Showing posts with label appetite. Show all posts
Showing posts with label appetite. Show all posts

Thursday, April 6, 2017

Morning vs. Afternoon Cardio: Early Birds DO Have a Fat Loss Advantage, Authors of New Human Study Conclude

I know, this may be disappointing, but the study at hand won't settle the debate once and for all.
Even though Brad Schoenfeld's often-cited "fasted cardio" study suggests that the long-standing myth that "cardio", i.e. aerobic training at moderate intensities, would burn more body fat if you do it in a fasted state in the AM didn't yield the results proponents of "fasted cardio" hoped for, the myth that there's something to doing your cardio training in the AM is still unrefuted.

In their latest study, scientists from the Sports Medicine Research Center and the Department of Sports and Exercise Medicine at the Teheran University of Medical Science did now try to get to the bottom of the "early is better"-myth.

Based on the observation that exercise can significantly affect your appetite, wich almost 16% of the interventional trials that evaluated the correlation between physical activity and food intake showing that volunteers’ appetite decreases after exercise, and the majority indicating that it remained unchanged, they speculated that the often-cited mechanism, i.e. an increase in fatty acid oxidation with AM training (done in the fasted state) could be irrelevant compared to the effects of early exercise on (obese) subjects' appetite and thus food intake within a given 24h period.
Learn more about using cardio to lose body fat and if timing matters:

AM vs. PM Cardio - Fat Oxid. in Athletes

Breakin' the Fast, Cardio & Your Brain

Greater Gains With Cardio B4 Weights in the PM

AM Cardio Burns 50% More Fat over 24h, But...

How Much Cardio Messes W/ Your Strength Training?

Fasted Cardio While Dieting ≠ Greater Fat Loss
As Alizadeh, et al. point out in the corresponding paper in Clinical Obesity (Alizadeh 2017), "there are few studies that consider the effect of a single session of exercise at different times of day on appetite or food consumption". In view of the "lack of time, as is a common barrier in modern life," the authors do yet believe that "exercise should be undertaken at the best time of day in order to obtain maximal appetite suppression and greater weight loss" (ibid.). To figure out, whether this time is in the morning or the evening they conducted a 6-week study to compare the effect of 6 weeks of morning or evening aerobic exercise on appetite and anthropometric indices in N=48 20–45-year-old female participants with body mass index (BMI) of between 25 and 29.9 kg/m². Inactive patients were chosen "to eliminate the effects of other types of exercise on outcomes" (ibid.) and "to decrease the risk of musculoskeletal injuries during exercise testing and prescribed aerobic exercise" (ibid.).

A total of 25 patients participated in the morning aerobic exercise (ME) as group 1 and scheduled to perform their supervised training sessions within 8–10 AM, while the other subjects had to report at the lab between 2–4 PM. All exercise session included 30 min treadmill running in the VT heart rate (this is when you can no longer talk to someone without breathing heavily).
Figure 1: Baseline demographics, anthropometric measurements and physical characteristics of the study participants; data are expressed as mean ± SD unless otherwise stated. (Alizadeh 2017).
The subjects' rate or perceived exertion (RPE) was recorded in the peak of the exercise session at baseline and in the third and the sixth week of the trial. All participants were asked to complete food record forms 24 h before and after exercise sessions and to fill out an appetite visual analogue scale in order to estimate the level of prospective food consumption; fullness; hunger; satiety; and the desire to eat savoury, sweet, salty and fatty foods before the exercise session and 15 min after at baseline and in the third and the sixth week of the trial. In addition, body analysis and anthropometric measurements were taken at three time-points that have been mentioned before.
Figure 1: Changes in anthropometric variables over the course of the 6-week study (Alizadeh 2017).
As you can see in Figure 1 there was a "weighty" advantage for the AM group. The latter is in line with the scientists' observations that ...
  • Table 2: Summary of 24-h food records over time in the morning and evening exercise groups (Alizadeh 2017).
    even though subjects in both groups burned the same amount of energy during their workouts [the patterns of change of RPE, speed and estimated mean heart rate during the exercise session were similar over time between the two groups] and didn't have different post-workout appetite scores,
  • the effects on the subjects' energy intakes differed significantly [the subjects in the AM group consumed -17% less energy; most of the reduction came from carbs | Table 2]
Now, all that sounds great, what's not so great, however, is the fact that the scientists didn't find significant changes in body composition. Since they used a pretty unreliable Impedance Analyzer (AVIS33 body composition analyzer, Jawon Medical Co. Ltd, South Korea) to generate the lean mass and fat mass data in Figure 1, it does yet make more sense to focus on the skinfold data to assess the body fat reduction. Here we can see a surprisingly significant inter-group difference (see Figure 1, right), with...
which (the inter-group difference) is hard, if not impossible to explain. This leaves us with an increased loss of body weight, of which we cannot tell for sure where it was lost - not exactly what I would call convincing evidence in favor of AM cardio.
New "Fasted Cardio"-Study Falsifies the Myth of Superior Fat Loss on a Moderate Energy Deficit | more.
Calories count and cardio doesn't make you hungry: No, the short duration the scientists emphasize time-and-again is certainly not the most important weakness of the study (that's the way the body composition was assessed) - and still: There's one thing we may take away from the study that can help you (or your clients) lose weight: The energy you spend during cardio is not fully compensated later in the day; and that goes for both, not just the AM group.

AM cardio, on the other hand, appears to have the added bonus that it actually reduces the food intake and will thus result in an overall greater reduction in body weight.

