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PubMed2006

Cerebral processing of food-related stimuli: effects of fasting and gender.

To maintain nutritional homeostasis, external food-related stimuli have to be evaluated in relation to the internal states of hunger or satiety. To examine the neural circuitry responsible for integration of internal and external determinants of human eating behaviour, brain responses to visual and complex gustatory food-related stimuli were measured using functional magnetic resonance imaging in 18 healthy non-smokers (10 women, 8 men). Each individual was studied on two occasions, the order of which was counterbalanced; after eating as usual and after 24 h fasting. Raised plasma free fatty acids and lower insulin and leptin concentrations confirmed that participants fasted as requested. When fasted, participants reported more hunger, nervousness and worse mood and rated the visual (but not gustatory) food-related stimuli as more pleasant. The effect of fasting on hunger was stronger in women than in men. No circuitry was identified as differentially responsive in fasting compared to satiety to both visual and gustatory food-related stimuli. The left insula response to the gustatory stimuli was stronger during fasting. The inferior occipito-temporal response to visual food-related stimuli also tended to be stronger during fasting. The responses in the occipito-temporal cortex to visual and in the insula to gustatory stimuli were stronger in women than in men. There was no interaction between gender and fasting. In conclusion, food reactivity in modality-specific sensory cortical areas is modulated by internal motivational states. The stronger reactivity to external food-related stimuli in women may be explored as a marker of gender-related susceptibility to eating disorders.

Adult↗
PubMed2026

Preoperative Carbohydrate Supplementation Reduces Thirst and Improves Patient Satisfaction Before Elective Cesarean Delivery: A Randomized Controlled Trial.

BACKGROUND & AIMS: Prolonged preoperative fasting is a major source of patient discomfort, particularly thirst, before elective cesarean delivery. This study aimed to evaluate whether preoperative carbohydrate (CHO) supplementation could alleviate these discomforts and improve patient satisfaction without compromising safety. METHODS: In this single-center randomized controlled trial, 262 women scheduled for elective cesarean delivery under neuraxial anesthesia were randomly allocated to either the CHO group (Group CHO, n = 131), which received 355 mL of an oral carbohydrate solution on the night before and the morning of surgery, or the control group (Group C, n = 131), which followed conventional fasting. The primary outcome was the thirst Numeric Rating Scale (NRS, 0-10) score measured immediately before surgery. Secondary outcomes included hunger NRS, satisfaction NRS, and maternal and neonatal safety parameters. RESULTS: Baseline characteristics were comparable between groups. Despite a longer preoperative fasting duration in Group CHO (9.25 &#xb1; 1.05 vs. 8.74 &#xb1; 0.97 h, P < 0.001), this group exhibited significantly lower thirst NRS scores (1.69 &#xb1; 0.90 vs. 4.02 &#xb1; 0.99, P < 0.001) and hunger NRS scores (1.25 &#xb1; 0.94 vs. 2.09 &#xb1; 0.82, P < 0.001), as well as higher satisfaction NRS scores (7.70 &#xb1; 0.69 vs. 5.69 &#xb1; 1.17, P < 0.001). Subgroup analyses confirmed consistent benefits of CHO supplementation across most patient characteristics. Further analyses suggested that the maximum effect on thirst reduction occurred at approximately 9.2 h of solid fasting; however, the interaction between fasting duration and treatment group was not statistically significant (P = 0.187). CONCLUSION: Preoperative carbohydrate supplementation effectively reduces thirst and hunger and improves patient satisfaction before elective cesarean delivery without increasing maternal or neonatal risk. The beneficial effects were consistent across varying fasting durations, with exploratory spline analyses suggested a potential peak effect around 9.2 h, though this was not statistically significant and should be interpreted cautiously. These findings support the incorporation of carbohydrate loading into enhanced recovery protocols. TRIAL REGISTRATION: China Clinical Trial Registry ChiCTR2500097956.

