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Metabolic correlates of eating behavior in severe obesity

International Journal of Obesity volume 25, pages 258–264 (2001)Cite this article

Abstract

BACKGROUND: The benefit of spreading energy intake over many small meals (‘nibbling’) rather than few large ones (‘gorging’) for control of blood glucose, serum lipids and body fat accretion has been known for 60 y, but the mechanisms are poorly understood. Men exhibit more of a gorging eating pattern than women and are also more prone to the metabolic complications of obesity, as are women with a ‘male’, central distribution of adipose tissue. We have shown correlations between central fat distribution, and other components of the metabolic ‘Syndrome X’ and fatty infiltration of the liver. Here we study relationships between eating rate and fat distribution and test the hypothesis that gorging might be associated with fatty liver.

SUBJECTS AND METHODS: In 30 non-alcoholic, non-diabetic, severely obese women (body mass index, BMI=47±1 kg/m2; mean±s.e.m.) with a mean age of 36±1 y and 16 men (BMI: 52±3) age 38±2 y, who were candidates for anti-obesity surgery, we measured eating rate using an eating monitor, and fat distribution by the waist–hip circumference ratio (WHR). In addition in the 17 women and 11 men who had surgery, serum lipids were analyzed and routine liver biopsies were evaluated for steatosis by a pathologist blinded to the conditions of the study.

RESULTS: Men ate significantly faster than women (188±28 vs 123±9 g/min; P<0.01), and had more liver fat (score: 2.7±03 vs 1.5±0.3; P<0.01), with no statistically significant sex differences in s-cholesterol or s-triglycerides. Eating rate correlated with WHR (r=0.46; P<0.01, n=46), liver fat (r=0.55; P<0.01), and s-triglycerides (r=0.42; P<0.05) adjusting for sex. Liver fat correlated with WHR (r=0.50; P<0.05), s-triglycerides (r=0.70; P<0.01) and s-cholesterol (r=0.50; P<0.05), while there were no significant correlations with BMI or body weight. In multivariate analysis eating rate (32%), meal size (8%) and WHR (6%) contributed 46% of the variance in liver fat.

CONCLUSION: We showed increased eating rates in severely obese men and women with central fat distribution. Furthermore, increased eating rates were associated with fatty liver and elevated serum lipids. Eating rate in severely obese women and men may be a determinant of the metabolic syndrome.

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References

  1. Vague J . La differenciation sexuelle—facteur determinant des formes de l'obesité Presse Med 1947 30: 339–340.

    Google Scholar 

  2. Björntorp P . Hazards in subgroups of human obesity. [Editorial.] Eur J Clin Invest 1984 14: 239–241.

    Article  Google Scholar 

  3. Kissebah AH, Krakower GR . Regional adiposity and morbidity Physiol Rev 1994 74: 761–811.

    Article  CAS  Google Scholar 

  4. Reaven GM . Role of insulin resistance in human disease Diabetes 1988 37: 1595–1607.

    Article  CAS  Google Scholar 

  5. Kral JG, Schaffner F, Pierson RN, Wang J . Body topography as an independent predictor of fatty liver Metabolism 1993 42: 548–551.

    Article  CAS  Google Scholar 

  6. Marceau P, Biron S, Hould FS, Marceau S, Simard S, Thung SN, Kral JG . Liver pathology and the metabolic Syndrome X in severe obesity J Clin Endocrinol Metab 1999 84: 1513–1517.

    Article  CAS  Google Scholar 

  7. Kral JG, Lundholm K, Björntorp P, Sjöström L, Schersten T . Hepatic lipid metabolism in severe human obesity Metabolism 1977 26: 1025–1031.

    Article  CAS  Google Scholar 

  8. Goto T, Onuma T, Takebe K, Kral JG . The influence of fatty liver on insulin clearance and insulin resistance in non-diabetic Japanese subjects Int J Obes Relat Metab Disord 1995 19: 841–845.

    CAS  Google Scholar 

  9. Svedberg J, Strömblad G, Wirth A, Smith U, Björntorp P . Fatty acids in the portal vein of the rat regulate hepatic insulin clearance J Clin Invest 1991 88: 2054–2058.

    Article  CAS  Google Scholar 

  10. Fabry P, Tepperman J . Meal frequency—a possible factor in human pathology Am J Clin Nutr 1970 23: 1059–1068.

    Article  CAS  Google Scholar 

  11. Gwinup G, Byron RC, Roush WH, Kruger F, Hamwi GJ . Effect of nibbling versus gorging on glucose tolerance Lancet 1963 2: 165–167.

