Showing posts with label protein. Show all posts
Showing posts with label protein. Show all posts

Wednesday, November 4, 2015

No Additional Gains With PWO Protein + Leucine Shakes in Rookies? Why the "Shocking" Results of a Recent Study Don't Mean That They, Let Alone You, Cannot Benefit at All

You can't expect wonders from protein supplements... no matter, when you take them, by the way. But I wouldn't mark them down as useless - even for rookies - based on the study at hand.
When I look at the 14 year old kids who need an written permission from their mum to train at the gym buying protein tons o powders and dozens of bars from the vending machines at the gym, even I have to shake my head. Not necessarily, because they're buying those products, but rather about what they tell each other about the effects: "Yo,... recently I ate this protein bar right after my workout and I felt swole for day..."

Now, you know that I am into supplement psychology and have no doubt about the fact that said kiddo felt swole all day, but we all know that protein is in no way a supplement the muscle-building and strength advantages of which will show within hours. And with that, I have a perfect transition to today's topic: The recent study from University of Central Florida in Orlando (Boone. 2015).
You can learn more about protein intake at the waredownloadsoft

Are You Protein Wheysting?

5x More Than the FDA Allows!

More Protein ≠ More Satiety

Protein: Food or Supplement?

Protein Timing DOES Matter!

Less Fat, More Muscle!
You will probably remember the most striking result of this study in which Carleigh H. Boone and colleagues "examine[d] the short-term effect of resistance training with and without protein supplementation on changes in muscle morphology and strength in untrained young men" (Boone. 2015).

Some of you may now be wondering: Why on earth do they even test that? We have ample evidence that protein supplements are powerful muscle builders! And you are right, but as it is the case for (almost) every research question in exercise science, even the highly acclaimed benefits of pre- or post-workout protein supplementation are somewhat contested. There's the evidence that supports the benefits of peri-workout protein supplementation on exercise induced muscle gains. Unfortunately, many of these studies may have been over-interpreted. Why?

FSR ≠ more muscle. Just because the post-exercise fractional protein synthesis increases this does not mean that you will gain more muscle in the long term. Check out this SV Classic to learn why!
Well, many of the often-cited studies in rookies, like Biolo et al. (1995), Phillips et al. (1997), or Tipton et al. (1999), measured increases in acute muscle protein synthesis and markers of anabolism. Due to their short design, however, increased long-term gains could only be predict, but not detect. In my 2014 article "Study Confirms: Acute Post-Exercise Myofibrillar Protein Synthesis Is Not Correlated with Resistance Training-Induced Muscle Hypertrophy in Young Men" (read more) you have learned, though, that the assumption that significant increases in post-workout muscle protein synthesis will necessary lead to significant augmented increases in muscle size in the long run is logical. but futile.

There are studies where this is the case, e.g. Coburn et al. (2006); Hulmi et al. (2010); Walker et al. (2009); Willoughby et al. (2007) - in both, trained and untrained individuals, but as Boone et al. rightly point out, there are also studies by Antonio et al. (2000) or Hoffman et al. (2009) in which protein or amino acid supplements had no beneficial effects on muscle or strength gains in either or trained and untrained individuals. The randomized, double-blinded study Boone et al. (2015) conducted is thus by no means superfluous. It is yet no perfect either, because with a length of only our week, the scientists picked exactly the time-frame in which things, or I should say "gains" happen faster than you can measure them. Furthermore, the use o a lower body unilateral resistance training makes it very difficult to infer the effects of protein supplementation on (a) muscle morphology [cross-sectional area, muscle thickness, pennation angle], (b) lower body power output, (c) maximal dynamic strength, and (d) maximal isometric strength in other muscle groups and in response to an overall metabolically more demanding workout.
Protein Timing Does Matter! Yet Only in Trained Men. More Than 2x Higher Relative Protein Retention W/ Immedi-ate vs. 6h Post Whey Consumption in Bodybuilders vs. Rookies | read more
Why does trained vs. untrained matter? We know that the growth stimulus in response to exercise and the unused growth potential are both maximal in untrained individuals. As far as strength is concerned, they have the additional advantage of making rapid gains by learning to master the exercises properly and neurological adaptations which are for the most part responsible for the rapid strength increases in the first months of resistance training. It is thus only logical that there's evidence that rookies do in fact gain "no matter what", while advanced trainees will have to up their game by advanced training techniques, protein supplementation and as I pointed out in a 2014 article, here at the waredownloadsoft even protein timing, which appear to be pretty useless for the people who have just been picking up the bar- and dumbbells.
Since the scientists have concise dietary records (Figure 1) and used a supplementation regimen that included not just 17g of whey protein concentrate, but also 3g of cholostrum and an extra 2g of leucine (PLA was an iso-caloric amount of resistant maltodextrin) to trigger a maximal increase in protein synthesis when the shake was consumed ad-libitum (in this case whenever the subjects wanted) on non-training days and immediately after the training sessions on training days, the data is still worth discussing (also because I already mentioned it on Facebook and I don't want you to over-estimate the overall significance of the study).
Figure 1: Overview of the macronutrient (in g) composition of the subjects' diets at baseline and during the study (the value for protein include the amount of protein from the protein shake in the PRO group | Boone. 2015).
As you can see in Figure 1 the protein intake of the twenty untrained young men who were randomly assigned to either a resistance training + protein (PRO; 21.4 ± 1.9y, 75.3 ± 15.7kg) or resistance training + placebo (PLA; 22.9 ± 3.1y, 76.8 ± 14.4kg) group was almost identical at baseline (1.2g/kg) and increased from 1.2 to 1.3g/kg in the protein group (+18.2%) while it dropped to 1.0g/kg body weight in the placebo group (-17.1%).

