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Sucrose compared with artificial sweeteners: a clinical intervention study of effects on energy intake, appetite, and energy expenditure after 10 wk of supplementation in overweight subjects.
Sørensen, LB, Vasilaras, TH, Astrup, A, Raben, A
The American journal of clinical nutrition. 2014;(1):36-45
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Abstract
BACKGROUND There is a lack of appetite studies in free-living subjects supplying the habitual diet with either sucrose or artificially sweetened beverages and foods. Furthermore, the focus of artificial sweeteners has only been on the energy intake (EI) side of the energy-balance equation. The data are from a subgroup from a 10-wk study, which was previously published. OBJECTIVE The objective was to investigate changes in EI and energy expenditure (EE) as possible reasons for the changes in body weight during 10 wk of supplementation of either sucrose or artificial sweeteners in overweight subjects. DESIGN Supplements of sucrose-sweetened beverages and foods (2 g/kg body weight; n = 12) or similar amounts containing artificial sweeteners (n = 10) were given single-blind in a 10-wk parallel design. Beverages accounted for 80% and solid foods for 20% by weight of the supplements. The rest of the diet was free choice. Indirect 24-h whole-body calorimetry was performed at weeks 0 and 10. At week 0 the diet was a weight-maintaining standardized diet. At week 10 the diet consisted of the supplements and ad libitum choice of foods. Visual analog scales were used to record appetite. RESULTS Body weight increased in the sucrose group and decreased in the sweetener group during the intervention. The sucrose group had a 3.3-MJ higher EI but felt less full and had higher ratings of prospective food consumption than did the sweetener group at week 10. Basal metabolic rate was increased in the sucrose group, whereas 24-h EE was increased in both groups at week 10. Energy balance in the sucrose group was more positive than in the sweetener group at the stay at week 10. CONCLUSION The changes in body weight in the 2 groups during the 10-wk intervention seem to be attributable to changes in EI rather than to changes in EE.
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Effects of PYY3-36 and GLP-1 on energy intake, energy expenditure, and appetite in overweight men.
Schmidt, JB, Gregersen, NT, Pedersen, SD, Arentoft, JL, Ritz, C, Schwartz, TW, Holst, JJ, Astrup, A, Sjödin, A
American journal of physiology. Endocrinology and metabolism. 2014;(11):E1248-56
Abstract
Our aim was to examine the effects of GLP-1 and PYY3-36, separately and in combination, on energy intake, energy expenditure, appetite sensations, glucose and fat metabolism, ghrelin, and vital signs in healthy overweight men. Twenty-five healthy male subjects participated in this randomized, double-blinded, placebo-controlled, four-arm crossover study (BMI 29 ± 3 kg/m(2), age 33 ± 9 yr). On separate days they received a 150-min intravenous infusion of 1) 0.8 pmol·kg(-1)·min(-1) PYY3-36, 2) 1.0 pmol·kg(-1)·min(-1) GLP-1, 3) GLP-1 + PYY3-36, or 4) placebo. Ad libitum energy intake was assessed during the final 30 min. Measurements of appetite sensations, energy expenditure and fat oxidation, vital signs, and blood variables were collected throughout the infusion period. No effect on energy intake was found after monoinfusions of PYY3-36 (-4.2 ± 4.8%, P = 0.8) or GLP-1 (-3.0 ± 4.5%, P = 0.9). However, the coinfusion reduced energy intake compared with placebo (-30.4 ± 6.5%, P < 0.0001) and more than the sum of the monoinfusions (P < 0.001), demonstrating a synergistic effect. Coinfusion slightly increased sensation of nausea (P < 0.05), but this effect could not explain the effect on energy intake. A decrease in plasma ghrelin was found after all treatments compared with placebo (all P < 0.05); however, infusions of GLP-1 + PYY3-36 resulted in an additional decrease compared with the monoinfusions (both P < 0.01). We conclude that coinfusion of GLP-1 and PYY3-36 exerted a synergistic effect on energy intake. The satiating effect of the meal was enhanced by GLP-1 and PYY3-36 in combination compared with placebo. Coinfusion was accompanied by slightly increased nausea and a decrease in plasma ghrelin, but neither of these factors could explain the reduction in energy intake.
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Macronutrient-specific effect of FTO rs9939609 in response to a 10-week randomized hypo-energetic diet among obese Europeans.
