Investigating the effect of sex and ketosis on weight-loss-induced changes in appetite

Anna Lyngstad, Siren Nymo, Silvia R. Coutinho, Jens F. Rehfeld, Helen Truby, Bård Kulseng, Catia Martins

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Background: Diet-induced weight loss (WL) is usually accompanied by increased appetite, a response that seems to be absent when ketogenic diets are used. It remains unknown if sex modulates the appetite suppressant effect of ketosis. Objective: The aim of this study was to examine if sex modulates the impact of WL-induced changes in appetite and if ketosis alters these responses. Methods: Ninety-five individuals (55 females) with obesity (BMI [kg/m 2 ]: 37 ± 4) underwent 8 wk of a very-low-energy diet, followed by 4 wk of refeeding and weight stabilization. Body composition, plasma concentration of β-hydroxybutyrate (β-HB) and appetite-related hormones (active ghrelin, active glucagonlike peptide 1 [GLP-1], total peptide YY [PYY], cholecystokinin and insulin), and subjective feelings of appetite were measured at baseline, week 9 in ketosis, and week 13 out of ketosis. Results: The mean WL at week 9 was 17% for males and 15% for females, which was maintained at week 13. Weight, fat, and fat-free mass loss were greater in males (P< 0.001 for all) and the increase in β-HB at week 9 higher in females (1.174 ± 0.096 compared with 0.783 ± 0.112 mmol/L, P = 0.029). Basal and postprandial GLP-1 and postprandial PYY (all P< 0.05) were significantly different for males and females. There were no significant sex × time interactions for any other appetite-related hormones or subjective feelings of appetite. At week 9, basal GLP-1 was decreased only in males (P< 0.001), whereas postprandial GLP-1 was increased only in females (P< 0.001). No significant changes in postprandial PYY were observed over time for either sex. Conclusions: Ketosis appears to have a greater beneficial impact on GLP-1 in females. However, sex does not seem to modulate the changes in the secretion of other appetite-related hormones, or subjective feelings of appetite, seen with WL, regardless of the ketotic state. This trial was registered at clinicaltrials.gov as NCT01834859. Am J Clin Nutr 2019;109:1511-1518.

Original languageEnglish
Pages (from-to)1511-1518
Number of pages8
JournalThe American journal of clinical nutrition
Volume109
Issue number6
DOIs
Publication statusPublished - 1 Jun 2019

Keywords

  • Cholecystokinin
  • Fullness
  • Ghrelin
  • Glucagon-Like Peptide 1
  • Hunger
  • Ketosis
  • Peptide YY
  • Prospective Food Consumption
  • Very-Low-Energy Diet
  • Weight Loss

Cite this

Lyngstad, Anna ; Nymo, Siren ; Coutinho, Silvia R. ; Rehfeld, Jens F. ; Truby, Helen ; Kulseng, Bård ; Martins, Catia. / Investigating the effect of sex and ketosis on weight-loss-induced changes in appetite. In: The American journal of clinical nutrition. 2019 ; Vol. 109, No. 6. pp. 1511-1518.
@article{051784befc434feb94f2cb49020ff4b2,
title = "Investigating the effect of sex and ketosis on weight-loss-induced changes in appetite",
abstract = "Background: Diet-induced weight loss (WL) is usually accompanied by increased appetite, a response that seems to be absent when ketogenic diets are used. It remains unknown if sex modulates the appetite suppressant effect of ketosis. Objective: The aim of this study was to examine if sex modulates the impact of WL-induced changes in appetite and if ketosis alters these responses. Methods: Ninety-five individuals (55 females) with obesity (BMI [kg/m 2 ]: 37 ± 4) underwent 8 wk of a very-low-energy diet, followed by 4 wk of refeeding and weight stabilization. Body composition, plasma concentration of β-hydroxybutyrate (β-HB) and appetite-related hormones (active ghrelin, active glucagonlike peptide 1 [GLP-1], total peptide YY [PYY], cholecystokinin and insulin), and subjective feelings of appetite were measured at baseline, week 9 in ketosis, and week 13 out of ketosis. Results: The mean WL at week 9 was 17{\%} for males and 15{\%} for females, which was maintained at week 13. Weight, fat, and fat-free mass loss were greater in males (P< 0.001 for all) and the increase in β-HB at week 9 higher in females (1.174 ± 0.096 compared with 0.783 ± 0.112 mmol/L, P = 0.029). Basal and postprandial GLP-1 and postprandial PYY (all P< 0.05) were significantly different for males and females. There were no significant sex × time interactions for any other appetite-related hormones or subjective feelings of appetite. At week 9, basal GLP-1 was decreased only in males (P< 0.001), whereas postprandial GLP-1 was increased only in females (P< 0.001). No significant changes in postprandial PYY were observed over time for either sex. Conclusions: Ketosis appears to have a greater beneficial impact on GLP-1 in females. However, sex does not seem to modulate the changes in the secretion of other appetite-related hormones, or subjective feelings of appetite, seen with WL, regardless of the ketotic state. This trial was registered at clinicaltrials.gov as NCT01834859. Am J Clin Nutr 2019;109:1511-1518.",
keywords = "Cholecystokinin, Fullness, Ghrelin, Glucagon-Like Peptide 1, Hunger, Ketosis, Peptide YY, Prospective Food Consumption, Very-Low-Energy Diet, Weight Loss",
author = "Anna Lyngstad and Siren Nymo and Coutinho, {Silvia R.} and Rehfeld, {Jens F.} and Helen Truby and B{\aa}rd Kulseng and Catia Martins",
year = "2019",
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pages = "1511--1518",
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Lyngstad, A, Nymo, S, Coutinho, SR, Rehfeld, JF, Truby, H, Kulseng, B & Martins, C 2019, 'Investigating the effect of sex and ketosis on weight-loss-induced changes in appetite' The American journal of clinical nutrition, vol. 109, no. 6, pp. 1511-1518. https://doi.org/10.1093/ajcn/nqz002

Investigating the effect of sex and ketosis on weight-loss-induced changes in appetite. / Lyngstad, Anna; Nymo, Siren; Coutinho, Silvia R.; Rehfeld, Jens F.; Truby, Helen; Kulseng, Bård; Martins, Catia.