I would still say that we need further studies to confirm the consistency of this effect and assess more relevant outcome values, such as the effect on blood glucose management and DXA-confirmed body composition changes in both, couch potatoes as in the study at hand, and more athletic individuals, to say with confidence that it "appears that moderate- to high-intensity aerobic exercise in the morning could be considered a more effective program than evening exercise on appetite control, calorie intake and weight loss" (Alizadeh 2017). | Comment!
References:
  • Alizadeh, Z., Younespour, S., Rajabian Tabesh, M. and Haghravan, S. (2017), Comparison between the effect of 6 weeks of morning or evening aerobic exercise on appetite and anthropometric indices: a randomized controlled trial. Clinical Obesity. doi: 10.1111/cob.12187

Friday, November 11, 2016

Why's Maintaining 'Ur Fat Loss so F* Hard? Calorie Counter Will Ramp Up Your Appetite, No Matter What - Lifelong Anti-Weight-Gain Efforts Required in Formerly Obese Subjects

If  obesity is a chronic disease it cannot be surprising that it cannot be cured and weight loss maintenance requires life-long effort(s) on part of the formerly obese (note: things are different for non-obese individuals trying to shed extra-pounds).
I've discussed the issue of "metabolic damage" in a series of previous SuppVersity articles and pointed out that the scientific evidence supporting the disproportionate down-regulation of your metabolic rate with (significant) weight loss cannot support the exorbitant weight rebound we see in many so-called "weight-reduced individuals", who return to their "normal" dietary habits.

Now, a recent study from the US (Polidori. 2016) shows that this weight gain is mostly driven by a hitherto largely overlooked increase in appetite - an increase that goes way beyond any effects of "metabolic damage".
High protein helps, but do not counter the weight loss induced changes in RMR & appetite

Are You Protein Wheysting?

5x More Than the FDA Allows!

More Protein ≠ More Satiety

Protein Oxidation = Health Threat

Protein Timing DOES Matter!

More Protein = More Liver Fat?
Before we get into a discussion of the implications of this research, though, I would like to briefly summarize what Polidori et al. did to arrive at their important conclusion that...
"feedback control of energy intake plays an even larger role [than energy expenditure adaptations when it comes to the post-diet jojo-effect] and helps explain why long-term maintenance of a reduced body weight is so difficult" (Polidori. 2016)
Using a validated mathematical method the authors calculated the energy intake changes of 153 patients who lost a significant amount of weight over the course of a 52-week placebo-controlled trial with canagliflozin, a sodium glucose co-transporter inhibitor, a commonly used diabesity drug that increases urinary glucose excretion.
Association between adaptive thermogenesis and weight loss in 151 overweight patients from three studies after dietary or bariatric surgery-induced weight loss.
"Metabolic damage" does not scale with weight loss: While it would be logical to assume that there was a linear increase in "metabolic damage", i.e. the reduction of your resting metabolic rate, in response to each pound of body weight you've lost. The existing evidence, which has recently been reviewed by Müller et al. (2016), however, suggests that this link does not exist (see Figure on the left). This is also in line with the results of the study at hand and previous studies which didn't find an effect of increasing weight loss on the subjects' appetite (this is discussed in detail below).
In spite of the fact that we are talking about experimental evidence, the scientists still had to rely on math / statistics to come up with data on the actual energy intake of their subjects.
Metabolic damage in Biggest Losers | more
"We calculated the free-living energy intake changes in 153 patients treated with 300 mg/day canagliflozin over a 52-week trial using the mea-sured body weight data and an assumed mean UGE [urinary glucose excretion] of 90 g/day as inputs to a mathematical model that has recently been validated against an expensive biomarker method" (Polidori. 2016 | note: it is still debatable how accu-rate this calculation is as it depends on a relatively simple formula that uses a bunch of input parame-ters based on theoretical assumptions).
Now, this use of a sodium glucose co-transporter inhibitor and the resulting urinary loss of approximately 90 g of glucose per day (that's 360 kcal/day) is an important qualifier here, as it is a way of creating an energy deficit of which the scientists argue based on previous scientific evidence that the way the scientists induced an energy deficit ...
  • does not alter the subjects' energy expenditure (regular dieting would acutely decrease their metabolic rate) or central pathways controlling energy intake (hunger & appetite) and 
  • allows for weight loss even though the patients are not directly aware of being in an energy deficit - or, put more simply, without any 'dieting efforts' or austerity
As Polidori et al. point out, any observed increased energy intake countering the weight loss induced by SGLT2 inhibition therefore likely reflects the activity of the feedback control system - your body's very own 'calorie counter' as I have called it in the headline.
Learning from those who did it: Wyatt et al. used data from the National Weight Control Registry (Wyatt. 2005) to follow a still barren path in obesity research: studying what those who manage to lose weight and keep it off did right. Until now, way too much effort is spend on identifying diet mistakes; mistakes that would be automatically avoided if you did the right things. Unfortunately, there's no magic bullet or, as the authors say: "If weight loss maintenance requires “swimming upstream” against the environment, then these are the best swimmers" (Wyatt. 2016).

The use of refeeds was not part of Wyatt's research interest, but there's experimental evidence that refeeding twice a week promotes fat loss | more.
What Wyatt et al. were able to show, however, is that people who have successfully maintained weight loss share similarities in how they keep weight off. And here's what they did: (1) They didn't rely on dieting, only, but have increased their total physical activity (to 3,293 kcal per week) as well (only 9% of those who kept the weight off did it with dieting, only); (2) they didn't stop dieting / return to their old habits after losing a certain amount of weight, but maintained a tightly energy controlled diet; (3) they constantly monitored their weight and intervened when they saw weight gain of more than 3-5 pounds; (4) cheri-shing improvements in quality of life and self-confidence.

