Suleen Ho

Acute effects of whey protein isolate on cardiovascular risk factors in overweight, post-menopausal women.

OBJECTIVE The purpose of this study was to investigate the acute effects of dietary whey proteins on lipids, glucose and insulin, and resting energy expenditure in overweight and obese post-menopausal women, a population highly susceptible to cardiovascular disease. METHODS A three-way crossover design study was conducted where 20 overweight or obese, post-menopausal women were randomised to consume either 45 g whey protein isolate, 45 g sodium caseinate or 45 g of a glucose control in conjunction with a breakfast meal. Blood samples were taken for up to 6 h. RESULTS There was no significant change in postprandial incremental area under the curve (AUC) for total cholesterol, low density lipoprotein, high density lipoprotein, non-esterified fatty acids, Apo B48, insulin and leptin between groups. However, there was a significant decrease in the appearance of triglycerides (TG) in the blood by 21% and 27% after consuming the whey meal compared to control and casein meals, respectively, as measured by AUC. There was also a significant reduction by 27% and 32% in the AUC for TG:ApoB48 ratio in the whey group compared to the glucose and casein groups, respectively. There was a significantly lower AUC for blood glucose after the consumption of the whey and casein meal compared to glucose meal. CONCLUSION These findings suggest that a single dose of whey protein can decrease arterial exposure to smaller TG-enriched lipoprotein particles compared to the glucose and casein meals in the postprandial period in overweight and obese, post-menopausal women.

Comparative effects of A1 versus A2 beta-casein on gastrointestinal measures: a blinded randomised cross-over pilot study

Background/objectives:At present, there is debate about the gastrointestinal effects of A1-type beta-casein protein in cows’ milk compared with the progenitor A2 type. In vitro and animal studies suggest that digestion of A1 but not A2 beta-casein affects gastrointestinal motility and inflammation through the release of beta-casomorphin-7. We aimed to evaluate differences in gastrointestinal effects in a human adult population between milk containing A1 versus A2 beta-casein.Subjects/methods:Forty-one females and males were recruited into this double-blinded, randomised 8-week cross-over study. Participants underwent a 2-week dairy washout (rice milk replaced dairy), followed by 2 weeks of milk (750 ml/day) that contained beta-casein of either A1 or A2 type before undergoing a second washout followed by a final 2 weeks of the alternative A1 or A2 type milk.Results:The A1 beta-casein milk led to significantly higher stool consistency values (Bristol Stool Scale) compared with the A2 beta-casein milk. There was also a significant positive association between abdominal pain and stool consistency on the A1 diet (r=0.520, P=0.001), but not the A2 diet (r=−0.13, P=0.43). The difference between these two correlations (0.52 versus −0.13) was highly significant (P<0.001). Furthermore, some individuals may be susceptible to A1 beta-casein, as evidenced by higher faecal calprotectin values and associated intolerance measures.Conclusions:These preliminary results suggest differences in gastrointestinal responses in some adult humans consuming milk containing beta-casein of either the A1 or the A2 beta-casein type, but require confirmation in a larger study of participants with perceived intolerance to ordinary A1 beta-casein-containing milk.

Milk intolerance, beta-casein and lactose

True lactose intolerance (symptoms stemming from lactose malabsorption) is less common than is widely perceived, and should be viewed as just one potential cause of cows’ milk intolerance. There is increasing evidence that A1 beta-casein, a protein produced by a major proportion of European-origin cattle but not purebred Asian or African cattle, is also associated with cows’ milk intolerance. In humans, digestion of bovine A1 beta-casein, but not the alternative A2 beta-casein, releases beta-casomorphin-7, which activates μ-opioid receptors expressed throughout the gastrointestinal tract and body. Studies in rodents show that milk containing A1 beta-casein significantly increases gastrointestinal transit time, production of dipeptidyl peptidase-4 and the inflammatory marker myeloperoxidase compared with milk containing A2 beta-casein. Co-administration of the opioid receptor antagonist naloxone blocks the myeloperoxidase and gastrointestinal motility effects, indicating opioid signaling pathway involvement. In humans, a double-blind, randomized cross-over study showed that participants consuming A1 beta-casein type cows’ milk experienced statistically significantly higher Bristol stool values compared with those receiving A2 beta-casein milk. Additionally, a statistically significant positive association between abdominal pain and stool consistency was observed when participants consumed the A1 but not the A2 diet. Further studies of the role of A1 beta-casein in milk intolerance are needed.

