Acute load-dependent effects of oral whey protein on gastric emptying, gut hormone release, glycemia, appetite, and energy intake in healthy men

Hutchison, Amy T.; Piscitelli, Diana; Horowitz, Michael; Clifton, Peter; Standfield, Scott; Hausken, Trygve; Feinle‐Bisset, Christine; Luscombe-Marsh, Natalie D.

doi:10.3945/ajcn.115.117556

Cited by 60 publications

(65 citation statements)

References 51 publications

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“…The incretin hormones GLP‐1 and glucose‐dependent insulinotropic polypeptide (GIP) are known to be stimulated by whey protein and account for the “incretin effect”, the phenomenon by which insulin secretion is augmented when glucose is given enterally when compared to an isoglycaemic intravenous glucose infusion . Whey protein ingestion also increases plasma glucagon concentrations . Conversely, guar gum is associated with decreased plasma concentrations of GLP‐1 and insulin, and neutral effects on glucagon; therefore, the hormone responses to the whey/guar preload would be expected to represent a complex balance of competing influences and, indeed, we observed a postprandial increase in glucagon and decrease in GLP‐1, but no net effect on insulin concentrations.…”

Section: Discussionmentioning

confidence: 99%

A whey/guar “preload” improves postprandial glycaemia and glycated haemoglobin levels in type 2 diabetes: A 12‐week, single‐blind, randomized, placebo‐controlled trial

Watson

Phillips

et al. 2019

Diabetes Obesity Metabolism

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Aims: To evaluate the effects of 12 weeks of treatment with a whey/guar preload on gastric emptying, postprandial glycaemia and glycated haemoglobin (HbA1c) levels in people with type 2 diabetes (T2DM). Materials and methods:A total of 79 people with T2DM, managed on diet or metformin (HbA1c 49 ± 0.7 mmol/mol [6.6 ± 0.1%]), were randomized, in single-blind fashion, to receive 150 mL flavoured preloads, containing either 17 g whey protein plus 5 g guar (n = 37) or flavoured placebo (n = 42), 15 minutes before two meals, each day for 12 weeks. Blood glucose and gastric emptying (breath test) were measured before and after a mashed potato meal at baseline (without preload), and after the preload at the beginning (week 1) and end (week 12) of treatment. HbA1c levels, energy intake, weight and body composition were also evaluated.Results: Gastric emptying was slower (P < 0.01) and postprandial blood glucose levels lower (P < 0.05) with the whey/guar preload compared to placebo preload, and the magnitude of reduction in glycaemia was related to the rate of gastric emptying at both week 1 (r = −0.54, P < 0.001) and week 12 (r = −0.54, P < 0.0001). At the end of treatment, there was a 1 mmol/ mol [0.1%] reduction in HbA1c in the whey/guar group compared to the placebo group (49 ± 1.0 mmol/mol [6.6 ± 0.05%] vs. 50 ± 0.8 mmol/mol [6.7 ± 0.05%]; P < 0.05). There were no differences in energy intake, body weight, or lean or fat mass between the groups.Conclusions: In patients with well-controlled T2DM, 12 weeks' treatment with a low-dose whey/guar preload, taken twice daily before meals, had sustained effects of slowing gastric emptying and reducing postprandial blood glucose, which were associated with a modest reduction in HbA1c, without causing weight gain. K E Y W O R D Sgastric emptying, guar gum, postprandial glucose, preloads, type 2 diabetes, whey protein

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Section: Discussionmentioning

confidence: 99%

A whey/guar “preload” improves postprandial glycaemia and glycated haemoglobin levels in type 2 diabetes: A 12‐week, single‐blind, randomized, placebo‐controlled trial

Watson

Phillips

et al. 2019

Diabetes Obesity Metabolism

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“…30,31 It was suggested that AA and glucagon regulate each other in a feedback loop that involves α-cells and hepatocytes. It is also important to highlight the use of a dose Our results show that providing 15 g of EAA stimulates glucagon production, although the rise overall was not significantly different from baseline.…”

Section: Discussionmentioning

confidence: 99%

The effect of oral essential amino acids on incretin hormone production in youth and ageing

