Harry P. F. Peters

Effect of fat saturation on satiety, hormone release, and food intake

BACKGROUND Ileal delivery of fat reduces hunger and food intake through activation of the ileal brake. Physicochemical properties of fat have been shown to affect satiety and food intake. OBJECTIVE The objective of this study was to assess the effect of ileal fat emulsions with differing degrees of fatty acid saturation on satiety, food intake, and gut peptides (cholecystokinin and peptide YY). We hypothesized that long-chain triacylglycerols with diunsaturated fatty acids would increase satiety and reduce energy intake compared with long-chain triacylglycerols with monounsaturated or saturated fatty acids. DESIGN We performed a double-blind, randomized, crossover study in which 15 healthy subjects [mean age: 24 y; mean body mass index (in kg/m(2)): 22] were intubated with a naso-ileal catheter and participated in 4 experiments performed in random order on 4 consecutive days. After consumption of a liquid meal, subjects received a fat or control infusion in the ileum. Fat emulsions consisted of 6 g of 18:0 (shea oil; mainly 18:0), 18:1 (canola oil; mainly 18:1), or 18:2 (safflower oil; mainly 18:2) oils. Food intake was measured during an ad libitum lunch. Satiety questionnaires (visual analog scale) and blood samples were collected at regular intervals. RESULTS Compared with the control, only 18:2 and 18:1 significantly increased fullness and reduced hunger. No effect on food intake was observed. 18:1 and 18:2 increased cholecystokinin secretion significantly compared with the control. Fatty acid saturation did not affect peptide YY secretion. CONCLUSIONS When infused into the ileum, triacylglycerols with unsaturated fatty acids increase satiety, whereas triacylglycerols with saturated fatty acids does not. This trial was registered with the Dutch Trial Register as: ISRCTN51742545.

No effect of added β-glucan or of fructooligosaccharide on appetite or energy intake

BACKGROUND An increase in gastrointestinal viscosity or colonic fermentation is suggested to improve appetite control and reduce food intake. It has been proposed that beta-glucan and fructooligosaccharide (FOS) are food ingredients that increase gastrointestinal viscosity and colonic fermentation, but the results are inconclusive. OBJECTIVE The objective was to test the effect of FOS, beta-glucan, or a combination thereof on appetite ratings and food intake over 2 consecutive days. DESIGN In a 4-way balanced-order, crossover, double-blind design, 21 healthy volunteers [mean body mass index (in kg/m(2)) 25.9] consumed a meal-replacement bar at 0900 and an ad libitum lunch at 1300 on 2 consecutive days. On day 1 only, the subjects consumed a second (identical) bar at 1700 and a fixed snack at 1900. The control bar contained 0.3 g beta-glucan from 6.8 g oats (control), and the 3 equicaloric test bars contained an additional 0.9 g beta-glucan (from 8.0 g barley), 8 g FOS, or 0.9 g beta-glucan + 8 g FOS. Appetite scores and subsequent ad libitum test meal intakes were measured. Viscosities in response to bar consumption were determined under simulated gastric conditions. The results were analyzed by analysis of covariance. RESULTS The addition of beta-glucan, FOS, or a combination thereof did not affect appetite ratings or food intake, although the addition of beta-glucan to the bar doubled gastric viscosity (841 compared with 351 mPa . s). CONCLUSIONS Consumption of beta-glucan, FOS, or a combination thereof in meal-replacement bars at the levels tested for 2 consecutive days does not improve appetite control. Efficacy may have improved if the consumption period was longer, if the content of beta-glucan was greater, or if a form of beta-glucan that generates even higher gastric viscosity was consumed. This trial was registered at (clinicaltrials.gov) as NCT00776256.