No such differences existed with respect to the supervised resistance training programs which started with five minutes of non-fatiguing aerobic activity on a cycle ergometer at a self-selected resistance and cadence. This was followed by a specific warm-up consisting of body weight squats, alternating lunges, walking knee hugs, and glute kicks (10 each). The subsequent, actual training sessions is described as follows.
"Each training session consisted of unilateral countermovement jumps (CMJ), leg press (LP), and leg extension (LE) using the dominant leg. CMJ were performed for a total of three sets of 8 repetitions with maximal effort. The LP and LE exercises were performed for a total of three sets of 8-10 repetitions at 80% of the participant’s previously determined 1RM with 90 seconds allotted between sets and exercises. If a participant was unable to perform the minimum amount of repetitions during the first or second sets of LP or LE, weight was decreased to an intensity deemed appropriate by a certified trainer. Consequently, if the participant was able to perform all repetitions with proper form and minimal strain, weights were progressively increased during the subsequent training session at the certified trainer’s discretion" (Boone. 2015).
After twelve of these training sessions, which took place at the university’s Strength and Conditioning Lab, on three nonconsecutive days per week.
Why would it have been nice to know when the size and power gains were measured? The answer is "the pump", ... well, not exactly. It's rather the cell swelling that occurs in the hours and days after a workout. The latter may have increased the overall impression of size gains and thus reduced the significance of potential differences if there was not a interval of at least 5 better 7 days between the last workout and the measurement of the muscle sizes. Bullocks?
Working out leads to increases in water content (left) corresponding increases in muscle "size" (right) at the 10 & 20 cm measuring points of the the quads; all values expressed as relative changes (%) vs. baseline | more
No, reread my 2014 article "Cell Swelling Keeps Muscles "Pumped" For More Than 52h. Size Increases of Up to 16% After a Single Leg Workout! Plus: Changes in Tendon Water & Collagen Content" (read the full SV-Classic article)- that the data will be distorted is a proven fact, with just one study investigating the extent, though, we cannot tell if the data will always be 16% off and the difference thus practically relevant.

Another reason why I was specifically looking for information on the interval between the last training and testing sessions was the lack of increases in peak and mean power (the changes in Figure 2 are all non-significant). If we know when the testing was done, one may be able to tell if this was a result of residual fatigue or if there were in fact no power gains in any of the two groups.
I've plotted the size, strength and power gains, which were assessed on an unfortunately non-disclosed time (see box above for elaborations) in Figure 2:
Figure 2: While even the small size gain in the rect. femoris in the PRO group was stat. sign. compared to the pre-value, none of the visible differences between PRO and PLA reached stat. significance and the mean and peak power did not even change at all... well, statistically speaking (see box above for a discussion why this may be the case | Boon. 2015)
Now, it's not like there were no gains, the cross-sectional area and muscle thickness increased significantly, but the scientists observed neither statistically nor practically significant (mostly due to the large inter-individual differences, e.g. a standard deviation of +/-12% for the CSA increase of the Rectus Femoris in the PRO group).
Table 1: Changes in maximal dynamic, isometric, and specific strength following training - Values are means ± SD. * Significant change from Pre to Post (p < 0.05 | Boone. 2015).
Since the strength data in Table 1 is similarly inconclusive, there is little doubt that is - for the study at hand - 100% warranted to say that while "the current findings suggest that short-term resistance training resulted in significant increases in muscle strength and size in untrained young men", they also suggest that "[t]he addition of a post-exercise protein supplement used in the current investigation was not sufficient to enhance the effect of resistance training" (Boone. 2015).
Polydextrose and Resistant Malto-dextrin May be Useful Dieting Aids, But are They good Placebos?
So what? Don't dumb your protein supplements, yet ;-) Aside from the previously mentioned study duration and the unrealistic training regimen, there is another thing I would like to highlight to substantiate my previously voiced warning that you should not overestimate the practical significance of the study at hand: The "placebo" supplement. Usually you'll see that protein is tested against regular maltodextrin. In the study at hand, however, it was tested against resistant maltodextrin of which you, as a waredownloadsoft reader know that it has been shown to significantly curb the appetite in humans and rodents. More recently, Hira et al. (2015) calculated that only 10g of these resistant starches per day may be able to reduce the energy intake by a whopping 7%.

This puts the -9.4% reduction in energy intake in the placebo group into an altogether different light and makes me question whether the placebo was as inactive as it should be. I have to admit, though, that eventually a lower total protein intake and a lower total energy intake as it was observed in the PLA group at identical study outcomes would even substantiate the claim that additional protein is useless in rookies, but who knows which other unknown effects the 20g of the resistant maltodextrin "placebo" had ;-)

Enough of the speculations, though. Let's stick to the facts: (1) Very few of you will be in the first four weeks of their resistance training "career", (2) even fewer of you will train only one leg, and I'd hope that (3) none of you plan to train for only the next for weeks only. So, that alone would make me want to repeat the scientists' own suggestion that "more research needs to be done" while telling you to (a) keep the results of this study in mind and file them under "protein is no wonder drug", while (b) keep taking your protein supplements. There's good enough evidence to say that >90% of you are going to benefit in one area or another - and always remember whey is more than a muscle builder (learn more) | Comment on Facebook!
References:
  • Antonio, Jose, et al. "Effects of exercise training and amino-acid supplementation on body composition and physical performance in untrained women." Nutrition 16.11 (2000): 1043-1046.
  • Biolo, Gianni, et al. "Increased rates of muscle protein turnover and amino acid transport after resistance exercise in humans." American Journal of Physiology-Endocrinology And Metabolism 268.3 (1995): E514-E520.
  • Coburn, Jared W., et al. "Effects of leucine and whey protein supplementation during eight weeks of unilateral resistance training." The Journal of Strength & Conditioning Research 20.2 (2006): 284-291.
  • Boone, Carleigh H., et al. "Muscle strength and hypertrophy occur independently of protein supplementation during short-term resistance training in untrained men." Applied Physiology, Nutrition, and Metabolism ja.
  • Hira, Tohru, et al. "Resistant maltodextrin promotes fasting glucagon-like peptide-1 secretion and production together with glucose tolerance in rats." British Journal of Nutrition (2015): 1-9.
  • Hoffman, Jay R., et al. "Effect of protein-supplement timing on strength, power, and body-composition changes in resistance-trained men." International journal of sport nutrition 19.2 (2009): 172.
  • Hulmi, Juha J., Christopher M. Lockwood, and Jeffrey R. Stout. "Review Effect of protein/essential amino acids and resistance training on skeletal muscle hypertrophy: A case for whey protein." Nutrition & metabolism 7 (2010): 51.
  • Phillips, Stuart M., et al. "Mixed muscle protein synthesis and breakdown after resistance exercise in humans." American Journal of Physiology-Endocrinology And Metabolism 273.1 (1997): E99-E107.
  • Walker, Thomas B., Et Al. The Influence Of 8-Weeks Of Whey Protein And Leucine Supplementation On Physical And Cognitive Performance. Air Force Research Lab Brooks Afb Tx Human Effectiveness Directorate, 2009.
  • Willoughby, D. S., J. R. Stout, and C. D. Wilborn. "Effects of resistance training and protein plus amino acid supplementation on muscle anabolism, mass, and strength." Amino acids 32.4 (2007): 467-477.
Read more »

Net Protein Retention and Dietary Protein: When It Comes to Steaks, More Helps More - By Inhibiting Protein Breakdown

Want to maximize net protein retention? Order another one... another steak ;-)
In view of the WHO's recent epidemiological bogus publication, ... ah I mean their review of the epidemiological research that said that "red meat kills", it is quite surprising that the study Il-Young Kim and colleagues conducted in healthy young adults was even approved by the ethics committee of their respective research institutions. After all, the study involved measuring the whole body protein kinetics of young men and women after the consumption of ~40g (moderate protein, or MP) or, even "worse", ~70g (higher protein, HP) of protein in form of red meat (85% lean ground beef) in a regular food matrix (=as part of a normal meal | see Table 1 for an exact overview of the macronutrient content).
You can learn more about protein intake at the waredownloadsoft

Are You Protein Wheysting?