Humans↗
PubMed2003

An examination of at-home food preparation activity among low-income, food-insecure women.

A secondary analysis of data from a study of nutritional vulnerability among 153 women in families seeking charitable food assistance was undertaken to estimate the extent and nutritional significance of at-home food preparation activity for these women. At-home food preparation was estimated from women's reported food intakes from three 24-hour recalls. The relationships between food preparation and energy and nutrient intake, food intake, and 30-day household food security status were characterized. Almost all participants (97%) consumed foods prepared from scratch at least once during the three days of observation; 57% did so each day. Both the frequency and complexity of at-home food preparation were positively related to women's energy and nutrient intakes and their consumption of fruits and vegetables, grain products, and meat and alternates. The intakes by women in households with food insecurity with hunger reflected less complex food preparation but no less preparation from scratch than women in households where hunger was not evident, raising questions about the extent to which food skills can protect very poor families from food insecurity and hunger. Our findings indicate the need for nutrition professionals to become effective advocates for policy reforms to lessen economic constraints on poor households.

Adult↗
PubMed2004

Increasing the portion size of a sandwich increases energy intake.

OBJECTIVE: This study investigated the effect on energy intake of increasing the portion size of a food served as a discrete unit. DESIGN: A within-subject design with repeated measures was used. SUBJECTS/SETTING: The sample comprised 75 young adults (37 females and 38 males) from a university community. INTERVENTION: Individuals ate lunch in the lab once a week for 4 weeks. Each week, they were served one of four sizes of a deli-style sandwich (6, 8, 10, or 12 inches), of which they could eat as much as they wanted. MAIN OUTCOME MEASURES: Energy intakes were determined for each meal, as were ratings of hunger and satiety before and after each meal. STATISTICAL ANALYSES PERFORMED: A linear mixed model with repeated measures was used. The influence of subject characteristics was examined using analysis of covariance. RESULTS: The portion size of the sandwich significantly influenced lunch intake for both males and females (P<.0001). The majority of individuals consumed the entire 6-inch sandwich. When served the 12-inch sandwich, compared with the 8-inch sandwich, females consumed 12% more energy (74 kcal) and males consumed 23% more energy (186 kcal). Despite these differences, ratings of hunger and fullness were not significantly different after eating the 12-inch and 8-inch sandwiches. APPLICATIONS/CONCLUSIONS: These results suggest that increasing the portion size of a food served as a discrete unit leads to increased energy intake at a single meal without differentially influencing ratings of hunger and satiety. Dietitians should educate their clients about strategies to moderate the effect on intake of increased portions of high-calorie foods.

Adult↗
PubMed2006

Higher satiety ratings following yogurt consumption relative to fruit drink or dairy fruit drink.

OBJECTIVES: To compare the satiating power of semisolid and liquid yogurts with fruit beverages and dairy fruit drinks. DESIGN AND PROCEDURES: Thirty-two volunteers (16 men and 16 women), ages 18 to 35 years, consumed a 200-kcal preload stimulus on four separate occasions. A tray lunch was presented 90 minutes after the preload and food consumption was measured. METHODS: The stimuli were: a semisolid yogurt containing pieces of peach and eaten with a spoon (378 g), the same yogurt in a drinkable homogenized form (378 g), a peach-flavored dairy beverage (400 mL), and a peach juice beverage (400 mL). Participants rated hunger, thirst, satiety, and desire to eat at baseline and at 20-minute intervals after ingestion. RESULTS: The two yogurts (semisolid and liquid) led to lower hunger and higher fullness ratings as compared with the fruit drink or dairy fruit drink. There was no difference in satiety profiles between the yogurt that was eaten with a spoon and the drinkable version. Energy intakes at lunch were the same across all four conditions (mean+/-standard deviation, 806+/-43 kcal). CONCLUSIONS: The two yogurts were more satiating than the two beverages. However, lower hunger and higher fullness ratings after yogurt consumption did not lead to energy compensation at the next meal.

