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Prescription 2016: Natural Appetite Suppressants

May 30, 2016 Written by JP    [Font too small?]

Appetite suppressants have earned a well deserved, bad reputation in many medical circles. Time after time, so called miracle “diet pills” have failed to promote sustained weight loss and/or caused serious side effects. Perhaps the highest profile example is fen-phen, a drug combination consisting of fenfluramine and phentermine. In 1997, the FDA required that fen-phen be pulled from the US marketplace after numerous reports of heart valve disease and pulmonary hypertension became too common to ignore.

Clearly, I am an ardent supporter of natural medicine, but I am also a skeptic when it comes to any type of diet-related quick fixes. In the past and present, natural appetite suppressants have been found to be potentially hazardous. In 2004, the FDA banned the sale of (naturally sourced) ephedra because “the substance raises blood pressure and otherwise stresses the circulatory system”. In May 2016, similar side-effects were noted from another appetite reducer extracted from yoihimbe bark. Additionally, there are periodic reports of slimming supplements that are illegally adulterated with dangerous drugs such as sibutramine. However, even well intended supplements that aim to suppress appetite usually aren’t worth their price tag or risk. Simply stated, they’re almost always disappointing in a real world setting. The latest example is a failed experiment using a high polyphenolic grape extract. It was found to be safe, but it didn’t affect feelings of fullness, hunger or overall caloric intake.

What Works? Specific Dietary Choices: A recent study in the Journal of Nutrition reports that eating small, frequent meals does not tame a voracious appetite. Thankfully, there are a number of dietary strategies that are productive. Topping the list is: a) replacing grains with eggs at breakfast; b) adopting a higher-fat, lower carbohydrate diet rather than a low-fat diet; and c) adding plenty of spinach to your nutrition plan. The first two recommendations match the suggestions made by Dr. David Ludwig in his book, “Always Hungry”. You can read more about that here: (link 1 & link 2). The spinach tip is based on emerging evidence which shows that thylakoids, plant membranes extracted from spinach, reduce emotional eating and promote hunger satisfaction by delaying fat digestion and prompting the release of gut peptides that beneficially influence appetite regulation.

What Works? Liquid Preloading: Drinking approximately two glasses of water (500 ml) a half-hour prior to meals has been shown to decrease hunger and weight in several peer-reviewed studies. In fact, one trial documented a 13% reduction in caloric intake in the subsequent meal. Also of note, staying properly hydrated can enhance your mood. And, as we all know, poor mood states often lead to unwise food (and drink) choices.

What Works? Fiber Supplementation: A study presented in the May 2016 edition of Appetite reveals that supplementing with 6.8 grams of psyllium fiber prior to breakfast and lunch resulted in a “statistically significant reduction in hunger and desire to eat, and increased fullness between meals compared to placebo”. Other forms of fiber such as the highly viscous PolyGlycopleX (PGX) and a-galacto-oligosaccharides (GOS), a prebiotic fiber, have also been demonstrated to enhance satiety. As a bonus, these fiber sources curtail body fat and inflammation, while improving blood sugar management.

What Works? Spicy Solutions: Caraway, fennel and fenugreek are a group of spices that have been used traditionally to support healthy digestion. Recently, their role as natural appetite suppressants has come to light. In March 2016, a triple-blind, placebo-controlled study in Phytotherapy Research noted a decline in appetite and carbohydrate intake in a group of obese women who received a caraway seed extract. A trial from 2015 describes how both fennel and fenugreek teas, consumed prior to a lunch buffet, led to decreased hunger and food consumption in a separate group of overweight women. What’s more, previous research from 2010 suggests that fenugreek may assist overweight men too by lowering their glucose/insulin ratio and moderating dietary fat consumption.

What Works? Mind-Body Solutions: Current studies reveal that a few fairly mainstream therapies may be of value to dieters seeking non-pharmaceutical and -surgical options. For starters, cognitive behavioral therapy (CBT) benefits those struggling with binge eating. And, mindfulness training provides a valuable adjunct to weight loss programs by minimizing “reward-driven eating”. On the alternative-front, Emotional Freedom Technique lessens food cravings in obese adults. Acupuncture scales down the desire to eat, possibly by diminishing the amount of active ghrelin, a gut hormone that stimulates appetite and influences how quickly hunger returns.

Today, I’ve outlined quite a few options for those who wish to attain better hunger management. All of the above alternatives can be used in a mix-and-match way. Personally, I would start with the defined dietary changes. However, if you believe you’re lacking in the fiber or hydration departments, focus on those resources. If you suspect that there are psychological or stress-related issues at play, follow the mind-body route. And, if you like tea, why not swap out your typical glass of juice, soda or wine with caraway, fennel and/or fenugreek tea? These are all worth trying and certainly much healthier and safer than the majority of products stocked in the average diet and weight loss aisles.

Note: Please check out the “Comments & Updates” section of this blog – at the bottom of the page. You can find the latest research about this topic there!

