Age and Sex Interact to Determine the Effects of Commonly Consumed Dairy Products on Postmeal Glycemia, Satiety, and Later Meal Food Intake in Adults.

BACKGROUND: Dairy consumption reduces postprandial glycemia and appetite when consumed with carbohydrates. OBJECTIVES: The objective was to test the effects of frequently consumed dairy products, age, and sex on glycemia, appetite, and food intake. METHODS: In a randomized, unblinded, crossover design, 30 older [60-70 y; BMI (kg/m2): 18.5-29.9] and 28 young (20-30 y; BMI: 18.5-24.9) adults consumed 500 mL of a calorie-free control (water), skim milk and whole milk, 350 g Greek yogurt, and 60 g cheddar cheese. Food intake at an ad libitum meal was measured 120 min later. Glycemia, appetite, and gastric hormone responses were measured premeal (15-120 min), within-meal (120-140 min), and postmeal (140-170 min). Effects of treatment, age, and sex and their interactions were analyzed using ANOVA followed by Tukey's post hoc test. RESULTS: All forms of dairy, compared with water, decreased postmeal glycemia, premeal appetite, and meal intake (P < 0.0001). Premeal glucose, insulin, and glucagon-like peptide 1 increased, and ghrelin decreased, but effects of dairy differed with age and sex. Older adults had 10% higher pre- and postmeal glucose (P < 0.01). Premeal appetite suppression per 100 kcal of treatments was more after yogurt than other dairy, but overall appetite suppression was less in older adults than in young adults and in males than in females (P < 0.05). Pizza intake was reduced by 175 kcal after yogurt and cheese and by 82 kcal after milks compared to water (P < 0.001). Mealtime reduction for treatment calories averaged 62% after yogurt and cheese but was less at 33% after milks (P < 0.05). Compensation was less in older (33%) than in young (63%) adults (P < 0.03). CONCLUSIONS: Dairy products consumed in usual forms before a meal stimulate metabolic responses leading to reduced premeal appetite, later food intake, and postmeal glycemia, but their effects differ in magnitude and with the sex and age of adults.

Role of Amino Acids in Blood Glucose Changes in Young Adults Consuming Cereal with Milks Varying in Casein and Whey Concentrations and Their Ratio.

BACKGROUND: Increasing the total protein content and reducing the casein to whey ratio in milks consumed with breakfast cereal reduce postprandial blood glucose (BG). OBJECTIVES: We aimed to explore associations between plasma amino acids (AAs), BG, and glucoregulatory hormones. METHODS: In this repeated-measures design, 12 healthy adults consumed cereal (58 g) and milks (250 mL) with 3.1 wt% or high 9.3 wt% protein concentrations and with casein to whey ratios of either 80:20 or 40:60. Blood was collected at 0, 30, 60, 120, 140, 170, and 200 min for measurement of the primary outcome, BG, and for the exploratory outcomes such as plasma AA, gastric emptying, insulin (INS), and glucoregulatory hormones. Measures were made prior to and after an ad libitum lunch at 120 min. Exploratory correlations were conducted to determine associations between outcomes. RESULTS: Pre-lunch plasma AA groups [total (TAA), essential (EAA), BCAA, and nonessential (NEAA)] were higher after 9.3 wt% than 3.1 wt% milks by 12.7%, 21.4%, 20.9%, and 7.6%, respectively (P ≤ 0.05), while post-lunch AA groups were higher by 10.9%, 19.8%, 18.8%, and 6.0%, respectively (P ≤ 0.05). Except for NEAA, pre-lunch AAs were higher after 40:60 than 80:20 ratio milks by 4.5%, 8.3%, and 9.3% (P ≤ 0.05). When pooled by all treatments, pre-lunch AA groups associated negatively with BG (r/ρ ≥ -0.45, P ≤ 0.05), but post-lunch only TAA and NEAA correlated (r ≥ -0.37, P < 0.05). Pre-lunch BG was inversely associated with Leu, Ile, Lys, Met, Thr, Cys-Cys, Asn, and Gln (r/ρ ≥ -0.46, P ≤ 0.05), but post-lunch, only with Thr, Ala, and Gly (r ≥ -0.50, P ≤ 0.05). Pre-lunch associations between AA groups and INS were not found. CONCLUSIONS: Protein concentration and the ratio of casein to whey in milks consumed at breakfast with cereal affect plasma AA concentrations and their associations with decreased BG. The decrease in BG could be explained by INS-independent mechanisms. This trial was registered at www.clinicaltrials.gov as NCT02471092.