More Protein ≠ Autom. Fat Loss

More Protein ≠ More Satiety
Protein: Food or Supplement?

Protein Timing DOES Matter!

Too Much Whey Pro-Diabetic?
Whole protein kinetics? Yes, that's different from what you see in the average "whey protein builds muscle study", in which the researchers measure only the fractional protein synthesis. Kim et al. went one step further and measured the protein synthesis (PS), breakdown (PB), and net balance (NB) in their subjects, twenty-three healthy subjects [18 – 40 yrs] who were recruited from the Little Rock area using local newspaper advertisements and flyers posted around the University of Arkansas for Medical Sciences (UAMS) campus and the Little Rock area. Now, it's not like humans had a display you can use to read these variables, so eventually, they were still calculated based on the determinations of the rate of appearance (Ra) into the plasma of phenylalanine and tyrosine, and the fractional Ra of endogenous tyrosine converted from phenylalanine as in a previous study by the same team of researchers (Kim. 2015a). Since this technique is unable to distinguish between the different sites of protein breakdown.and storage, the results of the study at hand could describe increases or decreases in splachnic (=organ) protein synthesis or breakdown, too. It is thus not possible to exclude a null effect on skeletal muscle protein synthesis and breakdown based on the available data.

Whole protein kinetics, two different amounts of protein, with and without exercise

There were yet other things Kim's study had in common with many of the aforementioned "whey protein studies": The study had a run-in that was included to minimize any potential effects of the protein content of the subjects' baseline diets. The subjects ate their high or medium protein meals in the fasted state and the participants - or at least some of them - also trained. To be more specific, the subjects were randomly assigned into an exercise group (X, n=12) protocol consisting of 3 sets of 10 repetitions of bench press, lateralis pull-down, leg press, and leg extension each at 80% of 1 repetition maximum (1 RM, the maximum weight that can be lifted for one repetition) at a pace of 30 sec per set (rest interval between sets was less than 2 min, and the entire exercise bout was completed in ~45 – 50 min), or a resting group (R, n=11).
Table 1: Overview of the macronutrient intake during the 4-day run-in and the actual experiment (Kim. 2015b)
So much for the study design. Let's take a look at the results now: When the scientists analyzed the data from the 7-h stable isotope tracer infusion protocol that was used to determine the rate of protein synthesis (PS), breakdown (PB) and net protein balance (NP), they realized that...
  • exercise did not significantly affect protein kinetics and blood chemistry, while 
  • feeding, in general, resulted in a positive net protein balance at both levels of protein intake,
Boring? You're right. This would hardly be a 'waredownloadsoft newsworthy' study if the researchers had not also confirmed what most of you probably already suspected: The high protein meal lead to a significantly greater increase in net protein balance than the medium protein meal.
Figure 1: It's the decrease in protein breakdown, not the marginal increase in protein synthesis that makes the difference between the net protein balance after the high and medium protein meals (Kim. 2015b).
Interestingly enough, this increase in net protein balance was achieved primarily through a greater reduction in PB and to a lesser extent stimulation of protein synthesis (for all, p<0.0001). This is an important results, because it suggests that all previously reported ceiling effects for protein synthesis could be irrelevant when we are talking about a potential limit of protein intake beyond which you won't be able to see further beneficial effects on body composition in general and the accrual of lean mas in particular.
Figure 2: The analysis of the inter-group differences in EAAs, glucose and insulin suggest that the difference is meadiated mainly by the increase in serum EAAs and not a "side effect" of increased, highly anticatabolic (Fukagawa. 1985) insulin.
Bottom line: When it comes to interpreting the results, two things are important. Firstly, it is worth mentioning that the previously described decrease in protein breakdown was achieved in response to a greater increase in plasma EAAs (p<0.01) - not in response to increased insulin levels (inter-group differences were non-significant over time). That's important because it means that you wouldn't see the same effect by simply adding more insulinogenic carbs to the meal in order to increase the levels of one of the most powerful inhibitors of protein breakdown: insulin (Fukagawa. 1985)!

Sounds great, right? More helps more! True, there's yet (a) the previously hinted at problem that we can't tell if what the scientists measured was muscle or splachnic protein. Furthermore, the results of the study are (b) valid only if the protein comes from slow-digesting meat. From previous research, I discussed in detail back in 2013, already, we know that the ingestion of similarly high amounts of fast digesting proteins, like whey, does not inhibit, but rather trigger an increase in protein breakdown and gluconeogenesis that uses the ingested protein as a substrate. Now, that doesn't mean that using too much whey protein will cost you muscle mass. What it does mean, though, is that you'll be "Protein Wheysting" if you mistakenly believe that the results of Kim's study apply with a very slow digesting protein source apply turbo-proteins, as well.

So what's the verdict?  Don't economize on protein, but don't fool yourself to believe that with protein more is always always better. Maybe I should also remind you that when you're dieting a high protein intake can yield better results than a very high one and that's a conclusion from a metabolic ward study | Tell me and others what you think on Facebook!
References:
  • Fukagawa, N. K., et al. "Insulin-mediated reduction of whole body protein breakdown. Dose-response effects on leucine metabolism in postabsorptive men." Journal of Clinical Investigation 76.6 (1985): 2306.
  • Kim, Il-Young, et al. "Quantity of dietary protein intake, but not pattern of intake, affects net protein balance primarily through differences in protein synthesis in older adults." American Journal of Physiology-Endocrinology and Metabolism 308.1 (2015): E21-E28.
  • Kim, et al. "The anabolic response to a meal containing different amounts of protein is not limited by the maximal stimulation of protein synthesis in healthy young adults." Am J Physiol Endocrinol Metab (November 3, 2015b). doi:10.1152/ajpendo.00365.2015.
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Too Much Whey Today, Type II Diabetes Tomorrow - Human Study: Whey Reduces Muscular Glucose Uptake by 25%!

