA). After 2 h, ad libitum food intake at a buffet meal was recorded. In females, but not males, insulin sensitivity improved (HOMA%S +35%, p = 0.016, marginally significant) with longer fast duration (16 h vs. 12 h), but paradoxically, postprandial glycaemia was higher (glucose iAUC +37%, p = 0.002). Overall, males showed no differences in glucose or insulin homeostasis. Both sexes consumed more energy (+28%) at the subsequent meal (16 h vs. 12 h). Delaying the first meal of the day by 4 h by extending the fasting period may have adverse metabolic effects in young, healthy, adult females, but not males.

Effects Of Acute Exercise On Appetite Regulation And Energy Intake In Men And Women

PURPOSE: Compare energy intake and appetite regulation responses between men and women following acute bouts of aerobic (AEx) and resistance exercise (REx). METHODS: Men and women (n=12 each) with overweight/obesity matched on age (32.3±2 vs. 36.8±2 yrs, p=0.14) and BMI (28.1±1.2 vs 29.0±1.5 kg/m2, p=0.64) completed 2 conditions; 1) AEx (65-70% of age-predicted maximum heart rate for 45 min) and 2) REx (1-set to failure on 12 exercises). Each condition was initiated in the post-prandial state (35 minutes post breakfast). Appetite (visual analog scale for hunger, satiety and prospective food consumption [PFC]) and hormones (ghrelin, PYY, and GLP-1) were measured before and every 30 minutes for 3 hours following consumption of a standardized breakfast. Post exercise ad libitum energy intake at the lunch meal was also measured. RESULTS: There was no difference in relative ad libitum energy intake between men and women following either AEx (43.4±5 vs.45.4±4% of total energy needs, p=0.80) or REx (48.3±3 vs. 46.6±3% of total energy needs, p=0.81). In the AEx condition there were no differences in area under the curve (AUC) for satiety or PFC between men and women, although men reported higher PFC vs women at the 30 (33.3±5 vs. 17.5±4mm, respectively, p=0.03) and 90 min (49.8±6 mm vs 30.2±6 mm, respectively, p=0.03) post-prandial time points. Additionally, in the AEx condition, a greater hunger AUC was detected in men vs women (7815±638 vs 5428±762 mm, respectively, p=0.02), which was driven by men reporting significantly greater hunger vs women at the 90 min post-prandial time point (42.7±5 vs.16.6±4 mm, p<0.001). No differences in AUC for ghrelin, PYY, and GLP-1 were noted between men and women following either AEx or REx (all p>0.05). However, significantly higher ghrelin was observed in women vs. men at the 150 (807.6±37 vs. 652.2±41 pg/mL, respectively, p=0.01) and 180 min (812.4±39 vs. 677.5±49 pg/mL, respectively, p=.05) post-prandial time points. CONCLUSIONS: The data suggest that men report greater hunger and PFC than women following acute AEx, and that women have higher ghrelin levels than men following acute REx. Future work is needed to examine if sex-based differences in appetite regulation and energy intake are present with chronic exercise of differing modalities.

Decreased Ghrelin And Increased PYY And GLP-1 Following Acute Aerobic Vs Resistance Exercise

