Regulators of Food Intake

National Institute Of Diabetes And Digestive And Kidney Diseases

Investigators

Linked publications & trials

Abstract

Energy intake and dietary macronutrient composition is the most difficult part of the energy balance equation to measure. In a natural history study of factors which predict food intake and using an inpatient computerized vending machine system, food intake has been measured over 280 individuals. In individuals undergoing the study more than once the intra-class correlation coefficient is very high (r=0.9) indicating that these studies although performed in an inpatient setting are very reproducible. This study has demonstrated that higher respiratory quotient, the ratio of carbohydrate oxidation to lipid oxidation which predicts weight gain, also predicts energy intake. The component of respiratory quotient which best predicted food intake was higher carbohydrate oxidation indicating a role for carbohydrate (likely glycogen) balance in the regulation of short term food intake. However, we did not find that glycogen depletion increased food intake in a follow-up study. We have also demonstrated that one of the most important determinants of food intake is fat free mass. There is a strong positive association between fat free mass (adjusted for height) and food intake, which persists even when adjusted for fat mass. Fat free mass is the major determinant of energy expenditure, and 24 hour energy expenditure is also strongly associated with energy intake. Furthermore, even after adjustment for fat free mass, the residual of energy expenditure was still associated with energy intake. However in mediation analysis, energy expenditure is a more important predictor of energy intake than fat free mass. This indicates that homeostatic of energy needs may be determined by metabolic rate, and that increases in metabolic rate (as a weight loss intervention) may have the paradoxical effect of stimulating excess caloric intake. In fact in further analyses, we have found that energy intake adjusted for energy expenditure predicts weight gain. We have begun investigating this energy sensing link further in a protocol which investigates if increased energy expenditure (as induced by cold) will lead to increases in food intake. In this protocol we are investigating also the timing of the increase in energy expenditure, whether this energy sensing occurs immediately or following the cold induced increase in EE. Using this ad libitum vending machine model, we have found that calories from soda intake predicted future weight gain indicating a role for sweetened beverages as contributes to the current obesity epidemic. We have also recently found that individuals who select a higher percentage of foods in high simple sugar/high fat content category gain more weight. In an effort to understand behavioral and psychosocial factors, we have also investigated whether socioeconomic status and food insecurity are associated with energy intake. We found that those with higher food insecurity scores, eat more during the ad libitum period indicating an important psychosocial component is at work in determining calorie intake. To develop methods to measure free living food intake, we have ongoing studies which are validating chewing and swallowing monitors using our automated vending machines. Our initial pilot study of ten individuals demonstrated that eating events can be captured on these monitors and that overall eating events do correlate with calorie intake, but we are analyzing results of an additional 17 individuals who have had measurements of energy intake while wearing these monitors. We are continuing our study investigating stable isotopes as biomarkers for dietary patterns. Individuals (n=40) will consume diets over 3 months which vary by meat, soda and fish content and plasma, hair, and adipose tissue samples will be analyzed for changes in the stable isotopes C13 and N15 as well as specific amino acids (such as phenylalanine) which may be even better markers of meat versus soda intake. We will also investigate how these dietary patterns affect behavioral and performance testing, glucose tolerance and energy expenditure. We have currently completed 28 volunteers in this intensive study which requires a 14 week stay on our inpatient unit. We are currently measuring the stable isotope ratios in all these participants. Preliminary analyses indicate that we can differentiate that N15 enrichment in both plasma and hair does identify individuals who are consuming fish over the 13 weeks study period, and that C13 can differentiate intake of meat versus no meat diets. Stable isotope measurement of phenylalanine also demonstrated discrimination of soda versus no soda intake.