Thursday, April 16, 2015

News Quickie: Regular Eating Patterns May Boost Weight Loss | Protein Increases Satiety, Influence on Food Intake is Limited, Though | Sugar Reduction ≠ Weight Loss | More

So you're eating "healthy"? Sure?
Time to clean my "may be worth an article" folder by putting out another installment of the SuppVersity short news. Today with a colorful potpourri of studies and experiments that were presented at the Summer Meeting of the Nutrition Society and are now subsequently published in the corresponding Proceedings of the Nutrition Society. 

Studies that are mostly, but not exclusively related to weight loss (or its prevention). Studies on protein, meal timing, appetite, eating for bone health and sugar reduction.
Learn more about the effects of your diet on your health at the SuppVersity

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  • Potassium and magnesium (not calcium alone) are necessary to keep your bones strong - In a random sample of 4000 individuals from the approximately 25,000 participants in the EPIC-Norfolk cohort scientists from the University of East Anglia were observed that combined dietary magnesium and potassium intake are positively associated with a quantitative measure of bone density (Hayhoe. 2015).
    Table 1: The higher the BUA (ultrasound attenuation), the stronger the bone. The higher the potassium and magnesium intake, the higher the BUA - it's as easy as that (Hayhoe. 2015).
    As the scientists point out, these results complement the limited literature studying other populations (Tucker. 1999; New. 2000; Rondanelli. 2013); and while the various beneficial effects of magnesium are widely appreciated (and on the web often totally overblown), the ones of potassium are still largely ignored (learn more about the low potassium epidemia).
  • Reduction of simple sugars alone is not enough to lose weight - In view of the fact that simple sugars are blamed to be driving the obesity epidemic, the appearance of tons of "sugar free" products of the market did not yet reverse the ever-increasing mean weights of the average Westerner, it appeared to be a smart move to examine the impact of an 8-week sugar reformulated product exchange on energy intake, energy expenditure (EE) and most importantly energy balance (EB), in a double-blind, randomised, controlled, crossover design Markey. 2015).

    Things look different in overweight individuals who consume artificially sweetened products | learn more
    For the study that was conducted by researchers from the University of Reading, forty five healthy, non-dieting, non-obese volunteers (14 male, 31 female; age: 32·0 (SD 9·8) years; BMI: 23·5 (SD 3·0) kg/m²) were randomly assigned to consume either regular sugar or sugar-reformulated food and drink products including confectionary, pasta sauces, baked beans, muesli, condiments and sugar-sweetened beverages for a 56 d period, with a 28 d washout period. The minimum target difference in dietary NMES intake between the regular and reformulated product exchange was 38 g/d (152 kcal). Weighed food diaries (4 d) and accelerometer data (7 d) were used to assess EI, EE and EB at baseline and following each dietary exchange period.

    In contrast to what the "bad sugar myth" would suggest, there was no significant effect of the intervention on body weight, EI, EE or EB; and that despite the fact that (1) the scientists had predicted a weight loss of at least 2.5kg body weight and irrespective of (2) the fact subjects actually reduced both their sugar and total carbohydrate intakes. Since much of the reduction in energy intake was compensated for "partly through increased voluntary fat intake", a blinded "sugar reduced diet" will not have significant effects on energy balance and thus body weight in either men or women.
  • Scientists confirm and quantify the satiety bonus of high protein breakfasts - "The fundamental contributing factor to the current obesity epidemic is energy imbalance," (Tolan. 2015) and I wish there were not a couple of dozen gurus who are debating that, but that's a different topic, so let's not lose sight of the context in which Tolan & Drummond wrote this statement.

    The researchers from the Queen Margaret University investigated if normal protein (NP; 15% energy), moderate protein (MP; 25% energy) and high protein (HP; 35% energy) quantities at breakfast proportionately increase subjective satiety and decrease within day energy intake. In the corresponding single blind three way crossover study, 12 healthy subjects (4 male, 8 female) (BMI = 23·9 ± 0·65 kg/m²) aged 21–31 years consumed three isocaloric breakfasts containing approximately 15%, 25% and 35% energy from protein, one week apart. Appetite parameters were measured via Visual Analogue Scale ratings before and after each breakfast and hourly thereafter.
    Figure 1: Macronutrient composition (g, left) and 8h fullness, hunger and desire to eat ratings  (Tolan .2015)
    The results in Figure 1 (right) clearly indicate a reduction in hunger and desire to eat and an increase in fullness that was however not linear. It is thus not surprising that there was only a trend in for a reduced mean energy intake between breakfast conditions. Only if this trend woul persist in the long run "this may prove to be a beneficial strategy within the multidisciplinary prevention or treatment of obesity" (Tolan. 2015).
  • Regular eating patterns may boost your weight loss efforts! And in this case regular does not mean "more frequently" it does simply mean that you stick to a plan like having breakfast at 6:00, lunch at 12:00 and dinner at 18:00.