    Article  CAS  Google Scholar 

  12. Hollifield G, Parson W . Metabolic adaptations to a stuff and starve feeding program. I. Studies of adipose tissue and liver glycogen in rats limited to a short daily feeding period J Clin Invest 1962 41: 245–249.

    Article  CAS  Google Scholar 

  13. Wadhwa PS, Young EA, Schmidt K, Elson CE, Pringle DJ . Metabolic consequences of feeding frequency in man Am J Clin Nutr 1973 26: 823–830.

    Article  CAS  Google Scholar 

  14. Jenkins DJA, Wolever TMS, Vuksan V et al. Nibbling versus gorging: metabolic advantages of increased meal frequency New Engl J Med 1989 321: 929–934.

    Article  CAS  Google Scholar 

  15. Jenkins DJA, Wolever TMS, Ocana AM, Vuksan V, Cunnane SC, Jenkins M . Metabolic effects of reducing rate of glucose ingestion by single bolus versus continuous sipping Diabetes 1990 9: 775–781.

    Article  Google Scholar 

  16. Jenkins DJA, Ocana A, Jenkins AL et al. Metabolic advantages of spreading the nutrient load: effects of increased meal frequency in non-insulin dependent diabetes Am J Clin Nutr 1992 55: 461–467.

    Article  CAS  Google Scholar 

  17. Hermier D . Lipoprotein metabolism and fattening in poultry J Nutr 1997 127 (Suppl 5): 805S–808S.

    Article  CAS  Google Scholar 

  18. Kissileff H . Is there an eating disorder in the obese? Ann NY Acad Sci 1989 575: 410–419.

    Article  CAS  Google Scholar 

  19. Kral JG, Kissileff HR . Fat distribution and eating behavior J Cell Biochem 1992 16B (Suppl): 262.

    Google Scholar 

  20. Spitzer RL, Devlin M, Walsh BT, Hasin D, Wing R, Marcus M, Stunkard A, Wadden T, Yanovski S, Agras S, Mitchell J, Nonnas C . Binge eating disorder: A multisite field trial of diagnostic criteria Int J Eating Disord 1992 11: 191–203.

    Article  Google Scholar 

  21. Kissileff HR, Klingsberg G, Van Itallie VB . Universal eating monitor for continuous recording of solid or liquid consumption in man Am J Physiol 1980 238: R14–R22.

    CAS  Google Scholar 

  22. Kissileff HR, Thornton J, Becker E . A quadratic equation adequately describes the cumulative food intake curve in man Appetite 1982 3: 255–272.

    Article  CAS  Google Scholar 

  23. Cohn C, Joseph D . Changes in body composition attendant on force feeding Am J Physiol 1959 196: 965–968.

    Article  CAS  Google Scholar 

  24. Cohn C, Joseph D . Role of rate of ingestion of diet on regulation of intermediary metabolism (‘meal eating vs nibbling’) Metabolism 1960 9: 492–500.

    CAS  PubMed  Google Scholar 

  25. Tepperman J, Brobeck J, Long CNH . The effects of hypothalamic hyperphagia and of alterations in feeding habits on the metabolism of the albino rat Yale J Biol Med 1942 15: 855–874.

    Google Scholar 

  26. Banerji MA, Buckley C, Chaiken RL, Gordon D, Lebovitz HE, Kral JG . Liver fat, serum triglycerides and visceral adipose tissue in insulin-sensitive and insulin resistant black men with NidDM Int J Obes Relat Metab Disord 1995 19: 846–850.

    CAS  Google Scholar 

  27. Ferster CB, Nurnberger JI, Levitt EB . The control of eating J Math 1961 1: 87–109.

    Google Scholar 

  28. Rising R, Larson DE, Ravussin E . Do obese eat faster than lean subjects? Food intake studies in Pima India men Obes Res 1994 2: 19–23.

    Article  CAS  Google Scholar 

  29. Hill SW, McCutcheon NB . Contributions of obesity, gender, hunger, food preference, and body size to bite size, bite speed, and rate of eating Appetite 1984 5: 73–83.

    Article  CAS  Google Scholar 

  30. Kissileff HR . Where should human eating be studied and what should be measured Appetite 1990 19: 61–68.

    Article  Google Scholar 

  31. Hsu LKG, Betancourt S, Sullivan SP . Eating disturbances before and after vertical banded gastroplasty: a pilot study Int J Clin Eating Disord 1996 13: 23–34.

    Article  Google Scholar 

  32. Karmann H, Rideau N, Zorn T, Malan A, Maho YL . Early insulin response after food intake in geese Am J Physiol 1992 263: R782–R784.

