Fortifying a meal with oyster mushroom powder beneficially affects postprandial glucagon-like peptide-1, non-esterified free fatty acids and hunger sensation in adults with impaired glucose tolerance: a double-blind randomized controlled crossover trial

Purpose Impaired glucose tolerance (IGT) is a pathophysiological condition characterized by insulin resistance with known metabolic consequences such as postprandial hyperglycemia and hypertriglyceridemia. We hypothesized that fortifying a meal with mushrooms rich in β-glucans may diminish glucose and triglyceride responses by improving postprandial gastrointestinal hormone release. Methods In a randomized controlled crossover study, 22 subjects with IGT ingested a meal either enriched with 20 g powder (8.1 g β-glucans) of oven-dried Pleurotus ostreatus (enriched meal, EN) or without enrichment (control meal, CON). Blood was collected before and repeatedly within 4 h after the meal to determine AUC of glucose (primary outcome), insulin, triglycerides, non-esterified free fatty acids (NEFAs), glucagon-like peptide-1 (GLP-1), gastric inhibitory polypeptide (GIP) and ghrelin. Appetite sensations (hunger, satiety, fullness, and desire to eat) were assessed before and after meal consumption by visual analog scales. Results Postprandial glucose, insulin, triglycerides, GIP and ghrelin concentrations as well as the corresponding AUCs did not differ between EN and CON. NEFAs-AUC was 14% lower (P = 0.026) and GLP-1-AUC 17% higher (P = 0.001) after EN compared to CON. Appetite ratings did not differ between treatments, except for hunger (AUC 22% lower after EN vs. CON; P = 0.031). Conclusion The observed immediate postprandial metabolic changes indicate that an easily manageable fortification of a single meal with powder from dried oyster mushrooms as β-glucan source may improve postprandial metabolism. If the effect is preserved long term, this measure can diminish the risk for further development of overweight/obesity and type 2 diabetes in subjects with IGT. Clinical trial registration German Clinical Trial Register on 09/08/2018; trial-ID: DRKS00015244.

Effects of 60-Day Saccharomyces boulardii and Superoxide Dismutase Supplementation on Body Composition, Hunger Sensation, Pro/Antioxidant Ratio, Inflammation and Hormonal Lipo-Metabolic Biomarkers in Obese Adults: A Double-Blind, Placebo-Controlled Trial

In animals it has been demonstrated that Saccharomyces boulardii and Superoxide Dismutase (SOD) decrease low-grade inflammation and that S. boulardii can also decrease adiposity. The purpose of this study was to evaluate the effect of a 60-day S. boulardii and SOD supplementation on circulating markers of inflammation, body composition, hunger sensation, pro/antioxidant ratio, hormonal, lipid profile, glucose, insulin and HOMA-IR, in obese adults (BMI 30–35 kg/m2). Twenty-five obese adults were randomly assigned to intervention (8/4 women/men, 57 ± 8 years) or Placebo (9/4 women/men, 50 ± 9 years). Intervention group showed a statistically significant (p < 0.05) decrease of body weight, BMI, fat mass, insulin, HOMA Index and uric acid. Patients in intervention and control groups showed a significant decrease (p < 0.05) of GLP-1. Intervention group showed an increase (p < 0.05) of Vitamin D as well. In conclusion, the 60-day S. boulardii-SOD supplementation in obese subjects determined a significant weight loss with consequent decrease on fat mass, with preservation of fat free mass. The decrease of HOMA index and uric acid, produced additional benefits in obesity management. The observed increase in vitamin D levels in treated group requires further investigation.

Systemic Delivery of hGhrelin Derivative by Lyophilizate for Dry Powder Inhalation System in Monkeys

Ghrelin is the peptide that increases the hunger sensation and food intake and is expected to be clinically applied for treatment of diseases such as cachexia and anorexia nervosa. In the clinical application of ghrelin, injections are problematic in that they are invasive and inconvenient. Thus, we aimed to develop a formulation that can eliminate the need for injections and can be applied clinically. We prepared formulations of an hGhrelin derivative, in which the octanoyl group essential for expression of activity is modified to avoid rapid des-acylation, using lyophilizate for a dry powder inhalation (LDPI) system. The formulation of hGhrelin derivative was optimized by the addition of phenylalanine, of which the fine particle fraction of 5 µm or less was 41.7 ± 3.8%. We also performed pharmacokinetic/pharmacodynamic tests in monkeys using the optimum formulation that can be applied clinically. The absolute bioavailability of inhaled hGhrelin derivative with respect to that intravenously injected was 16.9 ± 2.6%. An increase in growth hormone was shown as an effect of the inhaled hGhrelin derivative similar to intravenous injection. The LDPI formulation can deliver the hGhrelin derivative systemically, and it is expected to be applied clinically as a substitute for injections.