Dose-Dependent Suppression of Hunger by a Specific Alginate in a Low-Viscosity Drink Formulation

Addition of specific types of alginates to drinks can enhance postmeal suppression of hunger, by forming strong gastric gels in the presence of calcium. However, some recent studies have not demonstrated an effect of alginate/calcium on appetite, perhaps because the selected alginates do not produce sufficiently strong gels or because the alginates were not sufficiently hydrated when consumed. Therefore, the objective of the study was to test effects on appetite of a strongly gelling and fully hydrated alginate in an acceptable, low‐viscosity drink formulation. In a balanced order crossover design, 23 volunteers consumed a meal replacement drink containing protein and calcium and either 0 (control), 0.6, or 0.8% of a specific high‐guluronate alginate. Appetite (six self‐report scales) was measured for 5 h postconsumption. Relevant physicochemical properties of the drinks were measured, i.e., product viscosity and strength of gel formed under simulated gastric conditions. Hunger was robustly reduced (20–30% lower area under the curve) with 0.8% alginate (P < 0.001, analysis of covariance), an effect consistent across all appetite scales. Most effects were also significant with 0.6% alginate, and a clear dose‐response observed. Gastric gel strength was 1.8 and 3.8 N for the 0.6 and 0.8% alginate drinks, respectively, while product viscosity was acceptable (<0.5 Pa·s at 10 s−1). We conclude that strongly gastric‐gelling alginates at relatively low concentrations in a low‐viscosity drink formulation produced a robust reduction in hunger responses. This and other related studies indicate that the specific alginate source and product matrix critically impacts upon apparent efficacy.

Intragastric layering of lipids delays lipid absorption and increases plasma CCK but has minor effects on gastric emptying and appetite

Intestinal intubation studies have demonstrated that lipids induce satiety, but the contribution of lipid processing by the stomach on satiety remains poorly understood. In this explorative, randomized, placebo-controlled, crossover study we tested whether delayed lipid absorption, increased cholecystokinin (CCK), decelerated gastric emptying (GE), and increased satiety can be achieved by controlling lipid distribution in the stomach. Six healthy men were intubated nasogastrically. Two treatments were performed and repeated in duplicate. In the oil-on-top treatment (OT), subjects received a fat-free liquid meal (LM, 325 ml, 145 kcal) followed by intragastric infusion of 4 g of high-oleic-acid rapeseed oil (4.6 ml, 36 kcal) labeled with 77 mg glyceryl-[(13)C]trioleate. In the emulsion treatment (EM, control), 4 g of labeled rapeseed oil was incorporated into the LM (325 ml, 181 kcal); 4.6 ml of saline was infused as a control. In OT and EM a second LM was consumed at time t = 270 min. Plasma (13)C-C18:1, CCK and satiety were measured over 480 min. GE was determined by the paracetamol absorption test. OT delayed oleic acid absorption shown by an increased lag time of absorption (EM: 37 +/- 7 min; OT: 75 +/- 10 min; P < 0.01) and time at maximum concentration (EM: 162 +/- 18 min; OT: 280 +/- 33 min; P = 0.01). OT released more CCK than EM (P = 0.03), including increased CCK after the second meal. OT accelerated initial GE until 30 min postprandial. OT showed a tendency (P = 0.06) to suppress hunger and increase satiety and fullness 120-270 min postprandially. The results demonstrate that low amounts of lipids, when separated from the aqueous phase of a meal, delay lipid absorption and increase CCK. An escalating-dose study should determine whether this could have implications for the development of weight-control foods.

The effect of lipid droplet size on satiety and peptide secretion is intestinal site-specific.

BACKGROUND & AIMS : Infusion of fat into the small intestine induces satiety. Reducing fat droplet size accelerates fat digestion, but the effect on satiety after ileal fat infusion is not known. The aim of the study was to compare the effects of fat emulsions differing in droplet size (fine, coarse) infused in either duodenum or ileum on satiety, gastric emptying and peptide secretion. METHODS In a randomized single-blind crossover study 15 healthy volunteers received, after intubation with a nasoileal tube, 4 different treatments on 4 consecutive days. After consumption of a liquid meal, 6 g of fine or coarse fat emulsion was infused into duodenum or ileum. Study parameters were satiety, gastric emptying and gut peptides. These parameters were statistically evaluated using ANCOVA. RESULTS In the duodenum, Fine emulsion significantly reduced hunger, increased fullness, delayed gastric emptying, but did not affect peptide secretion versus Coarse. In the ileum, Fine emulsion did not affect hunger, fullness, or gastric emptying, but significantly increased peptide secretion versus Coarse. CONCLUSIONS Compared to larger fat droplets, smaller droplets significantly affect satiety, gastric emptying and gut peptide release, but with the effect being dependent on the intestinal location of fat delivery. DUTCH TRIALREGISTER: NTR1515.