    CAS  PubMed  Google Scholar 

  33. Wiley JH, Leveille GA . Significance of insulin in the metabolic adaptation of rats to meal ingestion J Nutr 1970 100: 1073–1080.

    Article  CAS  Google Scholar 

  34. Teff KL, Engelman K . Oral sensory stimulation improves glucose tolerance: effects on post-prandial glucose, insulin, C-peptide and glucagon Am J Physiol 1996 270: R1371–R1379.

    CAS  Google Scholar 

  35. Andersen DK, Elahi DA, Brown J, Tobin JD, Andres R . Oral glucose augmentation of insulin secretion: interactions of gastric inhibitory polypeptide with ambient glucose and insulin levels J Clin Invest 1978 62: 152–161.

    Article  CAS  Google Scholar 

  36. Creutzfeldt W, Ebert R, Willms B, Frerichs H, Brown JC . Gastric inhibitory polypeptide (GIP) and insulin in obesity: increased response to stimulation and defective feedback control of serum levels Diabetologia 1978 14: 15–24.

    Article  CAS  Google Scholar 

  37. Leveille GA, Chakrabarty K . Absorption and utilization of glucose by meal-fed and nibbling rats J Nutr 1968 96: 69–75.

    Article  CAS  Google Scholar 

  38. Wisén O, Johansson C . Gastrointestinal function in obesity: motility, secretion, and absorption following a liquid test meal Metabolism 1992 41: 390–395.

    Article  Google Scholar 

  39. Kimura K, Kamiyama Y, Ozawe K, Honjo I . Changes in adenylate energy change of the liver after an oral glucose load Gastroenterology 1976 70: 665–668.

    CAS  PubMed  Google Scholar 

  40. Porte DJ, Schwartz MW . Diabetes complications: why is glucose potentially toxic? Science 1996 272: 699–700.

    Article  CAS  Google Scholar 

  41. Wise SD, Nielsen MF, Cryer PE, Rizza RA . Overnight normalization of glucose concentrations improves hepatic but not extrahepatic insulin action in subjects with type 2 diabetes mellitus J Clin Endocrinol Metab 1998 83: 2461–2469.

    CAS  PubMed  Google Scholar 

  42. Phillips WT, Schwartz JG, McMahan CA . Rapid gastric emptying of an oral glucose solution in type 2 diabetic patients J Nucl Med 1992 33: 1496–1500.

    CAS  PubMed  Google Scholar 

  43. Horowitz M, Cunningham KL, Wishart JM, Jones KL, Read NW . The effect of short-term dietary supplementation with glucose in gastric emptying of glucose and fructose and oral glucose tolerance in normal subjects Diabetologia 1996 39: 481–486.

    Article  CAS  Google Scholar 

  44. Cohen JC, Noakes TD, Benade AJS . Serum triglyceride responses to fatty meals: effects of meal fat content Am J Clin Nutr 1988 47: 825–827.

    Article  CAS  Google Scholar 

  45. Hennes MMI, Shrago E, Kissebah AH . Receptor and postreceptor effects of free fatty acids (FFA) on hepatocyte insulin dynamics Int J Clin Obes 1990 14: 831–841.

    CAS  Google Scholar 

  46. Phillips WT, Schwartz JG, McMahan CA . Reduced postprandial blood glucose levels in recently diagnosed noninsulin-dependent diabetics secondary to pharmacologically induced delayed gastric emptying Dig Dis Sci 1993 38: 51–58.

    Article  CAS  Google Scholar 

  47. Schwartz JG, Guan D, Green GM, Phillips WT . Treatment with an oral proteinase inhibitor slows emptying and acutely reduces glucose and insulin levels after a liquid meal in type 2 diabetic patients Diabetes Care 1994 17: 255–262.

    Article  CAS  Google Scholar 

Download references

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Authors and Affiliations

  1. Department of Surgery, SUNY HSC at Brooklyn, New York, USA

    JG Kral & MC Buckley

  2. Obesity Research Center, Columbia University, New York, USA

    HR Kissileff

  3. Mt Sinai Medical Center, New York, USA

    F Schaffner

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  1. JG Kral
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  2. MC Buckley
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  3. HR Kissileff
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  4. F Schaffner
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Kral, J., Buckley, M., Kissileff, H. et al. Metabolic correlates of eating behavior in severe obesity. Int J Obes 25, 258–264 (2001). https://doi.org/10.1038/sj.ijo.0801469

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Keywords

  • fatty liver
  • Syndrome X
  • dyslipidemia
  • fat distribution

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