Weight Management & Satiety

Hi Readers –  I’m honored to let you know that Dr. Heather Leidy is blogging today regarding research .

– Mitch

Two key forces exist which act against our desire to be healthy and manage body weight.  First, we have internal ‘physiological’ signals which respond to energy restriction, dieting, and weight loss and lead to increased hunger and reductions in fullness (satiety).   Many individuals respond to these signals and eat in excess, leading to the prevention of sustained weight loss and/or obesity.  We are also constantly bombarded by the modern food environment containing food-centered advertisements and easy access to highly palatable, energy dense, sugar-laden snacks.  This type of environment shifts our eating away from physiological need towards reward-driven over-eating.

To add to the problem, many Americans follow unhealthy dietary practices further intensifying these behaviors.  One in particular is the now-common habit of skipping breakfast which is strongly associated with over-eating/snacking (especially in the evening), weight gain, and obesity.  Fortunately, there are several dietary strategies that have been implemented to target and prevent both types of eating behavior.  These include increased dietary protein and breakfast consumption.

We’ve published several articles focusing on the beneficial effects of a modest increase in protein intake ^(1-4).   Through these studies, we found that an increase in protein consumption from 15% of daily intake to 25-30% of intake leads to improvements in appetite control and satiety^(1-4).  In fact, a higher protein diet, containing lean meat and eggs, leads to increased fullness throughout the day and reduced desire to eat and preoccupation with thoughts of food throughout the evening hours compared to a normal protein diet—even during weight loss^(1,3).   It is quite clear that a diet containing an increase in dietary protein, still well-within the dietary guidelines, is beneficial for appetite control.

Based on this data as well as the negative outcomes associated with breakfast skipping, we are now focusing on the daily addition of a protein-rich breakfast in those who skip the morning meal.  We recently report that  skipping breakfast leads to greater hunger and reduced satiety (i.e., fullness) throughout the morning hours, leading to a greater amount of food consumed at lunch time compared to a normal protein breakfast⁵.  We also found that eating a higher protein breakfast (38% of the meal as high quality dairy and egg protein, 49 g) leads to even greater benefits by further reducing appetite and subsequent food intake.

In our most recent study⁶, we focused on whether breakfast would actually alter food-related brain activation known to stimulate reward-driven eating behavior.  In this study, ‘breakfast skippers’ consumed meals containing either normal quantities of protein or higher protein (i.e., 40% of the meal as dairy and egg protein).  Compared to breakfast skipping, the consumption of both types of breakfast meals led to reductions in brain activation patterns in regions controlling appetite, motivation to eat, and food reward.  The higher protein breakfast led to even greater reductions in these activations compared to the normal protein breakfast.  These data suggest that incorporating a healthy breakfast containing protein-rich foods may be a simple dietary strategy to improve appetite control and prevent over-eating.

References:

¹Leidy HJ, et al.  2007  Higher protein intake preserves lean mass & satiety with weight loss in pre-obese & obese women.  Obesity 15:421-429.

²Leidy HJ, et al.   2007 Effects of acute & chronic protein intake on metabolism, appetite & ghrelin during weight loss. Obesity.  15:1215-25.

³Leidy HJ, et al.  2011 The effects of consuming frequent, higher protein meals on appetite and satiety during weight loss in overweight/obese men.  Obesity; 19 (4):  818-824.

⁴Leidy HJ, et al.  2010 The influence of higher protein intake and greater eating frequency on appetite control in overweight and obese men.  Obesity;  18(9):  1725-1732.

⁵Leidy HJ & Racki EM.  2010  The addition of a protein-rich breakfast and its effects on acute appetite control and food intake in `breakfast-skipping’ adolescents.  International Journal of Obesity.  34(7):  1125-1133.

⁶Leidy HJ, et al. 2011 Neural responses to visual food stimuli after normal vs. higher protein breakfast in breakfast-skipping teens-a pilot fMRI study.  Obesity; EPUB ahead of Print.  doi:10.1038/oby.2011.108

Hi Readers –  As you may have noticed, we have changed our blog name to Nutrition Unscrambled. Enjoy!

I was recently made aware of a blog called Raise Healthy Eaters. The site looks very good, and it offers a number of excellent tips on healthy eating for kids. A recent post discussed various nutritional myths, many of which were aimed at the micronutrient needs of children.