To learn more about the studies referenced in today’s column, please click on the following links:

Study 1 – FDA Announces Withdrawal Fenfluramine and Dexfenfluramine (link)

Study 2 – FDA Issues Regulation Prohibiting Sale of Dietary Supplements (link)

Study 3 – Dietary Supplement for Energy and Reduced Appetite Containing (link)

Study 4 – Detection of Sibutramine in Adulterated Dietary Supplements Using (link)

Study 5 – Postprandial Effects of a Polyphenolic Grape Extract (PGE) (link)

Study 6 – Higher Eating Frequency Does Not Decrease Appetite in Healthy (link)

Study 7 – Comparison of the Satiating Properties of Egg- Versus Cereal Grain (link)

Study 8 – The Effects of a Low-Carbohydrate Diet on Appetite: A Randomized (link)

Study 9 – Consumption of Thylakoid-Rich Spinach Extract Reduces Hunger (link)

Study 10 – Acute Effects of a Spinach Extract Rich in Thylakoids on Satiety (link)

Study 11 – Gut Fat Signaling and Appetite Control with Special Emphasis (link)

Study 12 – Efficacy of Water Preloading Before Main Meals as a Strategy for (link)

Study 13 – Immediate Pre-Meal Water Ingestion Decreases Voluntary Food … (link)

Study 14 – Water Consumption Increases Weight Loss During a Hypocaloric (link)

Study 15 – Water Consumption Reduces Energy Intake at a Breakfast Meal (link)

Study 16 – Mild Dehydration Affects Mood in Healthy Young Women (link)

Study 17 – Satiety Effects of Psyllium in Healthy Volunteers (link)

Study 18 – Effects of a Viscous-Fibre Supplemented Evening Meal and the (link)

Study 19 – Decreasing Cardiovascular Risk Factors in Obese Individuals Using (link)

Study 20 – A-Galacto-Oligosaccharides Dose-Dependently Reduce Appetite (link)

Study 21 – Psyllium Fiber Improves Glycemic Control Proportional to Loss (link)

Study 22 – Slimming and Appetite-Suppressing Effects of Caraway Aqueous … (link)

Study 23 – Fennel (Foeniculum vulgare) and Fenugreek (Trigonella foenum- (link)

Study 24 – Fenugreek Seed Extract Selectively Reduces Spontaneous Fat Intake (link)

Study 25 – Psychotherapy for Transdiagnostic Binge Eating: A Randomized (link)

Study 26 – Reduced Reward-Driven Eating Accounts for the Impact of a (link)

Study 27 – Food for Thought: A Randomised Controlled Trial of Emotional (link)

Study 28 – Effect of Laser Acupuncture on Anthropometric Measurements (link)

Study 29 – The Effects of Auricular Acupuncture on Weight Reduction and (link)

Highly Viscous Fiber (PGX) Promotes Fullness

Source: Appetite. 2014 Jun;77:72-6. (link)

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Posted in Alternative Therapies, Diet and Weight Loss, Food and Drink

26 Comments & Updates to “Prescription 2016: Natural Appetite Suppressants”

  1. JP Says:

    Updated 05/30/16:


    Appetite. 2016 May 9. pii: S0195-6663(16)30176-3.

    Make up your mind about food: A healthy mindset attenuates attention for high-calorie food in restrained eaters.

    Attention bias for food could be a cognitive pathway to overeating in obesity and restrained eating. Yet, empirical evidence for individual differences (e.g., in restrained eating and body mass index) in attention bias for food is mixed. We tested experimentally if temporarily induced health versus palatability mindsets influenced attention bias for food, and whether restrained eating moderated this relation. After manipulating mindset (health vs. palatability) experimentally, food-related attention bias was measured by eye-movements (EM) and response latencies (RL) during a visual probe task depicting high-calorie food and non-food. Restrained eating was assessed afterwards. A significant interaction of mindset and restrained eating on RL bias emerged, β = 0.36, t(58) = 2.05, p = 0.045: A health mindset – as compared to a palatability mindset – attenuated attention bias for high-caloric food only in participants with higher eating restraint. No effects were observed on EM biases. The current results demonstrate that state differences in health versus palatability mindsets can cause attenuated attention bias for high-calorie food cues in participants with higher eating restraint. Our findings add to emerging evidence that state differences in mindsets can bias attention for food, above the influence of trait differences.

    Be well!


  2. JP Says:

    Updated 05/30/16:


    Am J Clin Nutr. 2016 May 11.

    Increased colonic propionate reduces anticipatory reward responses in the human striatum to high-energy foods.

    BACKGROUND: Short-chain fatty acids (SCFAs), metabolites produced through the microbial fermentation of nondigestible dietary components, have key roles in energy homeostasis. Animal research suggests that colon-derived SCFAs modulate feeding behavior via central mechanisms. In humans, increased colonic production of the SCFA propionate acutely reduces energy intake. However, evidence of an effect of colonic propionate on the human brain or reward-based eating behavior is currently unavailable.