    A recent study on "Breakfast Skipping" which found: "Whether Skipping Breakfast Increases Insulin, Hunger and Blood Lipids Depends on One's Breakfast Habits" seems to corroborate the results of the study at hand. After all, the findings suggest that breakfast skipping could increase your obesity risk only if you are not used to skipping it, i.e. if you lack a regular meal pattern.
    In a recent study from the University of Nottingham (Alhussain. 2015), 11 healthy weight women (18–40 years) were studied in a randomised crossover trial with two phases of 2 weeks each. In Phase 1, participants consumed either a regular meal pattern (6meals/day) or an irregular meal pattern (varying from 3 to 9meals/day). In Phase 2, participants followed the alternative meal pattern to that followed in Phase 1, after a 2-weeks washout period.

    In the two phases, identical foods were provided to a participant in amounts designed to keep body weight constant. Participants came to the laboratory after an overnight fast at the start and end of each phase. Resting metabolic rate (RMR) was measured by indirect calorimetry, in the overnight fasted state and during the 3 h period after consumption of a milkshake, test drink.

    In view of the short study period you cannot expect to see changes in body weight, but there was a significant difference in total postprandial energy expenditure (measured for 3 h) by visit (P = 0·04). More specifically, the postprandial energy expenditure after the regular meal pattern was significantly higher than at baseline (25·8 ± 6·8 and 17·5 ± 8·9 kcal respectively; P = 0·002) or than after the irregular meal pattern (14·8 ± 11·7 kcal; P = 0·04). Practically speaking this could, as the scientists point out, "contribute to weight loss and obesity management, but further studies are needed in obese participants" (Alhussain. 2015) - ah, since all subjects were women, it would be interesting to see if that's the same for men, because men are usually less susceptible to the effects of "fasting", so maybe they are also less susceptible to the effects of not getting their meal "in time".
Overfeeding 101: Get an Overview of the Consequences of Short- & Long-Term Overfeeding | read more
Bottom line: Weight loss requires a caloric deficit and that's not automatically induced by either reducing sugar intake or eating more protein - even if the latter may make you feel more satiated. This is by the way now scientifically proven, because Till et al. (2015) have recently been able to demonstrate that"appetite is not a reliable predictor of energy intake" (Till. 2015). In their review appetite and actual food intake were linked in only 19% of the 442 papers they assessed. This does also mean that in 81% the measured appetite scores had no significance in terms of the actual food intake.

In a similar vein, it is not yet clear if the increase in postprandial energy expenditure Alhussain et al. (2015) report in their paper is of real-world significance. In view of the fact that "irregularity" is one important characteristic of obesogenic eating habits, it would yet be foolish to negate it without longterm studies that disprove this hypothesis | Comment on Facebook!
References:
  • Alhussain, M, M. A. Taylor and I. A. Macdonald. "Influence of the constancy of daily meal pattern on postprandial energy expenditure in healthy weight women". Proceedings of the Nutrition Society, 74, E141 (2015): doi:10.1017/S0029665115001561. 
  • Hayhoe, et al. "Combined dietary magnesium and potassium intake is associated with greater bone density in women in the EPIC-Norfolk cohort". Proceedings of the Nutrition Society, 74, E120 (2015): doi:10.1017/S0029665115001354. 
  • Markey, O. and J. A. Lovegrove. "Dietary energy compensation in response to reduced sugar diet in non-obese men and women". Proceedings of the Nutrition Society, 74, E121 (2015): doi:10.1017/S0029665115001366. 
  • New, Susan A., et al. "Dietary influences on bone mass and bone metabolism: further evidence of a positive link between fruit and vegetable consumption and bone health?." The American journal of clinical nutrition 71.1 (2000): 142-151.
  • Rondanelli, Mariangela, et al. "Update on nutrients involved in maintaining healthy bone." Endocrinología y Nutrición 60.4 (2013): 197-210.
  • Till, S, C. J. Harden, V. A. Grant and B. M. Corfe. "Appetite is not a reliable predictor of energy intake: interim reporting of a systematic literature review". Proceedings of the Nutrition Society, 74, E150 (2015): doi:10.1017/S0029665115001652. 
  • Tolan E. and S. Drummond. "An investigation into the satiating effects of differing quantities of protein consumed at breakfast." Proceedings of the Nutrition Society, 74, E130 (2015): doi:10.1017/S0029665115001457. 
  • Tucker, Katherine L., et al. "Potassium, magnesium, and fruit and vegetable intakes are associated with greater bone mineral density in elderly men and women." The American journal of clinical nutrition 69.4 (1999): 727-736.