In: The American journal of clinical nutrition, Vol. 109, No. 6, 01.06.2019, p. 1511-1518.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Investigating the effect of sex and ketosis on weight-loss-induced changes in appetite

AU - Lyngstad, Anna

AU - Nymo, Siren

AU - Coutinho, Silvia R.

AU - Rehfeld, Jens F.

AU - Truby, Helen

AU - Kulseng, Bård

AU - Martins, Catia

PY - 2019/6/1

Y1 - 2019/6/1

N2 - Background: Diet-induced weight loss (WL) is usually accompanied by increased appetite, a response that seems to be absent when ketogenic diets are used. It remains unknown if sex modulates the appetite suppressant effect of ketosis. Objective: The aim of this study was to examine if sex modulates the impact of WL-induced changes in appetite and if ketosis alters these responses. Methods: Ninety-five individuals (55 females) with obesity (BMI [kg/m 2 ]: 37 ± 4) underwent 8 wk of a very-low-energy diet, followed by 4 wk of refeeding and weight stabilization. Body composition, plasma concentration of β-hydroxybutyrate (β-HB) and appetite-related hormones (active ghrelin, active glucagonlike peptide 1 [GLP-1], total peptide YY [PYY], cholecystokinin and insulin), and subjective feelings of appetite were measured at baseline, week 9 in ketosis, and week 13 out of ketosis. Results: The mean WL at week 9 was 17% for males and 15% for females, which was maintained at week 13. Weight, fat, and fat-free mass loss were greater in males (P< 0.001 for all) and the increase in β-HB at week 9 higher in females (1.174 ± 0.096 compared with 0.783 ± 0.112 mmol/L, P = 0.029). Basal and postprandial GLP-1 and postprandial PYY (all P< 0.05) were significantly different for males and females. There were no significant sex × time interactions for any other appetite-related hormones or subjective feelings of appetite. At week 9, basal GLP-1 was decreased only in males (P< 0.001), whereas postprandial GLP-1 was increased only in females (P< 0.001). No significant changes in postprandial PYY were observed over time for either sex. Conclusions: Ketosis appears to have a greater beneficial impact on GLP-1 in females. However, sex does not seem to modulate the changes in the secretion of other appetite-related hormones, or subjective feelings of appetite, seen with WL, regardless of the ketotic state. This trial was registered at clinicaltrials.gov as NCT01834859. Am J Clin Nutr 2019;109:1511-1518.

AB - Background: Diet-induced weight loss (WL) is usually accompanied by increased appetite, a response that seems to be absent when ketogenic diets are used. It remains unknown if sex modulates the appetite suppressant effect of ketosis. Objective: The aim of this study was to examine if sex modulates the impact of WL-induced changes in appetite and if ketosis alters these responses. Methods: Ninety-five individuals (55 females) with obesity (BMI [kg/m 2 ]: 37 ± 4) underwent 8 wk of a very-low-energy diet, followed by 4 wk of refeeding and weight stabilization. Body composition, plasma concentration of β-hydroxybutyrate (β-HB) and appetite-related hormones (active ghrelin, active glucagonlike peptide 1 [GLP-1], total peptide YY [PYY], cholecystokinin and insulin), and subjective feelings of appetite were measured at baseline, week 9 in ketosis, and week 13 out of ketosis. Results: The mean WL at week 9 was 17% for males and 15% for females, which was maintained at week 13. Weight, fat, and fat-free mass loss were greater in males (P< 0.001 for all) and the increase in β-HB at week 9 higher in females (1.174 ± 0.096 compared with 0.783 ± 0.112 mmol/L, P = 0.029). Basal and postprandial GLP-1 and postprandial PYY (all P< 0.05) were significantly different for males and females. There were no significant sex × time interactions for any other appetite-related hormones or subjective feelings of appetite. At week 9, basal GLP-1 was decreased only in males (P< 0.001), whereas postprandial GLP-1 was increased only in females (P< 0.001). No significant changes in postprandial PYY were observed over time for either sex. Conclusions: Ketosis appears to have a greater beneficial impact on GLP-1 in females. However, sex does not seem to modulate the changes in the secretion of other appetite-related hormones, or subjective feelings of appetite, seen with WL, regardless of the ketotic state. This trial was registered at clinicaltrials.gov as NCT01834859. Am J Clin Nutr 2019;109:1511-1518.

KW - Cholecystokinin

KW - Fullness

KW - Ghrelin

KW - Glucagon-Like Peptide 1

KW - Hunger

KW - Ketosis

KW - Peptide YY

KW - Prospective Food Consumption

KW - Very-Low-Energy Diet

KW - Weight Loss

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U2 - 10.1093/ajcn/nqz002

DO - 10.1093/ajcn/nqz002

M3 - Article

VL - 109

SP - 1511

EP - 1518

JO - The American journal of clinical nutrition

JF - The American journal of clinical nutrition

SN - 0002-9165

IS - 6

ER -