Is it really bad to drink that whey shake before you eat the bananas, strawberries and blueberries, because whey makes you insulin resistant? Sounds "bogussy" and a closer look at the questionable methodological choices of the scientists who conducted the study don't make the results sign. more credible.
In the fitness community, whey protein is the #1 on the "must have supplement" list. Multi-vitamins? Creatine? Who cares, as long as you get your 30g of whey per day, you're good... really? One of you recently send me a study that would suggest that "good" is not exactly the right word to describe the effects of whey protein on at least one out of the set of well-established parameters of optimal metabolic health: Your muscles' insulin sensitivity.

In the paper that has been published in the reputable scientific journal "Diabetes", Gordon I. Smith and colleagues describe an experiment the results of which clearly suggest that whey doesed at 0.6g/kg fat free mass has a sign. insulin-desensitizing effect in twenty-two sedentary (<1.5 hour of exercise/w) and weight-stable (<2 kg change for at least 6 months), 50-65y old postmenopausal women who participated in this acute response study.
You can learn more about protein intake at the waredownloadsoft

Are You Protein Wheysting?

5x More Than the FDA Allows!

More Protein ≠ More Satiety

Protein: Food or Supplement?

Protein Timing DOES Matter!

Less Fat, More Muscle!
Acute response? Yes, there it is, the first in a line of problems that reduces the significance of the results. After all, testing the acute response to a certain health cannot tell you anything about the long-term effects on said parameter... especially if your subject group due to being sedentary and in an age where the parameter in question is deteriorating, anyway.

But let's not be the "it's not bros, so it's not valid for bros"-guys. Let's rather take a look at (a) the procedures and (b) the results and make up our minds later. And let's first take a look at a handful of important parameters of the study design: To determine the insulin sensitivity, the scientists used two hyperinsulinemic-euglycemic clamp sessions with the subjects being randomly assigned to do the procedure with vs. without whey protein first.
If you've got brawn and brain you cannot ignore that whey is much more than a potent muscle builder | learn more
"Before each clamp procedure, subjects were instructed to adhere to their usual diet and to refrain from vigorous physical activities for three days. Subjects were admitted to the Clinical Research Unit in the late afternoon, where they consumed a standard dinner between 1800 and 1900 h, and then fasted, except for water, until the next morning. At 0600 h, a catheter was inserted into an arm vein for the infusion of a stable isotope labeled glucose tracer; catheters for blood sampling were inserted into the radial artery of the opposite arm and in retrograde fashion into the femoral vein of one leg. At ~0645 h, a primed, constant infusion of [6,6- 2 H2]glucose (priming dose: 22 µmol·kg body wt-1, infusion rate: 0.22 µmol·kg body wt-1·min-1), purchased from Cambridge Isotope Laboratories Inc. (Andover, MA), was started and 4 h later the hyperinsulinemic-euglycemic clamp procedure was initiated with two 5-minute priming doses (first 200 mU·m-2 body surface area (BSA)·min-1 then 100 mU·m-2 BSA·min-1) of human insulin (Novolin R, Novo Nordisk, Princeton, NJ); for the remaining 230 min, insulin was infused at a rate of 50 mU·m-2 BSA·min-1. Euglycemia (at blood glucose concentration ~5.6 mM) was maintained by variable rate infusion of 20% dextrose (Baxter, Deerfield, IL) enriched to 2.5% with [6,6-2H2]glucose" ().
During the "whey trials", the subjects consumed 0.6 g of whey protein (unflavored Unjury®, ProSynthesis Laboratories, Inc, Reston, VA) per kg FFM dissolved in 360 ml water or the same volume of water alone. In addition, the researchers conducted a trial in which the subjects consumed the same amount of leucine.
Whey protein alone is gluconeogetic alone to increase the amount of glyocogen in liver (left) and muscle (right) of sedentary rats even if they don't eat a single ng of sugar or carbs (Morifuji. 2005). If you ignore the proven gluconeogenic effects, you must not complain if someone calls your study results irrelevant.
To understand the full "bogus" of the study at hand, you have to understand what a hyperinsulinemic-euglycemic clamp does. And you're lucky, it's not very difficult: The whole procedure is based on acutely raising a person's insulin levels to 100 μU/ml by continuously infusing insulin. The insulin levels are then kept constant, while just enough glucose is infused to keep the plasma levels of glucose stable. Higher rates of glucose infusion during the "clamp test" thus indicate a greater effect of insulin on glucose clearance and thus higher levels of insulin sensitivity. Now the bogus in this case is that it is (a) questionable how useful it is to compare a non-caloric to a caloric (and gluconeogenic) beverage with this test and (b) to ignore that part of the proven benefits of the caloric beverage you test are based on its ability to increase the same insulin levels you're keeping stable, anyway... not to speak of its effects on satiety. What? Yeah, I call that bogus.
To figure out if any effect they would observe was induced by whey, i.e. a complex protein, or just the most-applauded whey ingredient, i.e. leucine, the scientists ran a follow-up test (1-4 weeks later) in which the subjects consumed either 0.0684 g/kg FFM of pure leucine (that's equivalent to the amount of leucine in the whey protein)  dissolved in 360 ml Kool-Aid® (Kraft 94 Foods, Inc, Northfield, IL) or the same volume of the Kool-Aid® solution alone during the clamp procedure. I don't have to tell you that this was a mistake that makes the results of this follow-up useless for comparisons to the previous trial, in which the whey protein was mixed with water - Kool-Aid is after all all-carbohydrate - with 0.9g carbohydrates per ml of junk... ah, I mean per ml of the soft-drink.
Figure 1: Clearance of glucose during the hyperinsulemic clamp for the whole body and the legs (Smith. 2015). It is noteworthy that there control vs. active treatment signalling protein response (mTOR, p-AKT, ACC, etc. - not shown in figure) did not show differences that could explain the alleged negative effects of whey on glucose uptake (see Figure 2).
This does not mean that we couldn't use the data from the leucine trial, at all, though. But let's be honest, who cares about the non-significance of the effects of a non-gluconeogenic amino acid (meaning that leucine cannot be converted to glucose by the liver) if you cannot compare them to the significant decrease in insulin-mediated glucose disposal (38.8 vs 51.9 µmol glucose per µU insulin/ml / min; P<0.01) the scientists observed in the whey condition, because the test was messed due to the use of a different and by no means "neutral" control?
Figure 2: Don't worry, while the scientists cleverly call the glucose disappearance into the legs "leg glucose uptake" it's just the product of blood flow to the legs times whole body glucose disposal and suffers from the same methodological short-come as the whole body glucose disposal that assumes that whey was non-gluconeogenic (data from Smith. 2015)
Rather than as a basis to argue that whey is bad and leucine is good, you can use the Kool-Aid glitch and the fact that leucine cannot be converted to glucose in the liver to substantiate the following hypothesis: If the scientists had accounted for the gluconeogenic glucose load from whey when they tested their allegedly sugar-free (manufacturer claim) whey protein vs. water in the previous trial, they would probably have found no significant effect of whey protein on muscular glucose uptake, because the test wouldn't have been unfairly thwarted in favor of the water control which came without the additional glucose load from the whey-induced gluconeogenesis in the liver.
Figure 3: Both, acute and chronic realistic and thus relevant studies show beneficial effects of whey on glycemia (Petersen. 2009) and insulin sensitivity (Pal. 2010) - you decide which studies to trust ;-)
Plus, even if we assume that this hypothesis wasn't true (I am pretty convinced it is), the results of the study at hand would still be an inexplicable artifice that stands in stark contrast to the well-proven multi-facetted acute and chronic beneficial effects of whey protein on glucose- and weight-management in healthy, diabetic and pre-diabetic individuals (Layman. 2004; Frid. 2005; Peterson. 2009; Akhavan. 2010; Pal. 2010) - effects of which no one ever claimed that they were mediated by acute increases in muscular insulin sensitivity, by the way; and that despite the fact that the data from Pal (Figure 3, left) clearly indicates that these benefits occur in the real world.
Dairy or eggs? Why not just mix dairy and egg protein or dairy and eggs - A similar protein mix exerts most promising effects on anabolic signalling proteins related to increased muscle mass and fat loss, as the results of a study show | read more
What's the verdict, then - true or false? True. In the unrealistic and unfair comparison Smith et al. conducted, whey protein is inferior to water with respect to its effect on the post-menopausal body's ability to clear intravenously infused glucose from the blood stream.