Adolescent↗
PubMed2005

Effect of pioglitazone on body composition and energy expenditure: a randomized controlled trial.

BACKGROUND: Several clinical studies have demonstrated that body weight increases after treatment with thiazolidinediones (TZDs). Prior studies have demonstrated an increase in insulin-stimulated lipid storage in adipose tissue. Some, but not all, studies demonstrate reductions in visceral adipose tissue. Changes in body weight are the result of changes in energy intake, energy expenditure, or both. OBJECTIVES: Based on these findings, the primary aim of this study was to evaluate the effect of TZDs on visceral, subcutaneous, and total body fat. Secondary aims were to determine the effects of pioglitazone on (a) energy expenditure, (b) hunger and satiety, (c) blood lipids, and (d) the role of insulinemia/sulfonylurea usage on weight gain in patients with type 2 diabetes. SUBJECTS AND METHODS: We performed a randomized, double-blind, placebo-controlled trial in 48 men and women with type 2 diabetes who had not previously received treatment with TZDs. Patients were treated for 24 weeks with 45 mg/d of pioglitazone or a matching placebo. Body composition was measured by dual-energy x-ray absorptiometry. Visceral and subcutaneous fat were measured by computed tomography. Resting metabolic rate and thermogenic response to a test meal were measured by indirect calorimetry before and after a standardized meal. Hunger and satiety were measured with visual analog scales before and after the same test meal. Blood was collected for the measurement of fasting glucose and insulin levels, hemoglobin A 1c levels, and lipid content. RESULTS: Pioglitazone treatment resulted in a decrease in hemoglobin A(1c) level by 0.96 +/- 1.1% vs 0.11 +/- 0.8% in the placebo group (P < .005). Body weight and fat increased steadily in the patients treated with pioglitazone during the 6 months of the study (+3.9 +/- 3.1 kg at 6 months in pioglitazone-treated patients vs -0.8 +/- 3.4 kg in the placebo-treated patients). Subcutaneous fat in the trunk, arms, and legs were all increased in the pioglitazone-treated group. Visceral fat did not change significantly in either group. Neither resting metabolic rate nor the thermogenic responses to a meal were altered by pioglitazone. Subjective measures of hunger (visual analog scale) did not change with pioglitazone treatment. Triglycerides fell in the pioglitazone-treated group (-58.5 +/- 124 mg/dL, P < .003). Neither the prior use of sulfonylureas nor the level of insulinemia before treatment was a predictor of weight or fat change. CONCLUSION: Pioglitazone increased subcutaneous body fat, but not visceral fat. There was no measurable effect on energy expenditure or hunger/satiety. In contrast to the placebo-treated patient with diabetes, weight gain occurs in the face of falling hemoglobin A(1c) and triglyceride levels.

Adult↗
PubMed2004

Dietary restraint and heightened reactivity to food.

Previously, studies have explored the relationship between dietary behavior and salivary reactivity to food. Despite this, it remains unclear which behaviors are associated with enhanced reactivity. One problem is that measures of behavior have not been compared directly. In particular, it is unclear whether elevated reactivity is associated with measures of dietary restraint or with measures of failed dietary control and a tendency to overeat. To address this problem, we compared the association between salivary reactivity and scores on the subscales of the Three-Factor Eating Questionnaire (restraint, disinhibition, and hunger). Estimates of reactivity were derived from the difference between a baseline saliva measure and a similar measure taken in close proximity to hot pizza. Our second aim was to explore how salivary reactivity changes after a meal. Female participants (N=40) were tested before and after a lunch (cheese sandwiches). All tended to show reactivity to pizza before but not after lunch. No significant differences were associated with the disinhibition or hunger subscales. However, prelunch reactivity was significantly greater in those participants with high scores on the restraint scale. This does not appear to be related to reported levels of hunger before lunch. Rather, it may reveal an intrinsic difference between the reaction of restrained and unrestrained eaters to food.

