Weight Management & Satiety

Obesity is a multi-factorial and complex health issue. Current guidance for weight management encourages physical activity along with consuming an overall healthy eating pattern which includes whole grains, fruits, vegetables, lean proteins, low-fat and fat-free dairy products. A growing body of research suggests that dietary protein, specifically, can help promote satiety, facilitating weight loss when consumed as part of reduced energy diets.

Several clinical trials have specifically assessed the effects of high-quality protein from eggs on satiety and weight loss. For example:

  • In a study in overweight adults, calorie-restricted diets that included either eggs or a bagel for breakfast were compared; the people who consumed eggs for breakfast lowered their body mass index by 61%, lost 65% more weight, and reported feeling more energetic than those who ate a bagel for breakfast.
  • Men who consumed an egg breakfast versus a bagel breakfast showed that appetite hormones were suppressed following eggs at breakfast, as was energy intake over the course of the day.
  • A study of overweight premenopausal women that evaluated satiety responses to eating a turkey sausage and egg breakfast sandwich versus a low-protein pancake breakfast showed better appetite control and few calories consumed at lunch following the egg-based breakfast.
  • In a 3-month trial among subjects with type 2 diabetes, those who consumed 2 eggs per day for 6 days a week reported less hunger and greater satiety than those who consumed less than 2 eggs per week.

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New Evidence on Breakfast, Energy Balance, and Weight Loss

meal_plate_952x392-300x123In late 2013, the health halo surrounding breakfast was dented by an article published in The American Journal of Clinical Nutrition questioning the scientific evidence supporting recommendations to consume breakfast to achieve and maintain a healthy body weight.1  The authors argued that the overwhelming majority of the evidence was based on observational studies identifying associations between breakfast and body weight.  Very few randomized controlled trials (RCTs) specifically evaluating theeffects of daily breakfast consumption compared to no breakfast, on body weight outcomes, were available, and those that had been published did not strongly support a benefit of breakfast.  Since then, several RCTs evaluating breakfast consumption have been published, better defining the impact of regular breakfast meals on energy balance, with unexpected and intriguing results.

Researchers at the University of Alabama-Birmingham recently published results from a 16-week weight loss trial in 309 overweight and obese adults (aged 20-65 y) randomly assigned to receive instructions to either consume breakfast or skip breakfast. 2 Compliance within each group was high, with more than 90% of participants following their instructions.  There were no differences between groups for weight loss, suggesting that a general recommendation to eat breakfast is not influential in promoting weight loss in those trying to lose weight.  It is important to note that breakfast type was not controlled in this study, an important consideration in light of prior evidence showing greater satiety with higher protein breakfasts.3

While the weight loss results may seem perplexing given the evidence linking breakfast consumption to lower body mass indices, results from another RCT in the same journal suggest that breakfast may impart a benefit on a different aspect of energy balance.  Researchers from the University of Bath and Queen’s Medical Centre in the United Kingdom compared the effects of a prescribed breakfast meal (≥700 kcal before 11:00 am) to extended fasting (0 kcal until noon) on energy expenditure (via accelerometer) and energy intake (via food diaries) in lean adults over 6 weeks.4  Results were interesting, in that the breakfast eaters were more physically active, burning approximately 400 more kcal a day in activity (mostly light-intensity activity).  Energy intake was also increased in the breakfast eaters, with no differences between groups for changes in body weight.  The authors suggest that the availability of glucose in the morning provides the fuel necessary to facilitate physical activity.  Whether this same outcome will be seen in overweight or obese adults remains to be determined.

At the very least, the topic of breakfast is getting a lot more interesting!

 

References

1) Brown AW, Bohan Brown MM, Allison DB. Belief beyond the evidence: using the proposed effect of breakfast on obesity to show 2 practices that distort scientific evidence. Am J Clin Nutr. 2013;98:1298-308.

2) Dhurandhar EJ, Dawson J, Alcorn A, Larsen LH, Thomas EA, Cardel M, Bourland AC, Astrup A, St-Onge MP, Hill JO, Apovian CM, Shikany JM, Allison DB. The effectiveness of breakfast recommendations on weight loss: a randomized controlled trial. Am J Clin Nutr. 2014 Jun 4. [Epub ahead of print]

3) Westerterp-Plantenga MS, Lemmens SG, Westerterp KR. Dietary protein – its role in satiety, energetics, weight loss and health. Br J Nutr. 2012;108 Suppl 2:S105-12.