    OBJECTIVES: We investigated the effect of increased colonic propionate production on brain anticipatory reward responses during food picture evaluation. We hypothesized that elevated colonic propionate would reduce both reward responses and ad libitum energy intake via stimulation of anorexigenic gut hormone secretion.

    DESIGN: In a randomized crossover design, 20 healthy nonobese men completed a functional magnetic resonance imaging (fMRI) food picture evaluation task after consumption of control inulin or inulin-propionate ester, a unique dietary compound that selectively augments colonic propionate production. The blood oxygen level-dependent (BOLD) signal was measured in a priori brain regions involved in reward processing, including the caudate, nucleus accumbens, amygdala, anterior insula, and orbitofrontal cortex (n = 18 had analyzable fMRI data).

    RESULTS: Increasing colonic propionate production reduced BOLD signal during food picture evaluation in the caudate and nucleus accumbens. In the caudate, the reduction in BOLD signal was driven specifically by a lowering of the response to high-energy food. These central effects were partnered with a decrease in subjective appeal of high-energy food pictures and reduced energy intake during an ad libitum meal. These observations were not related to changes in blood peptide YY (PYY), glucagon-like peptide 1 (GLP-1), glucose, or insulin concentrations.

    CONCLUSION: Our results suggest that colonic propionate production may play an important role in attenuating reward-based eating behavior via striatal pathways, independent of changes in plasma PYY and GLP-1.

    Be well!


  3. JP Says:

    Updated 05/30/16:


    Nutrients. 2016 Apr 18;8(4).

    No Effect of Exercise Intensity on Appetite in Highly-Trained Endurance Women.

    In endurance-trained men, an acute bout of exercise is shown to suppress post-exercise appetite, yet limited research has examined this response in women. The purpose of this study was to investigate the effect of exercise intensity on appetite and gut hormone responses in endurance-trained women. Highly-trained women (n = 15, 18-40 years, 58.4 ± 6.4 kg, VO2MAX = 55.2 ± 4.3 mL/kg/min) completed isocaloric bouts (500 kcals or 2093 kJ) of moderate-intensity (MIE, 60% VO2MAX) and high-intensity (HIE, 85% VO2MAX) treadmill running at the same time of day, following a similar 48-h diet/exercise period, and at least 1-week apart. Blood was drawn pre-exercise (baseline), immediately post-exercise and every 20-min for the next 60-min. Plasma concentrations of acylated ghrelin, PYY3-36, GLP-1 and subjective appetite ratings via visual analog scale (VAS) were assessed at each time point. Acylated ghrelin decreased (p = 0.014) and PYY3-36 and GLP-1 increased (p = 0.036, p < 0.0001) immediately post-exercise, indicating appetite suppression. VAS ratings of hunger and desire to eat decreased immediately post-exercise (p = 0.0012, p = 0.0031, respectively), also indicating appetite suppression. There were no differences between exercise intensities for appetite hormones or VAS. Similar to males, post-exercise appetite regulatory hormones were altered toward suppression in highly-trained women and independent of energy cost of exercise. Results are important for female athletes striving to optimize nutrition for endurance performance. Be well! JP

  4. Jazzy Says:

    Thank you for this post. I got excited over the spinach until I read..”humans cannot utilize thylakoids in unprocessed vegetables, since the thylakoids are stacked inside non-digestible plant cell walls” meaning a spinach supplement would need to be taken :(( Spinach powders are very expensive. Do you think juicing might be effective?

  5. JP Says:

    Hi Jazzy,

    Plant cell walls can be broken down by cooking and select processing techniques such as chopping, mashing and pureeing. Therefore, creamed spinach, spinach soup or wilted spinach seem like good options. My hunch is that blending whole spinach leaves (in a smoothie) would be a better way to go than juicing. When you blend, you don’t lose any of the fiber and phytochemicals. In each instance, I would add some form of fat to the mix as well – not because of the thylakoids, but to enhance the absorption of fat-soluble antioxidants and vitamins.

    Be well!


  6. Jazzy Says:

    Thank you, yes sorry I meant blended up in my nutribullet. The addition of baby spinach leaves in my occasional protein smoothie always had a satiating effect and now I know why. I will definitely do this more often. Thanks again, am reading through your archives, great information!

  7. JP Says:

    The Nutribullet should get the job done!

    Thanks for the question and positive feedback!

    Be well!


  8. Rob Says:

    I find that cooking makes most types of vegetables easier to digest. Good post

  9. JP Says:

    Thank you, Rob.

    That tends to be the case. Most forms of cooking render vegetables easier to digest – frying is an exception. Additionally, cooking tends to increase the bioavailability of certain nutrients and phytochemicals. There’s still an important role for raw fruits and vegetables due to their enzyme content, lower glycemic index and overall nutrient content. That’s why I try to mix it up.

