Effect of overfeeding macronutrients on day-to-day food intake in man

OBJECTIVE: To test whether overfeeding isoenergetic doses protein, carbohydrate and fat would differentially influence appetite on the same day, and the subsequent day's food intake. DESIGN: Six men were each studied three times on a 5-day protocol. On days 1 and 2 they were fed a medium fat (MF) maintenance diet (comprising 40:47:13% fat, CHO and protein by energy) calculated at 1.6 x RMR. Subjects entered the calorimeter at 08.00 on day 3 for 48 h. On day 3 (manipulation day), they ate a MF diet at 1.5 x RMR with an additional 0.6 x RMR as protein (HP), carbohydrate (HC) or fat (HF). On days 4 and 5, (outcome days), subjects had ad libitum access to isoenergetically dense MF (40:47:13) foods (550kJ/100 g). Subjective hunger and satiety were tracked hourly during waking hours throughout days 1-5. RESULTS: Throughout day 3 subjects felt significantly more full and less hungry on the high protein diet relative to the other two diets (P = 0.002). Also by the end of day 3 each overfed nutrient led to a significant increase in its own balance of the other two diets (P < 0.01). These effects did not influence the subsequent day's energy intake. The alterations in nutrient balance by the end of day 3 were partially buffered by increases in the oxidative disposal of each overfed macronutrient throughout day 4 (which was proportionately greater for protein (P < 0.001) than carbohydrate (P = 0.07) or fat (P = 0.1)). CONCLUSIONS: HP diets were more satiating that isoenergetically-dense HC or HF diets on the day they are eaten. The HC diet was transiently more satiating than the HF diet after each meal. This study supports previous work which suggests that relatively large changes in nutrient balance produced on one day appear to be poorly compensated by changes in energy intake on a subsequent day in men.     

Fat substitution and food intake: effect of replacing fat with sucrose polyester at lunch or evening meals

The objective of the present study was to determine the effect of replacement of fat by sucrose polyester (SPE) within a lunch or evening meal on subsequent energy intake and appetite control. The 2 x 2 design was intended to examine the effect on appetite of reducing the total energy and fat content of a meal (lunch or dinner) by replacement of natural fat with 55 g SPE. The effects were monitored by measuring motivation to eat or actual food consumption during the remainder of the test day (day 1) and throughout the following day (day 2). The 2 x 2 design yielded four conditions which were a control meal (5192 kJ, 73.2 g fat) and a fat-replaced meal (3305 kJ, 54.6 g SPE, 24 g fat) at midday (lunch) or in the early evening (dinner). No significant differences were seen in ad lib. energy intake after the test meals on day 1 or day 2. Certain differences were detected in fat intake on day 2 but these did not suggest nutrient compensation in response to the fat replacement. Subjective assessment of motivation to eat did not indicate that the fat-reduced meal had a weaker satiating efficiency than the control meal. A reduction in fat content, using fat replacement, did not reduce the satiating efficiency of a test meal given at lunch or dinner. No energy or macronutrient compensation occurred following the reduction in energy or fat intake during the rest of the test day or during the whole of the next day.     

Breakfasts with different fiber and macronutrient contents do not differentially affect timing, size or microstructure of the subsequent lunch

The effects of four equienergetic breakfasts with varying fiber and macronutrient contents on hunger and satiety ratings, on subsequent lunch intake, and on postprandial carbohydrate and fat metabolism were investigated in normal weight male subjects in two experiments, in which lunch was offered at a predetermined time (Experiment 1) or in which the subjects were free to choose when to eat lunch (Experiment 2). Consumption of either a commercially available high fiber cereal (HFC, 10% fiber), a medium fiber cereal (MFC, 7% fiber), a low fiber cereal (LFC, 3% fiber), or a standard continental breakfast (0% fiber) on nonconsecutive days did not differentially affect hunger and satiety ratings, the size or microstructure of the subsequent lunch, and the breakfast to lunch intermeal interval (in Experiment 2). Plasma concentrations of glucose, lactate, and insulin increased more after the LFC breakfast than after the other breakfast varieties. A reactive postprandial hypoglycaemia occurred after the LFC breakfast, shortly before lunch. The plasma concentrations of fat metabolites (triglycerides, free fatty acids, beta-hydroxybutyrate) and of glucagon were not differentially affected by the breakfast varieties. The results are consistent with the assumption that energy content of a meal is the major determinant of subsequent energy intake in man and the fiber content and macronutrient composition have only a modulating effect.     