What is yet more important is that the overall message the study and the half-sentence "protein ingestion causes insulin resistance" (Smith. 2015) from the abstract are sending are false: In fact, the study at hand doesn't allow for any reliable conclusions with respect to either the long-term or acute real-world insulin sensitizing or desensitizing effects of whey protein, because the scientists used a method that does not account for extra glucose that is produced in the liver during the testing procedure via gluconeogenesis (I know that high insulin levels reduce gluconeogenesis, but they won't shut it off).

Against that background and in view of the existing data from dozens of practically relevant clinical trials which indicate that whey will have positive, not negative effects on glucose metabolism, it would appear foolish to cite use the study at hand to argue that the cosumption of whey protein may ruin your insulin sensitivity and "too much whey today" may turn you into a type II diabetic tomorrow | Let me know what you think on Facebook!

References:
  • Akhavan, Tina, et al. "Effect of premeal consumption of whey protein and its hydrolysate on food intake and postmeal glycemia and insulin responses in young adults." The American journal of clinical nutrition 91.4 (2010): 966-975.
  • Frid, Anders H., et al. "Effect of whey on blood glucose and insulin responses to composite breakfast and lunch meals in type 2 diabetic subjects." The American journal of clinical nutrition 82.1 (2005): 69-75.
  • Layman, Donald K., and Jamie I. Baum. "Dietary protein impact on glycemic control during weight loss." The Journal of nutrition 134.4 (2004): 968S-973S.
  • Morifuji, Masashi, et al. "Dietary whey protein increases liver and skeletal muscle glycogen levels in exercise-trained rats." British journal of nutrition 93.04 (2005): 439-445.
  • Pal, Sebely, Vanessa Ellis, and Satvinder Dhaliwal. "Effects of whey protein isolate on body composition, lipids, insulin and glucose in overweight and obese individuals." British journal of nutrition 104.05 (2010): 716-723.
  • Petersen, Brent L., et al. "A whey protein supplement decreases post-prandial glycemia." Nutr J 8.47 (2009): 1475-2891.
  • Smith, Gordon I., et al. "Protein ingestion induces muscle insulin resistance independent of leucine-mediated mTOR activation." Diabetes 64.5 (2015): 1555-1563.
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Casein-Hydrolysate Beats Whey as Intra-Workout Protein: Faster Time-Trial Times vs. Water, Non-Sign. Performance Boosts Compared to CHO, Whey & Whey + CHO Beverage

Whey or casein hydrolysate - or rather no protein - what to use in your intra-workout beverage for endurance?
Last week, waredownloadsoft reader Oscar Qiu asked me which protein supplements I would suggest he'd buy. My answer was simple: "Get a cheap whey protein and if you want to spend extra money, add some micellar casein. Dose it at a ratio of 20:10 whey:casein post-workout (learn why) and, if you feel you're not getting enough protein on a daily basis, optionally, take them at a ratio of 10:20 whey:casein right before bed" (learn more about pre-bed casein).

Now, I am not going to revise this basic supplementation advice I gave based on the results of a recent study from the University of the Witwatersrand (Oosthuyse. 2015), but it may still be worth considering that other protein sources like whey-hydrolysate (learn more) or, as in this case, casein-hydrolysate may have certain context-specific benefits over the aforementioned "staple proteins".
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In said study, Oosthuyse et al. tried to find the "protein most suitable for ingestion during endurance exercise" (Oosthuyse . 2015). To this ends, the researchers compared the effects of co-ingesting either
  • 15 g/h whey-hydrolysate with (whey-CHO) or without carbohydrates (whey-PLA) or
  • 15 g/h casein-hydrolysate with (casein-CHO) or without carbohydrates (casein-PLA).
In conjunction with the placebo, only, and the carbohydrate, only, trials there are six trials, i.e. placebo, placebo+whey, placebo+casein, the 63g/h fructose: maltodextrin (0.8:1) that made up the CHO content of the test beverages, alone, and in conjunction with either whey or casein-hydrolysates.
Table 1 + 2: Dietary records (mean ± SD) for 2 days preceding the day of each experimental trial (left); composition of the experimental beverages consumed during the trials (right | Oosthuyse. 2015).
Practically speaking this meant that 2h after the last meal (postprandial), 8 male cyclists ingested either: carbohydrate-only, carbohydrate-whey-hydrolysate, carbohydrate-casein-hydrolysate or placebo-water in a crossover, double-blind design during 2 h of exercise at 60 %Wmax followed by a 16-km time trial.
Why would you even want to consume protein during endurance exercises? As the authors point out, the mechanisms by which protein supplementation during exercise may potentiate endurance performance are (1)providing additional oxidative, gluconeogenic and anaplerotic substrate, (2) reducing endogenous protein catabolism (Korach-Andre. 2002; Koopman. 2004), (3) reducing exercise-induced muscle damage (Saunders. 2005, 2007 & 2009), (4) improving rehydration (Seifert. 2006) and (b) possibly delaying central fatigue (Skillen. 2008). While all of these potential mechanism are backed up by isolated studies, the results are far from being unambiguous with conflicting evidence being presented in several studies and reviews (Cermak. 2009; Breen. 2010; Hobson. 2015). The study at hand does however add a new perspective to the research by evaluated whether the addition of protein to a carbohydrate energy drink will affect exercise metabolism and specifically the rate of oxidation of the co-ingested carbohydrate, as well as using different forms of protein. With whey and whey hydrolysate being the predominantly used forms of protein in previous studies, it is thus well possible that the conflicting evidence would have been less conflicting if all studies had used casein hydrolysate instead.
Data were evaluated by magnitude-based inferential statistics and revealed only non-significant effects on carbohydrate oxidation, measured from 13CO2 breath enrichment, by either of the two protein hydrolysate in isolation (data not shown),
Figure 1: What really counts are the performance improvements (left) and potential gastrointestinal side effects during (right, c), yet not so much right after the time-trial (right, b | Oosthuyse. 2015).
This changed, when the carbohydrates came into play: While the increased carbohydrate availability obviously lead to increases in glucose oxidation in all trials, these increases were substantially decreased (98% very likely decrease) when the carbohdrate drink was co-ingested with casein-hydrolysate (mean ±SD, 242 ±44; 258±47; 277 ±33g for carbohydrate-casein, carbohydrate-whey and carbohydrate-only, respectively). As it was to be expected, this decrease in carbohydrate oxidation during exercise had to be compensated by increases in fat oxidation - in this case a 93% likely increase from 83 ±27 and 73 in the whey-carbohydrate and carbohydrate-only to 92 ±14 g in the casein-hydrolysate group.

