Which Is Better? Plant Based Hormones Or Animal Based
Nutrients. 2019 Jan; 11(1): 157.
A Plant-Based Meal Increases Gastrointestinal Hormones and Satiety More than an Free energy- and Macronutrient-Matched Candy-Meat Repast in T2D, Obese, and Healthy Men: A Three-Group Randomized Crossover Study
Martin Hill
iiPlant of Endocrinology, 113 94 Prague, Czechia; zc.odne@llihm
Received 2018 Dec 6; Accepted 2019 Jan ix.
Abstruse
Gastrointestinal hormones are involved in regulation of glucose metabolism and satiety. We tested the acute effect of meal composition on these hormones in iii population groups. A randomized crossover design was used to examine the effects of 2 energy- and macronutrient-matched meals: a processed-meat and cheese (M-meal) and a vegan repast with tofu (V-repast) on gastrointestinal hormones, and satiety in men with blazon two diabetes (T2D, n = 20), obese men (O, north = twenty), and good for you men (H, n = 20). Plasma concentrations of glucagon-like peptide -i (GLP-1), amylin, and peptide YY (PYY) were determined at 0, 30, 60, 120 and 180 min. Visual analogue scale was used to assess satiety. We used repeated-measures Analysis of variance (ANOVA) for statistical assay. Postprandial secretion of GLP-one increased after the V-meal in T2D (by xxx.5%; 95%CI 21.2 to 40.7%; p < 0.001) and H (by 15.8%; 95%CI eight.6 to 23.5%; p = 0.01). Postprandial plasma concentrations of amylin increased in in all groups after the Five-meal: by fifteen.7% in T2D (95%CI xi.8 to 19.6%; p < 0.001); past 11.5% in O (95%CI 7.8 to 15.iii%; p = 0.03); and by thirteen.8% in H (95%CI eight.four to 19.5%; p < 0.001). An increase in postprandial values of PYY later on the V-meal was significant only in H (by xviii.nine%; 95%CI vii.v to 31.three%; p = 0.03). Satiety was greater in all participants after the V-repast: past ix% in T2D (95%CI iv.4 to 13.6%; p = 0.004); by 18.vii% in O (95%CI 12.8 to 24.6%; p < 0.001); and by 25% in H (95%CI 18.2 to 31.7%; p < 0.001). Our results signal at that place is an increment in gut hormones and satiety, following consumption of a unmarried plant-based meal with tofu when compared with an energy- and macronutrient-matched processed-meat meat and cheese meal, in healthy, obese and diabetic men.
Keywords: gastrointestinal hormones, diet, plant-based, satiety, blazon 2 diabetes
i. Introduction
Obesity substantially increases the take chances of type 2 diabetes, cardiovascular disease, and sure types of cancer [1]. Lifestyle change, including improved dietary choices, represents a primary prevention tool [two,3]. The influence of diet in the development of insulin resistance, prediabetes, and type 2 diabetes was investigated intensively [4,5,six]. Gastrointestinal hormones are involved in regulation of glucose metabolism, energy homeostasis, satiety, and weight direction [vii]. Ingestion of food triggers secretion of incretin hormones from the gastrointestinal tract, namely glucagon-like peptide-one (GLP-one) and gastric inhibitory peptide (GIP), which raise insulin secretion and help maintain glucose homeostasis [8]. Furthermore, the satiety hormones GLP-1 [9], peptide YY (PYY) [x], pancreatic polypeptide (PP) [eleven] and amylin [12] regulate appetite and energy homeostasis. The release of these satiety hormones can depend on meal limerick and differs between dumb and normoglycemia [13].
Prospective observational studies indicate that consumption of red meat is positively associated with incidence of type 2 diabetes [14,15]. This association is particularly strong for processed meat. People consuming any processed meats accept a one third higher likelihood to develop diabetes compared with those who do not consume any [16]. Several studies demonstrated a harmful effect of saturated fatty acids from meat and other animal products on insulin resistance and glucose tolerance [4,17] as well as other health issues such as cardiovascular disease [eighteen]. In dissimilarity, people post-obit plant-based diets have their risk of diabetes cutting in half, compared with not-vegetarians [19]. Several randomized clinical trials in participants with type 2 diabetes demonstrated a greater increase in insulin sensitivity and improvement in glycemic command with a constitute-based diet when compared with a conventional nutrition [20,21].