Aspects I wouldn't include in the list, yet, are: consuming a low fat diet (that was probably due to the popularity of low fat back in the day), eating breakfast everyday (there simply is no convincing evidence that this will mechanistically promote weight loss and maintenance), and improve.
Beware: Chronic dieting at low deficit can make you fat | more!
It is also noteworthy that the study at hand provides additional evidence of the mechanisms which are driving the post-dieting weight regain (i.e. an increase in appetite and thus usually food intake) - a mechanism that is weight and not deficit dependent. This, in turn, may be considered further evidence of the existence of something many people call a "set point" (i.e. a given weight at which your body is "happy" and your appetite will match your energy requirements pretty well). Unfortunately, Polidori, et al. cannot explain why the weight-controlling appetite increase does not scale with the amount of weight the subjects lost. Why's that important? Well, if you lose 10kg or 20kg, your appetite will increase to the same extent. If we assume that this increase in appetite translates directly into increases in food intake, the rate of weight gain will be the same - regardless of whether you lose 10kg or 20kg of body weight - it's the total amount that counts.
Is it futile to even try to lose weight? An excellent comment by Priya Sumithran & Joseph Proietto says NO - (1) Modest (5–10 %) weight loss confers significant reductions in the risks of several weight-related conditions such as type 2 diabetes, obstructive sleep apnoea and non- alcoholic fatty liver disease [18], and is likely to be accompanied by milder metabolic adaptation | (2) Although the majority of people will eventually regain much of the lost weight, results are variable, and a proportion of people manage to maintain clinically beneficial weight loss even in the long-term: more than 4000 U.S. adults in the National Weight Control Registry database (97 % Caucasian, 80 % women), for example, have maintained a loss of at least 13.6 kg (30 lbs) for a mean of over 5 years |  (3) New pharmacological therapies that help weight loss and maintenance are becoming available (e.g. GLP-1 agonists) and other drugs that mimic the effects of RYGB surgery are in the development pipeline. And still, while there's hope, it's important to acknowledge that "[l]ike other chronic con-ditions, obesity is not cured after the phase of treatment (weight loss), and strategies for long-term management (maintenance of weight loss) are required " (Sumithran. 2016).
So does the study just confirm that people who have gotten fat once are doomed forever? That's difficult to tell, after all, some interventions such as RYGB weight loss surgery appear to have a decent rate of success. While the subjects may not turn into fitness models, many manage to maintain a decently healthy weight after crash-dieting down to a normal BMI-range.

Surgery may yet not be the only option. After all, there's reason to believe that there's a threshold level of weight loss after which the previously discussed compensation effects occur. It may thus well be possible that small weight changes are uncompensated by changes in energy intake. If we consider the previously referred to concept of a weight set-point to be dynamic in both directions, it is thus not impossible that losing your weight in baby-steps with adequate periods at an energy equilibrium (calories in = calories out) and no further weight loss in-between the short dieting periods may help you to lower your set-point and achieve (in the long-run) meaningful weight-loss without compensatory increases in appetite that will get you back to your original weight in no time | Comment on Facebook!
References:
  • Müller, Manfred J., Janna Enderle, and Anja Bosy-Westphal. "Changes in Energy Expenditure with Weight Gain and Weight Loss in Humans." Current Obesity Reports 5.4 (2016): 413-423.
  • Polidori, David, et al. "How strongly does appetite counter weight loss? Quantification of the feedback control of human energy intake." Obesity 24.11 (2016): 2289-2295.
  • Sumithran, Priya, and Joseph Proietto. "Maintaining weight loss: an ongoing challenge." Current Obesity Reports 5.4 (2016): 383-385.
  • Wyatt, Holly R., et al. "Lessons from patients who have successfully maintained weight loss." Obssity Management 1.2 (2005): 56-61.

Tuesday, November 1, 2016

Choosing & Processing Foods for Satiety: The Science 101 for Regular Consumers and Food Industry Insiders

Don't worry, this is no article about "Frankenfood" like salami bananas, ...
According to the drugs.com definition, a "designer food" is "a dietary supplements or foodstuffs containing nutrients and various combinations of vitamins, minerals, and other substances considered by some to offer clinically significant benefit, often without adequate scientific proof of efficacy." If you don't want your designer foods (or your self-prepared foods and meals) to fall into the latter category of products without adequate scientific proof of efficacy, this article is for you, because it summarizes the science on an often overlooked quality of food: its structure, and the effect the latter will have on your and/or customers' satiety.
Learn more about the satiety effects of foods, supplements and exercise

Whey to Casein Ratio not a Satiety Factor

Binging is just a natural starvation response

More Protein Doesn't Always More Satiety

Fluids and solids - What's More Satiating?

Tryptophan, the Satiety Amino Acid?

Always Hungry? What's Triggering Your Craving?
In a recent review, Campbell et al. have aptly illustrated how both the product and the way(s) costumers eat it affect the individual satiety (see Figure 1).
Figure 1: Satiety is more complex than calories in vs. calories out - In fact, it's hardly about calories at all.
Allegedly, the separate roles of the initial food structure, structural transformations, oral processing,
and dynamic sensory perception in satiation (makes you stop eating) and satiety (reduces your incentive to have another meal | see blue box) have not been fully established, but hey: you've got to start somewhere when designing functional (satiating and satiety promoting) foods is #1 on your private or professional agenda. So here's what we know:
  • food structure and texture contribute to satiation and satiety,
  • time required for oral processing has been shown to influence satiation/satiety,
If we were able to integrate the interaction of food structure, texture, and oral processing on satiation/satiety this may help us to produce more satiating foods and thus help people lose weight. So how can we do that?  Vliet, van Aken, de Jongh, & Hamer (2009) classified foods as fitting into broad categories of:
  1. fluids - fluids flow and have minimal or no yield stress (e.g. beverages like sodas or milk); 
  2. semi-solids - semisolids are fluid-like, have a high yield stress, and deform or break without fracturing into pieces (e.g., pudding, yogurt, and bananas); 
  3. soft solids - soft solids fracture into pieces but without sound (e.g., cooked egg white, some cheese and processed meats); and 
  4. hard solids - hard solids fracture into pieces and emit sound during fracture (e.g., crackers, toast, nuts, apples, and carrots). 
Needless to say that these overall physical properties are (a) a result of the foods individual food structure and can (b) be modified to a certain degree and thus affect an individual food's satiety effect by either natural (e.g. fermentation, mixing, etc.) or artificial (e.g. enzymatic treatments, adding thickening agents, etc.) means.