Figure 2:  Hydro whey and hydro casein have only slightly different amino acid makeups - *indicates essential amino acids (Oosthuyse. 2015).
Now, some people who are still believing in the long-overcome theory of exercise-induced fat loss may speculate that the increased fatty oxidation in the casein group would indicate that the co-ingestion of casein-hydrolysate would increase exercise-induced fat loss. You, as a waredownloadsoft reader know that the assumption that increased intra-workout fat oxidation would equal increased fat loss is total bogus. Accordingly, you will appreciate that the addition of casein to the intra-workout equation did have additional, practically relevant benefits: It lead to a significantly faster time trial ( − 3.6%; 90 % CI: ±3.2%) performances compared to placebo-water (95 % likely benefit).

Ok, now that you've hopefully memorized that you can safely ignore the non-existent fat-loss benefits of increased fat oxidation during exercise (assuming it is just to compensate a reduced CHO oxidation, as in this case), you must be careful not to jump to the similarly unwarranted conclusion that the time-trail times in Figure 1 would indicate that you or the (endurance) athletes you may be coaching should exchange all their "Gatorades" and other CHO-based intra-workout beverages for pure casein-hydrolysates.
Tired, exhausted, had to cut your workout short today? Is it the flu, or just too much BCAAs?
Don't flush all your Gatorade down the toilette, ... yet: For one, there are still issues with bloating and thirst during, as well as intestinal cramps after the workouts when you co-ingest protein and carbohydrates. More importantly, however, the performance increase the researchers saw with in the casein-hydrolysate trial reached statistical significance only in comparison to the water-placebo trial. The benefits were non-signifcant, even when casein was compared to carbohydrates, only. This does not negate that the study at hand suggest that you should prefer hydrolyzed casein over whey-hydrolysate as an intra-workout protein source. What the study certainly does not tell you, thouh, is that all athletes should replace their carbohydrate containing intra-workout beverages with water + casein-hydrolysate - even if the contemporary carbohydrate scare may make this non-alternative appealing.

Before making a final statement about "the optimal intra-workout protein source", it would also be necessary to know exactly what's responsible for the advantage - it could be the higer amount of glutamine in casein vs. whey, which could help curb the increase in ammonia during high intensity exercise (Bassini-Cameron. 2008) - a problem due to which consuming large amounts of BCAA supplements during exercise may actually do the opposite of what the shiny ads will tell you. It could yet also be any other difference in the amino acid make-up, the absorption kinetics or the peptide structure of whey- vs. casein-hydrolysates that explains the difference | Comment on Facebook!
References:
  • Bassini-Cameron, Adriana, et al. "Glutamine protects against increases in blood ammonia in football players in an exercise intensity-dependent way." British journal of sports medicine 42.4 (2008): 260-266.
  • Breen, Leigh, Kevin D. Tipton, and Asker E. Jeukendrup. "No effect of carbohydrate-protein on cycling performance and indices of recovery." Med Sci Sports Exerc 42.6 (2010): 1140-1148.
  • Cermak, Naomi M., et al. "Muscle metabolism during exercise with carbohydrate or protein-carbohydrate ingestion." Medicine and science in sports and exercise 41.12 (2009): 2158-2164.
  • Hobson, Ruth, and Lewis James. "The addition of whey protein to a carbohydrate–electrolyte drink does not influence post-exercise rehydration." Journal of sports sciences 33.1 (2015): 77-84.
  • Koopman, René, et al. "Combined ingestion of protein and carbohydrate improves protein balance during ultra-endurance exercise." American Journal of Physiology-Endocrinology and Metabolism 287.4 (2004): E712-E720.
  • Korach-Andre, Marion, et al. "Differential metabolic fate of the carbon skeleton and amino-N of [13C] alanine and [15N] alanine ingested during prolonged exercise." Journal of Applied Physiology 93.2 (2002): 499-504.
  • Oosthuyse, T., M. Carstens, and A. M. Millen. "Whey or Casein Hydrolysate with Carbohydrate for Metabolism and Performance in Cycling." International journal of sports medicine (2015).
  • Saunders, Michael J., Mark D. Kane, and M. Kent Todd. "Effects of a carbohydrate-protein beverage on cycling endurance and muscle damage." MEDICINE AND SCIENCE IN SPORTS AND EXERCISE. 36.7 (2004): 1233-1238.
  • Saunders, Michael J., Nicholas D. Luden, and Jeffrey E. Herrick. "Consumption of an oral carbohydrate-protein gel improves cycling endurance and prevents postexercise muscle damage." The Journal of Strength & Conditioning Research 21.3 (2007): 678-684.
  • Saunders, Michael J., et al. "Carbohydrate and protein hydrolysate coingestion's improvement of late-exercise time-trial performance." International journal of sport nutrition 19.2 (2009): 136.
  • Seifert, John, Joseph Harmon, and Patty DeClercq. "Protein added to a sports drink improves fluid retention." International journal of sport nutrition and exercise metabolism 16.4 (2006): 420.
  • Skillen, Rebecca A., et al. "Effects of an amino acid-carbohydrate drink on exercise performance after consecutive-day exercise bouts." International journal of sport nutrition 18.5 (2008): 473.
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High Fat, Low Carb +20g Whey = Reduced Satiety | Palatable Foods & Obesity | Food Addiction - Believes & Realities

After your workout, whey protein is fine. With a low carb + high fat breakfast, though, it may ruin the satiety inducing effects of the high fat + low CHO meal.
Today I am going to make the short news items actually short in order to be able to cover all the different studies investigating topics that range from the effects of TV watching and other distractions on your likelihood of snacking, the link between the amount of food kids consume when they are allowed to eat as much as they want at a buffet and their body fat levels, the differential effects of various macronutrients on appetite, satiety & co, the negative effects of believing in food addiction, the surprising insight that whey may be for low-carbers not and more.