If you’re interested in learning more about healthy eating for children, this blog is worth checking out. And while we’re on the topic of healthy eating for children, a couple of recent studies you should be aware of are:

Krebs NF, Gao D, Gralla J, et al. Efficacy and safety of a high protein, low carbohydrate diet for weight loss in severely obese adolescents. J Pediatr 2010.

The study demonstrated that severely obese adolescents who followed a high-protein, low-carbohydrate diet had significantly lower body mass index (BMI) after 13 weeks and were also able to maintain weight loss after six months versus those who followed a low-fat diet. The obese adolescents who followed the high-protein, low-carbohydrate diet also experienced greater fat mass loss and reductions in triglyceride levels.

 Leidy HJ, Racki EM. The addition of a protein-rich breakfast and its effect on acute appetite control and food intake in ‘breakfast skipping’ adolescents. Int J Obs 2010.

These researchers examined the impact of a protein-rich breakfast on adolescents who traditionally skipped breakfast. When the study participants ate a protein-rich breakfast the researchers observed that the teens were less hungry and ate approximately 130 fewer calories at lunch.

It continues to amaze me that nearly one in three American children are overweight or obese,  which increases their risk for developing chronic diseases such as diabetes, high blood pressure, heart disease and cancer. More and more research is suggesting that the high carbohydrate eating practices that have been so prevalent in the U.S. for many years may be exacerbating the problem. Newer studies suggesting the benefits of higher protein/lower carb diets, such as those cited above are provocative, and worth considering.

We’re all creatures of habit, and most of us tend to fall into a rut a meal time. Particularly at the breakfast meal. When you’re tired and sleepy it’s easy to go with the patterns you’re familiar with, and if getting up in the morning, pouring a cup of coffee and reaching for the breakfast cereal is your general routine, you’re not alone. But maybe you should take more time to think about your meal choices, particularly if you’re trying to cut calories. Did you know that a recent British Journal of Nutrition study indicated that when subjects were on a lower calorie weight loss diet they tended to eat fewer calories at lunch when they consumed a higher protein breakfast? Or that subjects who drank skim milk in the morning rather than fruit juice ate 200 kcals less at lunch (Am J Clin Nutr 2009)? Or that overweight subjects lost 65% more weight when they habitually ate an egg-centric breakfast than peers who ate a high carbohydrate breakfast of equal calories (Int J Obesity 2008)?

If you know the literature in this area, none of this should be overly surprising in light of the fact that many studies suggest that protein is more satisfying than carbohydrate or fat. So it stands to reason that a higher protein meal in the morning might prompt you to eat less at subsequent meals. But high carb, sugar laden foods (think donuts and Pop Tarts) have been staples of the American diet for some time because they taste good, and they’re convenient. Good reasons to indulge, but poor choices if your waistline and your health are priorities. Something to think about next time you wake up in a fog and you head to the cupboard for the “old standbys.” Sometimes change is good, and changing your breakfast eating habits can yield positive results.

– Mitch

Childhood obesity continues to be a major problem that afflicts many children in the US. According to the CDC, over 20% of the kids in America are considered obese, based on BMI. In spite of various high profile weight control programs recently developed to combat the epidemic, the sad fact is that overweight children tend to become overweight adults, and overweight adults are more prone to chronic disease conditions including CHD and Type 2 diabetes.

A recent study conducted at Yale University (MedlinePlus) offers some hope. In this long term project, overweight children participated in an intensive weight control program that included physical activity and frequent nutrition education. Initially, the children met twice per week to perform physical activity and attend classes on proper eating. After six months, they met twice per month. After two years, long after the activity and nutrition classes were curtailed, many of the kids who participated in the program maintained BMI. Control subjects who did not participate in the program continued to gain weight and increase their BMI. The moral of the story- -educational intervention in young, susceptible children may pay dividends. A cure for the epidemic? Hardly. But a step in the right direction. Certainly.

The recent Dietary Guidelines stressed nutrient density, among other things, as a way to eat healthier while consuming fewer calories. Relatively simple advise that by no means is a cure for the obesity epidemic. But it is sound advice. The Yale study is a good reminder that looking for foods and snacks that provide good nutrition without a lot of calories is the right thing to do for our kids. As parents, we’d do anything to protect our children’s health. Seeking nutrient dense food options is a form of health protection that is often overlooked.