But isn't that overrating the importance of texture?

Not really... After all, you must take into consideration that the texture of your foods will influence their satiating effect and your satiety (after the meal) by at least mechanisms, i.e.
  • oral processing parameters which are directly influenced, as well as adjusted to accommodate changes in food texture throughout the chewing sequence and ...
  • texture perception, which will influence your expectations of satiety, which - despite being a highly dynamic process that correlates with oral processing (chewing, etc.) will eventually have significant effects on the satiating and satiety effects of the foods you eat.
By turning a protein shake into a pudding with xanthan, for example, you will "force" yourself or your customers to consume the shake like a pudding: with a spoon. In addition, the mouthfeel of a pudding will leave them with the expectation that the product is more satiating than a watery whey protein shake - an expectation that usually turns into a self-fulfilling prophecy.
Table 1: Overview of the results of Campbell's review (2016); studies accompanied by a plus symbol (+) indicate that at least one measured marker of satiation/satiety was affected by texture
As Campbell et al. point out in their previously cited review, this has been shown in multiple study. Agrawal et al. (1998), for example, were one of the first to demonstrate the dependence of oral processing and thus your eating speed on intrinsic properties of food texture:
"Using a selection of cheeses, nuts, and carrots, the authors established a clear dependence of breakdown rate and activity of closing muscles on mechanical parameters – in this case, toughness and modulus of elasticity. More recent studies have expanded on this concept by utilizing a wider variety of foods varying in texture from fluids to soft and hard solids (Forde et al., 2013; Viskaal-van Dongen, Kok, & de Graaf, 2011). Though the foods were not characterized structurally, both Forde et al. (2013) and Viskaal-van Dongen et al. (2011) found significant differences in eating rates, ranging between 4 g/min for crisp foods such as rice cakes or tortilla chips, 100 g/min for soft cooked vegetables, and 650 g/min for thin beverages such as juice or soda. The total number of chews necessary to process 50 g samples ranged from 27 to 488 chews for mashed potatoes and tortilla chips, respectively while total oral processing time ranged from 27 s for canned tomatoes to 350 s for tortilla chips" (Cambell. 2016).
Now, I am probably not telling you something new, when I inform you that science shows that faster eating rates are associated with increased food intake. Thus the "real-world, real-food approach" (Campbell. 2016) indicates that foods requiring limited oral processing actions, such as liquids, semisolids, and soft, cooked solids, may be more easily over-consumed than hard or chewy solids, such as crackers, chips, or certain meats.
With its satiety-promoting effects soluble fiber will reduce the number of meals and prolong the intervals between meals on an ad-libitum diet. It will, however, not affect the satiating effect of an individual meal; meaning: if you are a binge eater whose extra body  fat is "acquired" from super-size meals, it's not going to get you lean.
Did you know that there's a difference between satiety and satiation? Satiety is what determines when and whether you're going to eat. Satiation is what tells your body that you can stop eating now.

Why would you care? Well, the answer can be found in a recent study on soluble fiber intakes, for example. While the latter will increase your satiety and thus reduce your meal frequency and the number of meals you will be consuming on an ad-libitum (eat when and how much you want), it won't affect your satiation. Practically speaking this means: Increasing the soluble fiber content of your diet is not going to magically prevent obesogenic binges - and, when all is said and done, 3x2000 kcal are as fattening as 6x1000kcal.
That doesn't sound so indisputable any longer, right? I mean we know that chips are not exactly more satiating than, say, chicken breasts. In this context, it is important to understand that pertinent studies measure eating rate by weight (g/min) rather than by total calorie intake (calories/minute). In our example, the chicken breast will yield higher eating speeds indicating that a higher amount (as in weight) of the product is being consumed per minute, but for a given amount of food, the caloric content of the chicken breasts is usually still significantly lower than that of potato chips, which is yet another example of the fact that you have to consider all variables (in this case, first and foremost texture, eating speed and relative energy density) and their interaction to predict the satiety and satiating effects of a meal.

But there's more to it than the difference between hard, soft and liquid. Even if you don't go beyond the structure (e.g. looking at the protein content of foods), modifying the microstructure with gelling protein-polysaccharides or reducing the creaminess by cutting down on fat will sign. affect the chewing rate and thus - at least theoretically - make foods more or less satiating.

So far so bad, because it's all theory!