Adolescent↗
PubMed2002

A transient surge of ghrelin secretion before feeding is modified by different feeding regimens in sheep.

Ghrelin is a recently identified orexigenic hormone secreted by the stomach and has been implicated in meal-time hunger. Several experiments demonstrate a transient surge in ghrelin secretion shortly before a scheduled meal, suggesting from the involvement of cephalic mechanisms. If ghrelin secretion is stimulated by hunger in sheep, plasma levels of ghrelin should be modified by different feeding regimens that affect hunger drive. To test this hypothesis, we investigated changes in plasma ghrelin concentrations in fed Suffolk rams ad libitum and in rams either twice or four times daily. Plasma ghrelin levels increased (P<0.05) abruptly just before every feeding period in sheep fed twice and four times daily and then fell shortly after feeding. Peak levels of the pre-prandial ghrelin surge were higher (P<0.01) in animals fed twice daily than in animals fed four times daily, leading to greater (P<0.05) areas under response curves over 12h. In contrast, the plasma ghrelin levels remained relatively low and constant in sheep fed ad libitum, with no evidence of surges in plasma ghrelin levels. These results confirm that the transient surge in plasma ghrelin levels occurs just before feeding and demonstrate that this can be modified by the feeding regimen in sheep.

Animals↗
PubMed2002

Development and preliminary validation of a silhouette satiety scale for children.

The purpose of this study was to determine whether young children are capable of using pictorial silhouettes to quantify feelings of satiety and provide preliminary data on the validity of this method. Subjects were 20 children, 4-6 years old, recruited from a preschool. We hypothesized that subjects would be able to use the silhouettes to communicate different levels of satiety when imagining eating situations associated with different levels of fullness. The study was conducted in three stages: Stage 1 probed children's spontaneous definitions of hunger and fullness and identified specific eating situations they associated with these feelings; Stage 2 tested whether children could perform basic quantitative discriminations applied to food-related stimuli; Stage 3 validated the silhouettes using an 'imagined eating situation' in which subjects used the silhouettes to rate how full their belly would feel in three distinct eating situations associated with different levels of satiety. Main results indicated that (1) most children readily associated the stomach with feelings of hunger (90%) and fullness (70%), (2) 80% of the children said they felt fullest after eating a meal, (3) 90-100% of the children were able to perform basic quantitative discriminations using food-related stimuli, and (4) children reported increasing feelings of satiety for situations associated with hunger, partial satiety, and satiety. Children were generally consistent in their ratings across testing sessions, although responses were less consistent for intermediary satiety levels. Young children may be more capable of quantitatively reporting feelings of satiety than is commonly believed, if appropriate experimental materials are used.

Child↗
PubMed1996

Relationships of consumer characteristics and food deprivation to food purchasing behavior.

A large part of domestic food intake may be determined by retail food purchase behavior, and it is commonly believed that this may be significantly influenced by the shopper's state of food deprivation. In the present study, 198 subjects recruited just prior to shopping at a large supermarket completed questionnaires eliciting information on demographic and situational variables, along with measures of time since last eating (TSLE), hunger, and dietary restraint. Upon leaving the store, subjects provided investigators with itemized receipts, having first identified all "unintended" purchases. There were no consistent main effects of TSLE, self-reported hunger, dietary restraint scores, or relative body weight on the number or cost of total, intended, and unintended food and nonfood purchases. However, there were significant interactions of weight status and measures of food deprivation upon measures of food purchasing. Although normal-weight subjects tended to increase their food purchases with food deprivation, the number and cost of food items fell markedly with extended food deprivation among overweight subjects. These effects were largely specific to food (i.e., generally not observed for nonfood purchases), but showed no consistent associations with unintended purchases or with particular foods or food groups. Higher dietary restraint and relative body weight were associated with lower reported hunger ratings, but not differences in mean TSLE, or other subject characteristics. These results run directly counter to common beliefs and recommendations for weight control and dieting, but support earlier work indicating that the food purchasing behaviors of normal-weight and overweight individuals are differently affected by food deprivation.

