Data from: The effect of meal frequency in a reduced-energy regimen on the gastrointestinal and appetite hormones in patients with type 2 diabetes: a randomised crossover study

Background: Appetite and gastrointestinal hormones (GIHs) participate in
energy homeostasis, feeding behavior and regulation of body weight. We
demonstrated previously the superior effect of a hypocaloric diet regimen
with lower meal frequency (B2) on body weight, hepatic fat content,
insulin sensitivity and feelings of hunger compared to the same diet
divided into six smaller meals a day (A6).Studies with isoenergetic diet
regimens indicate that lower meal frequency should also have an effect on
fasting and postprandial responses of GIHs.The aim of this secondary
analysis was to explore the effect of two hypocaloric diet regimens on
fasting levels of appetite and GIHs and on their postprandial responses
after a standard meal. It was hypothesized that lower meal frequency in a
reduced-energy regimen leading to greater body weight reduction and
reduced hunger would be associated with decreased plasma concentrations of
GIHs: gastric inhibitory peptide (GIP), glucagon-like peptide-1(GLP-1),
peptide YY(PYY), pancreatic polypeptide (PP) and leptin and increased
plasma concentration of ghrelin. The postprandial response of satiety
hormones (GLP-1, PYY and PP) and postprandial suppression of ghrelin will
be improved. Methods: In a randomized crossover study, 54 patients
suffering from type 2 diabetes (T2D) underwent both regimens.The
concentrations of GLP-1, GIP, PP, PYY, amylin, leptin and ghrelin were
determined using multiplex immunoanalyses. Results: Fasting leptin and GIP
decreased in response to both regimens with no difference between the
treatments (p=0.37 and p=0.83, respectively). Fasting ghrelin decreased in
A6 and increased in B2 (with difference between regimens p=0.023). Fasting
PP increased in B2with no significant difference between regimens
(p=0.17). Neither GLP-1 nor PYY did change in either regimen. The decrease
in body weight correlated negatively with changes in fasting ghrelin
(r=-0.4, p<0.043) and the postprandial reduction of ghrelin
correlated positively with its fasting level (r=0.9, p<0.001). The
postprandial responses of GIHs and appetite hormones were similar after
both diet regimens. Conclusions: Both hypocaloric diet regimens reduced
fasting leptin and GIP and postprandial response of GIP comparably. The
postprandial responses of GIHs and appetite hormones were similar after
both diet regimens. Eating only breakfast and lunch increased fasting
plasma ghrelin more than the same caloric restriction split into six
meals. The changes in fasting ghrelin correlated negatively with the
decrease in body weight. These results suggest that for type 2 diabetic
patients on a hypocaloric diet, eating larger breakfast and lunch may be
more efficient than six smaller meals during the day.