I am not sure if you've tried low-fat cheese; but if you have, you will have notice that it chews and, unfortunately, tastes like cardboard and is thus hardly more satiating than regular cheese. To actually make reliable predictions about the satiating and satiety effect of various foods, it does, therefore, take real-world studies the design of which usually look as described by Campbell et al., recently:
" Measurements of satiation and satiety typically fall into three categories: subjective panelist ratings, physiological measurements, and ad libitum intake. Subjective panelist ratings of hunger and fullness, often in the form of a 100 mm visual analog scale (VAS), represent the most direct and simplistic measurement of hunger and fullness. These ratings are often corroborated by offering an ad libitum snack or meal and measuring how many calories the panelist consumes following consumption of a test food. One can also measure physiological biomarkers associated with metabolism, satiation, and satiety, including glucose, insulin, ghrelin, leptin, cholecystokinin (CCK), glucagon-like peptide-1 (GLP-1), peptide YY (PYY), and gastric inhibitory peptide (de Graaf et al., 2004). Other physiological measurements include diet induced thermogenesis (Crovetti, Porrini, Santangelo, & Tesolin, 1997; Westerterp-Plantenga, Rolland, Wilson & Westerterp, 1999) and gastric emptying time (Blundell et al. 2010). While quantification of biomarkers provides an unbiased, physiological response, healthy panelists often exhibit wide ranges of biomarker concentrations and this biological variation can complicate interpretation of results. Combinations of the above measurements are more commonly utilized to account for biological and psychological variability" (Campbell. 2016).
From these studies, scientists have learned a lot. Not all of it was surprising. After all, we all have some knowledge of what is satiating and what is not. It is thus not a surprise that...
  • protein is the most satiating macronutrient, carbohydrates come in as a distant second and fats are really trailing behind;
Table 2: Dietary fibre content of foods in commonly served portions (Slavin .1987).
  • non-digestible carbohydrates are satiating, too  -  fiber (see Table 2) and resistant starches both fall into this category and are (rightly so) on the list of 'best-known satiety promoters'
That the satiating effect of protein is more or less independent of whether it is fast- or slow-digesting, on the other hand (see my recent article on whey and casein | read it), is something only a few people know. The same goes for the advantages of fiber with a high intrinsic viscosity – such as pectin, β-glucan, psyllium, guar gum, and alginate, which have been shown to have superior effects on individual's energy intake(s). Likewise on the list of often-overlooked satiety factors are...
  • polyphenolic compounds - these plant molecules have been shown to form high affinity, non-covalent bonds with both food proteins and digestive enzyme, will thus slow digestion and nutrient absorption... and thus up the satiety effect of the product and/or limit the nutrient uptake from the foods (e.g. tannins in cocoa, fruits, tea, cinnamon, and peanuts have been shown to be 'carb blockers')
Figure 3: Even for high protein foods, turning a solid into a liquid significantly compromises its satiety effect as measured by the dietary energy consumed after an isocaloric protein preload in 40 obese & lean subjects (Mourao. 2016).
  • grinding or homogenizing food - while solidifying is a tried and proven method to make a food more satiating, grinding, pureeing, homogenizing and co will decrease the satiety effects of foods such as a chunky fruit yogurt, chicken, etc. that will be less satiating when you puréed it and/or created a pie of it
  • increasing food volume - that's not by switching from chocolate to zucchini; rather than that it's about turning a soup-like food into a foam and/or simply using water to add volume
Figure 4: Mean overall intake at a breakfast test meal (±SEM) in grams (a) and kilocalories (b) that was served after a preload with 2mm (filled) or 50 mm (open bars). * represents significance at P < 0.05 (Lett. 2016).
  • modifying the lipid droplet size - emulsion with smaller droplets are more satiating than those with large(r) fat droplets (Lett. 2016)
Can xanthan reduce the glycemic response to "sweet treats" like this? Learn more in this SuppVersity Classic.
Ok, we know relatively little, but... the little we know leaves no question that satiety is not just about macros. After all, calories count and the amount of energy you will consume depends on more parameters than "your macros".

With that being said, the addition of fiber is already used extensively in the food industry. What is hardly noticed by consumers and producers alike, however, is that simply adding volume by stirring air / adding water (in)to a product will likewise add to the satiating effect of a given food; the same goes for water. In fact, up to now producers add air (e.g. ice-cream) and water (e.g. to ham) mostly to make the production cheaper. That this has satiating side effects, on the other hand, is rarely used on purpose | Comment!
References: 
  • Campbell, Caroline L., Ty B. Wagoner, and E. Allen Foegeding. "Designing foods for satiety: The roles of food structure and oral processing in satiation and satiety." Food Structure (2016).
  • Lett, Aaron M., Jennifer E. Norton, and Martin R. Yeomans. "Emulsion oil droplet size significantly affects satiety: A pre-ingestive approach." Appetite 96 (2016): 18-24.
  • Mourao, D. M., et al. "Effects of food form on appetite and energy intake in lean and obese young adults." International journal of obesity 31.11 (2007): 1688-1695.
  • Slavin, Joanne L. "Dietary fiber: classification, chemical analyses, and food sources." Journal of the American Dietetic Association 87.9 (1987): 1164-1171.

Tuesday, October 25, 2016

Total Protein, not its Whey-to-Casein Ratio Determines the Satiety Effects of a Standardized Chocolate-Vanilla Shake

No, that's not a photo from the study.
This is not the first SuppVersity article to discuss the satiating effect of dietary protein, but it's the only one addressing the notion that a lower whey-to-casein ratio in a high-protein milk beverage would go hand in hand with an increased satiety effect.

Why should it? Well, as Amelinda et al. (2016) point out, "whey and casein protein have different digestion rates" it is thus only logical to assume that combining them may result in a prolonged satiating effect.
High-protein diets are much safer than pseudo-experts say, but there are things to consider...

Practical Protein Oxidation 101

5x More Than the FDA Allows!

More Protein ≠ More Satiety

Protein Oxidation = Health Threat

Protein Timing DOES Matter!

