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Title: The Daily Consumption of a Protein-rich Breakfast for Long-term Improvements In Appetite, Glucose

Control, and Body Weight Management in Overweight &Obese ‘Breakfast Skipping’ Adolescents – NPB #10-173 - Revised

Investigator: Heather J. Leidy, PhD Institution: University of Missouri Date Submitted: 9/10/12 Industry Summary:

The purpose of the current study was to identify whether the daily addition of a protein-rich (pork-based) breakfast

leads to beneficial, long term improvements in appetite, glucose control, and body weight management in ‘breakfast

skipping’ young people. To do this, 54 overweight/obese ‘breakfast skipping’ adolescents were randomly assigned to a

normal-protein (cereal-based) breakfast group, a high protein (pork-based) breakfast group, or a control group. For 12

weeks, the breakfast groups were provided with breakfast meals to consume each day, whereas the control group

continued to skip breakfast. Perceived appetite and satiety; daily, continuous glucose monitoring; daily food intake;

body weight; and body composition were measured pre and post-study. The study showed that the daily addition of a

high protein breakfast prevented the increase in fat mass over the 12 week period compared to skipping breakfast.

Potential mechanisms include the observed increases in appetite control and satiety, leading to reductions in daily

intake and evening snacking compared to skipping breakfast. The high protein breakfast also led to improved glucose

control over the 12-week period. When comparing the normal protein and high protein breakfast groups, the high

protein breakfast led to greater reductions in daily intake, particularly reduced carbohydrates, as well as greater

increases in appetite control and satiety. In summary, the daily addition of breakfast, particularly a protein-rich, pork-

based breakfast, beneficially improves appetite control and satiety; glucose control; and food intake regulation in

overweight/obese ‘breakfast skipping’ adolescents. Further, this dietary strategy may improve body weight

management through the prevention of weight/body fat gain in young people. The study findings provide the pork

industry with novel, practical evidence supporting the role of a protein-rich breakfast including high-quality lean pork as

a key component of daily healthy eating, leading to improved body weight management in young people. For

correspondence: Heather J. Leidy, PhD; University of Missouri, Dept. of Nutrition and Exercise Physiology; email:

[email protected].

Keywords: High-protein breakfast; Breakfast-skipping Adolescents; Appetite Control & Satiety; Obesity

mailto:[email protected]

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Scientific Abstract: Background: Breakfast skipping is a common dietary habit practiced among adolescents and is strongly associated with

over-eating, weight gain, and obesity. Purpose: The study was designed to identify whether the daily consumption of a

high protein breakfast leads to beneficial, long term changes in appetite and glucose control, satiety, daily food intake,

and body weight management in overweight and obese ‘breakfast skipping’ adolescents. Methods: Fifty-seven

overweight/obese ‘breakfast skipping’ adolescents were randomly assigned to a Normal-Protein (NP), cereal-based

Breakfast (350 kcal; 15% Protein/65% Carbohydrates/20% Fat) group, a High Protein (HP), pork-based Breakfast (350

kcal; 40% Protein/40% Carbohydrates/20% Fat) group, or a Control (CON) (i.e., breakfast skipping) group. For 12 weeks,

the NP and HP groups were provided with breakfast meals to consume each day, whereas the CON group continued to

skip breakfast. Perceived appetite and satiety; daily, continuous glucose monitoring; daily food intake; body weight; and

body composition were measured during pre and post-study. Results: Although no differences in total body weight

were observed between groups, the CON tended to gain fat mass vs. HP and NP. Regarding energy intake regulation,

the HP group voluntarily reduced daily intake and carbohydrate consumption vs. CON and NP groups. The HP group also

reduced afternoon and evening snacking of high fat/high sugar foods vs. CON. No differences in snacking were observed

between HP vs. NP. The HP breakfast group displayed reduced hunger, desire to eat, and prospective food consumption

along with increased fullness vs. CON and greater reductions in hunger and desire to eat along with greater increases in

fullness vs. NP. Lastly, the HP breakfast led to improved glucose control throughout the 12-week period. Conclusions:

The daily addition of breakfast, particularly a protein-rich, pork-based breakfast, improved appetite control and satiety,

food intake regulation, and body weight management in overweight/obese ‘breakfast skipping’ adolescents. Funding

provided by The National Pork Board.

Introduction:

The obesity epidemic, currently affecting nearly 25 million young people in the United States alone, is

considered to be the greatest threat to public health this century [1]. Adolescence is a sensitive time to establish

energy balance as unhealthy weight gain leads to the development of numerous metabolic, neurological, cardiovascular,

and psychological abnormalities which continue into adulthood, reducing quality of life and increasing morbidity [2].