Grau, K, Hansen, T, Holst, C, Astrup, A, Saris, WH, Arner, P, Rössner, S, Macdonald, I, Polak, J, Oppert, JM, et al
International journal of obesity (2005). 2009;(11):1227-34
Abstract
BACKGROUND The A risk allele of rs9939609 of the fat mass- and obesity-associated gene (FTO) increases body fat mass. OBJECTIVE To examine whether FTO rs9939609 affects obese individuals' response to a high-fat, low-carbohydrate (CHO) (HF) or low-fat, high-CHO (LF), hypo-energetic diet and whether the effect of the FTO variant depends on dietary fat and CHO content. DESIGN In a 10-week, European, multi-centre dietary intervention study 771 obese women and men were randomized to either LF (20-25% of energy (%E) from fat, 60-65%E from CHO) or HF (40-45%E from fat, 40-45%E from CHO), hypo-energetic diet (measured resting metabolic rate multiplied by 1.3-600 kcal day(-1)). Body weight, fat mass (FM), fat-free mass (FFM), waist circumference (WC), resting energy expenditure (REE), fasting fat oxidation as % of REE (FatOx), insulin release (HOMA-beta) and a surrogate measure of insulin resistance (HOMA-IR) were measured at baseline and after the intervention. In all, 764 individuals were genotyped for FTO rs9939609. RESULTS For A-allele carriers the drop-out rate was higher on HF than LF diet (in AT, P=0.002; in AT/AA combined, P=0.003). Among those individuals completing the intervention, we found no effect of FTO rs9939609 genotype on Deltaweight, DeltaFM, DeltaFFM, DeltaWC or DeltaFatOx. However, participants with TT had a smaller reduction in REE on LF than on HF diet (75 kcal/24 h; interaction: P=0.0055). These individuals also showed the greatest reduction in HOMA-beta and HOMA-IR (interaction: P=0.0083 and P=0.047). CONCLUSION The FTO rs9939609 may interact with the macronutrient composition in weight loss diets in various ways; carriers of the A allele on LF diet appear to have a lower risk for drop out, and TT individuals have a smaller decrease in REE and greater decrease in HOMA-beta and HOMA-IR on LF than on HF diet.
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The effect of caffeine, green tea and tyrosine on thermogenesis and energy intake.
Belza, A, Toubro, S, Astrup, A
European journal of clinical nutrition. 2009;(1):57-64
Abstract
OBJECTIVES To investigate the effect of three different food ingredients tyrosine, green tea extract (GTE) and caffeine on resting metabolic rate and haemodynamics, and on ad libitum energy intake (EI) and appetite. METHODS Twelve healthy, normal weight men (age: 23.7 +/- 2.6 years, mean +/- s.d.) participated in a four-way crossover, randomized, placebo-controlled, double-blind study. Treatments were administered as tablets of 500 mg GTE, 400 mg tyrosine, 50 mg caffeine, or placebo, and were separated by >3-day washout. The acute thermogenic response was measured in a ventilated hood system for 4 h following ingestion. Blood pressure, heart rate (HR), and subjective appetite sensations were assessed hourly and ad libitum EI 4 h post-dose. RESULTS Caffeine induced a thermogenic response of 6% above baseline value (72 +/- 25 kJ per 4 h, mean +/- s.e.) compared to placebo (P<0.0001). The thermogenic responses to GTE and tyrosine were not significantly different from placebo. Tyrosine tended to increase 4-h respiratory quotient by 1% compared to placebo (0.01 +/- 0.005, P=0.05). Ad libitum EI was not significantly different between treatments but was reduced by 8% (-403 +/- 183 kJ), 8% (-400 +/- 335 kJ) and 3% (-151 +/- 377 kJ) compared to placebo after intake of tyrosine, GTE and caffeine, respectively. No significant difference in haemodynamics was observed between treatments. CONCLUSIONS Only caffeine was thermogenic in the given dose and caused no haemodynamic side effects. The sample size was probably too small to detect any appetite suppressant properties of the treatments. Further investigations are required.
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Reproducibility and power of ad libitum energy intake assessed by repeated single meals.