More Protein = More Liver Fat?
To test this hypothesis, the Indonesian researchers conducted a randomized, single-blind, cross-over study with 12 healthy, normal-weight men who received a standardized breakfast (tuna sandwich, which consisted of white bread and tuna sandwich spread, prepared to fulfill 20% of the individual DER with 16% of the energy coming from protein, 22% from fat and 62% from carbohydrate) followed by one of the three preloads in form of a milk beverage (140kcal) containing 15 g protein with whey-to-casein protein ratios of 20:80, 50:50, or 80:20.
Table 1: Energy and macronutrient content of the test beverages (Amelinda. 2016).
To assess the differential effects of the high vs. low whey / casein protein shake, the researchers assessed the subjective appetite ratings on a visual analog scale. What's more important, though, is that the scientists also measured the consecutive energy intake during (a) an ad-libitum lunch (spaghetti, fresh mushroom Italian sauce, corn oil, cheddar cheese, sugar, salt and pepper; prepared based on a standardized recipe and was mixed homogeneously by the same person for each test day the lunch provided 150 kcal / 100g with 13, 22 and 65% of the total energy provided by protein,
fat and carbohydrate, respectively) and (b) by the means of dietary recalls of food and drinks consumed during the remainder of the experimental day.
Figure 1: Mean subsequent energy intake during: (a) Lunch; (b) Remainder of the day; (c) Total energy intake. Error bars show 95% confdence interval (Amelinda. 2016).
In contrast to the authors' research hypothesis, their study showed that "there was no significant effect of the whey to casein protein ratio in milk beverages on the appetite ratings and subsequent energy intake" (Amelinda. 2016). If you take into account previous studies on the satiety benefits of high(er) protein intakes, too, the logical conclusion is that "[a] high protein content, as opposed to the type of protein, may be of greater importance in determining the satiating properties of protein and should be taken into account when developing weight loss products" (Amelinda. 2016).
Casein & whey - Many companies sell both. For a good reason! What's that reason? Well in combination they will do both, trigger and sustain maximal protein synthesis | learn more.
It may still make sense to choose specific whey-to-casein ratios: their effects on muscle protein synthesis. As previously discussed, it doesn't just make perfect sense to prolong the period of hyperaminoacidemia, i.e. the elevation of essential and non-essential amino acids in your blood, by adding some slow-digesting casein to your beloved post-workout whey shake, it has also been confirmed in a long-term study that this practice will actually produce a significant increase in lean mass gains in thirty-six resistance-trained males.

Ahh... and based on N=1 personal experience, I would like to add that real high protein foods are usually significantly more satiating than protein shakes | Comment on Facebook!
References:
  • Angela, Amelinda, et al. "Effect of Whey-to-Casein Protein Ratio in Chocolate-Vanilla Milk Beverage on Satiation and Acute Energy Intake." Kasetsart J. (Nat. Sci.) 49 (2016): 738 - 746 

Tuesday, September 27, 2016

Women Have a Hard(er) Time Losing Body Fat W/ Exercise 'cause it Increases Their Appetite More Than Men's, Right?

Is she going to binge after this body weight squat workout? Nah, don't worry...
I've repeatedly written about studies that show that the Taubs'ian notion that "exercise is useless because it just makes you hungry" is bullsh*t. It is indeed useless to work out to burn calories, it is yet never useless to work out - even if fat loss, not health or longevity is your goal.

What you should be aware of, though, is that there is a gender bias in the selecting of subjects in health sciences; and since the average subject in nutrition and exercise sciences is male and studies that have enough male and female subjects to identify relevant sex differences are rare, we don't really know if everything that has been "scientifically proven" can also be considered "scientifically proven" for female dieters and/or trainees.
Learn more about the (often ;-) small but significant difference at the SuppVersity

1g PRO per 2g CHO + Circuit T. for Women?

Is the Optimal Exercise Order Sex-Specific?

1-3mg Melatonin Shed Fat W/Out Diet & Exercise

Not Bulky! Lifting Will Make Toned & Strong.

How to Really Train Like a Woman

Sex-Differences in Fat Oxidation - Reviewed
The effects exercise will have on your appetite, for example, is such a research interest that has been investigated mainly in male subjects. As Alice E. Thackray, et al. (2016) point out in their latest paper in Nutrients, ...
"[...] opportunities to examine sex-based differences have been limited, but represent an interesting avenue of inquiry considering postulations that men experience greater weight loss after exercise interventions than women" (Thackray, 2016). 
In other words: While we don't know much, the few things we do know about the sex-specific interaction between exercise and your appetite are enough to draw a handful of practically highly relevant conclusions about optimal exercise and diet regimens for women.

Acute exercise, appetite, and compensation with energy intake - it's primarily individual

Before we delve deeper into sex-differences, though, I would like to remind you that the individual differences in fat and weight loss are not just better studied than those between men and women, they are probably also much more relevant than any sex difference - and that in spite of the fact that the research suggests that they are mediated by the same (individual) differences in compensatory behaviours that negate the exercise-induced energy deficit as the inter-individual differences.
Figure 1: The 2008 study by King et al. shows that (a) the individual differences in appetite are magnitudes larger than the actual effect of exercise and that (b) what the subjects make of it in terms of their effects on the subjects' actual energy intake cannot be predicted based on these subjective changes (King. 2008).
In their 2008 study, for example, King et al. found that the individual propensity to compensate for a reduction in energy intake and/or an increase in expenditure can explain weight loss differences that are larger than 50% - albeit with a standard deviation in the "compensators" that is significantly larger than the total weight loss.
SuppVersity Suggested Article: "Training "On Cycle", Done Right - Women See Much Better Results When Periodization is in Line W/ Menstrual Cycle" | read it
Did you know that women benefit from dieting and training in-sync with their menstrual cycle? I am pretty sure you know that as I've mentioned this before at the SuppVersity and even wrote a whole article about "Training on the Female Cycle"evidence  suggests that compared with untailored programs, synchronising diet and exercise training interventions around the hormonal changes that occur during the menstrual cycle elicits greater weight loss (Geiker, 2016) and improvements in muscle strength (learn more). Yet while we do know how cyclical fluctuations in sex hormones (estrogen and progesterone) alter appetite-regulatory hormone concentrations and energy intake in women (Buffenstein, 1995; Brennan, 2009), however, we don't know their interaction with exercise.
Similar discrepancies were found for the effect on subjective hunger, where the standard deviation of the subjects' hunger on a visual analog scale was ±9.6 mm and thus 240x larger than the average appetite increase of 0.4 mm/day. That's huge and it's quite a pity that the study didn't have enough subjects to conduct a meaningful analysis of the effect of the interactions of the subjects' sex on the increase in hunger the subjects experienced in King's 12-week study over the course of which the subjects trained five times a week without having to adhere to an energy restricted diet.