Eating Habits during COVID-19 Quarantine

The COVID-19 outbreak has affected billions of people worldwide. We are facing a critical situation with various challenges. Many countries have imposed restrictions in daily life activities to control the spread of virus. This caused change in working patterns and living conditions like staying indoors 1. This forced staying indoors for long time can cause stress conditions that directly affect eating habits. Prolonged stress triggers the release of cortisol that produce hunger sensation 2. In some people it also leads to binge eating disorder (BED). In BED there is regular and frequent intake of large quantities of food and no control over eating. Studies indicate that stress induces changes in our food preferences from low fat diet to high fat diet 3. Thus stress causes unhealthy food addiction that leads to obesity. Obesity boost the production of adipokines and other cytokines that eventually cause low grade inflammation, and affect the development of other metabolic conditions like diabetes and arterial hypertension 4. Data from different studies have shown high intake of food during quarantine in adults. A study was conducted in Poland to evaluate nutritional habits in adult during quarantine. About 50% people reported more eating and 43% stated weight gain. Weight loss was observed only in 18% of individuals. An increase in body mass index (BMI) was associated with high intake of fast-food, dairy and meat and, relatively less consumption of fruits, vegetables, and legumes during quarantine. This weight gain tendency was observed in older, overweight and obese subjects while underweight subjects showed a tendency towards weight loss 1. So, this study highlights a change in eating habits during quarantine and, obese and overweight people are more vulnerable. Thus, staying healthy during this period of confinement is challenging. Healthy eating habits during this time is important to enhance our immune system as virus is continuously spreading. It is important to remain physical active to control weight and eat balanced diet containing all essential nutrients. It is recommended to avoid high glycemic index carbohydrates like sweets, sugar or bread. Instead low glycemic index carbohydrates like brown rice, whole grain, legumes, vegetables and fruits should be used. Proteins are an important part of diet, so food rich in protein but with low percentage of fat should be included in diet 5. A balanced diet also helps in normal functioning of immune system.

Lipocalin-2 is an anorexigenic signal in primates

In the mouse, the osteoblast-derived hormone Lipocalin-2 (LCN2) suppresses food intake and acts as a satiety signal. We show here that meal challenges increase serum LCN2 levels in persons with normal or overweight, but not in individuals with obesity. Postprandial LCN2 serum levels correlate inversely with hunger sensation in challenged subjects. We further show through brain PET scans of monkeys injected with radiolabeled recombinant human LCN2 (rh-LCN2) and autoradiography in baboon, macaque, and human brain sections, that LCN2 crosses the blood-brain barrier and localizes to the hypothalamus in primates. In addition, daily treatment of lean monkeys with rh-LCN2 decreases food intake by 21%, without overt side effects. These studies demonstrate the biology of LCN2 as a satiety factor and indicator and anorexigenic signal in primates. Failure to stimulate postprandial LCN2 in individuals with obesity may contribute to metabolic dysregulation, suggesting that LCN2 may be a novel target for obesity treatment.

Surgical Treatment Of Obesity

Obesity is associated with numerous comorbidities and shortens life expectancy. Currently, over one third of adults in the United States are obese, making management of obesity a significant public health concern. Given the modest benefits of behavior change alone, weight loss surgery has become a popular tool in the treatment of obesity. Numerous studies have documented the benefits of weight loss surgery in promoting weight loss and resolution of comorbidities. The hormonal and physiologic changes that are induced by some weight loss procedures are not yet fully elucidated, but it is thought that changes in hunger sensation and metabolism drive the observed effects. This review contains 4 figures, 2 videos, 3 tables and 60 references Key words: bypass, obesity, sleeve gastrectomy, surgery, weight loss