I think this was a long enough preface. So, let's not waste anymore time, but rather dig into the papers I've found in the latest regular and special edition(s) [some are pre-release abstracts] of the scientific journal Appetite:
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  • Distraction during eating increases later snacking and reduced meal memory (Higgs. 2015) -  It is not actually surprising, but still interesting. If you are distracted by talking or watching TV or whatever else while you're eating this will have direct effects on your ability to recall what you've eaten and your snack choices (i.e. snacking vs. non-snacking).
    Figure 1: Mean snack (buiscits) when subjects were either focused on the meal or distracted (Higgs. 2015).
    In addition, Higgs et al. (2015) were able to show that the effect of distraction is larger when motivation to engage with the distracter was greater, i.e. someone who's watching a captivating TV series you will be more likely to snack later in the day than someone who more or less only "listens" to the charts on MTV. What's noteworthy, though, is that a "food related" TV program, will actually reduce the effect.

    Needless to say that focusing your attention on the actual eating process and the food you eat will decreased later snacking.
  • Intake at a single, palatable buffet test meal is associated with total body fat and regional fat distribution in children (Fearnbach. 2015) - Eventually the results of this study from the Pennsylvania State University just confirm what we already know. People and in this case kids who tent do overeat are more likely to be obese.
    Figure 2: The fatter the kids are the more palatable foods are consumed at the buffet (Fernback. 2015).
    The reason I still mention this study is thus not the fact that the buffet pirates are more likely to be obese, but rather the fact that the relationship between food intake and body fat is particularly significantly for palatable buffets and valid only for savory, but not sweet, foods.
  • Differential effect of fat and carbohydrate composition meals on food hedonics, satiation and satiety - The results of this investigation go against the current trend toward low carb diets, after all, Finlayson et al. clearly found that
    "When consumed in controlled amounts, LFHC [low fat high carb] meals induce a greater satiety (SQ) compared to isoenergetic HFLC [high fat low carb] meals. HFLC meals do not dampen the subsequent appeal bias for HFLC foods compared to matched LFHC meals" (Finlayson. 2015).
    What I personally find extra-surprising is that the study was conducted on forty-five overweight and obese adults who were studied on 2 separate days in which they were given access to HFLC or LFHC meals. Usually, overweight and obese people are the ones who best respond to low carb diets.
You're having problems controlling your appetite? Try eating with ear-plugs! Study from the University of Surrey in the UK shows (): When young, normal-weight individuals eat a standardized meal (606 kcal, 37 g protein, 85 g carbohydrates, 12 g fat) wearing ear-plugs, this boosts their perceived hunger (p = 0.029) and perceived fullness (p = 0.032).
  • Habitual high-fat consumers are not more susceptible to weight gain when exposed to increased portion sizes in a free-living setting (Dalton. 2005) - That's at least what the NIH worksite study suggests. In said study, two hundred thirty-three adults (67.7% women; age 42.6 ± 11.2; BMI 29.8 ± 6.4) were randomly allocated to one of four lunch size groups (400 kcal, 800 kcal, 1600 kcal, and no lunch control) for 6 months. Body weight and energy intake (assessed using 24 hr dietary recalls) were measured at baseline, and Months 1, 3 and 6. Of the 233 subjects, 75 were HF-C (40.2%E fat, SD: 3.0) and 74 were LF-C (26.6%E fat, SD: 3.2).

    Previous research from overfeeding studies yielded slightly different results with a minimal disadvantage for high fat intake | learn more
    Interestingly, there was no interaction between portion size exposure and fat intake according to habitual fat consumption. What the scientists did observe (and this may have skewed the results) was the fact that the subjects in the HF-C group had a higher BMI (M: 30.8, SD: 7.1) compared to LF-C (M: 28.1, SD: 5.5) and greater baseline total daily energy intake. It is nevertheless hard to debate that the weight change at months 1, 3 and 6 did not differ between HF-C and LF-C in response to portion size. Eventually it would thus appear as if the "habitual dietary energy density" was what actually determines ones obesity risk.
  • Fiber-enriched (inulin) squash smoothie decreases ad-libitum food intake in subsequent meal (Slevin. 2015) - Now the fact that the BMI-adjusted (thus g/kg/m²) preload drink, which contained 0.67 g/kg/m² inulin, 0.67 g/kg/m² squash and 8.89 g/kg/m² water the 12 normal weight and 12 obese women consumed 30 min before going to a buffet for lunch did decrease the ad libitum intake (219.7 kcal, p = 0.008; 101.6 g, p = 0.032) and total food intake (187.9 kcal; p = 0.019; 102.3 g, p = 0.033) is not surprising. The fact that it did so only in the obese women, but not in the normal-weight subjects, on the other hand may be considered a surprise-
    Figure 3: The more different food items the subjects selected, the more they eat (exact numbers for the different food items were not mentioned in the abstract that is currently available | Slevin. 2015)
    Not surprising, but insightful was the revelation that (a) the subjects' food intake significantly increased with increasing items at lunch (242.7 g, 349.2 g, 431.1 g, p = 0.018; 554.1 kcal, 640.9 kcal, 747.4 kcal, p < 0.001) and that (b) the preload was most effective at reducing hunger (p = 0.005) and total food intake (296.3 kcal, p = 0.009) in the 5 item condition, i.e. if the subjects were told that they may chose only 5 items (overall, the scientists did 3 trials, a control trial, a pre-load trial and a pre-load trial in which the subjects were allowed to select only 5-items).
  • Consumption of thylakoid-rich spinach extract reduces hunger, increases satiety and reduces cravings for palatable food in overweight women (Stenblom. 2015) - Thylakoids are contained in green-plant membranes like those of spinach (5g/100g spinach) and have been shown to reduce feelings of hunger as well as cravings for palatable food in human participants, during diet intervention and simultaneous weight loss in overweight women (Montelius. 2014M Stenblom. 2013 & 2014). What still had to be confirmed, though, is that these beneficial effects also affect the intake of such foods.