Men or women - that could still make an important difference

That this analysis could have yielded a significant difference between men and women, however, appears to be refuted by studies like Alajmi, et al. whose healthy male and female subjects had - within the previously described inter-individual differences - identical changes in the concentrations of the hunger-regulating acetylated form of ghrelin in response to 60 min treadmill running at 70% VO2peak (see Figure 2) - and that even though the men burned 57% more energy than the women.
Figure 2: Time-averaged total area under the curve (AUC) for appetite ratings (left); and plasma acylated ghrelin concentrations (right) in the control trial (□), and after 60 minutes on the treadmill at 70% VO2peak (■) in Alajmi's study.
In fact, the data in Figure 2 appears to confirm - for both men and women - the anorexic effect that is often ascribed to exercise. The study by Alajmi et al. is yet only one out of four partly contradictory studies that investigate the sex-based differences in the regulation of appetite in response to acute exercise:
  • Kawano, et al. (2012) - The first acute exercise and appetite study that compared men and women was published in Obesity Research & Clinical Practice. The authors reported that 20 min of rope skipping exercise increased ratings of subjective hunger 30 min after exercise in women but not men - quite a surprising result, also because high(er) intensity exercise as rope skipping has been shown to be particularly appetite suppressive in the average (=male) study subject; furthermore, Thackray et al. rightly criticize that the authors did not "control for the potential confounding effects of the menstrual cycle, which represents an important consideration for acute exercise studies comparing men and women" (Thackray. 2016). In this regard, recent studies have given us a few interesting insights (see light blue box). However, whether appetite responses to exercise in women are influenced by the menstrual cycle phase is not known and "represents", as Thackray et al. write "a research avenue to consider in the future".
  • Hagobian, et al. (2012) - Scientists from the California Polytechnic State University tested the effects on both appetite and energy intake in 11 men and 10 women exercised for 60 min on a cycle ergometer at 70% VO2peak until 30% of total daily energy expenditure was expended (men, expenditure = 975 ± 195 kcal in 82 ± 13 min; women, expenditure = 713 ± 86 kcal in 84 ± 17 min) in a counterbalanced, crossover study.
    Figure 2: Energy intake (see captions) and macronutrient composition (graph shows %-ages, the figures indicate the actual intake in g) of the post-workout ad-libitum meal (Hagobian, 2012).
    In line with Alajmi et al. (2012) and in contrast to Kawano et al. (2012), Hagobian et al. (2012) found a sign. reduction in energy intake (P < 0.05) after exercise compared with rest in men (672 ± 827, 1133 ± 619 kcal, respectively) and women (−121 ± 243, 530 ± 233 kcal, respectively). A result the scientists interpret as evidence of the previously cited "effectiveness of acute exercise to suppress relative energy intake regardless of sex" (Hagobian, 2012).
  • Bailey, et al (2015) - While the previous studies tested relative intense steady state exercises, a 2015 study from the University of Bedfordshire focused on a very different type of exercise. In fact, the 'exercise intervention' consisting of walking a total of 28 min in form of 2 min bouts every 20 minutes was designed to investigate the effect of daily physical activity on appetite and energy intake in 6 male and 7 female inactive, but otherwise healthy subjects, whose appetite and appetite-regulatory hormones were not affected by the exercise intervention.
You probably already suspect it: intensity is a key regulator of the effects of exercise on subjective appetite, but since I've addressed that before while discussing the sex-differences only superficially, I want to refer you to my previous article and focus on the influence of sex of which separate studies in men and women, respectively appear to suggest that...
  • 24h energy intake is unchanged in both, men and women in the few studies that investigated this important parameter in male and female subjects in isolation
  • acute energy intake (post exercise) mostly remains the same, often decreases and rarely increases in men and women when studied in isolation
  • exercise intensity, that's what evidence suggests modulates the effects on energy intake for both, men and women; in that, low-intensity exercise such as walking appears to be more prone to increase energy intake than high(er) intensity exercise such as jogging or sprinting
  • dietary overcompensation, i.e. an extra energy intake that provided more energy than the subjects had burned during their workouts, does not occur in either men nor women
  • individuality reduce the validity of the results; as previously pointed out, the appetite response to exercise appears to be highly individual and whether that's due to genetics and/or baseline diet (e.g. low carb vs. low fat, etc.) will have to elucidated in the future 
The one thing that's still left to discuss is the chronic effect of exercise on appetite, hunger, the respective hormones and - most importantly - men's and women's energy intakes.

The effects of chronic exercise

Unfortunately, studies that compared the effects of chronic exercise on appetite and food intake of men and women directly, don't exist. What we do have, though, are studies on both men and women (not adequately powered for comparisons), as well as studies that investigate men and women in isolation. These studies suggest that...
  • complex interactions w/ weight loss in both men and women - If weight loss occurs in response to chronic exercise, that's, according to King, et al. (2009), because overweight individuals (men and women) balance any potentially existing increased drive to eat due to the extra energy expenditure with a concomitant increase in the satiety response to a meal (increased insulin sensitivity, decreased acetylated ghrelin, decreased leptin | Martins. 2010 & 2013).

