Revista de trastornos nutricionales y terapia

Abstracto

Congreso de Nutrición 2015: El impacto del consumo de fibra de inulina en las sensaciones de apetito y la ingesta de alimentos en situaciones agudas en mujeres en edad universitaria en Kuwait: un estudio aleatorizado, doble ciego y controlado con placebo - Younis A Salmean - Facultad de Ciencias de la Vida

Younis A Salmean

Los estudios en animales han demostrado que la inulina, una fibra fermentable, produce una reducción de la ingesta de energía y una pérdida de peso. Este estudio tiene como objetivo comparar el efecto de la suplementación con inulina en el perfil de apetito y la ingesta de alimentos. 40 mujeres en edad universitaria (20,3 ± 3,7 años (media ± DE)) matriculadas en la Universidad de Kuwait fueron asignadas aleatoriamente de forma doble ciego a una bebida de inulina (16 g/día en 330 ml de agua) o 330 ml de agua (placebo). Ambas bebidas eran isocalóricas y con sabor artificial en botellas de agua opacas idénticas. Las bebidas se tomaron diariamente durante 7 días (era de adaptación) y se utilizaron escalas analógicas visuales (VAS) para informar los perfiles de apetito el octavo día durante un laboratorio de alimentación. Las voluntarias en ayunas fueron controladas por la VAS en varios puntos de tiempo durante todo el día. No hubo diferencias significativas en la edad o el peso entre los dos grupos. El grupo placebo gastó cantidades significativamente mayores de energía en el almuerzo en comparación con el grupo de fibra (670 ± 174 kcal frente a 554 ± 217 kcal, p < 0,05). Las puntuaciones de VAS indicaron que el grupo placebo tenía un deseo significativamente mayor de comida en la mañana en comparación con el grupo de inulina (p < 0,05) y este deseo se mantuvo significativo durante al menos 2 horas y 45 minutos. El grupo placebo logró un aumento brusco del hambre y el deseo de comer alimentos temprano en el día y también experimentó índices de saciedad y satisfacción significativamente más bajos durante ese período (p < 0,05).

As reviewed before, previous studies suggest that fiber can affect hunger and/or satiety favorably, leading to reduced energy intake. Several animal studies have suggested that consumption of fermentable fibers can increase GLP-1 and proglucagon expression and improve glucose homeostasis. However, to our information, very few, mostly non homogeneous studies with adjustable fiber dosage investigated the impact of ITFs or inulin supplementation on appetite, hunger sensations, and food intake in the adult population. In our study, when participants consumed 16 g/day of ITFs in the morning, the average ratings in their ‘desire to eat’, ‘hunger’, and ‘prospective food consumption’ were significantly lower compared to the control group. In calculation, the fiber group recounted higher ‘fullness’ grades before lunch, signifying a possible impact from the fiber. However, because the adaptation period was a free-living phase, it is difficult to conclude that the observed benefits, although suggested, are due solely to the ITFs since the amount of food consumed from breakfast to lunch is unknown. However, looking at the data from the test day, where settings and food intake were controlled, it appears that consuming 16 g of ITFs in the morning lowered the desire to eat, hunger, and the interest in food consumption, and enhanced fullness and satisfaction for much longer compared to placebo. This is consistent with the findings of Cani et al, who found that 16 g of ITFs promoted satiety in healthy humans.

The impacts on appetite of the participants was thanks to ITF consumption since both groups consumed equal amounts of energy at breakfast (235 ± 18 kcal vs 230 ± 16 kcal) and were housed in exact conditions with minimal physical disturbances. The lingering impact of the ITFs on appetite sensations can explain why the fiber group has consumed 21% fewer calories from food at lunch, since most sensations favorably varies until 155 min post-breakfast, and shortly before lunch is served at 200 min. It is worth noting that the reduced consumption of food by the fiber group meant that they had more time to interact at the table during lunch, which may have led to a pattern of increased liquid consumption, a naturally anticipated response when liquids accompany meals. It would have been more ideal to provide water in place of juice, considering that liquid calories are less likely to elicit a precise dietary compensation response because swallowing does not trigger the internal satiety signal that masticating does.

One reason for previous studies failing to show a positive impact of fiber supplementation on VAS domains could be the use of inhomogeneous subject populations, in particular, a wider physiological age difference. Harrold included subjects with age ranges from 18–65, 1–64, and 20–60 years, respectively. The innate physiological response and magnitude of appetite and energy regulation complexes for older and younger people can be quite different. Anorexigenic signals in older adults prevail over orexigenic signals, contributing to prolonged satiety and inhibition of hunger, which can easily affect VAS reporting in a mixed population of wide physiological age ranges. It is, therefore, suggested that more homogeneous subject populations be used when investigating the impact of fiber on appetite and energy regulation. We designed our study to be practically homogeneous; thus, we enrolled college-age females, which may explain the agreement found in our study with that of Cani et al., where fiber intake had a big impact on satiety in 21–39-year-old participants.

Another probable reason for the contradiction of the results of preceding studies may be the dissimilar doses of ITFs used. The study by Karalus et al. testified no momentous benefits on craving ratings or weight of supplementing the diet with 10 g ITF fiber. The likely explanation for this is often the low fiber doses utilized in the study. The 10 g dose of ITFs isn't likely to supply any marked impact on appetite and hunger sensations. The 16 g of inulin used in our study is likely to be an effective dose to produce meaningful change in appetite sensations, as this amount has been shown to produce favorable changes in appetite sensations, and in appetite-related hormones and peptides.

Our statistics propose an influence on weightiness in the short term. After a week of supplementation, the fiber group saw no significant increase in body weight compared to its baseline, but the control group had a significant increase from its baseline. This is consistent with the findings of Parnell and Reimer, where supplementation with ITFs resulted in a significant reduction in weight in the fiber group while the control group experienced a significant weight gain.

Participants consuming the fiber reported a higher incidence of bloating and flatulence, which was anticipated. Although the incidence was higher among fiber consumers, the fiber was tolerated as no dropouts were reported as a result of supplement use.

In conclusion, dietary supplementation with 16 g/day of ITF fiber in the morning was found to reduce hunger, desire to eat, and prospective food consumption, and to increase fullness and satiety in acute settings, leading to reduced food intake at lunch. These consequences propose that ITF fiber is potentially a useful assistant dietary supplement for curbing appetite and possibly aiding weight management.

Biography

Younis Salmean es miembro del cuerpo docente del Departamento de Nutrición de la Universidad de Kuwait. El Dr. Salmean se graduó en la Universidad Estatal de California con una licenciatura en Ciencias de la Alimentación y Dietética, y posteriormente obtuvo una maestría y un doctorado en Nutrición Humana en la Universidad de Florida. Sus intereses de investigación actuales se centran en examinar el papel de la fibra y los prebióticos en la terapia nutricional médica, específicamente el papel de las fibras añadidas en diversos resultados de la enfermedad renal crónica y los biomarcadores relacionados. También se centra en examinar el papel que pueden desempeñar la fibra y los prebióticos en la promoción de la salud, el bienestar y la calidad de vida.

Este trabajo se presenta parcialmente en la 4ª Conferencia y Exhibición Internacional sobre Nutrición, del 26 al 28 de octubre de 2015, celebrada en Chicago, Illinois, EE. UU.