PURPOSE: To determine if aerobic exercise (AEx) and resistance exercise (REx) differentially influence acute energy intake and appetite regulation. METHODS: Physically inactive adults with overweight/obesity (n=24, 35±1.7 yrs, BMI: 28.5±1.0 kg/m2; 50% female) completed 2 conditions; 1) AEx (treadmill walking at 65-70% of age-predicted maximum heart rate for 45 minutes) and 2) REx (1-set to failure of 12 resistance exercises). Each condition was initiated in the postprandial state (35 minutes post breakfast). Appetite (visual analog scale for hunger, satiety and prospective food consumption [PFC]) and hormones (ghrelin, PYY, and GLP-1) were measured before and every 30 minutes for 3 hours following consumption of the standardized breakfast meal. Post exercise food cravings (following 90 min VAS and blood draw via Food Cravings Inventory [FCI] questionnaire) and ad libitum energy intake at the lunch meal were also measured. RESULTS: There was no difference in post-exercise ad libitum energy intake between conditions (AEx: 937±65 kcal vs. REx: 991±68 kcal). There were also no differences in post exercise food cravings, nor area under the curve (AUC) for hunger, satiety, or PFC. However, there was a trend for higher satiety scores 150 min post breakfast in the REx condition (AEx: 35±4 mm vs. REx: 42±4 mm, p=0.08). AUC for ghrelin (AEx: 143,592±7,464 pg/mL vs. REx: 130,737±4,928 pg/mL, p=0.002), PYY (AEx: 23,812±1,592 pg/mL vs. REx: 20,540±1,177 pg/mL, p<0.001), and GLP-1 (AEx: 1,615±110 pg/mL vs. REx: 1,314±93 pmol/L, p<0.001 were all higher in the AEx condition compared to REx. For ghrelin and PYY, the higher AUC for AEx was due to greater values for all of the post-exercise time points evaluated (all p<0.05). For GLP-1, the higher AUC for AEx was due to significantly higher levels at the 90 minute postprandial time point (p<0.001), and a trend for greater levels at the 120 minute time point (p=0.07). CONCLUSIONS: The data suggest that an acute bout of aerobic exercise appears to increase both ghrelin, an oreixgenic gut peptide, as well as PYY and GLP-1, anoretic gut peptides, compared to an acute bout of resistance exercise. However, acute ad libitum energy intake was not different between conditions. Future work is needed to determine if exercise modality influences chronic energy intake and appetite regulation.

Breakfast Characterization and Consumption by Low-Income Brazilians: Food Identity and Regional Food

The study aimed to evaluate the breakfast (BF) of the Brazilian low-income population, analyzing cultural aspects, such as the habit of consuming regional foods and the BF food identity markers. This cross-sectional study used a sample of 1872 low-income Brazilians. For the food consumption analysis, three 24–hour dietary recalls were used. For the qualitative analysis of the BF, we used three classifications: standard, full, partial, and without BF. Also, BF was considered as regional when at least one regional food (contained in a predefined list of regional foods) was consumed. For the analysis of BF's food identity markers, we evaluated all food groups and their frequencies. Of the 5616 possible BF meals available for the three days of consumption, 17.3% were skipped, a low percentage. A total of 4642 BF examples were analyzed. Standard type BF was prevalent in all regions, and full BF was rarely consumed by participants. Women during the weekend skipped BF less often. Out of all five Brazilian regions, the ones with the highest consumption of regional foods were the Midwest (46.6%) and the South (45.9%). The highest frequency of consumed foods in BF were coffee with cow’s milk (or milk with coffee), added sugar, bread, and margarine, indicating that these are the identity markers of BF in the studied sample. Considering that the percentage of standard type BF was very high and that the consumption of added sugar and margarine was accentuated, actions to stimulate the intake of fresh fruits and foods in all meals are necessary, especially in the first meal of the day. There is a need for new proposals for actions and programs with the purpose of expanding access to healthy and adequate regional foods, especially to low-income families.

The Effects of Snack Exposure, Package Size, and Variety on Subsequent Energy Intake in Healthy Adults