4) Betts JA, Richardson JD, Chowdhury EA, Holman GD, Tsintzas K, Thompson D. The causal role of breakfast in energy balance and health: a randomized controlled trial in lean adults. Am J Clin Nutr. 2014 Jun 4. [Epub ahead of print]

Observations from Experimental Biology 2014

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Today’s post comes from guest blogger, Apeksha Gulvady, PhD. Apeksha holds an MA and PhD in Nutritional Sciences from the University of Texas in Austin, where her research focused on the role of aging and diet-induced obesity on immune cell function. Apeksha previously worked with PepsiCo R&D, where she supported core nutrition business activities and priorities in both global foods and beverages, and has recently joined Edelman Public Relations to pursue her passion for nutrition communications.

For years, a single nutrient paradigm laid the foundation for the efforts of nutrition science to target nutrient deficiencies. As associations between lifestyle factors and chronic diseases became more evident, the focus of research fittingly transitioned from individual nutrients to foods as carriers of these nutrients, and finally to dietary patterns of food intake that can potentially impact health. Studies on protein advanced similarly and earned their way onto the dais at the 2014 Experimental Biology (EB) conference – the world’s largest life sciences annual meeting, comprised of 24,000+ scientific researchers, federal regulators, consumer groups and industry representatives.

After four exciting days at the conference in San Diego this year, attendees’ brains were brimming with information about the power of protein in the diet, among other key topics. Protein sessions were some of the best attended sessions overall, suggesting that protein research remains of prime interest to the nutrition science community. Protein studies, several of which were supported in part or full by the ENC research grant program, pointed to how adjustment of both quality and quantity of this macronutrient can bring about small but meaningful changes in metabolism and body composition.

In one study presented at EB 2014, egg protein, when consumed for breakfast, was shown to affect postprandial energy metabolism and provide increased satiety in overweight children.1 Protein, therefore, may play a key role in weight management. Another study demonstrated that consumption of one egg per day did not influence blood lipid levels in diabetic patients. Egg protein was thus concluded to not increase risk for cardiovascular disease in the study population.2

Beyond protein, evidence from a meta-analysis of dietary cholesterol and heart health suggested that previously declared correlations between dietary cholesterol consumption and heart disease may be unfounded.3 Researchers also investigated the effects of differential macronutrient distribution in the diet and found that lowering carbohydrate intake had the potential to decrease insulin resistance4 and accelerate fat oxidation.5 Exploring the link between diet, diabetes and cardiovascular disease, an animal study found whole egg protein increased blood vitamin D concentrations and favorably affected physiologic diabetic dysfunctions.6 And in another study of nutrient adequacy, eggs were found to potentially positively impact serum levels of certain carotenoids.7

As presented at the 2014 EB conference, current evidence thus suggests that consuming eggs as a source of high-quality protein may assist in weight loss, improve disease risk factors and promote intakes of certain nutrients. However, whether the aforementioned effects can be sustained over time warrants additional investigation.

References:

  1. Binns A, Gray M, Seo H-S, Zhang B, Luckett C, Smith K, Baum JI. Consumption of an egg-based breakfast reduces hunger and increases postprandial energy metabolism in normal weight (NW) and overweight (OW) school-aged children. FASEB J. 2014;28(1S):381.4.
  2. Ballesteros MN, Valenzuela F, Robles A, Artalejo E, Valdez H, Fernandez ML. One egg a day does not increase the risk for cardiovascular disease in diabetic patients. FASEB J. 2014;28(1S):381.5
  3. Berger SE, Raman G, Vishwanathan R, Jacques P, Johnson EJ. Dietary cholesterol and heart health: a systematic review and meta-analysis. FASEB J. 2014;28(1S):267.6.
  4. Watkins BA, Pappan KL, Kim J, Freidenreich D, Kunces L, Volk B, Saenz C, Volek J. Carbohydrate feeding and impact on global metabolomics in relation to insulin sensitivity in men with metabolic syndrome. FASEB J. 2014;28(1S):248.8.
  5. Kunces LJ, Volk B, Freidenreich D, Saenz C, Fernandez ML, Maresh C, Kraemer W, Phinney S, Volek J. Effect of a very low carbohydrate diet followed by incremental increases in carbohydrate on respiratory exchange ratio. FASEB J. 2014;28(1S):LB444.
  6. Van Wyk K, Schalinske K. Whole egg protein markedly increases blood vitamin D concentrations in male Sprague-Dawley rats. FASEB J. 2014;28(1S):1041.9.
  7. Aljohi H, Dopler-Nelson M, Wilson TA. Consumption of 12 eggs per week for 1 year increases serum zeaxanthin concentrations but not other major carotenoids, tocopherols, and retinol in humans. FASEB J. 2014;28(1S):645.25.

