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American Journal of Epidemiology Advance Access originally published online on February 18, 2009
American Journal of Epidemiology 2009 169(7):893-900; doi:10.1093/aje/kwn415
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American Journal of Epidemiology © The Author 2009. Published by the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org.

ORIGINAL CONTRIBUTIONS

Associations Between Macronutrient Intake and Self-reported Appetite and Fasting Levels of Appetite Hormones: Results From the Optimal Macronutrient Intake Trial to Prevent Heart Disease

Jeannette M. Beasley, Brett A. Ange, Cheryl A. M. Anderson, Edgar R. Miller, III, Thomas P. Erlinger, Janet T. Holbrook, Frank M. Sacks and Lawrence J. Appel

Correspondence to Jeannette M. Beasley, Center for Health Studies, Group Health Cooperative, 1730 Minor Avenue, Suite 1600, Seattle, WA 98101-1404 (e-mail: beasley.j{at}ghc.org).

Received for publication October 3, 2008. Accepted for publication December 17, 2008.

The authors compared effects of macronutrients on self-reported appetite and selected fasting hormone levels. The Optimal Macronutrient Intake Trial to Prevent Heart Disease (OMNI-Heart) (2003–2005) was a randomized, 3-period, crossover feeding trial (n = 164) comparing the effects of 3 diets, each rich in a different macronutrient. Percentages of kilocalories of carbohydrate, fat, and protein were 48, 27, and 25, respectively, for the protein-rich diet; 58, 27, and 15, for the carbohydrate-rich diet; and 48, 37, and 15 for the diet rich in unsaturated fat. Food and drink were provided for each isocaloric 6-week period. Appetite was measured by visual analog scales. Pairwise differences between diets were estimated using generalized estimating equations. Compared with the protein diet, premeal appetite was 14% higher on the carbohydrate (P = 0.01) and unsaturated-fat (P = 0.003) diets. Geometric mean leptin was 8% lower on the protein diet than on the carbohydrate diet (P = 0.003). Obestatin levels were 7% and 6% lower on the protein diet than on the carbohydrate (P = 0.02) and unsaturated-fat (P = 0.004) diets, respectively. There were no between-diet differences for ghrelin. A diet rich in protein from lean meat and vegetables reduces self-reported appetite compared with diets rich in carbohydrate and unsaturated fat and can be recommended in a weight-stable setting. The observed pattern of hormone changes does not explain the inverse association between protein intake and appetite.

appetite; cross-over studies; diet; dietary carbohydrates; dietary fats; dietary proteins; ghrelin; leptin

Abbreviations: OMNI-Heart, Optimal Macronutrient Intake Trial to Prevent Heart Disease; SD, standard deviation


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