Abstract Objectives The purpose of this study was to examine whether snack exposure, package size, and variety influence subsequent energy intake and food choice in healthy adults. Methods Thirty-one healthy young adults (age: 23.6 ± 0.7y; BMI: 23.0 ± 0.5 kg/m2) participated in a randomized crossover study. At baseline, participants completed a 3-day snack recall in which they reported any snack foods or beverages consumed outside of breakfast, lunch, and dinner eating occasions (Control). Following baseline, the participants were provided, in randomized order, with the following isocaloric pack-out coolers to consume for 3 non-consecutive days/pack-out type: 1) Standard: containing 11 commonly consumed snacks (e.g., salty snacks, desserts &amp; candy, fruit, vegetables, etc.); 2) Large Package: containing the same snacks at Standard but in larger package sizes; and 3) Variety: containing the same types of snacks as Standard plus an additional eight snacks. During the Control and pack-out assessment periods, standardized breakfasts, lunches, and dinners were provided. Three-day averaged ad libitum snack energy intake and food choices were assessed. Results Three-day average snack intake from Control was 747 ± 59 kcal, Standard was 1121 ± 111 kcal, Large Package was 1274 ± 138 kcal, and Variety was 1110 ± 103 kcal. Regardless of type, the exposure to free, snack pack-outs increased snack energy intake compared to Control (all, P &amp;lt; 0.005). Large Package increased snack energy intake vs. Standard (P = 0.01) and Variety (P = 0.02). Further, Large Package increased consumption of desserts &amp; candy, high fat, high sugar, and salty snacks vs. Standard (all, P &amp;lt; 0.03) and Variety (P &amp;lt; 0.02 to P = 0.06). Alternately, Variety increased consumption of fruits and vegetables compared to Large Package (P = 0.01) and Standard (P &amp;lt; 0.005). No other differences were observed. Conclusions Exposure to free, highly palatable snacks provided in larger package sizes led to greater energy consumption, especially from energy-dense snacks, in healthy adults, whereas snack variety increased nutrient-dense snacking without increased energy consumption. These results suggest that snack exposure, package size, and variety should be considered when developing dietary strategies to promote energy balance and healthy eating habits. Funding Sources Sabra Dipping Company and Internal Funds.

Severe Sleep Restriction Suppresses Appetite Independent of Effects on Food Intake-Regulating Hormones

Abstract Objectives Several nights of moderate (4–5 hr/night) sleep restriction increases appetite and energy intake, and may alter circulating concentrations of food intake-regulating hormones. Whether more severe sleep restriction has similar effects is undetermined. This study aimed to determine the effects of severe, short-term sleep restriction on appetite and food intake-regulating hormones. Methods Randomized, crossover study in which 18 healthy men (mean ± SD: BMI 24.4 ± 2.3 kg/m2, 20 ± 2 yr) were assigned to three consecutive nights of sleep restriction (SR; 2 hr sleep/night) or adequate sleep (AS; 7–9 hr sleep/night) with controlled feeding and activity throughout the 3-day period. On day 4, participants consumed a standardized breakfast. Appetite ratings, and circulating ghrelin, peptide-YY (PYY), glucagon-like peptide (GLP-1), insulin, and glucose concentrations were measured before and for 4hr after the meal. Ad libitum energy and macronutrient intakes were then measured at a provided buffet lunch. Results Median PYY (–21%) and GLP-1 (–14%) concentrations were lower, and median glucose (3%) concentrations were higher after SR relative to after AS (main effect of condition, P &amp;lt; 0.05; condition-by-time interaction, P = NS). Ghrelin and insulin did not differ between conditions. Mean hunger (–23%), desire to eat (–23%), and prospective consumption (–18%) ratings were all lower, and mean fullness (27%) ratings were higher after SR relative to after AS (main effect of condition, P &amp;lt; 0.05; condition-by-time interaction, P = NS). Ad libitum energy intake at the lunch meal was 14% lower after SR relative to after AS (–332 kcal [95% CI: −479, −185] P &amp;lt; 0.001), but macronutrient composition did not differ. Conclusions In contrast with reported effects of moderate sleep restriction, severe sleep restriction reduced appetite and energy intake. Appetite suppression was likely not due to the observed differences in food intake-regulating hormones as sleep-restriction induced reductions in PYY and GLP-1 concentrations would be expected to increase appetite. Funding Sources US Army MRDC. Authors’ views do not reflect official DoD or Army policy.