Effect of exercise and dietary restraint on energy intake of reduced-obese women

Self-selected food intake of 15 reduced-obese women living in a metabolic ward was studied for 14 consecutive days to determine the effect of exercise and other metabolic and behavioral variables on energy intake. A choice of prepared food items were offered at breakfast, lunch and dinner, and a variety of additional food items were available continuously 24 h/day. Subjects performed either moderate intensity aerobic exercise (A-EX) (n = 8) expending 354 +/- 76 kcal/session or low intensity resistance weight training (R-EX)(n =7) expending 96 +/- kcal/session, 5 days/week. Mean energy intakes (kcal/day, +/- SEM) of the exercise groups were similar: 1867 +/- 275 for A-EX, 1889 +/- 294 for R-EX. Mean energy intakes of individuals ranged from 49 to 157% of the predetermined level required for weight maintenance. Resting metabolic rate per kg 0.75 and the Eating Inventory hunger score contributed significantly to the between subject variance in energy intake, whereas exercise energy expenditure did not. Regardless of exercise, eight women consistently restricted their energy intake (undereaters), and seven other consumed excess energy (overeaters). Overeaters were distinguished by higher Eating Inventory disinhibition (P = 0.023) and hunger (p = 0.004) scores. The overeaters' diet had a higher fat content 34 +/- 1% (p = 0.007). Also, overeaters took a larger percentage of their daily energy, than that of undereaters, 27 +/- 1 energy intake in the evening, 13 +/- 2%, compared to undereaters, 7 +/- 1% (p = 0.005). We conclude that the Eating Inventory is useful for identifying reduced-obese women at risk of overeating, and these individuals may benefit from dietary counseling aimed at reducing fat intake and evening snacking.     

Relation between circulating leptin concentrations and appetite during a prolonged, moderate energy deficit in women

BACKGROUND: On the basis of observations in rodents, leptin is thought to play a key role in the regulation of energy expenditure and food intake, but less is known of its influence on ingestive behavior and energy balance in humans. OBJECTIVE: We examined the effect in women of a chronic energy deficit on plasma leptin concentrations and self-reported appetite and explored possible relations between leptin and appetite sensations. DESIGN: Twelve healthy women (body mass index, in kg/m2: 23-37) participated in a metabolic ward study in which 3 wk of neutral energy balance was followed by 12 wk of energy deficit (energy intake reduced by 2 MJ/d and energy expenditure increased by 0.8 MJ/d). Body weight and composition were monitored, fasting leptin concentrations were measured 4 times, and feelings of hunger, fullness, desire to eat, and prospective consumption were monitored hourly throughout the day on 7 selected days. RESULTS: Adiposity-adjusted leptin decreased by 54% after 1 wk of a moderate energy deficit and remained low after 6 and 12 wk. Leptin was associated with self-reported hunger, desire to eat, and prospective consumption (range of r: -0.6 to -0.7, P < 0.01). The greatest hunger increase coincided with the largest percentage drop in circulating leptin and the lowest final leptin concentration. The relation between leptin and hunger was not influenced by amount of weight or body fat loss. CONCLUSIONS: These findings support the idea that leptin is a physiologic regulator of hunger during energy deficits in humans; the role of leptin in the long-term regulation of food intake warrants further study.     

Interlocking intramedullary nailing of pathological fractures of the shaft of the humerus

In previous experiments using the fat substitute sucrose polyester (SPE, or olestra), no compensatory response was observed on day 2 after experimental manipulations, which reduced the percentage of energy from fat to approximately equal to 30% from 40% on day 1. In the present study a more severe manipulation was made; the amount of energy from fat was reduced from 32% to 20% to determine whether such a reduction would provoke any physiologic or behavioral response. Subjects came to the unit for two, 2-d test sessions. Intake on day 1 was fixed: subjects were given meals containing either control fat (11319 kJ, 32% of energy as fat) or SPE (9561 kJ, 20% of energy as fat). On day 2, intake was ad libitum. On day 1 subjects rated themselves as more hungry while consuming the fat-substituted meals than when consuming the control meals and they disclosed greater hunger in the end-of-day questionnaires. The effect of the manipulation was carried over into day 2. By the end of day 2, subjects had compensated for 74% of the energy (fat) deficit caused by the previous day's manipulation. These results differ from those obtained when fat was reduced from 40% to 30% of energy; this more severe reduction reveals that a reduction in fat of this size can lead to a biobehavioral response. Together, these data suggest that people could change their diet to meet dietary guidelines; however, if a more severe reduction is attempted, adherence may be made more difficult by the strength of the compensatory response.     