    Similarly, Thackray et al. conclude in their previously cited review that this interactive effect between exercise, weight loss and appetite / energy intake also explain the complex alterations in appetite-regulatory hormones, of which they even go so far as to say that they "arise as a secondary consequence to changes in body mass" (Thackray, 2016)
  • overall, women are more susceptible to changes in energy balance - In the long-term, it becomes more apparent that women react more sensitive to changes in their energy balance. Comparing studies in men and women (direct comparisons don't exist) suggest that this is why women are more susceptible to perturbations in appetite-regulatory hormones and energy intake.
  • exercise is less likely to trigger dietary compensation than energy restriction - In contrast to the initially referenced statement of Gary Taubes, it's dieting that makes you hungry, not exercise in both men (King, 2011) and women (Alajmi, 2016). "Dietary restriction," Thackray et al. explain may simply "represent a greater challenge to appetite regulation and energy balance than exercise".

    Figure 3: The energy intake between men and women differed in a 12-week aerobic exercise training intervention in overweight and obese men (n = 35) and women (n = 72), but the effect on the objectively measured (quantified using laboratory-based test meal days) did not differ between the male and female subjects (Caudwell, 2013)..
    And since we know that women react more sensitive to changes in said energy balance, it is not exactly surprising that individual two separate studies by Stubbs et al. (2002a,b) show that only women will compensate ~33% of the extra energy they expended during seven days of daily moderate- or high-intensity exercise (Stubbs, 2002a), while men didn't change their energy intake, at all (Stubbs, 2002b) - at least if we trust their food logs and the subjects' own scales, because that's what Stubbs et al. used as their data source.

    That's a problem, because - as usual - other studies suggest an increased compensation in men or, just as one of the few tightly controlled studies in this field no sex- but sign. indiv. differences (Caudwell, 2013). 
Eventually, the jury is thus still out. While anecdotal evidence suggests and evolutionary considerations, i.e. "that women have evolved to store body fat to preserve energy balance and reproductive function" (Thackray, 2016), could even explain an increased energy expenditure in women, the hard evidence we'd need for a definitive conclusion is simply not there.
Not Exercise, But Dieting Makes You Hungry: Beneficial or No Effects on Appetite of Exercise in Lean & Obese. (Ab-) using Exercise to Make Up For Messy Diets Still a Bad Idea! More...
Don't complain, ladies. Use your energy in the gym! As Thackray et al. point out, most of the more recent experimental work "question[s] the prevailing view that exercise is less effective for inducing weight loss in women, with several studies showing equivalent effects of exercise training on body composition in both sexes when the exercise-induced energy expenditure is matched" (Thackray, 2016) - the latter is obviously rarely the case, after all, women have a lower body weight and a lower lean body mass. So even if they trained at the same intensity as men (which a comparison of the average male to the average female gym-goer suggests they don't), they still wouldn't burn as much energy...

Rather than to complain about how unfair life is when it comes to exercise and fat loss, women should use their energy in the gym and focus on the new research on how training and eating according to their menstrual cycle could augment both, their exercise-induced fat loss and the actually desired changes in body composition | Comment on Facebook!
References:
  • Bailey, Daniel P., et al. "Breaking up prolonged sitting time with walking does not affect appetite or gut hormone concentrations but does induce an energy deficit and suppresses postprandial glycaemia in sedentary adults." Applied Physiology, Nutrition, and Metabolism 41.3 (2015): 324-331.
  • Brennan, Ixchel M., et al. "Effects of the phases of the menstrual cycle on gastric emptying, glycemia, plasma GLP-1 and insulin, and energy intake in healthy lean women." American Journal of Physiology-Gastrointestinal and Liver Physiology 297.3 (2009): G602-G610.
  • Buffenstein, Rochelle, et al. "Food intake and the menstrual cycle: a retrospective analysis, with implications for appetite research." Physiology & behavior 58.6 (1995): 1067-1077.
  • Caudwell, Phillipa, et al. "No sex difference in body fat in response to supervised and measured exercise." Medicine & Science in Sports & Exercise 45.2 (2013): 351-358.
  • Geiker, Nina RW, et al. "A weight-loss program adapted to the menstrual cycle increases weight loss in healthy, overweight, premenopausal women: a 6-mo randomized controlled trial." The American journal of clinical nutrition (2016): ajcn126565.
  • Hagobian, Todd Alan, et al. "Effects of acute exercise on appetite hormones and ad libitum energy intake in men and women." Applied Physiology, Nutrition, and Metabolism 38.999 (2012): 66-72.
  • Kawano, Hiroshi, et al. "Appetite after rope skipping may differ between males and females." Obesity research & clinical practice 6.2 (2012): e121-e127.
  • King, Neil A., et al. "Individual variability following 12 weeks of supervised exercise: identification and characterization of compensation for exercise-induced weight loss." International Journal of Obesity 32.1 (2008): 177-184.
  • King, Neil A., et al. "Dual-process action of exercise on appetite control: increase in orexigenic drive but improvement in meal-induced satiety." The American journal of clinical nutrition 90.4 (2009): 921-927.
  • King, James A., et al. "Differential acylated ghrelin, peptide YY3–36, appetite, and food intake responses to equivalent energy deficits created by exercise and food restriction." The Journal of Clinical Endocrinology & Metabolism 96.4 (2011): 1114-1121.
  • Martins, Cecilia, et al. "The effects of exercise-induced weight loss on appetite-related peptides and motivation to eat." The Journal of Clinical Endocrinology & Metabolism 95.4 (2010): 1609-1616.
  • Martins, Catia, et al. "Effect of chronic exercise on appetite control in overweight and obese individuals." Medicine and science in sports and exercise 45.5 (2013): 805-812.
  • Stubbs, R. James, et al. "The effect of graded levels of exercise on energy intake and balance in free-living men, consuming their normal diet." European journal of clinical nutrition 56 (2002a): 129-140.
  • Stubbs, R. James, et al. "The effect of graded levels of exercise on energy intake and balance in free-living men, consuming their normal diet." European journal of clinical nutrition 56 (2002b): 129-140.