Effects of a weight management program delivered by social media on weight and metabolic syndrome risk factors in overweight and obese adults: A randomised controlled trial

Introduction The aim of this project was to evaluate the effectiveness of using social media to augment the delivery of, and provide support for, a weight management program delivered to overweight and obese individuals during a twenty four week intervention. Methods Participants randomly divided into either one of two intervention groups or a control group. The two intervention groups were instructed to follow identical weight-management program. One group received the program within a Facebook group, along with a support network with the group, and the other intervention group received the same program in a booklet. The control group was given standard care. Participants’ weight and other metabolic syndrome risk factors were measured at baseline and at weeks 6, 12, 18 and 24. Results The Facebook Group reported a 4.8% reduction in initial weight, significant compared to the CG only (p = 0.01), as well as numerically greater improvements in body mass index, waist circumference, fat mass, lean mass, and energy intake compared to the Pamphlet Group and the Control Group. Conclusions These results demonstrate the potential of social media to assist overweight and obese individuals with respect to dietary and physical activity modifications for weight management, and justify further research into the inclusion of social media in clinical weight management programs. It is anticipated that social media will provide an invaluable resource for health professionals, as a low maintenance vehicle for communicating with patients, as well as a source of social support and information sharing for individuals undergoing lifestyle modifications.

Effect on Insulin, Glucose and Lipids in Overweight/Obese Australian Adults of 12 Months Consumption of Two Different Fibre Supplements in a Randomised Trial

Higher fibre intakes are associated with risk reduction for chronic diseases. This study investigated the effects of supplementation with PolyGlycopleX® (PGX), a complexed polysaccharide, on insulin, glucose and lipids in overweight and obese individuals. In this double-blind 12 months study, participants were randomised into three groups: control (rice flour); PGX or psyllium (PSY). Participants followed their usual lifestyle and diet but consumed 5 g of their supplement before meals. Insulin was significantly lower in the PGX and PSY groups compared to control at 3 and 6 months and in the PSY group compared to control at 12 months. Serum glucose was significantly lower in the PGX group at 3 months compared to control. Total cholesterol was significantly lower in the PGX and PSY groups compared to control at 3 and 6 months. High density lipoprotein (HDL) cholesterol was significantly increased in the PGX group compared to control at 12 months. low density lipoprotein (LDL) cholesterol was significantly lower in the PGX group at 3 and 6 months compared to control and in the PSY group at 3 months compared to control. A simple strategy of fibre supplementation may offer an effective solution to glucose, insulin and lipid management without the need for other nutrient modification.

Social media for health promotion and weight management: a critical debate

BackgroundIn 2016 an estimated 1.9 billion adults world-wide were either overweight or obese. The health consequences of obesity are responsible for 2.8 million preventable deaths per year. The WHO now considers obesity as a global epidemic and recommends population-wide health promotion strategies to address this issue. Weight gain is caused by increased energy intake and physical inactivity, so treatment should focus on changes to behaviour regarding diet and physical activity.DiscussionThe WHO has also recognised the importance of social resources as a valuable agent for behaviour change in health promotion. Social resources are translated at the community level as support provided by significant others such as family, partners and peers, in the form of information, material aid and encouragement. Social support has been shown to improve health and well-being, whereas social isolation has been shown to have a negative impact on health outcomes. Social support provided by peers has been shown to be a useful strategy to employ in weight management programmes. The documented increased use of ICT and social media has presented health promoters with a potentially useful medium to increase social support for weight management.ConclusionWhile the use of social media for health promotion is an emerging field of investigation, preliminary research suggests that it increases participant engagement, and may provide a cost-effective tool to provide social support for individuals participating in weight management programmes. With stringent privacy protocols in place, social media may be a useful, cost-effective accompaniment to multifactorial weight management programmes. However more research is needed to identify how to make the best use of social media as health promotion tool.

Dairy Whey Proteins and Obesity

Studies show that whey protein and its bioactive components can promote greater health benefits compared to other protein sources such as egg and casein. The aim of this chapter is to review the effects of whey protein on metabolic syndrome risk factors. Consumption of whey protein has been shown to improve glucose levels and insulin response, promote a reduction in blood pressure, improve vascular function, and improve the lipid profile. The collective view of the current scientific evidence is that the consumption of whey protein may have beneficial effects on some symptoms of metabolic syndrome, as well as reducing cardiovascular risk factors.

Using Psyllium to Prevent and Treat Obesity Comorbidities

Current evidence supports the notion that the consumption of a high-fiber diet provides benefits to many components of metabolic syndrome (MS), cardiovascular disease, and type 2 diabetes. Psyllium is one of the most widely used fiber supplements because it is reasonably cheap and is better tolerated than other fiber supplements. Psyllium supplementation reduces appetite, improves blood glucose levels and the insulin response, reduces blood pressure, and has beneficial effects on the lipid profile in both animals and humans, thereby reducing metabolic risk factors. Psyllium seems to improve body weight in animals, but its effects on body weight in humans is unresolved. Psyllium supplementation may be beneficial for patients with metabolic syndrome risk factors such as hypercholesterolemia, hypertriglyceridemia, and hyperglycemia, but its efficacy in the management of body weight, body composition, appetite, and hypertension requires further investigation.