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.

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.

Protein Continues To Be a Priority at the Food & Nutrition Conference & Expo

The Academy of Nutrition and Dietetics’ Food & Nutrition Conference & Expo (FNCE) is the world’s largest gathering of credentialed nutrition professionals, Registered Dietitian Nutritionists (RDNs), and is also known to draw nutrition science researchers, policy makers, health-care providers and industry leaders for a four day conference addressing the latest food and nutrition information, research and trends. This year ENC traveled to Houston, TX to share the latest on egg nutrition research at the educational exhibit hall and Weight Management Dietetic Practice Group educational breakfast session.

Tia Rains, PhD, Senior Director of Nutrition Research & Communications at ENC and Heather Leidy, PhD, Assistant Professor in the Department of Nutrition & Exercise Physiology at the University of Missouri presented, Changing Paradigms on Weight Management and Macronutrient Intake . Visit ENC.org to download the full presentation, including practical meal plans to put the research into practice. Insights of the presentation included:

  • “Fat Phobia” may have contributed to the doubling of obesity rates since the 1970s as intake of grains, fruit juices, sodas and snacks increased while consumption of red meat, dairy and eggs decreased.1
  • Many people think adults eat more protein than they need. However, recommendations for protein are based on the structural and functional properties of amino acids, determined by nitrogen balance studies. This means that the requirement is based on preventing loss of lean body mass in healthy individuals.  No other functional measures of protein status have been considered in establishing the RDA and no health benefits of protein have been considered either.2
  • Emerging benefits of increased dietary protein include: Improved lipid profile, blood glucose modulation, improved retention of muscle (elderly), increased satiety, improved body composition and weight management.3-9
  • A diet rich in protein is a viable strategy to prevent and/or treat obesity based on studies showing increased appetite control and satiety reduced reward-driven eating behavior .3-9
    • 25-30% of daily energy intake (24-30 grams per eating occasion) is optimal to elicit the above responses.

The Egg Nutrition Center educational exhibit also drew crowds as we shared the latest researcheducational materials and ENC offerings for health professionals such as, continuing education credits through webinars and materials.

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How do you build your breakfasts to include 25-30 grams of protein?

If you would like more breakfast examples, join Egg Nutrition Center and Produce for Better Health Foundation for a webinar Building a Better Breakfast with High-Quality Protein and Produce presented by Neva Cochran on Wednesday, November 20th 2 pm ET. Register here.

References:

1Flegal, K M, et al.  Prevalence of obesity and trends in the distribution of body mass index among U.S. adults, 1999-2010. Journal of the American Medical Association. 2012; 307(5), 491-497

2Layman, D. Dietary guidelines should reflect new understanding about adult protein needs. Nutrition & Metabolism 2009; 6(12), www.nutritionandmetabolism.com/content/6/1/12

3Leidy, HJ.  Beneficial effects of a higher-protein breakfast on the appetitive, hormonal and neural signals controlling energy intake regulation in overweight/obese “breakfast skipping” late-adolescent girls. Am J Clin Nutr . 2007; 97(4): 677-688

4Leidy, HJ, et al. Effects of acute and chronic protein intake on metabolism, appetite, and ghrelin during weight loss. Obesity. 2007; 15(5): 1215-25

5Leidy, HJ, et al.  The influence of higher protein intake and greater eating frequency on appetite  control in overweight and obese men. Obesity. 2010; 18(9): 1725-32

6Modified from: Fulgoni VL. Current protein intake in America: Analysis of the National Health and Nutrition Examination Survey 2003-2004 AJCN; 2008; 87(supp):1554S-78

7Wycherley TP, et al. Effects of energy-restricted high-protein, low-fat compared with standard-protein, low-fat diets: a meta-analysis of randomized controlled trials. AJCN. 2012; 96(6): 1281-98

8Skov et al. Randomized trial on protein vs carbohydrate in ad libitum fat reduced diet for the treatment of obesity. Int J Obesity. 1999; 23(5): 528-536

9Symons et al.  Aging does not impair the anabolic response to a protein-rich meal.  AJCN. 2007; 86(2): 451-456.

Setting Standards for the Science of Satiety

It’s well known that around the world, obesity rates are higher than they were in previous decades. 

The pharmaceutical, fitness, food, and supplement industries have responded, commercializing a number of products and services to support weight loss efforts.  Satiety, in particular, has been a target across all of these industries.  Hunger and preoccupations with food are often cited as barriers to maintaining a weight loss diet.  Given the potential for satiety to favorably affect obesity, several regulatory agencies and scientific organizations have established guidelines and position statements to standardize the study and communication of satiety enhancement.

One of the first groups to proactively address satiety was the International Life Sciences Institute (ILSI) Europe.  In 2008, they formed the Eating Behaviour and Energy Balance Task Force, a group of scientific experts charged with generating “a wider understanding of satiety benefits and claims and the appropriate methods for their substantiation”.  The efforts of the Task Force have resulted in five publications, including recommendations on standardized satiety methodology, consumer interpretation of satiety benefits, and biomarkers of appetite regulation.1-5

Most recently, the Task Force published proceedings of a one-day workshop held November 27, 2012 in Brussels, Belgium.5  One of the key outputs from the meeting was the recognition that there is a need for more longer-term studies on the efficacy of satiety enhancement for weight loss.  To date, the over-whelming majority of satiety studies have been in an acute setting, usually only over a few hours.  It is not known whether all satiety-enhancing foods/beverages will sustain their benefit over longer periods of time.

Another key output was agreement among the experts that the benefits of satiety extend beyond just weight loss.  For example, cognitive performance has been shown to be tightly associated with feelings of hunger and satiety in both children and adults.  Similar findings have been reported for mood.

Clearly, this is an area that continues to evolve and has the potential to benefit many.  The Egg Nutrition Center has invested in this area for several years given the satiating properties of eggs.6-8  The majority of the research suggests that higher protein meals tend to be more satiating than high carbohydrate meals, particularly when the protein is consumed at the breakfast meal.  These data corroborate findings of other studies, which have been conducted over the course of a day, a few days and, in some cases, for several weeks.

1Bilman EM, Kleef Ev, Mela DJ, et al. Consumer understanding, interpretation and perceived levels of personal responsibility in relation to satiety-related claims. Appetite. 2012;59:912-20.
2Blundell J, de Graaf C, Hulshof T, et al. Appetite control: methodological aspects of the evaluation of foods. Obes Rev. 2010;11:251-70.
3Delzenne N, Blundell J, Brouns F, et al. Gastrointestinal targets of appetite regulation in humans.Obes Rev. 2010;11:234-50.
4Hetherington MM, Cunningham K, Dye L, et al. Potential benefits of satiety to the consumer: scientific considerations. Nutr Res Rev. 2013;26:22-38.
5Griffioen-Roose S, Wanders A, Banati D. Satiety and appetite control claims: Getting it right for consumers. Nutr Bull. 2013;38:373-77.
6Vander Wal JS, Marth JM, Khosla P, et al. Short-term effect of eggs on satiety in overweight and obese subjects. J Am Coll Nutr. 2005;24:510-5.
7Leidy HJ, Ortinau LC, Douglas SM, Hoertel HA. Beneficial effects of a higher-protein breakfast on the appetitive, hormonal, and neural signals controlling energy intake regulation in overweight/obese, “breakfast-skipping,” late-adolescent girls. Am J Clin Nutr. 2013;97:677-88.
8Ratliff J, Leite JO, de Ogburn R, et al. Consuming eggs for breakfast influences plasma glucose and ghrelin, while reducing energy intake during the next 24 hours in adult men. Nutr Res. 2010;30:96-103.