Adult↗
PubMed1997

Diet-induced thermogenesis and satiety in humans after full-fat and reduced-fat meals.

Diet-induced thermogenesis was measured during and after a full-fat lunch, an identical but reduced-fat, reduced-energy lunch, and an iso-energetic reduced-fat lunch in 32 normal-weight men and women, age 35-55. Hunger and satiety were scored during and after the lunches, and their relationship to diet-induced thermogenesis was assessed. Diet-induced thermogenesis was relatively higher after the reduced-fat, reduced-energy lunch compared to the full-fat lunch (6.7% vs. 5.2%; p < 0.05). The respiratory quotients were significantly lower after the full-fat lunch than after the 2 reduced-fat lunches (p < 0.05). After the iso-energetic reduced-fat lunch, hunger scores were significantly reduced and satiety scores significantly increased (p < 0.05) until 1800 h. compared to the other 2 lunches. Satiety scores were positively related to the magnitude of diet-induced thermogenesis expressed as an absolute increase in metabolic rate during and after the meal. We conclude that hunger and satiety scores, substrate utilization, and diet-induced thermogenesis showed clear and different short-term responses to diets that differed with respect to the percentage energy from fat and/or the energy content of the meal.

Adult↗
PubMed1996

Changes in taste and satiety in dietary-restrained women following stress.

Stress has been shown to increase food consumption in women with high levels of dietary restraint (restrainers) but decrease consumption in nonrestrainers. The present study was designed to replicate the differential eating pattern following stress and measure physiological and subjective responses to food over repeated taste presentations. Restrained (N = 16) and nonrestrained (N = 16) women were given eight taste presentations of a food followed by an ad lib taste test. Between taste trials, half of the restrainers and nonrestrainers performed a variation of the Stroop stressor while remaining subjects sat quietly. Salivation to the food cue was measured at each trial as well as ratings of food liking, hunger, fullness, and arousal. Results showed significant effects of restraint on food liking and stress condition on hunger. Restrainers increased liking ratings over taste trials whereas ratings for nonrestrainers increased and then decreased to baseline levels by the last trial (p = 0.05). Nonstressed subjects showed an increase in hunger ratings, whereas ratings for stressed subjects did not show any stable directional pattern (p = 0.04). Salivary responses decreased for all groups (p = 0.01). A significant interaction of restraint by stress for intake was found (p = 0.03); restrainers increased consumption following stress whereas nonrestrainers decreased consumption as compared with controls. The data suggest that the Stroop task can influence intake in restrainers, but the changes in intake did not directly correspond to the changes observed during the presentations of the taste cues and stressor.

Adolescent↗
PubMed1999

Comparison of the effects of a high-fat and high-carbohydrate soup delivered orally and intragastrically on gastric emptying, appetite, and eating behaviour.

To investigate the effects of fat and carbohydrate on appetite, food intake and gastric emptying with and without the influence of orosensory factors, a group of nine healthy, fasted male subjects took part in two separate paired experiments involving high-fat and high-carbohydrate radiolabelled soup preloads. In the first experiment subjects received direct intragastric isocaloric infusions of either a high-fat tomato soup or a high-carbohydrate tomato soup (400 kcal in 425 mL) over 15 min, on two occasions. In the second paired experiment subjects ingested the same high-fat and high-carbohydrate soup over 15 min. In both experiments ratings of hunger and fullness were recorded over a period of 135 min and gastric emptying was measured by scintigraphy. Food intake was evaluated from a test meal (yoghurt drink) given 2 h after the end of the soup infusion/ingestion. When soup was administered intragastrically (Experiment 1) both the high-fat and high-carbohydrate soup preloads suppressed appetite ratings from baseline, but there were no differences in ratings of hunger and fullness, food intake from the test meal, or rate of gastric emptying between the two soup preloads. When the same soups were ingested (Experiment 2), the high-fat soup suppressed hunger, induced fullness, and slowed gastric emptying more than the high-carbohydrate soup and also tended to be more effective at reducing energy intake from the test meal. The results of these studies demonstrate that orosensory stimulation plays an important role in appetite regulation, and also indicate that subtle differences in orosensory stimulation produced by particular nutrients may profoundly influence appetite and gastrointestinal responses.

