ESPEYB19 15. Editors’ Choice Obesity (3 abstracts)
15.2. Postprandial glycaemic dips predict appetite and energy intake in healthy individuals
Wyatt P , Berry SE , Finlayson G , O’Driscoll R , Hadjigeorgiou G , Drew DA , Khatib HA , Nguyen LH , Linenberg I , Chan AT , Spector TD , Franks PW , Wolf J , Blundell J & Valdes AM
Nat Metab. 2021;3(4):523-9. doi: 10.1038/s42255-021-00383-x.PubMed ID: 33846643
Brief summary: this study of around 1000 adults administered standard breakfast meals and showed wide variability and continuously monitored glucose levels up to 3 h afterwards. Notably, those individuals with lower glucose levels at 2 to 3 h after meals reported higher levels of appetite and consumed hundreds more calories each day.
It is increasingly recognized that, not only patients with diabetes, but also healthy individuals vary widely in their glycemic responses to food and other lifestyle factors. This study from Kings College London efficiently collected data through continuous glucose monitors and the ZOE app (which has been made famous by its collection of data on COVID-19). They also sent out standardized breakfasts (muffins!) hence collecting data on over 8000 breakfasts.
While previous studies have focused on peak glucose levels following oral glucose challenge or standard meals, the current study recognized that many people have significant dips in glucose levels 2 to 3 h after meals. They observed that these individuals reported higher levels of hunger and consumed 75 calories more by 3 to 4 hours after breakfast, and over 300 calories more across the whole day. These findings were confirmed in a US validation cohort.
The underlying mechanisms are unclear and could involve brain sensing of changes in glucose, central actions of insulin, and interactions with the gut microbiome. However, regardless of the mechanisms, the authors are optimistic that awareness of our individual responses to food may help us identify those foods that lead to more stable changes in our personal glucose profiles and hence give us greater control over our appetites and weight gain.
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ESPE Yearbook of Paediatric Endocrinology
ISSN 1662-4009 (Online)
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