Nosotros investigated postprandial metabolism in response to two meals matched for energy and macronutrient content: a processed-meat and cheese burger and a plant-based burger with tofu. We measured the physiological response to these meals in men with type 2 diabetes, torso mass index (BMI) and age-matched obese normoglycemic men, and healthy age-matched controls. Our hypothesis is that a plant-based meal produces higher levels of gastrointestinal hormones and increased satiety in men with type 2 diabetes or obesity while having a negligible event on healthy men. Our results will provide insight into the pathophysiologic mechanisms of the development of type 2 diabetes and volition be used to inform the testify base for dietary guidelines for men with type 2 diabetes.
2. Materials and Methods
2.1. Trial Design
We used a pattern of a randomized crossover written report and enrolled 60 men; xx men diagnosed with type 2 diabetes (T2D), 20 obese, BMI- and historic period-matched men (O), and twenty historic period-matched healthy controls (H) with 2 interventions. Screening was performed over the telephone, contacting men from our hospital database who met the inclusion criteria. Eligible potential study participants came for an in-person meeting and were provided with details about the study participation. Recruitment was performed between June 2015 and June 2017. All men gave a written consent prior to enrollment in the study. This report was approved by the Ethics Committee of the Thomayer Hospital and Found for Clinical and Experimental Medicine in Prague, Czechia on August 13, 2014. The protocol identification number is G14-08-42. The trial is prospectively registered with ClinicalTrials.gov (ID: {"blazon":"clinical-trial","attrs":{"text":"NCT02474147","term_id":"NCT02474147"}}NCT02474147).
two.2. Study Participants
All written report participants were Caucasian men with a Czech nationality. Men with type ii diabetes were between xxx–65 years old. Their body mass index (BMI) was between 25–45 kg/mii and they were treated by lifestyle lonely or with oral hypoglycemic agents (metformin and/or sulfonylureas) for at least one year, who had an HbA1c from ≥42 to ≤105 mmol / mol, (≥six.0 to ≤xi.8%) and at least iii hallmarks of the metabolic syndrome. Our obese men were BMI- and age-matched to men with blazon 2 diabetes. Healthy men were age-matched controls inside a healthy BMI range (BMI between 19–25 kg/yardtwo) and with normal glucose tolerance. Exclusion criteria were thyroid, liver or kidney disease, drug or alcohol abuse, unstable drug therapy or a meaning weight loss of more than than 5% of body weight in the terminal iii months.
2.3. Randomization and Masking
All men attended 2 report mornings. Before their get-go test morning, they were randomly assigned to an order of the test meals by the study medico (MK). Order of intervention was determined with a random sequence generator. The randomization protocol could not exist accessed beforehand. The interventions were unmasked. MK was not involved in information assay. Outcome assessors were blinded to the interventions.
2.four. Interventions
All men fasted for a minimum of 10 to 12 hours overnight. Men with type 2 diabetes were instructed to skip their diabetes medication the evening and the morn before the assessments. The meal consisted of either a processed meat and cheese burger (M-repast), or a plant-based tofu burger (V-meal). The staff delivered the meals fresh from the vendor. Tap water was allowed ad libitum. Plasma concentrations of gastrointestinal hormones, and self-reported satiety on a visual analogue scales were measured. Measurements were taken at baseline (time 0) and then thirty, sixty, 120 and 180 min subsequently both meals.
two.v. Measurements
Anthropometric measures and blood force per unit area: A stadiometer was used to measure out meridian and a periodically calibrated scale accurate to 0.one kg was used to measure body weight. Waist circumference was measured with a tape measure placed at the midpoint between the lowest rib and the upper function of the iliac os. Resting claret pressure was measured in a seated position subsequently 5 min of resting, using a digital M6 Comfort monitor (Omron, Kyoto, Japan). Out of three measurements, the get-go measurement was disregarded, and a mean value was calculated for the remaining two measurements.
Gastrointestinal and appetite hormones. The concentrations of glucagon-similar peptide-1 (GLP-1), amylin, and peptide YY (PYY) were measured using a Milliplex MAP Human Metabolic Hormone Magnetic Bead Console (HMHEMAG-34K) (Millipore, Billerica, MA, The states) and a Luminex 100 IS analyzer (Luminex Corporation, Austin, TX, USA).
