Monday, January 11, 2016

Can a High Protein Breakfast Control Appetite, Calories and Blood Sugar?

Can a high protein breakfast help control appetite, calorie intake, and “blood sugar” levels all day? How much protein do we need at breakfast to achieve these effects?  

Multiple studies have suggested that protein can indeed help regulate our appetite all day, and can even help us avoid “swings” in our blood glucose levels.

An interesting study from the University of Missouri examined both issues at the same time. The paper is quite long - about 25 pages if you try to print it - and includes extensive technical details about the research, analysis, and references.  Patients often ask me to summarize research, and "translate it back into English", so I’ll try to get it down to a few paragraphs! I’ll include excerpts from the article in italics, then “translate it into English” in my own words in bold type.  First, here is the link:
Background:  Protein is generally regarded to be more satiating (filling and satisfying) than an equivalent amount of digestible carbohydrate or fat [1-4]. (Protein “tells” your brain you are full, better than carbohydrate or fat do.)  

This may be particularly true when protein is consumed at breakfast. (Despite the recent controversy in the headlines, breakfast may indeed be a key for weight loss...but it has to be the right kind of breakfast, one with protein.)
Acute intervention studies have shown that protein-rich breakfast meals reduce appetite and increase satiety throughout the morning relative to moderate or low-protein breakfast meals [6-8]. (High protein breakfasts keep you more full than lower protein breakfasts.)...
Protein-rich breakfast meals have also been shown to reduce energy intake at a subsequent ad libitum lunch meal [6,7,9-11]. (High protein breakfasts lead people to eat fewer calories at lunch -even if they aren’t counting calories,  and eat as much as they want.)
Such effects have been demonstrated at protein intakes ≥20 g, and most consistently at intakes ≥30 g of protein per meal [6,7,9-12].( 20 grams of protein at breakfast may be helpful, but 30 grams is even more likely to be effective.)
Leidy et al. [12] found that higher protein intake at breakfast (35 vs. 13 g) was associated not only with greater satiety and less hunger throughout the morning, but also with reduced energy intake from snacks in the evening hours, particularly high-fat snacks...(35 grams of protein in the morning resulted in people eating fewer calories in the evening - and particularly helped people cut down on fatty snacks.)
In addition to the satiety properties of dietary protein, the consumption of higher protein meals has been proposed to improve glucose homeostasis. (Higher protein meals may help control blood sugar.)
Several meta-analyses from long-term, higher protein, weight loss and/or weight maintenance diets report reductions in glycated hemoglobin and/or fasting insulin concentrations with higher vs. normal protein diets [14,15].  (Good quality studies have shown that higher protein diets can improve our blood sugar averages over several months, and can improve how our body uses/"burns" carbohydrates.)  
Since larger postprandial glucose elevations have been shown to be associated with an increased risk for the development of type 2 diabetes mellitus [16] and cardiovascular disease [17], it is of interest to identify dietary strategies, such as higher protein intake at breakfast... (blood sugar spikes which occur immediately after meals are particularly damaging to our bodies, and can lead to diabetes and heart disease, so it’s important to figure out how to avoid the spikes, so we can lower our risk. And breakfast protein is one way to decrease the blood sugar spikes, all day even after later meals.)
Average dietary protein intake in the US is adequate based on current recommendations [18]. However, data from the National Health and Nutrition Examination Survey (NHANES) survey suggest that the majority of dietary protein is consumed at dinner, with protein intakes at breakfast averaging ~10 g in women and 15 g in men, well below levels shown to favorably affect appetite and metabolism [19] (Timing is important.  While over the course of a day Americans may get enough protein to survive, they don’t eat enough of it in the morning, and then they eat too much at night.)
In an analysis of NHANES data, our group found that higher protein intake at breakfast was inversely associated with energy intake at lunch, and higher non-protein intake at breakfast was positively associated with energy intake at lunch [19]. (In other words, not all breakfasts are equal! High protein breakfasts led people to eat fewer calories at lunch, but low protein breakfasts led people to eat MORE at lunch!  A Poptart will make you hungry, while a high protein meal will keep you full later.  This is why some studies seem to contradict each other about the importance of breakfast.)
High protein, easy to prepare breakfast options with greater satiating potential would likely facilitate the consumption of calorically-restricted, protein-rich diets. (Simplify your protein at breakfast, and you’re more likely to succeed.)
The mechanisms whereby dietary protein promotes satiety are not completely understood. It has been hypothesized that a high-protein meal may modulate the post-absorptive release of hormones and neurochemicals in the gastrointestinal tract that down-regulate appetite [41]. In particular, consumption of high-protein meals has been shown to decrease levels of the hunger-stimulating hormone ghrelin and/or promote the increase in the satiety-stimulating hormones peptide YY (PYY) and glucagon-like peptide-1 (GLP-1), resulting in increased perceptions of satiety [8,9,26,42,43]. (We don’t know for sure WHY protein works, but we know it DOES work.  We also have some good  good leads, and research is ongoing.  But that shouldn’t stop you from doing what works!)
Results suggest that convenience meals providing 30 or 39 g protein/serving produce greater appetite control, lower postprandial glycemia and insulinemia, and reduced subsequent intake at lunch relative to a low-protein control, or no breakfast...
And there you have it.  Go ahead and take a look at the whole paper, and references if you have the time - it is very interesting!  My own personal experience using higher protein breakfasts, and my clinical experience with patients using this strategy, certainly is in alignment with this study.  Of course higher protein breakfasts are just one part of a healthy lifestyle strategy...but they are a great start.  
Call us any time if you’d like help creating a healthy diet plan and comprehensive lifestyle strategy to help you feel better, and be healthier.  We are here to help you get set up, then solidify your new habits so they become “second nature”, and we are here to help you “problem-solve” when new challenges come up, or if you get off track. Read more about our approach here: 

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We have some great, tasty, and convenient high protein options here:

Nutr J. 2015; 14: 17.Published online 2015 Feb 10. doi:  10.1186/s12937-015-0002-7 PMCID: PMC4334852 A randomized, controlled, crossover trial to assess the acute appetitive and metabolic effects of sausage and egg-based convenience breakfast meals in overweight premenopausal women
Tia M Rains,corresponding author Heather J Leidy, Kristen D Sanoshy, Andrea L Lawless, and Kevin C Maki 

Beneficial effects of a higher-protein breakfast on the appetitive, hormonal, and neural signals controlling energy intake regulation in overweight/obese, “breakfast-skipping,” late-adolescent girls1,2,3   Collectively, these data suggest that the daily addition of breakfast, particularly one rich in protein, appears to be an appropriate strategy to improve satiety, reduce food motivation/reward, and improve diet quality by replacing unhealthy evening snacking with nutrient-rich foods at breakfast in overweight/obese teen girls.”

2013 American Society for Nutrition  

References from the first article:


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