Gregersen, NT, Flint, A, Bitz, C, Blundell, JE, Raben, A, Astrup, A
The American journal of clinical nutrition. 2008;(5):1277-81
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Abstract
BACKGROUND The reproducibility of the measurement of ad libitum energy intake (EI) is not well known. Furthermore, it is not known whether standardized conditions before the test day influence this measure. OBJECTIVE The objective was to examine the reproducibility and power of the measurement of ad libitum EI with and without prior diet standardization. DESIGN Fifty-five healthy, normal-weight men were tested in 2 groups, one with (D, n = 32) and one without (ND, n = 23) prior diet standardization, on 2 different identical occasions. They were given a standardized energy-fixed breakfast and then an ad libitum lunch 4.5 h later. Reproducibility was assessed by the coefficient of repeatability. RESULTS No effect of prior diet standardization was seen on the reproducibility of ad libitum EI (P = 0.56), but diet standardization increased ad libitum EI significantly (P < 0.001). The correlation between ad libitum EI on the 2 test days was r = 0.861 (R(2) = 0.742, P < 0.0001) and r = 0.654 (R(2) = 0.428, P < 0.001) in the D and ND groups, respectively. The coefficient of repeatability and CV were 1478 kJ and 8.9% compared with 1831 kJ and 14.5% in the D and ND groups, respectively. A paired design with a study power of 0.8 requires 17 and 26 subjects, with and without prior diet standardization, respectively, to detect a difference of 500 kJ in EI. CONCLUSIONS The ad libitum test meal used to measure spontaneous EI is reproducible, and the reproducibility does not seem to be influenced by prior standardization. However, prior diet standardization exerts a significant effect on ad libitum EI.
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The effect of salatrim, a low-calorie modified triacylglycerol, on appetite and energy intake.
Sørensen, LB, Cueto, HT, Andersen, MT, Bitz, C, Holst, JJ, Rehfeld, JF, Astrup, A
The American journal of clinical nutrition. 2008;(5):1163-9
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Abstract
BACKGROUND Salatrim is modified triacylglycerol that is rich in short-chain fatty acids and stearic acid. It is used as a lower-calorie fat replacer. In addition, it has been hypothesized that salatrim's reduced absorption in the small intestine may lead to greater amounts of fat in the gastrointestinal tract, which may decrease appetite and energy intake through the release of appetite-regulating gastrointestinal hormones. OBJECTIVE We aimed to compare the effects of salatrim and traditional fat on appetite, ad libitum energy intake, and gastrointestinal hormones. DESIGN Twenty-two healthy, young, normal-weight men participated in a randomized, double-blind, crossover study. Test meals were a traditional fat meal and a salatrim meal with a mixture of traditional fat and salatrim. Visual analogue scales were used to record appetite and well-being every 30 min, and blood was sampled frequently. An ad libitum lunch was served 4.5 h after the test meal. RESULTS The salatrim meal increased fullness (P = 0.04) and decreased hunger (P = 0.06) significantly more than did the traditional fat meal. The traditional fat meal increased well-being (P = 0.02). There was no significant difference in ad libitum energy intake or overall energy intake between the 2 test days. No significant differences in blood glucose, insulin, triacylglycerol, ghrelin, cholecystokinin, glucagon-like peptide-1, or peptide YY concentrations were found. A significantly (P = 0.01) smaller increase in free fatty acids was observed after the salatrim meal than after the traditional fat meal. CONCLUSIONS Salatrim had a modestly more suppressive effect on appetite than did a traditional fat. Gastrointestinal hormones did not seem to be involved.
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Whole flaxseeds but not sunflower seeds in rye bread reduce apparent digestibility of fat in healthy volunteers.
Kristensen, M, Damgaard, TW, Sørensen, AD, Raben, A, Lindeløv, TS, Thomsen, AD, Bjergegaard, C, Sørensen, H, Astrup, A, Tetens, I
European journal of clinical nutrition. 2008;(8):961-7
Abstract
OBJECTIVE The aim of this study was to measure the apparent digestibility of fat and the transit time upon addition of whole sunflower seeds (SU) or flaxseeds (FL) to rye breads consumed as part of a whole diet. METHOD In a randomized crossover study, gross intake and faecal excretion of fat and energy were measured in 11 young healthy men aged 24.6+/-2.7 years. During each 7 days intervention periods, the subjects received a basal diet plus 300 g of one of four rye breads: (1) rye bread; (2) rye bread with SU; (3) rye bread with FL; (4) low extraction rate rye bread with SU and FL. Fat binding properties of rye breads (1) and (3) were determined by in vitro digestion. RESULTS Addition of whole SU or FL to breads increased daily gross intake of fat and energy (P<0.001). The amounts of apparently digested fat (g/day) and energy were lowered when subjects consumed the SU or FL rye bread (P<0.001). The effect on energy digestibility of FL was more pronounced than that of SU. The in vitro fat digestibility of rye breads and whole diets show fat-binding properties of FL when compared to the rye bread diet (P<0.05). CONCLUSIONS Enrichment of bread with whole FL does not appear to result in increased fat and energy intake when added to breads, but the results rather indicate an impairment of nutrient utilization.