Abdulla

Bass

Stokes

et al. 2019

Endocrino Diabet & Metabol

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Background The effect of substantive doses of essential amino acids (EAA) on incretin and insulin production, and the impact of age upon this effect, is ill‐defined. Methods A 15‐g oral EAA drink was administered to young (N = 8; 26 ± 4.4 years) and older (N = 8; 69 ± 3.8 years) healthy volunteers. Another group of younger volunteers (N = 9; 21 ± 1.9 years) was given IV infusions to achieve equivalent plasma amino acids (AA) profiles. Plasma AA, insulin, glucagon‐like peptide‐1 (GLP‐1) and glucose‐dependent insulinotropic peptide (GIP) were quantified over 2 hours. Results In younger recruits, EAA‐induced rapid insulinaemia and aminoacidaemia with total amino acids(AA), EAA and branched chain amino acids (BCAA) matched between oral and IV groups. Insulin peaked at 39 ± 29 pmol L−1 at 30 minutes following oral feeding compared to 22 ± 9 pmol L−1 at 60 minutes following IV feeding (P: NS). EAA peaked at 3395 μmol L−1 at 45 minutes during IV infusion compared to 2892 μmol L−1 following oral intake (Feeding effect: P < 0.0001. Oral vs IV feeding: P: NS). There was an 11% greater increase in insulin levels in the 120 minutes duration of the study in response to oral EAA as opposed to IV EAA. GIP increased following oral EAA (452 pmol L−1 vs 232 pmol L−1, P < 0.05). Age did not impact insulin or incretins production. Conclusion Postprandial rises in EAA levels lead to rapid insulinaemia which is higher with oral compared with IV EAA, that is attributed more to GIP and unaffected by age. This finding supports EAA, on their own or as part of high‐protein meal, as nutritive therapeutics in impaired glycaemia and ageing.

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“…Whey protein has been shown to have an insulinotropic effect compared with non-dairy proteins [33] in some studies but not all [34]. Whey protein consumed in amounts of 20 g/day before or after a carbohydrate meal stimulated insulin, glucagon-like peptide-1 (GLP-1) and gastric inhibitory polypeptide (GIP) and delayed gastric emptying resulting in decreased postprandial glycaemia in people with diet-controlled T2DM [35,36]. It appears that 2.8 g whey in milk and yogurt of our dairy/chicken/nuts/wholegrain meal has no effect on postprandial glycemia and insulin secretion and that meat and dairy protein probably have equivalent effects on insulin release.…”

Section: Discussionmentioning

confidence: 99%

Differential Effects of Red Meat/Refined Grain Diet and Dairy/Chicken/Nuts/Whole Grain Diet on Glucose, Insulin and Triglyceride in a Randomized Crossover Study

2016

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Epidemiological studies suggest that a diet high in processed meat, with a high glycemic index is associated with an increased risk of type 2 diabetes. It is not clear if this is due to altered insulin sensitivity or an enhanced postprandial glucose. We aimed to compare the acute metabolic response of two different types of meals after ingestion of the matching diet for four weeks. The study was a randomized, crossover acute meal study. Volunteers consumed either a red meat/refined grain meal or a dairy/chicken/nuts/wholegrain meal after four weeks of the matching diet. After a three-week washout period and four weeks of the alternate diet, they consumed the matching meal. The diets differed with respect to both protein and carbohydrate sources. Blood samples were taken for 180 min for the measurement of glucose, insulin, C-peptide and triglyceride. Fifty-one participants (age: 35.1 ± 15.6 years; body mass index: 27.7 ± 6.9 kg/m2, 17 with normal and 34 with impaired glucose tolerance) completed two meal tests. The area under the curve (p < 0.001) and incremental area under the curve (p = 0.001) for insulin was significantly higher after the red meat/refined grain diet than after the dairy/chicken/nuts/whole grain diet. There was an interaction between meal and glucose tolerance group (p < 0.05) in the area under the curve (AUC) and the incremental area under the curve (iAUC) of glucose; the red meat/refined grain diet increased glucose relative to the dairy/chicken/nuts/whole grain diet only in the normal group (+2.5 mmol/L/3 h). The red meat/refined grain diet increased glucose and insulin responses compared with the dairy/chicken/nuts/whole grain diet. This meal pattern would increase pancreatic stress long term and may account for the increased risk of type 2 diabetes with this diet.

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Acute load-dependent effects of oral whey protein on gastric emptying, gut hormone release, glycemia, appetite, and energy intake in healthy men

Abstract: These findings indicate that, in healthy lean men, the rate of gastric emptying of whey protein is independent of load and determines the initial gastrointestinal hormone response. This study was registered at www.anzctr.org.au as 12611000706976.

Cited by 60 publications

References 51 publications

A whey/guar “preload” improves postprandial glycaemia and glycated haemoglobin levels in type 2 diabetes: A 12‐week, single‐blind, randomized, placebo‐controlled trial

A whey/guar “preload” improves postprandial glycaemia and glycated haemoglobin levels in type 2 diabetes: A 12‐week, single‐blind, randomized, placebo‐controlled trial

The effect of oral essential amino acids on incretin hormone production in youth and ageing

Differential Effects of Red Meat/Refined Grain Diet and Dairy/Chicken/Nuts/Whole Grain Diet on Glucose, Insulin and Triglyceride in a Randomized Crossover Study

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