    Be well!


  10. JP Says:

    Updated 06/17/16:


    Int J Food Sci Nutr. 2016 Jun 16:1-9.

    The effects of the combination of egg and fiber on appetite, glycemic response and food intake in normal weight adults – a randomized, controlled, crossover trial.

    This study evaluated appetite and glycemic effects of egg-based breakfasts, containing high and moderate protein (30 g protein and 20 g protein +7 g fiber, respectively) compared to a low-protein cereal breakfast (10 g protein) examined in healthy adults (N = 48; age 24 ± 1 yr; BMI 23 ± 1 kg/m2; mean ± SE). Meals provided 390 kcal/serving and equal fat content. Food intake was measured at an ad libitum lunch meal and blood glucose response was measured. Visual analog scales (VAS) were used to assess hunger, satisfaction, fullness, and prospective food intake. The egg-based breakfast meal with high protein produced greater overall satiety (p < 0.0001), and both high protein and moderate protein with fiber egg-based breakfasts reduced postprandial glycemic response (p < 0.005) and food intake (p < 0.05) at subsequent meal (by 135 kcal and 69 kcal; effect sizes 0.44 and 0.23, respectively) compared to a cereal-based breakfast with low protein and fiber. Be well! JP

  11. JP Says:

    Updated 06/30/16:


    Food Funct. 2016 Jun 29.

    Functional properties of spinach (Spinacia oleracea L.) phytochemicals and bioactives.

    Overwhelming evidence indicates that diets rich in fruits and vegetables are protective against common chronic diseases, such as cancer, obesity and cardiovascular disease. Leafy green vegetables, in particular, are recognized as having substantial health-promoting activities that are attributed to the functional properties of their nutrients and non-essential chemical compounds. Spinach (Spinacia oleracea L.) is widely regarded as a functional food due to its diverse nutritional composition, which includes vitamins and minerals, and to its phytochemicals and bioactives that promote health beyond basic nutrition. Spinach-derived phytochemicals and bioactives are able to (i) scavenge reactive oxygen species and prevent macromolecular oxidative damage, (ii) modulate expression and activity of genes involved in metabolism, proliferation, inflammation, and antioxidant defence, and (iii) curb food intake by inducing secretion of satiety hormones. These biological activities contribute to the anti-cancer, anti-obesity, hypoglycemic, and hypolipidemic properties of spinach. Despite these valuable attributes, spinach consumption remains low in comparison to other leafy green vegetables. This review examines the functional properties of spinach in cell culture, animals and humans with a focus on the molecular mechanisms by which spinach-derived non-essential phytochemicals and bioactives, such as glycolipids and thylakoids, impart their health benefits.

    Be well!


  12. JP Says:

    Updated 08/01/16:


    J Food Sci. 2016 Jul 29.

    High Protein Pasta is Not More Satiating than High Fiber Pasta at a Lunch Meal, Nor Does it Decrease Mid-Afternoon Snacking in Healthy Men and Women.

    This study compared satiety after high protein pasta (16 g protein, 6 g fiber), high fiber pasta (11 g protein, 8 g fiber) or control pasta (11 g protein, 6 g fiber) in a randomized, placebo-controlled, double-blind crossover trial. Participants were 36 healthy and men and women from the University of Minnesota campus. Fasted men and women ate calorie controlled, but macronutrient different pastas at 12:00 pm along with 500 mL of water. The primary outcome was satiety assessed by Visual Analogue Scales at 0, 15, 30, 45, 60, 90, 120, and 180 min daily after consuming the pastas. Secondary outcomes were calories consumed at an ad libitum snack at 3:00 pm, calories from food intake, gastrointestinal tolerance, and palatability. No differences were found among the pasta treatments for satiety, snacking, or gastrointestinal tolerance. Men ate significantly more calories for the rest of the (P = 0.007) after the high protein pasta versus the high fiber pasta (1701 ± 154 compared with 1083 ± 154) with control pasta being intermediate to the other treatments. No significant differences were found for gastrointestinal tolerance, but the palatability ratings showed the high protein pasta was less tasty (P = 0.03) and less pleasant (P = 0.01) than the other 2 pastas. Satisfaction was positively associated with pleasantness and negatively associated with aftertaste. Our results do not support the idea that high protein or high fiber pasta produces a greater satiety response compared to pasta with lower amounts of either nutrient. It is likely that since pasta is already a very satiating food, the subjects were unable to differentiate between the 3 conditions.

    Be well!


  13. JP Says:

    Updated 08/16/16:


    Am J Clin Nutr. 2016 Aug 10.

    Epicatechin, procyanidins, cocoa, and appetite: a randomized controlled trial.

    BACKGROUND: In 2 randomized controlled trials, it was reported that dark chocolate acutely decreased appetite in human subjects, but the authors did not assess the types or concentrations of cocoa compounds that are needed. Other studies have suggested that the cocoa compounds epicatechin and procyanidins may be involved.