0033 Recurrent Circadian Disruption While Minimizing Sleep Loss in Humans Impairs Glucose Tolerance Only in The Presence of High-Fat Diet

Abstract Introduction Nearly 14% of Americans experience chronic circadian disruption due to shift work, increasing their risk of obesity and cardiometabolic disorders. These disorders are also exacerbated by modern eating habits such as frequent snacking and consumption of high-fat foods. Here we used a forced desynchrony protocol to investigate the effect of 3 weeks of recurrent circadian disruption (RCD) with minimal sleep loss on glucose metabolism in humans on a lower or higher fat diet (LFD and HFD, respectively). Methods Six healthy adults (38-69yrs; 3f) participated in a 37-day inpatient protocol with LFD (25–27% fat) and 15.67-hr fasting duration, or HFD (45–50% fat) and 13-hr fasting duration. The protocol included three weeks of RCD consisting of 28-hr “days” with 11.67-hr sleep opportunities (=10hrs/24hr). Glucose and insulin responses to a standardized breakfast were conducted at baseline, at an aligned circadian phase after 2–3 weeks of exposure to RCD, and after 1 week of recovery. Frequent blood samples were assayed for glucose and insulin; the Area-Under-Curve was calculated from start of breakfast through postprandial minute 180. Results Total Sleep Time was similar in Baseline and RCD in both groups. Participants on the LFD showed no change in glucose AUC during RCD compared to Baseline. Insulin AUC was lower during RCD (p=0.0269) and Recovery (p=0.0443) than Baseline. In contrast, participants on the HFD showed a significant increase in glucose AUC during RCD compared to Baseline (p&amp;lt;0.0001); AUC returned to Baseline during Recovery. There was no significant change in insulin AUC on the HFD. Conclusion RCD (in the absence of sleep loss) led to impaired glucose tolerance when combined with HFD, but not when combined with LFD. These results suggest that LFD may be part of healthy strategies for people experiencing RCD. Support Study supported by P01AG009975 and conducted in the Brigham and Women’s Hospital Center for Clinical Investigation, part of Harvard Clinical and Translational Science Center supported by UL1TR001102. Authors supported by a fellowship from the Finnish Cultural Foundation (KMZ); T32HL007901 and F32HL143893 (RKY); T32HL007901 and F32AG051325 (NV); K24HL105664 (EBK); R01HL118601 (FAJLS).

Bioavailability of Epigallocatechin Gallate Administered With Different Nutritional Strategies in Healthy Volunteers.

The flavanol epigallocatechin gallate (EGCG) is being tested for the treatment of several diseases in humans. However, its bioavailability and pharmacokinetic profile needs a better understanding to enable its use in clinical trials. There is no consensus on the most appropriate concentration of EGCG in the body to obtain the maximum therapeutic effects. Therefore, the aim of this study is to analyze the bioavailability of EGCG orally administered alone or with different food supplements after overnight fasting in order to determine its optimal conditions (high concentrations in blood and the lowest interindividual variations) to be used as a pharmacological tool in human trials. Ten healthy volunteers (5 men and 5 women) aged 25 to 35 years were recruited prospectively. Three series of clinical experiments with a washout period of seven days among each were performed: (1) Teavigo® (EGCG extract) alone, (2) Teavigo® with a standard breakfast, and (3) FontUp® (Teavigo® commercially prepared with fats, carbohydrates, proteins, vitamins, and minerals). Blood samples were collected at 0, 30, 60, 90, 120, 180, 240, and 360 min after EGCG intake. Free EGCG in plasma was measured using a liquid chromatography and mass spectrometry UPLC-ESI-MS/MS analytical method. The pharmacokinetic variables analyzed statistically were area under the curve (AUC0–360), Cmax, Cav, Cmin, T1/2, and Tmax. EGCG (Teavigo®) alone was the group with higher AUC0–360, Cmax, and Cav both in men (3.86 ± 4.11 µg/mL/kg/6 h; 5.95 ng/mL/kg; 2.96 ng/mL/kg) and women (3.33 ± 1.08 µg/mL/kg/6 h; 6.66 ng/mL/kg; 3.66 ng/mL). Moreover, FontUp® was the group with the highest value of T1/2 both in men (192 ± 66 min) and women (133 ± 28 min). Teavigo® intake after fasting overnight revealed the highest concentration of EGCG in plasma according to its pharmacokinetic profile, indicating that this is an excellent alternative of administration if the experimental design requires good absorption in the gastrointestinal tract. Moreover, EGCG taken along with food supplements (FontUp®) improved the stability of the molecule in the body, being the best choice if the experimental design wants to reduce interindividual variation.

