Impact of isoenergetic intake of irregular meal patterns on thermogenesis, glucose metabolism and appetite: a randomized controlled trial.

Abstract

BACKGROUND\nEvidence is emerging that inter-daily meal pattern variability potentially impacts on response such as thermic effect of food (TEF), macronutrient metabolism and appetite.\n\n\nOBJECTIVES\nTo investigate the effect of irregular meal pattern on TEF, glucose, insulin, lipid profile and appetite regulation in females with overweight or obesity and confirmed insulin resistance.\n\n\nDESIGN\nIn a randomized crossover trial, 9 females [mean±SD BMI: 33.3±3.1 kg/m2) with confirmed insulin resistance consumed a regular (14 days; 6 meals/d) and an irregular (14 days; 3-9 meals/d) meal pattern separated by a 14-d wash-out interval. Identical foods were provided during the interventions and at the start and end of each meal pattern participants attended the laboratory after an overnight fast. Energy expenditure, glucose, insulin, lipids, adiponectin, leptin, glucagon-like peptide 1 (GLP-1), peptide YY (PYY), and ghrelin were measured at baseline and for three hours after consumption of a test drink, after which an ad libitum test meal was offered. Subjective appetite ratings were recorded before and after the test drink, after the ad libitum meal, and during the intervention. Continuous interstitial glucose monitoring was undertaken for 7 consecutive days during each intervention.\n\n\nRESULTS\nTEF (over 3 h) was significantly lower post-irregular intervention compared with post-regular (97.7±19.2 kJ*3h in post-regular visit, and 76.7±35.2 kJ*3h in post-irregular visit (Paired T-test, P = 0.048). Differences in HOMA-IR between the two interventions (3.3±1.7 and 3.6±1.6 in post-regular and post-irregular meal pattern, respectively) were not significant. Net iAUC for GLP-1 concentrations (over 3 h) post-regular meal pattern were higher (864.9±456.1 pmol/L*3h) than post-irregular meal pattern (487.6±271.7 pmol/L*3h), (Paired T-test; P = 0.005).\n\n\nCONCLUSION\nFollowing a 14-d period of irregular meal pattern, TEF was significantly less than following regular meal pattern potentially compromising weight management if sustained long term.www.clinicaltrials.gov (ID number; NCT02582606).