    OBJECTIVE: We sought to test the hypotheses that, compared with placebo (an alkalized cocoa mixture containing essentially no epicatechin or procyanidins), the following beverages cause a decrease in appetite: 1) a nonalkalized cocoa mixture; 2) epicatechin plus placebo; and 3) procyanidins plus placebo. We measured the concentrations of cocoa compounds in all beverages.

    DESIGN: We used a 4-way randomized, crossover, placebo-controlled trial that was balanced for period and carryover effects in 28 healthy, young-adult men. We also conducted a smaller (n = 14), parallel, secondary randomized trial in which we explored the effects of higher doses of epicatechin and procyanidins. Our primary measure of appetite was ad libitum pizza intake 150 min after beverage ingestion. We used a linear mixed-model analysis.

    RESULTS: Intakes of beverages with the nonalkalized cocoa mixture that contained 0.6 mg epicatechin, 0.2 mg catechin, and 2.9 mg monomer-decamer procyanidins/kg body weight did not decrease pizza intake significantly (P = 0.29) compared with intake of the placebo. In the smaller secondary trial, a combination of epicatechin and the nonalkalized cocoa mixture that contained 1.6 mg epicatechin/kg body weight significantly decreased pizza intake by 18.7% (P = 0.04).

    CONCLUSIONS: Our nonalkalized cocoa mixture was associated with an acute decrease in food intake only after being supplemented with epicatechin. It is possible that epicatechin at a dose of >1.6 mg/kg body weight, alone or in concert with appropriate catalytic cocoa compounds, may be useful for helping people control their food intakes.

    Be well!


  14. JP Says:

    Updated 08/30/16:


    Nutrients. 2016 Aug 26;8(9). pii: E524.

    Effect of Consuming Oat Bran Mixed in Water before a Meal on Glycemic Responses in Healthy Humans-A Pilot Study.

    BACKGROUND: Viscous dietary fibers including oat β-glucan are one of the most effective classes of functional food ingredients for reducing postprandial blood glucose. The mechanism of action is thought to be via an increase in viscosity of the stomach contents that delays gastric emptying and reduces mixing of food with digestive enzymes, which, in turn, retards glucose absorption. Previous studies suggest that taking viscous fibers separate from a meal may not be effective in reducing postprandial glycemia.

    METHODS: We aimed to re-assess the effect of consuming a preload of a commercially available oat-bran (4.5, 13.6 or 27.3 g) containing 22% of high molecular weight oat β-glucan (O22 (OatWell®22)) mixed in water before a test-meal of white bread on glycemic responses in 10 healthy humans.

    RESULTS: We found a significant effect of dose on blood glucose area under the curve (AUC) (p = 0.006) with AUC after 27.3 g of O22 being significantly lower than white bread only. Linear regression analysis showed that each gram of oat β-glucan reduced glucose AUC by 4.35% ± 1.20% (r = 0.507, p = 0.0008, n = 40) and peak rise by 6.57% ± 1.49% (r = 0.582, p < 0.0001). CONCLUSION: These data suggest the use of oat bran as nutritional preload strategy in the management of postprandial glycemia. Be well! JP

  15. JP Says:

    Updated 12/16/16:


    J Nutr Sci Vitaminol (Tokyo). 2016;62(5):288-294.

    Thorough Mastication Prior to Swallowing Increases Postprandial Satiety and the Thermic Effect of a Meal in Young Women.

    There is evidence to support that mastication may contribute to the prevention of weight gain via reduction of appetite sensations and subsequent energy intake. However, the metabolic effect of mastication after consumption of a daily meal, composed of the staple food (rice), soup, main and side dishes, is limited. Therefore, the effect of thorough mastication on greater satiety and the thermic effect of a meal (TEM) was investigated in young women. In study 1, energy expenditure (EE) derived from masticatory muscle activity for 20 min was measured while chewing hard, tasteless, non-caloric gum in seven subjects. In study 2, ten subjects consumed a solid meal performing 30 chews per mouthful (30 CPM), or swallowed the same, pureed meal without chewing (0 CPM) on two separate days, and postprandial EE, substrate oxidation, subjective appetite ratings and autonomic nervous system (ANS) activity for 3 h were examined. Both test meals were iso-caloric (2,510 kJ) and -weighted (884 g), and consumed in 20 min. From study 1, the EE of mastication itself for the 20 min was estimated to be 3.7±0.8 kJ. From study 2, significantly higher TEM (134.2±15.5 vs. 67.8±13.8 kJ/3 h, p<0.001) as well as satiety (p=0.005), and tendency toward greater fat oxidation (p=0.090) and ANS activity (p=0.069) were observed after consumption of the meal with 30 CPM compared to 0 CPM. In conclusion, thorough mastication before swallowing increased postprandial satiety and the TEM in young women, suggesting such eating behavior may be useful for preventing obesity.

    Be well!


