Impact of isoenergetic intake of irregular meal patterns on thermogenesis, glucose metabolism, and appetite: a randomized controlled trial

Alhussain, Maha H; Macdonald, Ian A; Taylor, Moira A

Abstract

Background
Evidence is emerging that interdaily meal pattern variability potentially affects response such as thermic effect of food (TEF), macronutrient metabolism, and appetite.

Objectives
To investigate the effect of irregular meal pattern on TEF, glucose, insulin, lipid profile, and appetite regulation in women who are overweight or with obesity and confirmed insulin resistance.

Design
In a randomized crossover trial, 9 women [mean ± SD BMI (in kg/m2): 33.3 ± 3.1] with confirmed insulin resistance consumed a regular (14 d; 6 meals/d) and an irregular (14 d; 3-9 meals/d) meal pattern separated by a 14-d washout interval. Identical foods were provided during the interventions, and at the start and end of each meal pattern, participants attended the laboratory after an overnight fast. Energy expenditure, glucose, insulin, lipids, adiponectin, leptin, glucagon-like peptide 1 (GLP-1), peptide YY (PYY), and ghrelin were measured at baseline and for 3 h after consumption of a test drink, after which an ad libitum test meal was offered. Subjective appetite ratings were recorded before and after the test drink, after the ad libitum meal, and during the intervention. Continuous interstitial glucose monitoring was undertaken for 7 consecutive days during each intervention.

Results
TEF (over 3 h) was significantly lower postirregular intervention compared with postregular (97.7 ± 19.2 kJ*3 h in postregular visit and 76.7 ± 35.2 kJ*3 h in postirregular visit, paired t test, P = 0.048). Differences in HOMA-IR between the 2 interventions (3.3 ± 1.7 and 3.6 ± 1.6 in postregular and postirregular meal pattern, respectively) were not significant. Net incremental AUC for GLP-1 concentrations (over 3 h) for the postregular meal pattern were higher (864.9 ± 456.1 pmol/L*3 h) than the postirregular meal pattern (487.6 ± 271.7 pmol/L*3 h, paired t test, P = 0.005).

Conclusions
Following a 14-d period of an irregular meal pattern, TEF was significantly less than following a regular meal pattern, potentially compromising weight management if sustained long term. This study was registered at www.clinicaltrials.gov as NCT02582606.

• Journal Article Type: Article
• Acceptance Date: Sep 21, 2021
• Online Publication Date: Sep 23, 2021
• Publication Date: 2022-01
• Deposit Date: Jul 20, 2023
• Publicly Available Date: Jul 27, 2023
• Journal: The American Journal of Clinical Nutrition
• Print ISSN: 0002-9165
• Electronic ISSN: 1938-3207
• Publisher: Elsevier BV
• Peer Reviewed: Peer Reviewed
• Volume: 115
• Issue: 1
• Pages: 284-297
• DOI: https://doi.org/10.1093/ajcn/nqab323
• Keywords: Nutrition and Dietetics; Medicine (miscellaneous)
• Public URL: https://nottingham-repository.worktribe.com/output/7378981
• Publisher URL: https://www.sciencedirect.com/science/article/pii/S0002916522001319?via%3Dihub