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.

What Should We Eat & When We Should Eat It

What should we eat and when we should eat it?

These are questions on the minds of almost every health-conscious and weight-conscious consumer. Recent research seems to be providing some answers, or at least providing us with some interesting food-for-thought. A just-completed study done in Israel, for example, indicates that eating the largest meal of the day at breakfast not only helps obese subjects maintain lower blood glucose, insulin, and triglyceride levels than their counterparts who eat their largest meal at the dinner hour, it also helps with weight loss. In this study the group that ate the larger breakfast lost an impressive 17 pounds after 12 weeks on a 1400 kcal/d diet, versus a 7 pound weight loss for the large dinner group.

Other recent studies indicate that subjects who eat higher protein breakfasts tend to be more satisfied and eat fewer calories over the course of the day. Taken together these studies have led many researchers and nutritionists to re-consider the long held belief that carbohydrates should be the main staple of our diets, at all meals. More and more studies suggest that carbs, while indispensable for athletes or active people who burn what they consume, should be ramped down in the average American diet. And substituting protein for the carbs we remove from the diet may aid the cause, by promoting satiety and the constant desire to eat more throughout the day.

Market research data suggests that consumers are getting the message. A recent article in Business Week indicates that breakfast cereal sales for most of the large manufactures are in decline. Analysts point to changing consumer behaviors, including a growing reluctance to eat simple carbs, and a rising concern about a gluten allergy. And though diet fads of this nature often come and go, the growing body of literature pointing to the importance of breakfast in general, and high protein breakfasts in particular, may mean this is a trend that’s here to stay.

Skipping Breakfast: Is When You Eat as Important as What You Eat?

There has been quite a bit of buzz recently over a study out of Harvard1 looking at the relationships between eating patterns and coronary heart disease (CHD) risk.  Researchers analyzed data from the Health Professionals Follow-up Study, one of the largest prospective cohort studies (51,529 male health professionals) initiated back in 1986 when these men were between 40 and 75 years of age.  Participants have been evaluated at regular intervals since then, resulting in a plethora of data on disease incidence, dietary habits, and mortality. From these data, researchers analyzed associations between eating habits, specifically if and when meals were consumed, and development of CHD.

There were several interesting findings from this analysis. For example, men who ate late at night had a 55% higher risk of CHD than men who did not eat late at night. Further, there was no difference in CHD risk in men who ate 1 to 2 times a day versus men who ate ≥6 times a day. But the media focused on only one finding, that skipping breakfast was associated with a 27% greater risk of CHD. And the resultant headlines used more riveting language such as, “skipping breakfast causes heart attacks”.

But a closer look at the data suggests that it may not be a very simple relationship. In fact, it’s never quite so simple when it comes to these prospective cohort studies.  For example, men who did not report eating breakfast were more likely to exhibit unfavorable diet and lifestyle habits, such as smoking, being less physically active, and drinking more alcohol. Although these factors were included and adjusted for in the statistical models, there may be other potentially important lifestyle factors which were not assessed or assessed inadequately that may influence the relationship between breakfast eating and CHD risk.

Men who did not report eating breakfast were also more likely, albeit slightly, to have high cholesterol, high blood pressure, and a higher body mass index.  Once these conditions were accounted for in the statistical models, there was no longer an association between skipping breakfast and incident CHD.  How strong is the relationship between breakfast eating and risk of heart disease when you can completely attenuate the effect by adjusting for known mediators of CHD?

That’s not to say that this isn’t an important piece of the puzzle for understanding the impact of eating behaviors on disease risk.  In fact, this new observational evidence dovetails nicely with findings from randomized, controlled trials showing favorable effects of breakfast eating on CHD risk factors2,3. Plus, eating breakfast, particularly one rich in nutrient-dense food choices, has been shown to impart other benefits, as reviewed in this recent blog. However like all observational evidence, results are merely associations and should be interpreted in this context before jumping to conclusions about breakfast skipping causing heart attacks.

1. Cahill LE, Chiuve SE, Mekary RA, Jensen MK, Flint AJ, Hu FB, Rimm EB. Prospective Study of Breakfast Eating and Incident Coronary Heart Disease in a Cohort of Male US Health Professionals. Circulation. 2013;128:337-43.

2. Farshchi HR, Taylor MA, Macdonald IA. Deleterious effects of omitting breakfast on insulin sensitivity and fasting lipid profiles in healthy lean women. Am J Clin Nutr. 2005;81:388-96.

3. Astbury NM, Taylor MA, Macdonald IA. Breakfast consumption affects appetite, energy intake, and the metabolic and endocrine responses to foods consumed later in the day in male habitual breakfast eaters. J Nutr. 2011;141:1381-9.

More Data in Support of a Higher Protein Diet

In recent years, more and more research has demonstrated the benefits of higher protein diets. The growing body of literature is driving many to rethink  the conventional nutrition dogma that has been  prevalent for the past fifty years or so–a  high carbohydrate, low fat, moderate protein diet is the best way to ward off disease and to promote good health.

A study recently published in the Journal of Nutrition adds to the protein story1. The study, a part of the larger DiOGenes project designed to investigate the potential of dietary protein to prevent weight gain in European subjects, looked at the impact of higher protein diets in children (ages 5-18) of overweight and obese parents2. It has been shown that children of obese parents are more than twice as likely as children of normal-weight parents to become obese, and to develop the co-morbidities associated with obesity.