Adult↗
PubMed2003

NPY attenuates positive cortical DC-potential shift upon food intake in man.

Previous studies have shown that the regulation of hunger and satiety is accompanied by coordinate changes in cortical excitability. Starved subjects show a transient negative shift in the scalp-recorded cortical direct current (DC-)potential in the beginning of eating, indicating increased cortical excitability. With increasing satiety, the DC negativity becomes soon replaced by a reward related positive potential shift. Neuropeptide Y (NPY) is known from animal studies to increase food intake and induce weight gain, which might result from increasing hunger drive or reducing satiety. Here we investigated whether NPY affects the cortical sequelae of hunger and satiety regulation as reflected by cortical DC-potentials in man. DC-potentials were recorded over frontal (Fz, F3, F4), central (Cz, C3, C4) and parietal (Pz, P3, P4) electrode positions in 14 subjects who had abstained from eating for 15 h and who were intranasally administered 50 nmol of NPY and placebo 20 min prior to recordings. After a 3-min baseline epoch, subjects consumed 400 ml of liquid food within 5 min. Recordings ended 7 min after food consumption. In the placebo condition during food intake, with some delay a positive DC-potential shift developed which was most pronounced over frontal and central areas and reached maximum values 0-3 min after food consumption. NPY reduced this satiation associated positive shift (p<0.05) over all areas except P3 and Pz. Data suggest that NPY exerts its orexigenic influence by attenuating mechanisms of satiation.

Adult↗
PubMed1991

Psychological, hormonal and biochemical changes following carbohydrate bingeing: a placebo controlled study in bulimia nervosa and matched controls.

The responses of thirteen patients with bulimia nervosa and sixteen controls matched for age and weight are described following the ingestion of a carbohydrate and a calorie-free placebo mixture in simulated binges. Psychological, hormonal and biochemical parameters were measured before and at 15 minute intervals for two hours after the simulated binge. At baseline, the bulimics were clearly more symptomatic than the controls. The control population showed a specific satiating effect of carbohydrate upon hunger ratings. Bulimic patients responded differently showing a blunting of the normal sensation of hunger and an enhanced rating for nausea. Prolactin, growth hormone (GH) and cortisol failed to show a carbohydrate-mediated stimulation in either population. The bulimic patients showed a different pattern of GH release, but this was independent of the challenge condition. Large neutral amino acid (LNAA) levels fell following carbohydrate ingestion, but produced an increase of up to 20% in the tryptophan: LNAA ratio in both bulimic patients and the control group. Thus, while this increase in tryptophan availability failed to provoke hormone release, the time course of the carbohydrate specific effect on the sensations of hunger and nausea is compatible with a mechanism based on increased tryptophan availability. The confusion of satiety with nausea may provide a useful focus for the future treatment of patients with bulimia nervosa.

Adult↗
PubMed1997

Effects of food deprivation and a stressor on head pain.

This study sought to experimentally validate 2 self-reported trigger factors of headaches, namely negative affect (anxiety, depression, and anger) and hunger, and to investigate whether these triggers activated the same or different physiological mechanisms. Students (38 women and 18 men) who had suffered from frequent headaches (migraine or tension type) for 6 months or more were randomly assigned to 4 conditions, which involved manipulating hunger by means of 19 hr of food deprivation and negative affect by means of a stressor (difficult to solve anagrams). The findings were consistent with self-reports that hunger and negative affect can precipitate headaches in individuals who suffer from both migraine and tension-type headaches. The physiological responses to the experimental conditions differed, but the findings were not conclusive with respect to whether the trigger factors operated by means of a common biological pathway.