In vivo metabolism of a new anticancer agent, 6-N-formylamino-12, 13-dihydro-1,11-dihydroxy-13-(beta-D-glucopyranosil)5H-indolo [2,3-a]pyrrolo [3,4-c]carbazole-5,7(6H)-dione (NB-506) in rats and dogs: pharmacokinetics, isolation, identification, and quantification of metabolites

BACKGROUND: Epidemiologic studies have shown alcohol consumption to be inversely as well as positively related to body weight and body fat. Metabolic studies have shown an increase in energy intake as well as compensation after alcohol consumption. OBJECTIVE: Our objective was to assess the effects on energy intake of an apéritif compared with those of a water appetizer and 3 fruit juice appetizers. DESIGN: Fifty-two men and women aged 20-45 y with a body mass index (in kg/m2) between 20 and 32 were randomly given 1 MJ (340 mL) alcohol (wine or beer), fat (cream fruit juice), protein (protein fruit juice), carbohydrate (grape juice), or water, or no preload 30 min before an ad libitum lunch consumed from the universal eating monitor. RESULTS: Energy intake (3.5+/-0.3 MJ compared with 2.7+/-0.2 MJ, P < 0.001) and eating rate were higher (44+/-3 g/min compared with 38+/-3 g/min, P < 0.01), meal duration was longer (14 min compared with 12.0 min, P < 0.01), satiation started to increase later (3.5 min compared with 1.5 min, P < 0.01), and eating was prolonged after maximum satiation (2.5 min compared with 0.6 min, P < 0.01) after an apéritif than after a fat, protein, or carbohydrate appetizer,. Twenty-four-hour energy intake was higher on a day that an apéritif was consumed than after water or no preload. CONCLUSION: Twenty-four-hour energy intake was elevated with a 1-MJ apéritif but not with a 1-MJ liquid carbohydrate, fat, or protein appetizer.     

Covert manipulation of energy density of high carbohydrate diets in 'pseudo free-living' humans

OBJECTIVE: This study examined the effects of varying the energy density (ED) of high carbohydrate (HC) diets on food and energy intake (EI), subjective hunger and body weight in humans. DESIGN: Randomised cross-over design. Subjects were each studied twice during 14 d, throughout which they had ad libitum access to one of two covertly-manipulated diets. SUBJECTS AND METHODS: Six healthy men (mean age (s.d.)=32.17 y s.d. (5.26 y), mean weight=69.74 kg s.d. (2.75 kg), mean height=1.76 m s.d. (0.05 m), body mass index (BMI)=22.57 (2.2) kg/m2) were studied. The fat, carbohydrate (CHO) and protein content (as % energy) and ED of each diet were 21:66:13% and 357 kJ/100 g, (low-energy density (LED)) or 22:66:12% and 629 kJ/100 g (high-energy density (HED)). A medium fat diet was provided at maintenance (1.6 x BMR, MF for 2 d) before each ad libitum period. Subjects could alter the amount, but not the composition of foods eaten. RESULTS: Mean EI was 8.67 and 14.82 MJ/d on the LED and HED diets, respectively. Subjects felt significantly more hungry on the LED diet, than on the HED diet (F(1,160)38.28; P < 0.001) and found the diets to be similarly pleasant (72.72 mm vs 71.54 mm (F(1,392)0.31; P = 0.579)). Mean body weight decreased on the LED diet at a rate of 0.1 kg/d and increased at 0.06 kg/d on the HED diet (F(1,131)86.60; P < 0.001), giving total weight changes of -1.41 kg and +0.84 kg, respectively, both of which were significantly different from zero (P < 0.01). CONCLUSION: Excess EI is possible on HC, HED diets, at least under conditions where diet selection is precluded. Comparison of these results with previous studies, which altered ED using fat, suggests that CHO may be a better cue for hunger than fat.     