Fat Emulsion Intragastric Stability and Droplet Size Modulate Gastrointestinal Responses and Subsequent Food Intake in Young Adults

Background: Intragastric creaming and droplet size of fat emulsions may affect intragastric behavior and gastrointestinal and satiety responses. Objectives: We tested the hypotheses that gastrointestinal physiologic responses and satiety will be increased by an increase in intragastric stability and by a decrease in fat droplet size of a fat emulsion. Methods: This was a double-blind, randomized crossover study in 11 healthy persons [8 men and 3 women, aged 24 ± 1 y; body mass index (in kg/m2): 24.4 ± 0.9] who consumed meals containing 300-g 20% oil and water emulsion (2220 kJ) with 1) larger, 6-μm mean droplet size (Coarse treatment) expected to cream in the stomach; 2) larger, 6-μm mean droplet size with 0.5% locust bean gum (LBG; Coarse+LBG treatment) to prevent creaming; or 3) smaller, 0.4-μm mean droplet size with LBG (Fine+LBG treatment). The participants were imaged hourly by using MRI and food intake was assessed by using a meal that participants consumed ad libitum. Results: The Coarse+LBG treatment (preventing creaming in the stomach) slowed gastric emptying, resulting in 12% higher gastric volume over time (P < 0.001), increased small bowel water content (SBWC) by 11% (P < 0.01), slowed appearance of the 13C label in the breath by 17% (P < 0.01), and reduced food intake by 9% (P < 0.05) compared with the Coarse treatment. The Fine+LBG treatment (smaller droplet size) slowed gastric emptying, resulting in 18% higher gastric volume (P < 0.001), increased SBWC content by 15% (P < 0.01), and significantly reduced food intake by 11% (P < 0.05, equivalent to an average of 411 kJ less energy consumed) compared with the Coarse+LBG treatment. These high-fat meals stimulated substantial increases in SBWC, which increased to a peak at 4 h at 568 mL (range: 150–854 mL; P < 0.01) for the Fine+LBG treatment. Conclusion: Manipulating intragastric stability and fat emulsion droplet size can influence human gastrointestinal physiology and food intake.

The relationship between appetite scores and subsequent energy intake: An analysis based on 23 randomized controlled studies

BACKGROUND/OBJECTIVES Several studies have assessed relationships of self-reported appetite (eating motivations, mainly by Visual Analogue Scales, VAS) with subsequent energy intake (EI), though usually in small data sets with limited power and variable designs. The objectives were therefore to better quantify the relationships of self-reports (incorporating subject characteristics) to subsequent EI, and to estimate the quantitative differences in VAS corresponding to consistent, significant differences in EI. SUBJECTS/METHODS Data were derived from an opportunity sample of 23 randomized controlled studies involving 549 subjects, testing the effects of various food ingredients in meal replacers or 100-150 ml mini-drinks. In all studies, scores on several VAS were recorded for 30 min to 5 h post-meal, when EI was assessed by ad libitum meal consumption. The relationships between pre-meal VAS scores and EI were examined using correlation, linear models (including subject characteristics) and a cross-validation procedure. RESULTS VAS correlations with subsequent EI were statistically significant, but of low magnitude, up to r = 0.26. Hunger, age, gender, body weight and estimated basal metabolic rate explained 25% of the total variance in EI. Without hunger the prediction of EI was modestly but significantly lower (19%, P < 0.001). A change of ≥15-25 mm on a 100 mm VAS was the minimum effect consistently corresponding to a significant change in subsequent EI, depending on the starting VAS level. CONCLUSIONS Eating motivations add in a small but consistently significant way to other known predictors of acute EI. Differences of about 15 mm on a 100 mm VAS appear to be the minimum effect expected to result in consistent, significant differences in subsequent EI.