Thus, it is essential to identify the potential contributors and successful strategies that target weight control in the youth

population to reverse the obesity epidemic and prevent or delay serious health complications.

One of the more common, yet unhealthy dietary habits practiced by many adolescents is breakfast skipping [3-

6]. Previous cross-sectional and prospective studies have shown that breakfast skipping is strongly associated with poor

diet quality, over-eating (especially in the evening), and obesity [3, 7-9]. Skipping breakfast has also been shown to

negatively impact attention and memory, academic test scores, and school performance/grades [3] . These common,

yet unhealthy dietary behaviors are disconcerting at this sensitive life-stage due to the fact that dietary habits and

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practices are developed and become solidified during adolescence and will continue throughout adulthood further

impacting body weight and overall health and well-being [2].

With respect to the benefits of consuming breakfast on a daily basis, observational studies indicate that

breakfast leads to a higher quality diet as well as decreased total energy intake, dietary fat, and cholesterol compared to

skipping breakfast [10]. Some data suggest that breakfast consumption might lead to improvements in blood lipid and

insulin profiles if the meal is of high quality [11]. Eating breakfast has also been associated with improved learning and

enhanced school performance as well as reduced absenteeism, tardiness, suspensions, and disciplinary conflicts [12].

One of the key studies surrounding breakfast and body weight management pertains to the men and women who are

part of the National Weight Control Registry (NWCR) [13]. To date, the NWCR has followed over 5,000 individuals who

have lost ≥13.6 kg (30 lbs) for ≥1 year with the goal to identify the characteristics of individuals who have succeeded at

long-term weight loss. When examining the dietary habits of these individuals, 78% reported eating breakfast on a daily

basis whereas only 4% never eat breakfast [13] . Taken together, these data suggest that eating breakfast may be a

beneficial strategy to combat obesity and improve overall health.

However, limited data exists regarding whether the addition of breakfast leads to better appetite control and

body weight management in overweight and obese adolescents who skip the morning meal. Further, most of the

breakfast meals consumed by the subjects in the previously mentioned studies were carbohydrate-rich, ready-to-eat

cereals. Whether the macronutrient composition of the foods (e.g., protein) consumed at breakfast impacts these

outcomes has not been fully explored.

We recently completed two acute pilot studies examining the beneficial effects of breakfast, with specific

emphasis on dietary protein in ‘breakfast skipping’ adolescents [14, 15]. In the first study, we found that the addition of

breakfast led to reductions in perceived appetite, increases in perceived satiety, increases in the satiety-hormone PYY,

and reductions in energy intake at the next eating occasion compared to skipping breakfast [14]. Furthermore,

additional benefits were observed when the breakfast was higher in dietary protein [14]. The previous outcomes

primarily target the homeostatic signals involved with energy balance/energy regulation. While these responses are

significant and meaningful, the current obesogenic environment, particularly increased availability of highly palatable,

energy dense food and increased presence of powerful food stimuli (i.e. billboards, commercials, and vending machines)

contribute substantially to the shift away from eating according to homeostatic need towards reward-driven eating, the

latter of which leads to positive energy balance and obesity. Thus, our second study examined the neural activation of

specific brain regions associated with reward-driven eating in response to breakfast in ‘breakfast skipping’ adolescents

[15]. Brain activation through fMRI was specifically examined prior to lunch. We found that breakfast consumption led

to reduced activation in specific brain regions previously implicated in reward-driven eating behavior compared to

skipping breakfast [15]. Additionally, the higher protein breakfast led to reduced activation prior to lunch compared to a

normal protein meal [15]. These data suggest that increased dietary protein at breakfast might be a beneficial, modest

strategy to reduce the impact of the modern food environment in overweight ‘breakfast skipping’ adolescent girls.

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Although these acute studies have shown supportive data, no studies to date have been completed to

examine the long-term effects following the habitual incorporation of breakfast in those who chronically skip the

morning meal. Given that the consumption of higher protein meals leads to improved appetite control & satiety, the

integration of protein-rich foods at breakfast might provide additional benefits.

Objectives:

We proposed to conduct a longitudinal (i.e., 12 week), controlled-feeding study in overweight/obese ‘breakfast skipping’

adolescents to complete the following:

1) Identify whether the daily addition of a protein-rich, pork-based breakfast leads to beneficial changes in daily

appetite & satiety, glucose control, food intake, & body weight/composition

2) Identify whether the daily addition of protein-rich, pork-based breakfast meals leads to greater changes in

daily appetite & satiety, glucose control, food intake, & body weight/composition vs. the daily consumption

of normal protein, cereal-based breakfast meals.