Increased milk protein content and whey-to-casein ratio in milk served with breakfast cereal reduce postprandial glycemia in healthy adults: An examination of mechanisms of action.

This study describes the effects on glycemic response and the underlying mechanisms of action of increasing the protein concentration and decreasing the casein-to-whey ratio in milk when consumed with a high glycemic breakfast cereal. Twelve healthy men and women, aged 18 to 30 yr and with a body mass index of 20 to 24.9 kg/m2, consumed (in random order) milk beverages (250 mL) containing either 3.1 or 9.3% protein and casein-to-whey ratios of either 80:20 or 40:60. We measured postprandial appetite, glucose, regulatory hormones, and stomach emptying rate over 200 min, as well as food intake at an ad libitum meal at 120 min. Although pre-meal appetite was suppressed to a greater extent with milk beverages that had high (9.3%) compared with regular (3.1%) protein content, food intake was similar among all 4 treatments. Pre-meal mean blood glucose was lower with beverages that had high rather than regular milk protein content, with the lowest glucose peaks after the high milk protein treatment with the 40:60 casein-to-whey ratio. Pre-meal insulin and C-peptide levels were not affected by milk protein content or casein-to-whey ratio, but pre-meal glucagon-like peptide 1 was higher after the treatment containing high milk protein and the 40:60 casein-to-whey ratio, and pre-meal cholecystokinin was higher after the treatments containing high milk protein content. Plasma paracetamol response was also lower after the treatments containing high compared with regular milk protein content. When consumed with carbohydrate, milk beverages with high protein content and (to a lesser extent) a decreased casein-to-whey ratio lowered postprandial glycemia through insulin-independent mechanisms, primarily associated with delayed stomach emptying.

Role of single serving form of dairy on satiety and postprandial glycaemia in young and older healthy adults.

Dairy proteins reduce appetite and improve postprandial glycaemic response in adults. However, there are no reports of dairy in amounts usually consumed on satiety and postprandial glycaemia in either young or older adults. In a randomized crossover design, 30 healthy young adults (age: 23.5 ± 0.5 years; body mass index (BMI): 21.8 ± 0.4 kg/m2) and 30 healthy/overweight older adults (age: 65.2 ± 0.5 years; BMI: 24.7 ± 0.6 kg/m2) consumed 1 serving (according to manufacturers' labels) of skim milk (0.1% milk fat (MF)), whole milk (3.25% MF), plain Greek yogurt (2% MF), cheddar cheese (31% MF), and water (energy-free control) after a 12-h fast. Subjective appetite was measured every 15-30 min over 3 h. Blood glucose and insulin were measured at baseline and every 15-30 min over 2 h. All dairy treatments reduced post-treatment subjective appetite area under the curve (AUC) over 3 h by 8%-17% more than water. Greek yogurt reduced appetite 3-h AUC more than skim and whole milk by 9% and 7%, respectively (p < 0.0001). Post-treatment blood glucose 2-h AUC was 42% lower in young compared with older adults (p = 0.003). It was also 52%-78% lower after cheese compared with milks and yogurt (p < 0.0001). Post-treatment insulin AUC after cheese was only 10%-15% of that after milks and Greek yogurt (p < 0.0001). We conclude that single servings of dairy differ in effect on postprandial satiety and glycaemia and merit consideration in management of metabolic syndrome.

The effect of dairy and nondairy beverages consumed with high glycemic cereal on subjective appetite, food intake, and postprandial glycemia in young adults.