Five Steps to Prevent Overweight in Children in the First Five Years of Life

Mary-Donkersloot-headshotToday’s blog post comes from Mary Donkersloot, a registered dietitian and nutrition consultant with a private nutrition practice in Beverly Hills, California. Donkersloot has helped individuals dealing with diabetes, heart disease, weight management and eating disorders for more than 20 years. She is also one of ENC’s Health Professional Advisors.

 

A new study of more than 7000 U.S. children by Emory Health Sciences has found that a third of children who were overweight in kindergarten were obese by the eighth grade, and almost every child who was obese remained that way (1). With this new information, it is paramount that parents and caregivers learn the basics of how to help kids develop an eating style that will prevent weight issues. Here are five steps that may be helpful:

#1 Provide meal and snack structure.

Kids need a routine with predictable meal times, which generally best works out to be comprised of 3 meals and 3 snacks — breakfast, lunch, dinner, with a snack in between each and perhaps one at bedtime. Feeding toddlers whatever they want, whenever they want, may interfere with their ability to self-regulate their appetite and is a formula for overeating and weight gain.

#2  Limit processed foods high in sugar, fat and salt.

These may interfere with the child’s ability to eat in response to hunger, rather than impulse or reward (2). Instead of sugary cereals at breakfast, serve an egg and a slice of whole grain toast. Instead of crackers or cookies for snacks, make a snack a mini-meal, like almond butter on a small amount of whole grain bread with a glass of milk.

#3  Avoid sugary beverages.

Soda is an obvious issue, given its high calorie, low nutrient content. But juice should be limited as well, since when we drink calories, we don’t cut back as much, if at all, at the next meal, which can lead to overeating. (3,4) Choose water or milk instead of sugary beverages.

#4  Serve a fruit or vegetable each time you feed your child. 

Including fruit in milkshakes or smoothies and adding vegetables to soups and sandwiches can help increase the nutrient and fiber content of children’s meals. Fiber is particularly important. Not only does their fiber help to give a sense of fullness, vegetables and fruits also provide vital phytochemicals that protect the health of the child and promote healthy growth and development.

#5  Eat more home-cooked meals.

Many of the typical “kid’s meals” in restaurants add up to 1000 calories or more, especially those with pasta and sauce, or burgers, fries and soda. Kids who dine out soon suffer from “portion distortion,” or unrealistic expectations of what is a normal portion size. This may result in them feeling cheated when they are served a smaller portion of pasta at home.

While these changes may not be feasible overnight, remember baby steps can go a long way in developing a healthier routine for your child.

Mary Donkersloot, RD

 

References

  1. Cunningham SA, Kramer MR, Venkat Narayan KM. Incidence of childhood obesity in the United States. N Engl J Med 2014; 370:403-411.
  2. Johnson SL, Taylor-Holloway LA. Non-Hispanic white and Hispanic elementary school children’s self-regulation of energy intake. Am J Clin Nutr 2006; 83(6):1276-82.
  3. Ludwig DS, Peterson KE, Gortmaker SL. Relation between consumption of sugar-sweetened drinks and childhood obesity. Lancet 2001; 357:505-8.
  4. Mrdjenovic G, Levitsky DA. Nutritional and energetic consequences of sweetened drink consumption in 6- to 13-year-old children.  J Pediatr 2003; 142:604-10.

Start 2014 With a Protein-Rich Breakfast

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January. A new year. A clean slate. No matter what happened in 2013, no matter what kind of health and nutrition goals were set (and perhaps never accomplished), in 2014 everyone gets a fresh start.