Production of chickens with marginal vitamin A deficiency

Marginally vitamin A-deficient 1-d-old chickens capable of remaining healthy for at least 6 weeks were produced using a two-generation model. In this model, hens fed on diets with a limited vitamin A content were used to obtain 1-d-old chickens which were marginally deficient in vitamin A. Only hens with a narrow range of plasma retinol values (0.60-0.85 mumol/l) were satisfactory for this purpose. Above this range the 1-d-old chickens were not marginally vitamin A deficient. Below this range egg production and hatchability were affected to some extent depending on the degree of vitamin A deficiency. Even when egg production and hatchability remained at a high level in such birds, the 1-d-old chickens produced were not sufficiently strong to survive the first weeks of life. The advantages of the two-generation model for producing marginally vitamin A-deficient chickens are the increased uniformity and predictability of the chickens with respect to body-weight, general health and vitamin A status. However, it does take about 3 months to produce such chickens.

Measuring satiety with pictures compared to visual analogue scales. An exploratory study

Visual analogue scales (VAS) are a standard tool used to measure subjective appetite. To explore a potentially more intuitive and precise alternative, we developed a method based on pictures and assessed its performance characteristics vs. VAS. The objective was to compare the capacity of the two methods to discriminate appetite ratings between interventions. Both methods were applied within a previously published trial in which 16 healthy adults received standardised meals followed by three different ileal infusions in a balanced crossover design. At regular intervals volunteers indicated how many units of individually pictured food portions (for 10 different items) they would like to eat, and also scored six VAS. Methods were compared over different timeframes and assessed for their sensitivity to intervention effects. Pictures were more sensitive than VAS in differentiating intervention effects; however, further refinement and validation would be needed for pictures to become a standardised and accepted alternative to VAS for this type of research.

Aerated drinks increase gastric volume and reduce appetite as assessed by MRI: a randomized, balanced, crossover trial

BACKGROUND Compared with nonaerated, isocaloric controls, aerated foods can reduce appetite throughout an entire dieting day. Increased gastric volumes and delayed emptying are possible but unexplored mechanisms. OBJECTIVE We tested the hypothesis that aerated drinks (foams) of differing gastric stability would increase gastric distension and reduce appetite compared with a control drink. DESIGN In a randomized, balanced, crossover trial, 18 healthy male participants consumed the following 3 skimmed-milk-based test products (all 110 kcal): 2 drinks aerated to foams by whipping (to 490 mL), one drink that was stable in the stomach [stable foam (SF)], and one drink that was less stable in the stomach [less-stable foam (LSF)], and a nonaerated drink [liquid control (LC); 140 mL]. Over 4 h, stomach contents (foam, air, and liquid) were imaged using magnetic resonance imaging (MRI), and self-reported appetite ratings were collected and quantified by the area under the curve or time to return to baseline (TTRTB). RESULTS Compared with the LC, both foams caused significantly increased gastric volumes and reduced hunger (all P < 0.001). Compared with the LSF, SF further produced a significantly slower decrease in the total gastric content (P < 0.05) and foam volume (P < 0.0001) and a longer TTRTB (197 compared with 248 min, respectively; P < 0.05), although the hunger AUC was not statistically different. Results for other appetite scales were similar. CONCLUSIONS With this MRI trial, we provide novel insights on the gastrointestinal behavior of aerated drinks by measuring separate volumes of foam, liquid, and air layers in the stomach. Appetite suppression induced by foams could largely be explained by effects on gastric volumes and emptying, which may be further enhanced by foam stability. This trial was registered at clinicaltrials.gov as NCT01690182.