The objective was to compare the effect of dairy and nondairy beverages when consumed with carbohydrate at breakfast on subjective appetite, food intake (FI), and postprandial glycemia (PPG) in healthy young adults. Twenty-six healthy males and females (13 males and 13 females; 23.0 ± 2.6 years; BMI: 22.3 ± 1.5 kg/m2) participated in a randomized crossover study. They consumed nonisocaloric amounts (250 mL) of almond beverage, soy beverage, 1% fat milk, yogurt beverage, and water (control) with cereal and 120 min later, an ad libitum meal. Subjective appetite, PPG, and insulin were measured at baseline and at intervals before and after the meal at which FI was measured. Post-treatment blood glucose was lowest following soy beverage compared with all treatments but was not different from milk (p = 0.0002). There were no differences between any other treatments. However, over the first hour, PPG for all treatments was 27% lower compared with water (p < 0.0001). Milk and yogurt beverage led to the highest insulin concentrations post-treatment (p < 0.0001) but there were no differences between treatments postmeal. All treatments reduced appetite and led to lower FI at the meal compared with water, but FI was lower after milk compared with all treatments except yogurt beverage (p < 0.0001). Both dairy and nondairy beverages consumed with a high glycemic cereal at breakfast increased satiety and decreased FI compared with water with cereal. Despite higher carbohydrate content, all beverages led to similar or lower PPG than the water breakfast, but dairy beverages increased insulin more than nondairy beverages.

The effect of dairy products consumed with high glycemic carbohydrate on subjective appetite, food intake, and postprandial glycemia in older adults.

The objective was to compare the effect of liquid, semi-solid, and solid dairy products and a nondairy beverage when consumed with glycemic carbohydrate on subjective appetite, food intake (FI), and post-prandial glycemia (PPG) in healthy older adults. Thirty healthy men and women (14 males and 16 females; age: 64.6 ± 2.4 y; BMI: 25.6 ± 2.5 kg/m2) participated in a randomized crossover study. Treatments were one of 250 mL of 2% fat milk and soy beverage, 175 g of 2% Greek yogurt, and 30 g of Cheddar cheese consumed as part of an isocaloric (380 kcal) meal with bread and jam. Water alone served as the energy-free control for subjective appetite. At 180 min after consumption, the participants were fed an ad libitum meal to measure FI. Subjective appetite, blood glucose, and insulin were measured at baseline and at intervals both before (post-treatment) and after the meal (postmeal). Cheese and yogurt resulted in lower post-treatment blood glucose than milk and soy beverage when consumed with carbohydrate (p < 0.0001), but no differences among any treatments were observed postmeal. Treatments led to similar insulin concentrations. Post-treatment appetite was lower than after the water control for all treatments but suppressed more by cheese and yogurt compared with milk (p < 0.0001). There were no differences in FI among treatments. Cheese and yogurt increase satiety and lower PPG more than milk or a soy beverage when consumed with carbohydrate.

Pre- and within-meal effects of fluid dairy products on appetite, food intake, glycemia, and regulatory hormones in children.

The effect of beverages commonly consumed by children in-between or with meals on short-term food intake (FI) and glycemic control has received little attention. Therefore, 2 experiments were conducted in 9- to 14-year-old children following a randomized repeated-measures design. Experiment 1 (n = 32) compared the effects of water (control) and isocaloric (130 kcal) amounts of 2% milk, chocolate milk, yogurt drink, and fruit punch on subjective appetite and FI. Experiment 2 (n = 20) compared the effects of isocaloric (130 kcal) amounts of 2% milk and fruit punch on subjective appetite, FI, and glycemic and appetite hormone responses. One serving of the beverages was given as a pre-meal drink at baseline (0 min) and a second serving 60 min later with an ad libitum pizza meal. Meal FI in experiment 1 was lower by 14% and 10%, respectively, after chocolate milk and yogurt drink (p < 0.001), but not milk, compared with water. Cumulative energy intake (beverages plus meal) was higher after caloric beverages than water. In experiment 2, no differences occurred in pre-meal but post-meal glucose was 83% higher in overweight/obese than normal-weight children (p = 0.02). Milk led to higher pre-meal glucagon-like peptide-1 and post-meal peptide tyrosine tyrosine (PYY) than fruit punch (p < 0.01) but insulin did not differ between treatments. In conclusion, dairy products consumed before and with a meal have more favourable effects on FI, appetite, and satiety hormones than a sugar-sweetened beverage, but all caloric beverages result in more cumulative calories than if water is the beverage.

Pubertal status, pre-meal drink composition, and later meal timing interact in determining children's appetite and food intake.