2.6. Statistical Analysis
Sample size was estimated based on a power assay with an alpha of 0.05 and a power of 0.80 to detect between intervention differences in postprandial GLP-one secretion. This required 14 participants in each grouping to complete both interventions. Intention to treat analysis was performed, using repeated-measures Assay of variance (ANOVA). We included inter-individual factors (T2D vs. obese vs. healthy controls), intra-individual factors (fourth dimension during the meal examination) and interaction between factors (divergence degree betwixt fourth dimension profiles of each group) in the model. Spearman'south correlations were calculated to examination the relationship between postprandial changes in gastrointestinal hormones. They were calculated for the fasting plus for changes (30–0, lx–thirty, 120–sixty, and 180–120 minutes after ingestion of standard meal): for each flow separately, and and so for all 5 values combined. Analyses were undertaken using PASS 2005 statistical software (Number Cruncher Statistical Systems, Kaysville, UT, USA), with the statistician blinded to the analyses. All results are presented equally ways with 95% confidence intervals (CI).
3. Results
The flow diagram is shown in Figure i. Participant characteristics are shown Table 1. The meal composition is shown in Table two.
Enrollment of the participants and completion of the written report.
Tabular array 1
Characteristics of the study population. Data are means ± standard divergence (SD).
| Characteristic | Patients with T2D (n = 20) | Obese (n = xx) | Healthy Subjects (n = twenty) |
|---|---|---|---|
| Age—years | 47.8 ± eight.2 | 43 ± 7.0 | 42.7 ± 7.1 |
| Weight—kg | 108.ii ± 11.9 | 103.4 ± 13.3 | 77.iv ± viii.1 |
| BMI—kg × thousand−2 | 34.5 ± 3.four | 32.7 ± 3.9 | 23.eight ± one.5 |
| Waist—cm | 106.9 ± 23.half-dozen | 109 ± viii.5 | 85 ± v.iii |
| HbA1c (IFCC)—mmol/mol | 48.5 ± 8.1 | 36.4 ± three.0 | 36.ane ± 3.ii |
| Fasting plasma glucose—mmol/L | 7.2 ± ane.five | 5.1 ± 0.three | five.1 ± 0.four |
| TGC—mmol/L | 2.ane ± ane.1 | two.2 ± 1.1 | 1.1 ± 0.six |
| LDL—mmol/L | 2.6 ± 0.1 | 3.3 ± 0.7 | 2.8 ± 0.vii |
| Blood pressure—mm Hg | 144.4 ± xiii.4/96.2 ± eight.viii | 134.8 ± 7.6/xc ± 6.8 | 124 ± eleven.four/80.vii ± v.6 |
| Duration of diabetes—years | iv.25 ± three.25 | - | - |
Table 2
Composition of the test meals.
| Meal | M-meal | V-repast |
|---|---|---|
| Total weight (1000) | 200 | 200 |
| Energy content (kCal) | 513.vi | 514.9 |
| Carbohydrates (m) (%) | 55 (44.8%) | 54.two (44%) |
| Proteins (g) (%) | twenty.5 (sixteen.7%) | nineteen.nine (16.two%) |
| Lipids (g) (%) | 22 (38.six%) | 22.viii (39.8%) |
| Saturated fatty acids (g) | 8.6 | 2.2 |
| Fiber (1000) | 2.ii | 7.8 |
Gastrointestinal Hormones and Satiety
Postprandial secretion of GLP-ane increased subsequently the 5-meal in T2D (past 30.five%; 95%CI 21.two to xl.seven%; p < 0.001) and H (by 15.8%; 95%CI 8.vi to 23.5%; p = 0.01; Figure 2A). Postprandial plasma concentrations of amylin increased in all groups later on the V-meal: by 15.7% in T2D (95%CI 11.8 to 19.6%; p < 0.001); by 11.5% in O (95%CI vii.viii to xv.3%; p = 0.03); and by 13.8% in H (95%CI viii.four to 19.v%; p < 0.001; Figure 2B). An increase in postprandial values of PYY after the 5-meal was significant simply in H (past 18.9%; 95%CI 7.5 to 31.3%; p = 0.03; Figure 2C). Satiety was greater in all participants after the 5-meal: by ix.0% in T2D (95%CI four.4 to xiii.vi%; p = 0.004); by 18.7% in O (95%CI 12.viii to 24.half-dozen%; p < 0.001); and by 25.0% in H (95%CI 18.2 to 31.7%; p < 0.001; Figure 2D). A positive human relationship was observed betwixt Δ PYY and GLP-1 (r = 0.511, p < 0.001; Figure iii).
