Study links blood sugar imbalance with increased appetite

While the ‘calorie principle’ has underpinned nutritional and weight loss advice over the last few decades, the fact is that different types of calorie are ‘burned’ differently in the body. What this means is that it’s not just the amount of calories we consume, but the form that they come in that dictates the impact they have on weight. There is evidence, for instance, that for a given calorie intake, those that eat the most fat (and least carbohydrate) are the ones who lose the most weight [1,2,3].

There is another reason why weighing-up foods according to their calorie intake can fall wide of the mark when it comes to assessing their likely impact on body weight. This has to do with appetite. Two foods might have the same calorie content but very different appetite-sating potential. 500 calories worth of steak and vegetables, for instance, might be more sating than 500 calories worth of cornflakes and milk, and this clearly has implications for subsequent food intake and overall weight.

One apparent major determinant of a food’s appetite sating potential is its glycaemic index (which gives a measure of the speed and extent a food releases sugar into the bloodstream). Basically, the higher a food’s GI, the less satisfying it tends to be. Of 20 studies published between 1977 and 1999, 16 showed that low GI foods promoted the satisfaction derived from that meal and/or reduced subsequent hunger [4]. Overall, the results of the studies show that an increase in the GI by 50 per cent reduces the satisfaction it gives by about 50 per cent.

One of the theories about how a food’s GI influences its ability to quell appetite has to do with fluctuation in blood sugar levels. This concept was tested recently in a group of overweight and obese women [5]. All the women in this study were fed the same breakfast and lunch. This was supplemented with a glucose (high GI) drink. On one occasion the women consumed the glucose drink at breakfast. On another occasion, the drink was consumed in eight portions throughout the day. The women had their appetite assessed at hourly intervals during the day, as well as blood levels of both glucose and insulin.

Compared to those taking the sugar drink in eight portions throughout the day, those having it in one sitting at breakfast were more hungry four hours after breakfast and several hours after lunch. These differences appeared to be more closely linked to levels of blood glucose than insulin. The authors of this study concluded that their findings support the idea that changes in blood glucose can affect appetite.

The evidence suggests that those who want to put a natural brake on their appetite should emphasise low-GI foods in their diets. This doesn’t just mean keeping a check on sugary soft drinks, of course. It also means controlling intake of many starchy carbohydrates such as bread and breakfast cereals. It is perhaps the generally high GI nature of these foods which explains why individuals often say that if they eat these foods for breakfast, they get hungrier in the morning compared to eating nothing.

One breakfast meal that is low GI and I find tends to truly satisfy is Bircher muesli, which I recommend is made of a blend of oats, natural yoghurt, ground/chopped nuts and some fresh/dried fruit. My experience is that individuals who eat this sort of wholesome fare at the start of the day tend not to find their appetite running out of control later on.

References:

1. Lean M E, et al. Weight loss with high and low carbohydrate 1200 kcal diets in free living women. Eur J Clin Nutr 1997;51:243-248

2. Wien M A, et al. Almonds vs complex carbohydrates in a weight reduction program. Int J Obes 2003;27:1365-1372

3. Young CM, et al. Effect of body composition and other parameters in obese young men of carbohydrate level of reduction diet. Am J Clin Nutr 1971;24:290-6

4. Roberts SB. High-glycemic index foods, hunger, and obesity: is there a connection? Nutrition Review 2000 58:163-169

5. A high-glycemic meal pattern elicited increased subjective appetite sensations in overweight and obese women. Arumugam V, et al. Appetite;2007 25 July [Epub ahead of print].

12 Responses to Study links blood sugar imbalance with increased appetite

  1. Hilda Glickman 4 September 2007 at 12:05 am #

    I agree with comments but would like to point out the question of biochemical individuality. I know you cannot generalise from a few cases but there seem to be people who can go all day on a bowl of cereal and milk. Personally I need protein to keep me satisfied and find that almost any carbs make me hungry much sooner than protein. This is probably because I have too much of an insulin surge, perhaps prediabetic. Even complex carbs can raise some people’s blood sugar too high unless eaten with protein. Also some ‘complex’ carbs seem to acy very similarly to ordinary carbs. Is it not the case that in the end it is all sugar? Hilda

  2. Dr John Briffa 7 September 2007 at 5:39 am #

    I agree with the concept of biochemical individuality Hilda, which I explore in more depth in my book. But you’re right again, many ‘complex’ carbs are essentially sugar, can be very disruptive to blood sugar and insulin levels, and are not ideal foods.

  3. Tiggy 7 September 2007 at 11:06 pm #

    Does Bircher Muesli have less sugar than the usual kind? I used to eat muesli but stopped because of the sugaryness of it, including the dried fruit. As I have insulin resistance, would it be a bad breakfast choice? I find it hard to eat anything in the mornings, though in the winter I try to eat porridge with cinnamon. People say to eat a yoghurt for breakfast, but there’s no way that’s going to happen! Recently I’ve been having a small wholegrain pitta with peanut butter.

    Where can you buy this low GI muesli?

    Tiggy.

  4. Samantha 8 September 2007 at 11:49 am #

    The recipe for Bircher Muesli is in John’s book, but is really simple to make up. I’ve made it a few times now and it’s really tasty,easy to digest and filling. You can also mix and match ingredients so you don’t get bored with the same flavours!

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