Puberty is a period of development that alters energy intake patterns. However, few studies have examined appetite and food intake (FI) regulation during development of puberty in children and adolescents. Therefore, the objective was to measure the effect of pubertal status on FI and subjective appetite after pre-meal glucose and whey protein drinks in 9- to 14-year-old boys and girls. In a within-subject, randomized, repeated-measures design, children (21 pre-early pubertal, 15 mid-late pubertal) received equally sweetened drinks containing Sucralose (control), glucose, or whey protein (0.75 g/kg body weight) in 250 mL of water 2 h after a standardized breakfast on 6 separate mornings. Ad libitum FI was measured either 30 or 60 min later and appetite was measured over time. In pre-early and mid-late pubertal boys and girls there was no effect of sex on total FI (kcal). Glucose and whey protein drinks reduced calorie intake similarly at 30 min. But at 60 min, whey protein reduced FI (p < 0.001) compared with control and glucose in pre-early pubertal children, but not in mid-late pubertal children. However, sex was a factor (p = 0.041) when FI was expressed per kilogram body weight. Pubertal status did not affect FI/kilogram body weight in boys, but it was 32% lower in mid-late pubertal girls than at pre-early puberty (p = 0.010). Appetite was associated with FI in mid-late pubertal children only. In conclusion, pubertal development affects appetite and FI regulation in children.

Acute decrease in serum testosterone after a mixed glucose and protein beverage in obese peripubertal boys.

BACKGROUND AND OBJECTIVES: Delayed puberty and lower levels of testosterone (T) have been observed in adult obese males and some adolescent males. In adult men, enteral glucose ingestion results in acute lowering of serum testosterone levels; however, this has not been studied in adolescents. We aimed to examine the acute effect of a glucose/protein beverage on serum T concentration changes in obese peripubertal males. A second objective was to determine whether change in T concentration was related to appetite hormone levels. PATIENTS AND METHODS: Twenty-three overweight and obese males aged 8-17 in pre-early (Tanner stage 1-2) and mid-late (Tanner stage 3-5) puberty were included in this cross-sectional study at the Clinical investigative unit at the Hospital for Sick Children. Participants consumed a beverage containing glucose and protein, and blood samples measuring pubertal hormones, ghrelin and glucagon-like peptide-1 (GLP-1) were taken over 60 min. RESULTS: Across pubertal stages, there was a significant decrease in T levels in adolescent boys (-18·6 ± 3·1%, P < 0·01) with no proportional differences between pre-early and mid-late puberty (P = 0·09). Decrease in T was associated with a decrease in LH (r = 0·52, P = 0·02), and fasting T was inversely correlated with fasting ghrelin (r = -0·51, P = 0·03) with no correlation with GLP-1. CONCLUSIONS: Intake of a mixed glucose/protein beverage acutely decreases T levels in overweight and obese peripubertal boys. A potential mechanism for this decrease may be secondary to an acute decrease in LH, but this requires further evaluation.

Obesity, sex and pubertal status affect appetite hormone responses to a mixed glucose and whey protein drink in adolescents.

BACKGROUND AND OBJECTIVES: Little information is available on how food intake regulatory hormones may be altered during pubertal development and across the weight spectrum in adolescents. Therefore, the effect of obesity, sex and pubertal status on subjective appetite and appetite hormones in response to a mixed glucose and whey protein drink was determined in 8-18 year old adolescents. PATIENTS AND METHODS: A cross-sectional cohort study was conducted at the Hospital for Sick Children, Toronto. After a 12 h fast, normal weight (n = 5 female, 4 male) and obese (n = 5 female, 4 male) adolescents (Experiment 1), and pre-early pubertal (n = 10) and mid-late pubertal (n = 10) obese male adolescents (Experiment 2) consumed a 250 ml glucose (30 g) and whey protein (30 g) beverage. Insulin, PYY, ghrelin and subjective appetite were measured over 120 min. RESULTS: Obese adolescents (Experiment 1) have higher insulin, PYY and lower ghrelin (P < 0·006) than normal weight controls, with a more pronounced effect in males (P < 0·037). Puberty (Experiment 2) did not affect insulin (P = 0·305), but the change in PYY in response to the drink was greater (P = 0·032) and ghrelin was lower (P = 0·026) in mid-late pubertal than pre-early pubertal obese males. Average appetite 60 min post-drink was higher in obese and mid-late pubertal adolescents, but not related to hormone changes. CONCLUSIONS: Obesity, sex and pubertal status affect macronutrient-stimulated appetite hormone secretion and these factors may alter food intake in obese children during pubertal development.