The first month of the year always results in lofty New Year’s resolutions, many of which involve personal and family health goals. As a health professional, you know how difficult it can be to help clients change their lifestyle habits, so this year, guide them toward incremental, achievable goals that will encourage them to gradually, but continuously, see results. When it comes to healthy eating goals, one idea is to suggest that clients start small, by focusing on just one meal, like breakfast.

The importance of eating breakfast for physical and mental health has been well established, and eggs are a perfect choice as part of a nutritious breakfast. The protein in eggs provides steady and sustained energy because it does not cause a surge in blood sugar or insulin levels, which can lead to a rebound effect or energy “crash” as blood sugar levels drop (1). Also, several scientific studies have examined the cognitive benefits of eating breakfast, such as improved memory recall time, improved grades and higher test scores (2,3). Even kids know that breakfast is the most important meal of the day. In one study, the majority of children surveyed agreed that eating breakfast helped them pay attention and stay energized throughout the day (4). Moreover, research shows that eating breakfast is a marker for overall health and good behavior in school children. Breakfast eaters are less likely to miss school due to illness or other issues, and are less likely to be tardy to class. (5)

It is no secret that a large portion of individuals’ New Year’s resolutions are goals for weight loss. The great news is that weight loss goals coincide directly with eating breakfast and eggs, in particular. In a study published in the International Journal of Obesity, eating eggs for breakfast as part of a reduced-calorie diet helped overweight dieters feel more energetic than dieters who ate a bagel breakfast of equal calories and volume (6). This is a crucial point for clients who want to lose weight because eating plans that leave a person feeling hungry are not sustainable and will be quickly abandoned.

If your clients are looking for a delicious way to follow your advice, lead them to the incredibleegg.orgrecipe page for quick and delicious egg recipes like these Mini Breakfast Egg, Tomato & Spinach Flatbread Pizzas.

What other nutrition resolutions are you suggesting to your clients this year? Add to the list of goals and advice in the comments section below!

 

References

  1. Layman DK. Protein quantity and quality at levels above the RDA improves adult weight loss. JACN 2004; 23(6): 631S-636S.
  2. Rampersaud G, et al. Breakfast habits, nutritional status, body weight, and academic performance in children and adolescents. JADA 2005; 105:743-760.
  3. Pollitt E, et al. Fasting and cognition in well- and undernourished school children: a review of three experimental studies. AJCN 1998; 67:779S-784S.
  4. Reddan J, et al. Children’s perceived benefits and barriers in relation to eating breakfast in schools with or without Universal School Breakfast. J Nutr Education Behav 2002; 34(1):47-52.
  5. Murphy JM, et al. The relationship of school breakfast to psychosocial and academic functioning: cross-sectional and longitudinal observations in an inner-city school sample. Arch Pediatr Adolesc Med 1998; 152:899-907.
  6. Vander Wal JS et al , et al. Egg breakfast enhances weight loss. Int J of Obesity 2008: 32(10):1545-1551.

Brief Protein Research Round Up

Here’s what we’ve been reading here at ENC regarding protein the past couple of weeks! Check the articles out!

Protein/Macronutrient Composition
“Myofibrillar muscle protein synthesis rates subsequent to a meal in response to increasing doses of whey protein at rest and after resistance exercise”  (Witard et al. Am J Clin Nutr. E-pub ahead of print)This randomized controlled trial in resistance-trained young men (N=48) showed that 20 and 40 g of whey protein isolate (WPI) consumed immediately after exercise increased myofibrillar muscle protein synthesis by ~50%, whereas no stimulation was observed with 10 g WPI.Both Dietary Protein and Fat Increase Postprandial Glucose Excursions in Children With Type 1 Diabetes, and the Effect Is Additive” (Smart et al. Diab Care. 2013;36:3897-3902)This randomized controlled crossover trial in children with type 1 diabetes (N=33) showed that breakfast meals containing 40 g protein or 35 g fat resulted in greater postprandial glucose excursions; the higher protein meal had a protective effect on the development of hypoglycemia. 

“Protein leverage and energy intake” (Gosby et al. Obes Rev. 2013;E-pub ahead of print)

This analysis of data collected from 38 published experimental trials measuring ad libitum intake in subjects confined to menus differing in macronutrient composition showed that percent dietary protein was negatively associated with total energy intake irrespective of whether carbohydrate or fat were the diluents of protein.

Tell us any interesting protein research that you have recently read.