Adult↗
PubMed2000

Short-term regulation of food intake in children, young adults and the elderly.

OBJECTIVE: The present study investigated the effects of consuming preloads with different macronutrient and energy contents on subsequent intake and subjective feelings of hunger and satiety in children, young adults and the elderly. SUBJECTS: 30 Children (4-6 y), 33 young adults (18-26 y) and 24 elderly (61-86 y). DESIGN: A 'preload test meal' design was applied. Subjects were given four different strawberry yoghurt preloads that varied in energy and macronutrient content, or no yoghurt. Children, young adults and elderly consumed 200, 340 and 300 g of the preload, respectively. One yoghurt was low-fat, low-carbohydrate and low in energy (the control; 0.7 MJ/500 g serving), one yoghurt was high-fat and medium in energy (71% of energy (en%) of fat; 2 MJ/500 g serving), one yoghurt was high-carbohydrate and medium in energy (87 en% of carbohydrate; 2 MJ/500 g serving) and the fourth yoghurt was high-fat and high-carbohydrate and high in energy (42 en% of fat and 53 en% of carbohydrate; 3 MJ/500 g serving). Ninety minutes after preload consumption, subjects had an attractive ad libitum lunch-buffet. Energy intake at lunch and subjective feelings of hunger and satiety were analysed. RESULTS: The ability to compensate at lunch did not differ among the three age groups. Compared to the no-preload condition, all children, young adults and elderly ate significantly less after the high-fat and high-carbohydrate yoghurt. The energy compensation observed in the children ranged between -21% and 34%, in the young adults between 15% and 44% and in the elderly between 17% and 23%. Hunger responses were clearly different between young adults and the elderly. Compared to the no-preload condition, the young adults showed larger differences in their appetite ratings than the elderly, indicating that the elderly were less sensitive to the energy content of the preload than the young adults. CONCLUSION: We conclude that the ability to regulate the food intake within a preload 90 min test meal paradigm did not differ among children, young adults and the elderly. SPONSORSHIP: This study was funded by the European Commission as part of project FAIR-CT95-0574.

Adolescent↗
PubMed2001

The effect of acute hyperglycaemia on appetite and food intake in Type 1 diabetes mellitus.

AIMS: To determine the effects of acute hyperglycaemia on appetite and food intake in Type 1 diabetes mellitus. METHODS: Two separate studies, each involving eight adults with uncomplicated Type 1 diabetes, were performed: one in the fasted state (A) and the other after a nutrient preload (B). In both studies, perceptions of appetite (hunger and fullness) and food intake at a buffet meal were evaluated during euglycaemia (blood glucose, approximately 6 mmol/l) and hyperglycaemia (blood glucose, approximately 14 mmol/l). Both experiments were randomized and single-blind. In study A, appetite was assessed in the fasted state for 90 min before the buffet meal. In study B, a nutrient 'preload' of Ensure and milk containing 13C-octanoic acid was consumed 90 min before the meal. Gastric emptying of the preload was quantified with a radioisotopic breath test technique. RESULTS: There was no significant difference in plasma insulin concentrations between euglycaemia and hyperglycaemia in either study. In study A, there were no differences in hunger, fullness or energy intake between the two treatment days. In study B, subjects were slightly less hungry between the preload and buffet meal during hyperglycaemia than euglycaemia (P = 0.04), and tended to have slower gastric emptying during hyperglycaemia (emptying coefficient, 3.89 +/- 0.16 vs. 3.57 +/- 0.21; P = 0.052), but there was no difference in food intake between hyperglycaemia and euglycaemia. CONCLUSIONS: Acute hyperglycaemia suppresses hunger after a nutrient preload, but not in the fasted state, in patients with uncomplicated Type 1 diabetes. This effect is small and not associated with changes in food intake.

Adolescent↗