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Materials & Methods: Study Participants:

‘Breakfast skipping’ adolescent boys and girls were recruited through flyers posted around the Columbia, MO area and

through University of Missouri email listserv. Eligibility included the following: 1) age 13-20 y; 2) overweight to obese

(BMI between 25-39.9 kg/m2; 85th-99th percentile); 3) no metabolic, psychological, or neurological diseases/conditions;

4) not currently/previously on a weight loss or other special diet (in the past 6 months); 5) will maintain current physical

activity level throughout the study; and 6) consistently skips breakfast every week day (i.e., 5 days/week). As shown in

Figure 1, 320 individuals were interested in the study; 67 met all screening criteria, signed the study consent, and began

the study; 54 completed all study procedures. Subject characteristics of those that completed the study are shown in

Table 1.

Figure 1: Recruitment and Screening

Table 1: Subject Characteristics from the 54 Completed Study Participants

Characteristics Mean ± SEM

Age (y) 19 ± 1

Weight (kg) 84.8 ± 2.2

BMI (kg/m2) 29.7 ± 4.6

Breakfast Skipping (#occasions/week) 6 ± 1

First Eating Occasion of the Day (hr:min) 1:00 pm ± 0:30 min

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Outcome

Dietary Intervention

Dietary Recalls x x x x x x x x x

Ad Libitum Feeding Assessment x x x

Dietary Compliance x x x x x x x x x x x x

Physical Activity x x x x x x x x x

Perceived Appetite & Satiety x x x x x x x x x

Continuous Glucose Monitoring x x x x x x x x x

Body Weight x x x x x x x x

Body Composition x x

Wk 12

Begins ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------->Baseline

Wk 6 Wk 7 Wk 8 Wk 9 Wk 10 Wk 11Wk 0 Wk 1 Wk 2 Wk 3 Wk 4 Wk 5

Experimental Design:

Fifty-seven overweight/obese ‘breakfast skipping’ adolescents were randomly assigned to a Normal-Protein (NP), cereal-

based Breakfast group, a High Protein (HP), pork-based Breakfast group, or a Control (CON) group. For 12 weeks, the NP

group was provided with ready-to-eat cereals (350 kcal/meal; 15% protein; 65% carbohydrates; 20% fat), whereas the

HP group was provided with pork-based breakfast meals (350 kcal/meal; 40% protein; 50% carbohydrates; 20% fat) to

consume each day. The CON group continued to skip breakfast. As shown in Figure 2, perceived appetite and satiety,

continuous glucose monitoring, daily food intake, body weight, and body composition were measured throughout the

study.

Figure 2: Experimental Design and Study Outcomes

Breakfast:

The NP and HP groups were provided with their respective breakfast meals to consume, at home, between 6:00-9:45 am

each day over the 12-week period. As shown in Table 2, the energy content of the NP and HP breakfast meals was 350

kcal. However, the NP meals contained 15% (13g) protein, 65% carbohydrates, and 20% fat and were 4 different kinds

of ready-to eat cereals (i.e., Cheerios®, Chex®, Flakes, and Oatmeal Squares®). The HP meals contained 40% (35g total;

14 g of pork-based) protein, 40% carbohydrates and 20% fat and were 4 different kinds of ‘home-cooked’ meals

containing various pork products (i.e., Pancakes with raspberry syrup and ham; blueberry waffles with syrup and pork-

sausage patty; scramble and yogurt-covered fruit bites; and an breakfast wrap. A one-week meal rotation was

incorporated such that each specific meal was consumed for 7 consecutive days; then, the next meal was provided, etc.

After 28 days, the rotation was repeated two times.

Adherence to the breakfast meals:

To document adherence to the breakfast meals, the participants returned any uneaten breakfast food and containers.

They also complete daily food check-off logs including a list of food items and quantities to be consumed at breakfast.

They were instructed to check off all foods that were consumed. Any uneaten food was identified and later subtracted

from the prescribed intake. Eating foods at breakfast not provided by the study was highly discouraged. If this occurred,

these food items were recorded on the food log and energy content and macronutrient composition was determined.

Average breakfast compliance was 100% for CON, 97 ± 4% for NP, and 98 ± 3% for the HP groups.

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Table 2: Breakfast Meals

Breakfast Characteristics Breakfast Skipping

(CON)

Normal Protein Meals (NP)

High Protein Meals (HP)

Type of Meal Nothing Ready-to-Eat Cereals Pork-rich Home-cooked

Meals

Energy Content 0 350 350

Macronutrient Composition Protein/Carbohydrates/Fat

0 15/65/20 40/40/20

Protein (g) Pork protein (g)

0 0

13 0

35 11

Carbohydrates (g) 0 35 57

Fat (g) 0 8 8

Study Procedures: Body Weight and Body Composition: Fasted-state body weight was measured every 2 weeks on an electronic platform

scale. Whole body total mass, fat mass, and fat free mass were determined at baseline and post-study using Dual-

energy X-ray Absorptiometry (DXA; Hologic; Discovery QDR DXA 4500A).