In this study, families were randomized to 1 of 5 diets consisting of a combination of higher and lower protein foods, and higher and lower glycemic index foods. Diet, body composition, blood pressure, and various serum cardiovascular markers were measured in 253 children at baseline, and at one and six months following diet intervention. Among other things, children in the higher protein group demonstrated a smaller waist circumference and lower serum LDL cholesterol levels compared to the lower protein group at 6 months. In a separate analysis, high protein subjects had reduced waist circumference, and lower blood pressure and serum insulin than did subjects in the lower protein group.  Taken together, these results suggest that increased protein intake may improve markers associated with body composition and cardiovascular disease risk in high-risk children.

This study was unique in that it is one of the first randomized control trials to demonstrate the benefits of higher protein diets in children of overweight/obese parents. Most prior studies of this nature have relied on epidemiological data. Research on the health impact of macronutrients undoubtedly will continue, but more and more it appears that there may be an alternate dietary approach to the high carbohydrate, low fat and protein paradigm.

1. Damsgaard CT, Papadaki A, Jensen SM, Ritz C, Dalskov SM, Hlavaty P, Saris WH, Martinez JA, Handjieva-Darlenska T, Andersen MR, Stender S, Larsen TM, Astrup A, Mølgaard C, Michaelsen KF; Diogenes. Higher protein diets consumed ad libitum improve cardiovascular risk markers in children of overweight parents from eight European countries. J Nurt 2013;143(6):810-7.

2. Gögebakan O, Kohl A, Osterhoff MA, van Baak MA, Jebb SA, Papadaki A, Martinez JA, Handjieva-Darlenska T, Hlavaty P, Weickert MO, Holst C, Saris WH, Astrup A,Pfeiffer AF; DiOGenes. Effects of weight loss and long-term weight maintenance with diets varying in protein and glycemic index on cardiovascular risk factors:the diet, obesity, and genes (DiOGenes) study: a randomized, controlled trial. Circulation 2011;124(25):2829-38.

Inside the Shell: 13 Essential Vitamins and Minerals

Many health professionals recognize the mighty nutrient package of the whole egg and are encouraging their patients and clients to include eggs as part of a diet that focuses on nutrient-rich, whole foods. The high-quality protein in eggs is also becoming more well-known for its satiating effects, which could assist with weight loss and weight management in addition to preventing muscle loss.

In motivating clients to make wise food choices, there are other benefits to consuming eggs as part of a balanced diet that health professionals can highlight. For instance, eggs are an excellent source of choline and selenium as defined by the U.S. Food and Drug Administration1, 2. Eggs are also a good source of riboflavin, Vitamin D, and phosphorus1, 2. For a food to be considered an “excellent source” of a particular nutrient, it must contain more than 20% of the daily value2. To be considered a “good source” of a particular nutrient, a food must provide between 10% and 19% of the daily value2.

Check out these past posts for more detail on specific egg nutrients that support health:

Stay tuned for an updated post on selenium next week!

Other important nutrients that can be found within an egg include vitamin B12, pantothenic acid, vitamin A, vitamin B6, zinc and calcium. For more information on these nutrients, check out the Egg Nutrition Center research library, and let us know what nutrients you’d like to read about in upcoming posts.

In the meantime, below is a tasty recipe that pairs eggs with nutrient-rich vegetables to boost nutrient content even more – enjoy!

Broccoli Quiche in Colorful Peppers

Makes 4 servings

Peppers-150x150

Ingredients:

  • 4 medium red, yellow, or green bell peppers (4 oz. each)
  • 1 cup frozen broccoli florets, defrosted
  • 4 eggs
  • ½ cup milk
  • ½ tsp. garlic power
  • ¼ tsp dried Italian seasoning

Directions:

  1. Heat oven to 325°F. CUT about 1/2 inch off tops of peppers; remove seeds. PLACE peppers upright in custard cups; place cups in baking pan.
  2. SPOON 1/4 cup broccoli into each pepper. BEAT eggs, milk, garlic powder and Italian seasoning in medium bowl until blended. POUR evenly over broccoli.
  3. BAKE in center of 325°F oven until knife inserted near center comes out clean, 60 to 70 minutes. LET STAND 5 minutes.

Nutrition Information (per serving):

Calories: 132, total fat: 6g, saturated fat: 2g, polyunsaturated fat: 1g, monounsaturated fat: 2g, cholesterol: 188mg, sodium: 95mg, carbohydrates: 10g, dietary fiber: 3g, protein: 9g, vitamin A: 4053.8IU, vitamin D: 56IU, folate: 80mcg, calcium: 78.2mg, iron: 1.4mg, choline: 137.5mg.

References:

  1. Egg Nutrition Center. All in one egg! Patient/Client Education Materials. Accessed April 8, 2013.
  2. Food and Drug Administration. Guidance for Industry: A Food Labeling Guide. Appendix B: Additional Requirements for Nutrient Content Claims.http://www.fda.gov/Food/GuidanceRegulation/GuidanceDocumentsRegulatoryInformation/LabelingNutrition/ucm064916.htmUpdated October 9, 2012. Accessed April 8, 2013

New Research: Protein Makes the Most of Breakfast

egg wrap

A new study published online by the American Journal of Clinical Nutrition points to the benefits of choosing a higher-protein breakfast. Researchers at the University of Missouri found that study participants who consumed a protein-rich egg and beef breakfast, versus a typical ready-to-eat cereal breakfast, reported increased feelings of fullness. Compared with participants who skipped breakfast altogether, those who ate the high-protein meal also experienced significant improvements in hunger and satiety hormone levels and reduced food cravings prior to dinner (as shown from reduced neural activation).

Additionally, those who ate the egg and beef breakfast also consumed fewer high-fat snacks later in the evening. These findings suggest that getting more protein in the first meal of the day may be a useful strategy for those looking to manage weight. More details of the study can be found here, along with insights from lead researcher Heather Leidy, PhD and breakfast tips from registered dietitian Neva Cochran, MS, RD, LD.