  16. JP Says:

    Updated 01/08/17:


    Appetite. 2017 Feb 1;109:124-130.

    An exploratory study of Mindfulness Based Stress Reduction for emotional eating.

    Emotional eating is an important predictor of weight loss and weight regain after weight loss. This two part study’s primary aim was to explore changes in emotional eating in a general population of individuals taking the Mindfulness Based Stress Reduction (MBSR) program, with a secondary aim to explore whether changes in mindfulness predicted changes in emotional eating. Self-reported survey data exploring these questions were collected before and after the intervention for two sequential studies (Study 1 and Study 2). While there were no control groups for either study, in both studies emotional eating scores following the MBSR were significantly lower than scores prior to taking the MBSR (p < 0.001; p < 0.001) In Study 2, changes in mindfulness were correlated with changes in emotional eating (r = 0.317, p = 0.004). These results suggest that MBSR may be an effective intervention for emotional eating, and that further research is warranted to examine effects on weight loss and maintenance. Be well! JP

  17. JP Says:

    Updated 01/30/17:


    Nutrients 2017, 9(2), 89

    Consuming Two Eggs per Day, as Compared to an Oatmeal Breakfast, Increases Plasma Ghrelin while Maintaining the LDL/HDL Ratio

    Abstract: Eggs contain high quality protein, vitamins, minerals and antioxidants, yet regular consumption is still met with uncertainty. Therefore, the purpose of this study was to compare the effects of consuming two eggs per day or a heart-healthy oatmeal breakfast on biomarkers of cardiovascular disease (CVD) risk and satiety measures in a young, healthy population. Fifty subjects participated in a randomized crossover clinical intervention; subjects were randomly allocated to consume either two eggs or one packet of oatmeal per day for breakfast for four weeks. After a three-week washout period, participants were allocated to the alternative breakfast. Fasting blood samples were collected at the end of each intervention period to assess plasma lipids and plasma ghrelin. Subjects completed visual analog scales (VAS) concurrent to dietary records to assess satiety and hunger. Along with an increase in cholesterol intake, there were significant increases in both low-density lipoprotein (LDL) and high-density lipoprotein (HDL) cholesterol following the egg consumption period (p < 0.01). However, there was no difference in the LDL/HDL ratio, a recognized biomarker of CVD risk, nor in the plasma glucose, triglycerides or liver enzymes, between diet periods. Several self-reported satiety measures were increased following the consumption of eggs, which were associated with lower plasma ghrelin concentrations (p < 0.05). These results demonstrate that compared to an oatmeal breakfast, two eggs per day do not adversely affect the biomarkers associated with CVD risk, but increase satiety throughout the day in a young healthy population. Be well! JP

  18. JP Says:

    Updated 01/31/17:


    Nutrients 2017, 9(2), 91

    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.

    Be well!


  19. JP Says:

    Updated 04/18/17:


    Nutr Health. 2017 Jan 1:260106017704361.

    The acute effects of baobab fruit ( Adansonia digitata) on satiety in healthy adults.

    BACKGROUND: The baobab fruit is high in both dietary fibre and polyphenols and therefore may increase satiety. The aim of the study was to measure the effects of baobab fruit extract on satiety.

    METHODS: The study was conducted on 20 healthy participants. The study was a one-day single-blind crossover design. Participants were randomised to either a test smoothie consisting of 15 g of baobab extract or a control smoothie without the addition of baobab. Subjective ratings of satiety were taken on visual analogue scales immediately pre-consumption and then post-consumption, and energy intake at a post ad libitum meal was recorded.

    RESULTS: Subjective measures of hunger were reduced following the test smoothie compared with the control ( p < 0.05). There was no significant difference in calorie intake at an ad libitum meal. CONCLUSIONS: This research has positive implications for the use of baobab for reducing hunger, possibly having a positive effect on weight maintenance. Be well! JP

  20. JP Says:

    Updated 05/01/17:


    Nutr Healthy Aging. 2017 Mar 31;4(2):157-168.

    Ratios of soluble and insoluble dietary fibers on satiety and energy intake in overweight pre- and postmenopausal women.

    BACKGROUND: Fibers’ properties impact different mechanisms involved in satiety and energy intake regulation and metabolic outcomes. OBJECTIVE: Evaluate the effect of fiber types and menopausal status on satiety and metabolic responses in overweight women. METHODS: In a randomized within-subjects design, 19 overweight/obese women [9 premenopausal and 10 postmenopausal] consumed 3 preloads that varied by fiber content and source: 1) 3:1 ratio of soluble:insoluble fiber (SF), 2) 1:3 ratio of soluble:insoluble fiber (IF), 3) no fiber control (NFC). Subjective satiety, cholecystokinin (CCK), glucose, insulin, and triglyceride (TG) were measured for 3 h post-preload followed by in-lab ad libitum test meal and 32 hour food intake monitoring. RESULTS: Significant preload, time and preload by menopausal status interaction was apparent for hunger and fullness (p < 0.05 for both) with SF preload predominantly more satiating in postmenopausal women. CCK and insulin were significantly lower after SF preload (p < 0.0001 for both). Post-preload glucose responses differed by menopausal status: postmenopausal women distinguished between fiber types unlike premenopausal women (p = 0.02). TG was significantly elevated after the IF preload compared to NFC and SF (p = 0.007 and p = 0.008, respectively).CONCLUSIONS: Customized/personalized dietary recommendations for women during their premenopausal and postmenopausal years can help maximize metabolic and appetite control. Be well! JP

  21. JP Says:

    Updated 06/19/17:


    J Evid Based Complementary Altern Med. 2017 Jan 1:2156587217707143.