The influence of thermic effect of food on satiety

OBJECTIVES: To evaluate energy expenditure after three isoenergetic meals of different nutrient composition and to establish the relationship between the thermic effect of food (TEF), subsequent energy intake from a test meal and satiety sensations related to consumption. DESIGN: The study employed a repeated measures design. Ten subjects received, in a randomized order, three meals of 2331+/-36 kJ (557+/-9 kcal). About 68% of energy from protein in the high protein meal (HP), 69% from carbohydrate in the high carbohydrate meal (HC) and 70% from fat in the high fat meal (HF). SETTING: The experiments were performed at the University of Milan. Subjects: Ten normal body-weight healthy women. METHODS: Energy expenditure was measured by indirect calorimetric measurements, using an open-circuit ventilated-hood system; intake was assessed 7h later by weighing the food consumed from a test meal and satiety sensations were rated by means of a satiety rating questionnaire. RESULTS: TEF was 261+/-59, 92+/-67 and 97+/-71 kJ over 7 h after the HP, HC and HF meals, respectively. The HP meal was the most thermogenic (P < 0.001) and it determined the highest sensation of fullness (P=0.002). There were no differences in the sensations and thermic effect between fat and carbohydrate meals. A significant relationship linked TEF to fullness sensation (r=0.41, P=0.025). Energy intake from the test meal was comparable after HP, HC and HF meals. CONCLUSIONS: Our results suggest that TEF contributes to the satiating power of foods.     

Dietary manipulation and energy compensation: does the intermittent use of low-fat items in the diet reduce total energy intake in free-feeding lean men?

OBJECTIVE: The effect of two low-fat treatments on ad libitum energy intake (EI) was investigated in five lean men living within a metabolic facility. DESIGN: Diet was controlled over two consecutive periods of 12 d when either, i) all foods eaten or ii) only a single (lunch) meal, was manipulated to increase the fat content from 20, 40 to 60% of energy, and ad libitum EI measured. RESULTS: All foods: EI increased from 8.6 (2.9 s.d.)-14.8 (3.1 s.d.) MJ/d and energy density (ED) from 4.1 (0.8 s.d.)-7.7 (1.6 s.d.) kJ/g as fat content increased from 20-60% (P < 0.0001). There was no decrease in weight of food eaten across diets (P > 0.05) and hence no energy compensation. Lunch meal: EI (20%:13.1 MJ/d, 40%:13.8 MJ/d, 60%:14.8 MJ/d) and ED (6.03 kJ/g, 5.89 kJ/g, 6.41 kJ/g) increased but not significantly across treatments (P > 0.05). There was partial energy compensation on the low-fat 20% diet (due in part to compensatory increase in fat intake), but no compensation for the high-fat 60% diet. CONCLUSIONS: Changes in total dietary fat and ED result in concomitant changes in EI; low fat diets reducing EI. However, the dietary strategy of intermittent use of low- and high-fat items fail to significantly alter ED, and hence EI, in free-feeding lean men. Whilst there is a trend towards reduction in intake, manipulation of the fat content of a single meal may not be sufficient to induce significant long-term weight loss.     

Sympathetic nervous system activity and resting metabolic rate in vegetarians

We examined the resting metabolic rate (RMR) and sympathetic nervous system activity of young male vegetarians (n = 17) and nonvegetarians (n = 40). Subjects were characterized for RMR by indirect calorimetry, norepinephrine kinetics from infusions of tritiated norepinephrine, energy and macronutrient intake from a 3-day food diary, and body composition by underwater weighing. Vegetarians reported a greater relative intake of carbohydrates (62% +/- 5% v 51% +/- 6%, P < .01) and a lower relative intake of fat (25% +/- 5% v 33% +/- 6%, P < .01) than nonvegetarians, whereas no differences were observed in daily energy intake, body composition, or maximal aerobic capacity (VO2max) between groups. Vegetarians exhibited an 11% higher absolute RMR (1.29 +/- 0.15 v 1.16 +/- 0.13 kcal/min, P < .01), a higher plasma concentration of norepinephrine (216 +/- 33 v 165 +/- 18 pg/mL, P < .01), and a greater norepinephrine appearance rate (0.50 +/- 0.08 v 0.36 +/- 0.09 micrograms/min, P < .01) than nonvegetarians. After statistically controlling for differences in relative amounts of carbohydrate and fat in the diet and for norepinephrine concentrations, no significant differences in adjusted RMR between vegetarians and nonvegetarians were noted. These results suggest that the higher RMR observed in young male vegetarians is partially mediated by differences in dietary macronutrient composition and increased sympathetic nervous system activity.     