Postprandial changes in plasma concentrations of gastrointestinal hormones and in satiety in patients with diabetes (D), obese subjects (O), and healthy controls (H) subsequently the ingestion of the processed-meat meat M-meal (M, blue) and the vegan Five-repast (5, orange). Data are expressed as mean with 95% conviction intervals, using a repeated-measures Analysis of variance (ANOVA). * p < 0.05; ** p < 0.01; *** p < 0.001. (A): GLP-1: Meal: F = 19.3, p < 0.001; Grouping: F = 115.9, p < 0.001; Repast × Grouping: F = 1.ii, p = 0.309; Subj (Grouping): F = 16.3, p < 0.001. (B): Amylin: Meal: F = 33, p < 0.001; Grouping: F = 469.1, p < 0.001; Meal × Group: F = 0.7, p = 0.506; Subj (Grouping): F = 21.3, p < 0.001. (C): PYY: Meal: F = 4, p = 0.05; Group: F = twoscore.7, p < 0.001; Meal × Group: F = 0.6, p = 0.532; Subj (Group): F = 17, p < 0.001. (D): Satiety: Meal: F = 25.6, p < 0.001; Group: F = 33, p < 0.001; Meal × Group: F = 0.8, p = 0.472; Subj (Group): F = five.half-dozen, p < 0.001.
Correlation of postprandial concentrations of Δ GLP-one and Δ PYY after both meals in all men. Spearman'south correlation was calculated for the relationship between changes in concentrations of investigated parameters. r = 0.511, p < 0.001.
four. Discussion
Our study identified differences in markers of postprandial metabolism following the ingestion of a single plant-based repast when compared with a processed-meat meal that was matched for energy and macronutrient composition, peculiarly an increase in postprandial concentrations of GLP-1, amylin, and PYY. The differences were well-nigh noticeable in men with dysregulated glucose metabolism, those diagnosed with type 2 diabetes. Perchance surprisingly, greater satiety was reported by all men post-obit the 5-meal. Contrary to our hypothesis, the difference between the meals was noticeable besides in healthy volunteers. Our results provide comment on the interplay betwixt components of gastrointestinal signalling during digestion in three separate participant groups.
We observed college postprandial secretion of GLP-1 in obese men compared with healthy men. The highest concentrations of GLP-1 equally a upshot of GLP-1 resistance were observed in men with T2D. GLP-1 was primarily associated, together with GIP, with the incretin consequence, i.e. the increase in insulin secretion after meal ingestion in response to release of gut hormones [22]. The incretin outcome is macerated in people with T2D [23,24] due to decreased beta-jail cell sensitivity [25]. Several hypotheses were formulated to explain loss of beta-cell sensitivity. Widely accustomed concepts include hyperglycaemia- and hyperlipidaemia-associated receptor desensitization [26]. A few studies indicated that a high consumption of saturated fat increases the gamble of impaired glucose tolerance [four,17] due to decreased beta-cell sensitivity and function. Preserving the chapters of beta-cells to secrete insulin in line with irresolute demand is a key goal in diabetes management [27]. Insulin secretion and beta-cell function may be enhanced, using unlike approaches that reduce body weight and fat (such equally diet and exercise, bariatric surgery, or GLP-1 agonists) or favorably influence fatty distribution (such as thiazolidinediones) [27,28]. As medications and bariatric surgery come up with price and potential side furnishings, lifestyle interventions should exist the first-choice handling. Information technology was demonstrated that a xvi-calendar week found-based diet intervention improves insulin resistance and beta-cell role in overweight subjects, addressing both cadre pathophysiologic mechanisms involved in diabetes at the same time [29]. Our results are in line with these hypotheses and further demonstrate that a plant-based meal may increase the postprandial concentrations of GLP-1, particularly in men with T2D.
The highest postprandial concentrations of PYY were observed in men with diabetes, existence higher than in obese men and twice higher than in healthy men. PYY is synthesized and co-secreted together with GLP-1 [30]. PYY is a satiety hormone, because it decreases food intake and appetite after intravenous. administration [10] and the anorectic effects of PYY were pronounced even among obese and diabetic patients [31]. Furthermore, exaggerated secretion of PYY, together with GLP-1, plays a key role in metabolic improvements after bariatric surgery [32]. Nosotros found a positive human relationship between the postprandial changes in PYY concentrations and changes in satiety in all men. Increased PYY secretion indicates an improved regulation of satiety and weight management in insulin-resistant individuals [33]. Its secretion is mostly dependent on the presence of free fatty acids in the pocket-sized intestine [34]. Therefore, the ascension in the PYY concentrations reflects the contact of lipids and other nutrients with the small intestine [35] and it is plausible to hypothesize that high concentrations of PYY in obese and diabetic men may but reverberate their baseline high-fat diet.