    Modified Qigong Breathing Exercise for Reducing the Sense of Hunger on an Empty Stomach.

    BACKGROUND: The aims of this study were to determine whether a modified Qigong breathing exercise can reduce the sense of hunger and identify possible mechanisms.

    METHODS: The results from the test group, which performed the exercise, are compared with the control group, which performed deep breathing. Intestinal pressure measurements, stomach pH monitoring, and participant surveys were used for assessment.

    RESULTS: Stomach pH was increased by 3 (0.2) and intestinal pressure was reduced by 12 (0.5) mm Hg in the experimental group and did not change significantly in the control group. The study provides strong evidence that the exercise can significantly reduce, or even suppress the sense of hunger on an empty stomach.

    CONCLUSION: This breathing exercise provides comfort in different circumstances, such as lack of regular meals, limited volume or caloric diet, and even during temporary complete absence of food in therapeutic fasting.

    Be well!


  22. JP Says:

    Updated 07/13/17:


    Physiol Behav. 2017 Jul 6.

    Coconut oil has less satiating properties than medium chain triglyceride oil.

    It is well established that the consumption of medium-chain triglycerides (MCT) can increase satiety and reduce food intake. Many media articles promote the use of coconut oil for weight loss advocating similar health benefits to that of MCT. The aim of this study was to examine the effect of MCT oil compared to coconut oil and control oil on food intake and satiety. Following an overnight fast, participants consumed a test breakfast smoothie containing 205kcal of either (i) MCT oil (ii) coconut oil or (iii) vegetable oil (control) on three separate test days. Participants recorded appetite ratings on visual analogue scales and were presented with an ad libitum lunch meal of preselected sandwiches 180min after consumption of the breakfast. The results showed a significant difference in energy and macronutrient intakes at the ad libitum meal between the three oils with the MCT oil reducing food intake compared to the coconut and control oil. Differences in food intake throughout the day were found for energy and fat, with the control having increased food intake compared to the MCT and coconut. The MCT also increased fullness over the three hours after breakfast compared to the control and coconut oils. The coconut oil was also reported as being less palatable than the MCT oil. The results of this study confirm the differences that exist between MCT and coconut oil such that coconut oil cannot be promoted as having similar effects to MCT oil on food intake and satiety.

    Be well!


  23. JP Says:

    Updated 08/01/17:


    Food Nutr Res. 2017 Jul 2;61(1):1341808.

    Acute fiber supplementation with inulin-type fructans curbs appetite sensations: a randomized, double-blind, placebo-controlled study.

    Background: Research points to a benefit of inulin fiber on appetite and weight regulation but results remain mixed. Objectives: To test the impact of 16 g/d of Inulin-type fructans (ITFs) on appetite and food intake in acute settings. Design: Forty college age females received either a fiber drink with 16 g of ITFs in 330 ml water or placebo. On the 8th day of the study, appetite sensations were assessed using visual analogue scale (VAS) along with food intake. Repeated-measures ANOVA were performed comparing VAS ratings during test day. Energy consumption was compared using paired t-tests. Significance was determined at p<0.05. Results: On the 8th day, the fiber group reported lower ratings for hunger, desire to eat, and prospective food consumption with significantly higher ratings for satisfaction and fullness. Subsequently, the fiber group consumed 21% less kcal from food at lunch (453 ± 47 kcal) compared to controls (571 ± 39 kcal) (p<0.05). Conclusions: Consuming 16 g/d of ITFs in the morning for 7 days, and after an overnight fast, curbed appetite sensations and helped reduce food intake during lunch meal. These findings highlight the potential of using ITFs in weight management. Future studies should explore ITFs long term benefits.

    Be well!


  24. JP Says:

    Updated 10/02/17:


    Appetite. 2017 Sep 25.

    Effects of 3-week total meal replacement vs. typical food-based diet on human brain functional magnetic resonance imaging food-cue reactivity and functional connectivity in people with obesity.

    OBJECTIVES: Calorie restriction via total meal replacement (TMR) results in greater reduction of food cravings compared to reduced-calorie typical diet (TD). Direct evidence of the impact of these interventions on human brain fMRI food-cue reactivity (fMRI-FCR) and functional connectivity is absent. We examined the effects of a 3-week 1120 kcal/d TMR intervention as compared to an iso-caloric TD intervention using an fMRI-FCR paradigm.