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Effects of PYY1-36 and PYY3-36 on appetite, energy intake, energy expenditure, glucose and fat metabolism in obese and lean subjects.
Sloth, B, Holst, JJ, Flint, A, Gregersen, NT, Astrup, A
American journal of physiology. Endocrinology and metabolism. 2007;(4):E1062-8
Abstract
Peptide YY (PYY)(3-36) has been shown to produce dramatic reductions in energy intake (EI), but no human data exist regarding energy expenditure (EE), glucose and fat metabolism. Nothing is known regarding PYY1-36. To compare effects of PYY(1-36) and PYY(3-36) on appetite, EI, EE, insulin, glucose and free fatty acids (FFA) concentrations, 12 lean and 12 obese males participated in a blinded, randomized, crossover study with 90-min infusions of saline, 0.8 pmol x kg(-1) x min(-1) PYY(1-36) and PYY(3-36). Only four participants completed PYY(3-36) infusions because of nausea. Subsequently, six lean and eight obese participants completed 0.2 pmol x kg(-1) x min(-1) PYY(3-36) and 1.6 pmol x kg(-1) x min(-1) PYY(1-36) infusions. PYY(3-36) [corrected] produced [corrected] lower ratings of well-being and [corrected] increases in heart rate, [corrected] FFA, and [corrected] postprandial [corrected] insulin concentrations. Furthermore, high-dose [corrected] PYY(3-36) (0.8 [corrected] pmol x kg(-1) x min(-1)) produced decreased [corrected] EI and increased postprandial [corrected] glucose concentrations and tendency to reduced EE [corrected]
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Associations between postprandial insulin and blood glucose responses, appetite sensations and energy intake in normal weight and overweight individuals: a meta-analysis of test meal studies.
Flint, A, Gregersen, NT, Gluud, LL, Møller, BK, Raben, A, Tetens, I, Verdich, C, Astrup, A
The British journal of nutrition. 2007;(1):17-25
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Abstract
It is unclear whether postprandial blood glucose or insulin exerts a regulatory function in short-term appetite regulation in humans. The aim of this study was to investigate, by use of meta-analysis, the role of blood glucose and insulin in short-term appetite sensation and energy intake (EI) in normal weight and overweight participants. Data from seven test meal studies were used, including 136 healthy participants (ALL) (92 normal weight (NW) and 44 overweight or obese (OW)). All meals were served as breakfasts after an overnight fast, and appetite sensations and blood samples were obtained frequently in the postprandial period. Finally, an ad libitum lunch was served. Data were analysed by fixed effects study level (SL) meta-regression analysis and individual participant data (IPD) regression analysis, using STATA software. In SL analysis, postprandial insulin response was associated with decreased hunger in ALL, NW and OW (P < 0.019), and with increased satiety in NW (P = 0.004) and lower subsequent EI in OW (P = 0.022). Multivariate IPD analysis showed similar associations, but only in NW for hunger, satiety and EI (P < 0.028), and in ALL for EI (P = 0.016). The only association involving blood glucose was the multivariate IPD analysis showing an inverse association between blood glucose and EI in ALL (P = 0.032). Our results suggest that insulin, but not glucose, is associated with short-term appetite regulation in healthy participants, but the relationship is disrupted in the overweight and obese. We conclude that the postprandial insulin response may be an important satiety signal, and that central nervous system insulin resistance in overweight might explain the blunted effect on appetite.
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Impact of the menstrual cycle on determinants of energy balance: a putative role in weight loss attempts.
Davidsen, L, Vistisen, B, Astrup, A
International journal of obesity (2005). 2007;(12):1777-85
Abstract
Women's weight and body composition is significantly influenced by the female sex-steroid hormones. Levels of these hormones fluctuate in a defined manner throughout the menstrual cycle and interact to modulate energy homeostasis. This paper reviews the scientific literature on the relationship between hormonal changes across the menstrual cycle and components of energy balance, with the aim of clarifying whether this influences weight loss in women. In the luteal phase of the menstrual cycle it appears that women's energy intake and energy expenditure are increased and they experience more frequent cravings for foods, particularly those high in carbohydrate and fat, than during the follicular phase. This suggests that the potential of the underlying physiology related to each phase of the menstrual cycle may be worth considering as an element in strategies to optimize weight loss. Studies are needed to assess the weight loss outcome of tailoring dietary recommendations and the degree of energy restriction to each menstrual phase throughout a weight management program, taking these preliminary findings into account.