Effect of fenfluramine on food intake, mood, and performance of humans living in a residential laboratory

Five male and four female normal weight research volunteers, participating in 13-day residential studies, received oral fenfluramine (20, 40 mg) or placebo at 09:30 and 17:00. Food intake, performance, and subjective ratings were measured throughout the day. Carbohydrate intake was manipulated by providing lunch meals high (males: 120 g; females: 80 g) or low (males: 25 g; females: 16 g) in carbohydrate on 8 days; on the remaining days subjects self-selected lunch. Total caloric intake (approximately 2800 Kcal) did not differ among the low- and high-carbohydrate, and self-selected lunch conditions when subjects received placebo, indicating caloric compensation. Total carbohydrate intake was significantly less, however, when subjects consumed the low-carbohydrate lunch compared to the other lunch conditions. Fenfluramine significantly decreased total caloric intake (approximately 500 kcal) by decreasing meal size, not number, only when subjects consumed the low-carbohydrate lunch. Fenfluramine was only an effective anorectic drug when subjects consumed a lunch with fewer calories and a lower carbohydrate:protein ratio than self-selected baseline. Also, fenfluramine improved performance on a range of computer tasks and increased ratings of "Alert," "Friendly," and "Talkative," while decreasing ratings of "Tired" and "Irritable."     

Acute effects of exercise or sauna on appetite in obese and nonobese men

To study the effect of exercise on appetite in men, hunger, thirst, taste perception, energy intake, and macronutrient choice were assessed in relation to exercise and to sauna; the latter was done to correct for dehydration and rise in body temperature. Since exercise is used to prevent and cure obesity, subjects included obese as well as nonobese men. Thirty subjects (25 +/- 7 years, BMI 22.8 +/- 1.6 and 28.5 +/- 1.9) were given twice, in random order before and after 2 h of cycling at 60% of Wmax, 2 h of sauna, or 2 h of rest, an ample choice from solid and liquid almost single-macronutrient food items and a taste perception test with solutions of sucrose, citric acid, NaCl, quinine, a mixture of these, and a carbohydrate electrolyte solution. After cycling as well as after sauna, in comparison to after rest, subjects lost 3 +/- 0.5% of body mass, while thirst, fluid intake, perception of sweet at relatively low concentrations, and percentage of energy coming from carbohydrate increased significantly. Only after cycling compared to after rest did perception of bitterness at a low concentration increase and hunger and energy intake decrease. We conclude that exercise induced a short-term reduction in hunger and energy intake, whereas exercise and sauna induced a short-term increase in taste perception of sweet at the lower concentration, while macronutrient preference of carbohydrate increased.     

Sex hormones, body fat distribution, resting metabolic rate and glucose-induced thermogenesis in premenopausal obese women

The topographic specificity of upper body obesity is known to be at the origin of a series of metabolic complications. In contrast to this negative effect, women with abdominal obesity usually can lose more body weight than women with gluteal-femoral obesity. In order to find some contributive explanations for this effect, we studied resting metabolic rate (RMR) and glucose-induced thermogenesis (GIT) in both types of obesity. Since upper body obesity is characterized by androgen excess, a relationship between body fat distribution, sex hormones, RMR and indices of thermogenesis was studied. Of 39 obese women who were recruited (mean age: 32.4 +/- 9.3 years), 30 were compared for analysis. Upper body obesity (waist-to-hip ratio (WHR): 0.84 +/- 0.02; body mass index (BMI) 36.2: 36.2 +/- 6.0) is not characterized by differences in RMR, whereas glucose-induced thermogenesis is significantly higher in this subgroup (P < 0.008), expressed as percentage increase above RMR (18.3 +/- 8.5 vs. 11.9 +/- 3.6%) or as percentage of metabolisable energy intake (8.2 +/- 3.3 vs. 5.8 +/- 2.3%). Correlation coefficient data show that GIT determinants are closely related to WHR (r = 0.43; P < 0.01) and not to BMI. Resting metabolic rate, both in absolute terms and corrected for fat-free mass (FFM), is not related to indices of androgenicity, but is negatively related to serum oestradiol levels; this negative relationship with oestradiol disappears when RMR is corrected for both fat mass (FM) and FFM. GIT parameters are not related to free testosterone or oestradiol, regardless of the phase of the menstrual cycle.(ABSTRACT TRUNCATED AT 250 WORDS)     

Effect of energy density and fat level of milk formulas on subsequent food and energy intake in preschool children