Postprandial amylin concentrations were higher in all men subsequently the Five-meal. The highest concentrations were observed among obese men, and the everyman in healthy ones. Amylin plays an of import role in glucose metabolism and energy homeostasis [36] and is among satiety signals [37]. It is secreted in response to food and reduces eating by promoting satiation, together with GLP-1 and PYY. Interestingly, amylin analogues take been tested every bit an innovative treatment option of diabetes and obesity [38]. This farther underlies the importance of postprandial increase in amylin concentrations, particularly in obese and diabetic men.
All men reported increased satiety later the V-meal. This might exist partly explained by the fibre content of plant-foods, although most acute studies of meals differing in fibre consumption did not demonstrate enhanced satiety [39]. Since enhancing satiety is ane of the major challenges in the dietary treatment of obesity and T2D, plant-based meals may exist an effective strategy in solving this problem.
The main components responsible for the beneficial effects of a plant-based meal on satiety and the secretion of gastrointestinal hormones are fibre and bioactive compounds, such as polyphenols. Dietary fibre may increment PYY secretion and satiety in healthy people [40]. Additionally, resistant starch was shown to increment PYY concentrations in overweight individuals [41]. Furthermore, the bachelor evidence suggests that polyphenols increment GLP-1 secretion, increase its half-life by inhibiting dipeptidyl peptidase-4, and stimulate β-cells to secrete insulin [42]. The consequence of boosted bioactive compounds of constitute foods on satiety and secretion of gastrointestinal hormones is an emerging area of research.
The chief strength of this study is our comprehensive measurement of the postprandial state. We identified differences in the signalling of mechanisms behind the wellness improvements associated with plant-based diets. Nosotros recorded markers of both signal and response to meliorate consider the coaction of digestion and metabolism. We performed the same tests in men with blazon 2 diabetes, BMI and age-matched men, and age-matched good for you men so to consider differences in postprandial metabolism by country. Finally, our meals were commonly consumed meals served in quantities typically ingested, making the study results highly applicable and practical. This study as well has several limitations. This is an astute meal test, with express application to habitual diets and lifetime dietary patterns. However, when comparing these single repast responses, nosotros identified metabolism differences that advise longer-term studies would be beneficial to meet if institute-based diets trigger additive or synergistic responses that improve markers of diabetes progression or prevent its incidence. Differences in the saturated fatty and dietary fibre content of meals may have influenced our results. However, these differences are primal when comparing plant-based diets with diets containing meat, so while this difference is non controlled for in this study, it does increase the generalisability of our results. In this study, the T2D and obese men were BMI-matched, while healthy controls had a significantly lower BMI. This difference in BMI may influence some of the responses we recorded.
five. Conclusions
Our findings indicate that institute-based meals with tofu may exist an constructive tool to increase postprandial secretion of gastrointestinal hormones, every bit well as promote satiety, compared to processed meat and cheese, in healthy, obese, and diabetic men. These positive properties may have practical implications for the prevention of type two diabetes.
Acknowledgments
The authors gratefully acknowledge Andrew Reynolds for his kind assist with the concluding edits of the manuscript.
Abbreviations
| BMI | body mass alphabetize |
| HbA1c | glycated haemoglobin |
| GLP-1 | glucagon-similar peptide -1 |
| PYY | peptide YY |
Author Contributions
H.Thou. and T.P. designed the study, wrote the grant application, and study protocol. M.K. recruited the patients, randomized the lodge of the test meals, and collected the information. Grand.H. (Martin Haluzik) and R.P. acquired and analysed data. K.H. (Martin Hill) carried out statistical analyses and interpretation of data. L.T. and H.K. drafted the manuscript. All authors had full access to data, critically revised the article and approved the manuscript for publication. H.Chiliad. is the guarantor of this work and takes responsibility for the integrity of the information and the accuracy of the analysis.
Funding
This work was supported by the project grant AZV15-27338A from Ministry of Health, Prague, Czech Commonwealth.
Conflicts of Interest
Hana Kahleova is Manager of Clinical Enquiry at Physicians Committee for Responsible Medicine, a non-profit organization providing diet research and education. None alleged.
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Articles from Nutrients are provided here courtesy of Multidisciplinary Digital Publishing Institute (MDPI)
Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6357017/
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