Can a Higher Protein/Low Glycemic Index vs. a Conventional Diet Attenuate Changes in Appetite and Gut Hormones Following Weight Loss? A 3-Year PREVIEW Sub-study

Marion E C Buso; Radhika V Seimon; Sally McClintock; Roslyn Muirhead; Fiona S Atkinson; Shannon Brodie; Jarron Dodds; Jessica Zibellini; Arpita Das; Anthony L Wild-Taylor; Jessica Burk; Mikael Fogelholm; Anne Raben; Jennie C Brand-Miller; Amanda Sainsbury

doi:10.3389/fnut.2021.640538

Can a Higher Protein/Low Glycemic Index vs. a Conventional Diet Attenuate Changes in Appetite and Gut Hormones Following Weight Loss? A 3-Year PREVIEW Sub-study

Front Nutr. 2021 Mar 22:8:640538. doi: 10.3389/fnut.2021.640538. eCollection 2021.

Authors

Marion E C Buso^{1

2}, Radhika V Seimon², Sally McClintock², Roslyn Muirhead³, Fiona S Atkinson³, Shannon Brodie³, Jarron Dodds², Jessica Zibellini², Arpita Das³, Anthony L Wild-Taylor², Jessica Burk², Mikael Fogelholm⁴, Anne Raben^{5

6}, Jennie C Brand-Miller³, Amanda Sainsbury⁷

Affiliations

¹ Division of Human Nutrition and Health, Wageningen University, Wageningen, Netherlands.
² The Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Camperdown, NSW, Australia.
³ School of Life and Environmental Sciences and Charles Perkins Centre, The University of Sydney, Camperdown, NSW, Australia.
⁴ Department of Food and Environmental Sciences, University of Helsinki, Helsinki, Finland.
⁵ Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark.
⁶ Steno Diabetes Center Copenhagen, Copenhagen, Denmark.
⁷ School of Human Sciences, Faculty of Science, The University of Western Australia, Crawley, WA, Australia.

Abstract

Background: Previous research showed that weight-reducing diets increase appetite sensations and/or circulating ghrelin concentrations for up to 36 months, with transient or enduring perturbations in circulating concentrations of the satiety hormone peptide YY. Objective: This study assessed whether a diet that is higher in protein and low in glycemic index (GI) may attenuate these changes. Methods: 136 adults with pre-diabetes and a body mass index of ≥25 kg/m² underwent a 2-month weight-reducing total meal replacement diet. Participants who lost ≥8% body weight were randomized to one of two 34-month weight-maintenance diets: a higher-protein and moderate-carbohydrate (CHO) diet with low GI, or a moderate-protein and higher-CHO diet with moderate GI. Both arms involved recommendations to increase physical activity. Fasting plasma concentrations of total ghrelin and total peptide YY, and appetite sensations, were measured at 0 months (pre-weight loss), at 2 months (immediately post-weight loss), and at 6, 12, 24, and 36 months. Results: There was a decrease in plasma peptide YY concentrations and an increase in ghrelin after the 2-month weight-reducing diet, and these values approached pre-weight-loss values by 6 and 24 months, respectively (P = 0.32 and P = 0.08, respectively, vs. 0 months). However, there were no differences between the two weight-maintenance diets. Subjective appetite sensations were not affected by the weight-reducing diet nor the weight-maintenance diets. While participants regained an average of ~50% of the weight they had lost by 36 months, the changes in ghrelin and peptide YY during the weight-reducing phase did not correlate with weight regain. Conclusion: A higher-protein, low-GI diet for weight maintenance does not attenuate changes in ghrelin or peptide YY compared with a moderate-protein, moderate-GI diet. Clinical Trial Registry: ClinicalTrials.gov registry ID NCT01777893 (PREVIEW) and ID NCT02030249 (Sub-study).

Keywords: appetite; ghrelin; gut hormones; peptide YY; weight maintenance.

Associated data

ClinicalTrials.gov/NCT01777893
ClinicalTrials.gov/NCT02030249