AUTHOR=Buso Marion E.C. , Seimon Radhika V. , McClintock Sally , Muirhead Roslyn , Atkinson Fiona S. , Brodie Shannon , Dodds Jarron , Zibellini Jessica , Das Arpita , Wild-Taylor Anthony L. , Burk Jessica , Fogelholm Mikael , Raben Anne , Brand-Miller Jennie C. , Sainsbury Amanda 

TITLE=Can a Higher Protein/Low Glycemic Index vs. a Conventional Diet Attenuate Changes in Appetite and Gut Hormones Following Weight Loss? A 3-Year PREVIEW Sub-study

JOURNAL=Frontiers in Nutrition

VOLUME=8

YEAR=2021

URL=https://www.frontiersin.org/journals/nutrition/articles/10.3389/fnut.2021.640538

DOI=10.3389/fnut.2021.640538

ISSN=2296-861X

ABSTRACT=<p><bold>Background:</bold> Previous research showed that weight-reducing diets increase appetite sensations and/or circulating ghrelin concentrations for up to 36 months, with transient or enduring perturbations in circulating concentrations of the satiety hormone peptide YY.</p><p><bold>Objective:</bold> This study assessed whether a diet that is higher in protein and low in glycemic index (GI) may attenuate these changes.</p><p><bold>Methods:</bold> 136 adults with pre-diabetes and a body mass index of ≥25 kg/m<sup>2</sup> underwent a 2-month weight-reducing total meal replacement diet. Participants who lost ≥8% body weight were randomized to one of two 34-month weight-maintenance diets: a higher-protein and moderate-carbohydrate (CHO) diet with low GI, or a moderate-protein and higher-CHO diet with moderate GI. Both arms involved recommendations to increase physical activity. Fasting plasma concentrations of total ghrelin and total peptide YY, and appetite sensations, were measured at 0 months (pre-weight loss), at 2 months (immediately post-weight loss), and at 6, 12, 24, and 36 months.</p><p><bold>Results:</bold> There was a decrease in plasma peptide YY concentrations and an increase in ghrelin after the 2-month weight-reducing diet, and these values approached pre-weight-loss values by 6 and 24 months, respectively (<italic>P</italic> = 0.32 and <italic>P</italic> = 0.08, respectively, vs. 0 months). However, there were no differences between the two weight-maintenance diets. Subjective appetite sensations were not affected by the weight-reducing diet nor the weight-maintenance diets. While participants regained an average of ~50% of the weight they had lost by 36 months, the changes in ghrelin and peptide YY during the weight-reducing phase did not correlate with weight regain.</p><p><bold>Conclusion:</bold> A higher-protein, low-GI diet for weight maintenance does not attenuate changes in ghrelin or peptide YY compared with a moderate-protein, moderate-GI diet.</p><p><bold>Clinical Trial Registry:</bold><ext-link ext-link-type="uri" xlink:href="https://ClinicalTrials.gov" xmlns:xlink="http://www.w3.org/1999/xlink">ClinicalTrials.gov</ext-link> registry ID NCT01777893 (PREVIEW) and ID NCT02030249 (Sub-study).</p>