Pre-meal active video game playing increased subjective appetite but not food intake in children and adolescents

ObjectiveSedentary video game playing (VGP) and caloric preloads in the pre-meal environment have been shown to influence short-term food intake (FI) regulation in children. Other factors that may affect FI control include physical activity and/or heightened emotion. Therefore, we examined the effects of a glucose preload and 30 min of active VGP (aVGP) on subjective appetite, short-term FI, and subjective emotions in 9-14 year-old children. MethodsOn four test mornings approximately one-week apart, twenty-seven children (sex: 15M, 12F; age: 11.3 ± 0.3 years; BMI percentile: 55.3 ± 6.1%) consumed a standardized breakfast two hours prior to consuming 250 mL of either a 50 g glucose preload or Sucralose® control. Following the preload, participants participated in 30 min of quiet sitting or aVGP. Energy expenditure was measured during aVGP via indirect calorimetry. FI from an ad libitum pizza meal was measured after each test condition. Subjective appetite and emotions were measured at baseline (0 min), during treatment (15min), and immediately before the test meal (30 min). ResultsaVGP did not affect FI, but the glucose preload decreased FI compared with the sucralose control (∆ = 157 kcal, <0.001). Although not statistically significant (p=0.12), caloric compensation was lower following the glucose preload in the aVGP condition. Subjective appetite increased with time, and was higher in the sucralose control + aVGP condition (p=0.05). Change from baseline subjective emotion scores of anger and excitement were higher (p=0.03) and lower (p=0.02) after aVGP, respectively. ConclusionsNeither short-term FI nor net energy balance were affected by low-intensity aVGP (energy expenditure of 34 kcal). These findings suggest that a short bout of low-intensity aVGP does not alter energy balance during the study measurement period, and may not support achieving or maintaining healthy weights in children. However, future longitudinal studies are needed to confirm such advice.

Effect of liraglutide on food consumption, appetite sensations and eating behaviours in overweight people with type 1 diabetes.

To investigate the effects of 24 weeks of treatment with liraglutide added to basal/bolus insulin on energy intake, appetite sensations and eating behaviours in overweight/obese participants with type 1 diabetes (T1D). In a double-blinded crossover fashion, 15 participants were randomly assigned (1:1) to receive placebo or liraglutide for 24 weeks including a 1-month titration period from 0.6 to 1.2 to 1.8 mg, in addition to their insulin. The treatment was followed by a 1-month wash-out period. Participants were then assigned to the other treatment for another 24 weeks. Food intake was measured, visual analogue scales and Three-Factor Eating Questionnaires were completed. Paired rank tests were used to compare the variables. When treated with liraglutide, participants modified their ad libitum food consumption with decreased total intake and % fat and increased carbohydrates. Their appetite sensations were modified: fasting desire to eat, hunger and prospective food consumption were significantly reduced. The sensation of fullness was prolonged for a few hours after a standardized breakfast. Restraint and disinhibition were significantly reduced by liraglutide. In this randomized clinical trial, the addition of liraglutide to basal/bolus insulin therapy for 24 weeks in overweight/obese individuals with T1D significantly improved their food consumption, appetite sensations and eating behaviours.