    Figure 4: Intake from snack buffet. The effect size is too low to trigger weightloss wonders (Stenblom. 2015).
    Stenblom's study in the course of which the thylakoids were served in a cold blueberry drink, mixed with 2.5 g rapeseed oil (Zeta, Di Luca & Di Luca AB, Stockholm, Sweden) and 92.5 g blueberry soup (Ekströms original, Procordia Food AB, Eslöv, Sweden), immediately before breakfast on treatment test days clearly shows that an effect can be observed with real foods, too, but if you take a look at the only really relevant parameter in Figure 4, i.e. the actual food intake on the breakfast buffet, the effect size is negligible.
If you believe in food addiction you will never lose weight! Ok, ok. That's not what a recent study from the Universities of Liverpool and Bristol (Hardman. 2015) shows, but it does confirm that if you are made believe that food addiction is real by bogus articles like the subjects in that study you are (a) more likely to self-diagnose yourself with "food addiction" and will (b) be more susceptible to binging on indulgent foods.
  • Whey is not always appetite suppressing! Addition of whey protein to a fat-based breakfast has detrimental effects on satiety following subsequent feeding (Allerton. 2015) - You, as a waredownloadsoft reader know: Previous studies have shown that whey protein consumed either before or alongside a meal will make the latter more satiating. What you probably didn't know (I didn't but maybe suspected it) is the fact that this is only the case if the meal is not a low-carb meal.

    In their latest study, scientists from the Northumbria University in Newcastle upon Tyne found that healthy males (age 24 ± 2 years, mass 79.7 ± 3.8 kg, BMI 24.5 ± 2.1 kg/m2) consume significantly more of a pasta-based lunch meal  (3427 kJ; 49%, 37%, 14% energy from carbohydrate, fat, protein)  that was served 180 minutes after a fat-based breakfast if the latter contained 20g of whey protein (FAT + WP) than after a "whey protein free" breakfast. In addition, the ...
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    "[p]ostprandial ratings of perceived hunger, fullness, satisfaction and prospective consumption were similar after breakfast between trials (p > 0.05). Following lunch, levels of prospective consumption were higher under FAT+WP (time-averaged AUC; FAT+WP: 62 ± 7 vs FAT: 54 ± 6 mm, p = 0.024). Perceived satisfaction was significantly greater under FAT at 120 (FAT: 52 ± 5 vs FAT+WP: 38 ± 7 mm, p = 0.017) and 150 (FAT: 41 ± 5 vs FAT+WP: 30 ± 6 mm, p = 0.009) minutes post-lunch" (Allerton. 2015).
    Thus, it would appear as if people on a low-carb high fat diet, don't necessarily benefit to the same extend as people on a low(er) fat diet from adding whey protein to their meals. Or it may be even worse. As the scientists point out the "negative effects on responses to a subsequent meal were observed, with lower satisfaction and higher ratings of prospective consumption following prior ingestion of breakfast containing whey protein" - which would (emphasis on the conditional) mean nothing else than 'whey may do more harm than good for low carb high fat eaters who want to lose weight'... and yes, the effect may be mediated by the insulin spike that is higher for whey than for white bread (learn more)!
Latest Study on "Breakfast Skipping" Finds: Whether Skipping Breakfast Increases Insulin, Hunger and Blood Lipids Depends on One's Breakfast Habits (read it). The same may be the case for the cognitive effects and many other purported benefits of having, as well as the often heard of side effects of skipping breakfast.
What else do the latest Appetite articles have to offer? Well, there's the abstract to a soon-to-be-published article by Clayton et al. (2015) who investigated the effect of breakfast omission on subjective appetite, metabolism and satiety hormones and found that any effects (if they are even significant) are transient and do not extend beyond lunch. This would confirm what I've highlighted in several "breakfast omission" articles and reviews: The fact that you may be a breakfast skipper is not the reason you are fat and can't lose weight. If you decide you want to have breakfast and don't go low carb though, the preliminary data from Hofman et al. (2015) would indicate that a high carb + high energy is better for your cognitive performance than its high carb + low energy counterpart. Eventually, I do yet believe that even this depends on habituation. After all scientists found only recently that the ill metabolic effects of breakfast skipping are significant only in habitual breakfast eaters | Comment on Facebook!
References:
  • Allerton, et al. "Addition of whey protein to a fat-based breakfast has detrimental effects on satiety following subsequent feeding." Appetite 91 (2015). 
  • Clayton, et al. "Effect of breakfast omission on subjective appetite, metabolism, acylated ghrelin and active GLP-1." Appetite 91 (2015).
  • Dalton, et al. "Habitual high-fat consumers are not more susceptible to weight gain when exposed to increased portion sizes in a free-living setting. NIH worksite study." Appetite 91 (2015). 
  • Fearnbach, S. Nicole, et al. "Intake at a single, palatable buffet test meal is associated with total body fat and regional fat distribution in children." Appetite (2015).
  • Finlayson, et al. "Differential effect of fat and carbohydrate composition meals on food hedonics, satiation and satiety." Appetite 91 (2015).
  • Hardman, Charlotte A., et al. "“Food addiction is real”. The effects of exposure to this message on self-diagnosed food addiction and eating behaviour." Appetite 91 (2015): 179-184.
  • Higgs, Suzanne. "Manipulations of attention during eating and their effects on later snack intake." Appetite (2015).
  • Hofman, et al. "Effects of breakfast size on satiety, glucose, memory, and executive function." Appetite 91 (2015).
  • Koidis, et al. "Is satiation altered by earplugs in an eating rate study." Appetite 91 (2015).
  • Montelius, Caroline, et al. "Body weight loss, reduced urge for palatable food and increased release of GLP-1 through daily supplementation with green-plant membranes for three months in overweight women." Appetite 81 (2014): 295-304.
  • Slevin, C. "The effects of food variety and a BMI adjusted fibre preload on appetite and food intake in normal weight and obese females." Appetite 91 (2015).
  • Stenblom, Eva-Lena, et al. "Supplementation by thylakoids to a high carbohydrate meal decreases feelings of hunger, elevates CCK levels and prevents postprandial hypoglycaemia in overweight women." Appetite 68 (2013): 118-123.
  • Stenblom, E. L., et al. "Decreased Urge for Palatable Food after a Two-month Dietary Intervention with Green-plant Membranes in Overweight Women." J Obes Weight Loss Ther 4.238 (2014): 2.
  • Stenblom, Eva-Lena, et al. "Consumption of thylakoid-rich spinach extract reduces hunger, increases satiety and reduces cravings for palatable food in overweight women." Appetite 91 (2015): 209-219.
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