The aim of this study was to examine the effects of two levels of energy intakes and two levels of fat at breakfast, on the food and energy intakes in subsequent meal (lunch). The study was performed in 51 children both genders, with ages ranging from 24 to 48 months, attending a day care center. The children selected had normal nutritional status (weight/height index) according to the NCHS standards. The food intake was determined by differential weighing and energy intake was calculated from proximal analysis. The energy densities of the cow's milk formula used were 0.8 and 1.2 kcal/g, resulting in a total energy offer (breakfast) of 267.5 and 367.5 kcal respectively, the fat levels were 6.3 and 0.9 g/250 g of formula, using the design 2 x 2 factorial. In the study, 720 observations of food intake were conducted in those children consuming higher than 75% of the total food offered at breakfast. In the lunch-time were offered in alternated form two preparations with an 0.97 kcal/g of energy density. The results demonstrated that the children consumed significantly higher energy amounts in the subsequent meal, after being fed the high fat and lower energy-content breakfast. When the total energy intake (breakfast + lunch) was compared these results show that the caloric difference of breakfast was reduced and the degree of reduction was influenced by the fat level. These results show evidence for partial caloric compensation of 67% in the higher-fat level, and only 34% for the children with the lower of fat-level. It is conclude that the energy intake and fat intake at breakfast influences the energy intake at the subsequent meal. These findings are important to the preschool children's feeding with risk of malnutrition.     

Effect of an acute reduction in carbohydrate intake on subsequent food intake in healthy men

We investigated the effect of a combined carbohydrate and energy deficit in the regulation of food intake during 1 d. Seven lean, male subjects were studied in a crossover design. After 7 d of consuming a baseline diet (40% of energy as fat, 45% as carbohydrate, and 15% as protein), subjects were deprived of carbohydrate for 24 h; baseline amounts of fat and protein were consumed but only one-third of the baseline amount of carbohydrate. On the following outcome day, subjects were free to select ad libitum from a selection of either high-carbohydrate or low-carbohydrate food. On the baseline diet subjects consumed on average 10.9 +/- 1.7 MJ/d (carbohydrate: 305 +/- 49 g/d; fat: 116 +/- 18 g/d) and there was no difference in baseline intake between the two phases of the crossover study. During the deficit day, intake was reduced to 7.7 +/- 1.2 MJ/d [carbohydrate: 110 +/- 25 g/d (66% reduction); fat: 116 +/- 18 g/d]. On the outcome day, energy intake from high-carbohydrate foods was on average 10.5 MJ/d (carbohydrate: 430 +/- 112 g/d; fat: 48 +/- 20 g/d) compared with 16.6 MJ/d from high-fat foods (carbohydrate: 312 +/- 84 g/d; fat: 258 +/- 78 g/d). We conclude that the restoration of an energy deficit is not the main factor determining acute food intake. Rather, the data support the hypothesis that, under the conditions of our experiment, the intake of carbohydrate required to maintain carbohydrate balance was a more important factor in the regulation of acute food intake than was the restoration of energy deficit is not.     

Do Type-I diabetics eat a diet in accordance with recommendations?

The nutritional habits regarding intake of calories, carbohydrates, fat and protein of 25 nonobese type-I diabetic subjects were compared with the recommendations given at onset of diabetes by a dietician and with the official recommendations of the American Diabetes Association. Food questionnaires indicated that the subjects currently ate 39% more calories than originally recommended by the dietician. The carbohydrate part of total energy was 4 +/- 7% and thereby lower than recommended by the dietician and officially by the professional society (55%). Fat consumption was 38 +/- 7% of total energy and therefore higher than recommended (30%). 17.2% of total energy was fat with saturated fatty acids (recommendation: maximum 8 to 10%). Protein consumption was 1.25 +/- 0.35 g/kg BW/d and thereby above the recommended amounts (0.8 g/kg BW/d). Thus, dietary counseling of type-I diabetic subjects at disease onset is frequently hypocaloric, probably because of lack of appetite. Patients show a tendency to add fat and protein calories thereafter, instead of increasing carbohydrate intake. Dietary habits of type I diabetic subjects should therefore be re-evaluated periodically by a dietician and adjusted to the individual requirements and to the official guidelines.     