    METHODS: Thirty-two male and female subjects with obesity (19-60 years; 30-39.9 kg/m2) participated in a randomized two-group repeated measures dietary intervention study consisting of 1120 kcal/d from either 1) TMR (shakes), 2) TD (portion control). Pre-intervention and following the 3-week diet fMRI FCR, functional connectivity, food cravings (Food Craving Inventory) and weight were considered.

    RESULTS: Compared to TD, TMR showed increased fMRI-FCR of the bilateral dorsolateral prefrontal (dlPFC), orbitofrontal, anterior cingulate, primary motor and left insular cortices and bilateral nucleus accumbens regions in the post-intervention state relative to the pre-intervention state. Compared to TD, TMR was also associated with negative modulation of fMRI-FCR of the nucleus accumbens, orbitofrontal cortex and amygdala by dlPFC. Reduced body weight (4.87 kg, P < 0.001), body fat (2.19 kg, P = 0.004) and overall food cravings (0.41, P = 0.047) were seen in the TMR group. In the TD group reduced body weight (2.37 kg, P = 0.004) and body fat (1.64 kg, P = 0.002) were noted. Weight loss was significantly greater in TMR versus TD (2.50 kg, P = 0.007). CONCLUSIONS: Greater weight loss and reduced cravings, coupled with stronger activations and potential negative modulation of the food reward related regions by the dlPFC during exposure to visual food cues is consistent with increased executive control in TMR vs. TD. Be well! JP

  25. JP Says:

    Updated 10/06/17:


    J Diet Suppl. 2017 Oct 5:1-10.

    Effects of n-3 Polyunsaturated Fatty Acid Supplementation on Serum Leptin Levels, Appetite Sensations, and Intake of Energy and Macronutrients in Obese People: A Randomized Clinical Trial.

    Obesity is a common health problem. Appetite is one of the main obesity-controlling factors that can be influenced by leptin. Leptin reduces food intake and accelerates energy expenditure. Leptin levels can be affected by dietary factors such as fats, special amino acids, and fructose. This study aimed to determine the effects of polyunsaturated fatty acid n-3 (PUFA n-3) supplementation on serum leptin levels, appetite sensations, and dietary intakes in obese people. This study was performed on 60 obese individuals with body mass index (BMI) 30 (kg/m2) and above in 2012 in Tabriz, Iran. The participants were randomly allocated to the intervention (consumed two capsules containing 1 g/day n-3 fatty acids [180 mg EPA, 120 mg DHA] for 4 weeks) and control groups. Serum leptin levels were assessed by ELISA method, and visual analogue scale (VAS) questionnaire was completed for evaluating appetite sensations. The mean caloric [before = 1,575.39 (600), after = 1,236.14 (448.40)] and macronutrient intakes were decreased significantly in the intervention group (p < .05). After adjusting for baseline serum leptin levels, age, and gender values, the fullness item significantly increased in the intervention group [before = 2 (1-5), after = 3 (1-5), p = .034]. In addition, BMI decreased and serum leptin levels increased nonsignificantly in the intervention group. According to the results, PUFA n-3 decreased energy and macronutrient intakes, probably through the modulating of satiety. The short period of study caused the nonsignificant changes in BMI and circulatory leptin. Further studies are needed to confirm these results.

    Be well!


  26. JP Says:

    Updated 11/24/17:


    Endocr Connect. 2017 Nov 20.

    Effects of walking in water on gut hormone concentration and appetite: comparison with walking on land.

    The effects of water exercise on gut hormone levels and appetite currently remain unclear. The aim of the present study was to investigate the effects of treadmill walking in water on gut hormone levels and appetite. Thirteen men (mean±S.D. age: 21.6±2.2 years, body mass index: 22.7±2.8 kg/m2, peak oxygen uptake (VO2peak): 49.8±7.8 ml/kg per min) participated in the walking in water and on land challenge. During the study period, ratings of subjective feelings of hunger, fullness, satiety, and motivation to eat were reported on a 100-mm visual analogue scale. A test meal was presented after walking, and energy intake (EI) was calculated. Blood samples were obtained during both trials to measure glucagon-like peptide-1 (GLP-1), peptide YY (PYY), and acylated ghrelin (AG) levels. Hunger scores (How hungry do you feel?) were significantly lower during the water trial than during the land trial (P < 0.05). No significant differences were observed in EI between the water and land trials. GLP-1 levels were significantly higher in the water trial than in the land trial (P < 0.05). No significant differences were observed in PYY levels between the water and land trials. AG levels were significantly lower in the water trial than in the land trial (P < 0.01). In conclusion, changes in gut hormone levels during walking in water contribute to the exercise-induced suppression of appetite, and provide novel information on the influence of walking in water on the acute regulation of appetite. Be well! JP

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