Changes in plasma lipids and lipoproteins in humans during a 2-year period of dietary restriction in Biosphere 2

BACKGROUND: A cohort study was performed of 8 people sealed inside Biosphere 2 to evaluate the effects of dietary restriction in humans on lipid and lipoprotein levels and the relationship of these levels to energy, fat, and protein content of the diet, and body weight, weight change, and energy expenditure. METHODS: Eight healthy people aged 27 to 67 years, 4 women and 4 men, were sealed inside Biosphere 2 from September 26, 1991, to September 26, 1993, the longest sustained period in an "isolated confined environment" on record. They were studied throughout confinement and for more than 2 years after their exit and return to an ad libitum diet. Food available was severely restricted during most of the 2-year period inside Biosphere 2. High work output was maintained and food quality remained high, resulting in prolonged restriction of energy intake without malnutrition. RESULTS: Fasting plasma cholesterol, triglyceride, and high-density lipoprotein (HDL) cholesterol levels; HDL subfraction distribution; dietary energy, fat, and protein content intake; and height, weight, weight change, and energy expenditure were measured. Total plasma cholesterol and triglyceride levels decreased 30% and 45%, respectively. The HDL and low-density lipoprotein levels also decreased and, in some participants, levels of HDL2 subfractions were increased. Multivariate analysis showed that the major cause of these changes was energy restriction. CONCLUSIONS: Energy restriction was the major factor leading to low lipid and lipoprotein levels. Energy restriction with adequate nutrition of young and middle-aged people may substantially reduce risk for atherosclerosis and consequent coronary artery and cerebrovascular disease.     

Low fat intake and coronary artery disease in a population with higher prevalence of coronary artery disease: the Indian paradox

OBJECTIVE: To determine the association between saturated fat intake and prevalence of coronary artery disease (CAD) and coronary risk factors. DESIGN AND SETTING: Total community cross sectional survey of 20 urban streets out of 196 streets, in the city of Moradabad in north India. SUBJECTS AND METHODS: Adult population between 25 to 64 years inclusive comprised of 1806 subjects (904 men, 902 women) were divided into three groups according to level of saturated fat intake as assessed by 7-day dietary intake records (very low < 7%, low 7 to 10%, high > 10% energy (en) per day). RESULTS: We examined the relationship between CAD risk and levels of % en from fat intake. Low (7 to 10% en/day) and high (> 10% en/day) saturated fat were positively and significantly associated with higher prevalence of CAD. The prevalence of coronary risk factors (hypertension, hypercholesterolemia, obesity and sedentary lifestyle) were significantly higher among subjects with low and high saturated fat intake compared to subjects with very low (< 7%) saturated fat intake. Logistic regression analysis with adjustment for age showed that hypercholesterolemia (OR: men 0.89, women 0.68), hypertension (men 0.92, women 0.56), physical activity (men 0.80, women 0.36), obesity (men 0.82, women 0.88) and smoking (0.70 men) were significant risk factors of CAD. Low and high saturated fat intake were associated with more prestigious occupations, higher and middle income status and better educational levels compared to very low saturated fat intake. CONCLUSIONS: The prevalence of CAD and coronary risk factors was higher in urban Indians with low and high saturated fat intake than those with lower saturated fat intake. These findings suggest that the saturated fat intake should be < 7% en/day for prevention of CAD in Indians.     

Dietary fat type and energy restriction interactively influence plasma leptin concentration in rats

To investigate whether dietary fat source and energy restriction interactively influence plasma leptin levels and its association of leptin with insulin action, rats were fed diets containing either fish, safflower oil, or beef tallow (20% wt/wt) for 10 weeks. Groups of rats consumed each diet ad libitum or at 85% or 70% of ad libitum energy intake in a design that held fat intake constant. Graded levels of energy restriction caused body weight to decrease (P < 0.001) differently according to the dietary fat provided. Plasma leptin concentrations were 60% higher (P < 0.05) in the groups fed fish oil and safflower oil ad libitum compared with those in the beef tallow group, despite smaller perirenal fat mass and fat cell size in the fish oil-fed animals. Energy restriction resulted in a 62% decrease (P < 0.05) in leptin levels in fish oil- and safflower oil-fed rats, whereas no changes were observed in beef tallow-fed animals. Plasma insulin levels were lower (P < 0.05) in the fish oil group fed ad libitum compared with those in the two other diet groups. These data demonstrate a hyperleptinemic effect in animals consuming diets rich in polyunsaturated fatty acid, which can be normalized to the level of saturated fat consumption by mild energy restriction. Thus, dietary fatty acid composition, independent of adipose tissue mass, is an important determinant of circulating leptin level in diet-induced obesity.