Physical Activity: The participants were asked to maintain a consistent physical activity pattern throughout the 12-week

period. Accelerometry (Caltrac, XMax) was used to document energy expenditure. Each participant wore this device on

their left hip for 3 consecutive days during baseline and post study.

24-h Dietary Recalls: On 3 days during baseline and post-study, the participants completed 24-h dietary recalls using the

Automated Self-administered 24-hour Recall program (ASA24; National Cancer Institute). The participants were asked

to recall foods and beverages (name, brands, portion, preparation, location of consumption) consumed over the

previous 24-h period. Food type, energy content, fiber, sugar, and macronutrient composition of meals, snacks, and

daily intake were determined.

Snacking Assessments: During baseline and post-study, the participants were provided with a one-day packout cooler.

The packout consisted of commonly consumed foods. The participants consumed these ad libitum, throughout the day.

The foods, beverages, and snacks were weighed prior to the packout. The participants were asked to return any

uneaten foods and beverages. Food type, energy content, sugar, fiber, and macronutrient composition were

determined.

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Appetite and Satiety Questionnaires: Computerized questionnaires assessing hunger, fullness, desire to eat, and

prospective food consumption were completed every waking hour for 3 days during baseline and post-study. The

questionnaires contained visual analog scales incorporating a 100mm horizontal line scale. The questions were worded

as “how strong is your feeling of” with anchors of “not all” to “extremely.” The Adaptive Visual Analog Scale Software

was used (Neurobehavioral Research Laboratory and Clinic; San Antonio, TX).

Continuous Glucose Monitoring System (CGMS): During baseline and post-study, the participants reported to our facility

in the afternoon. A tiny CGMS sensor (iPRO, Medtronic; Minneapolis, MN) was inserted just under the skin on the

abdomen by a highly trained technician. The system automatically records an average glucose value every 5 minutes for

up to 72 hours. The participants wore the device for 3 consecutive days during each study period (i.e., baseline and

post-study). Throughout each of the 3 days, the participants also performed 4-5 finger-stick blood glucose readings

from a standard glucose meter for calibration.

Statistical Analyses:

To address Objective 1, a repeated-measures ANOVA examining main effect of time (pre vs. post) and the addition of

breakfast (HP breakfast vs. CON) will be performed on all stated outcomes. To address Objective 2, a repeated-

measures ANOVA examining main effect of time (pre vs. post) and breakfast meals (HP vs. NP meals) will be performed

on all stated outcomes. Data are presented as mean ± SEM. P<0.05 denotes significance; trends are reported if P<0.1.

Statistical analyses were performed using SPSS (ver. 19.0).

Results: Body Weight and Body Composition:

Pre vs. post-study change in body weight over the course of the 12-week study is shown in Figure 3. No significant Pre

vs. Post-study changes in body weight were found within each group. When comparing pre/post changes between

groups (Table 3), no differences in body weight were observed between groups. Pre vs. post-study change in body fat

over the course of the 12-week study is shown in Figure 4. Although no change in body fat was observed within the NP

and HP groups, the CON group gained fat mass (+1.58 ± 0.78 kg, p<0.05) over the 12-week period. When comparing

pre/post changes between groups (Table 3), the CON group gained more fat mass vs. HP (p<0.01) and NP (p=0.05). No

differences were observed between the breakfast groups. Similar findings were also observed when expressed as

percent body fat (Table 3).

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Figure 3: Pre/Post change in body weight in the controls (CON), Normal Protein (NP), and High Protein (HP) groups

Figure 4: Pre/Post change in body fat in the controls (CON), Normal Protein (NP), and High Protein (HP) groups

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Table 3: Body weight and body composition changes over the 12-week period

Pre/Post Changes Breakfast Skipping

(CON)



Total Body Weight (kg) +1.29 ± 1.27 +0.55 ± 0.45 -0.00 ± 0.66

Lean Mass (kg) -0.29 ± 0.56 +0.28 ± 0.33 +0.20 ± 0.48

Total Fat Mass (kg) +1.58 ± 0.87a +0.27 ± 0.27b -0.20 ± 0.32b

Percent Body Fat (%) +1.58 ± 0.70a +0.01 ± 0.26b -0.31 ± 0.26b

Different letters denote significance; p<0.05

Daily Energy Expenditure:

With all groups combined, daily energy expenditure was approximately 1870 kcal/d during baseline and 1820 kcal/d

during post-study. No changes in daily energy expenditure were observed over the course of the 12-week period or

between groups.

Daily Energy Intake:

Pre vs. post-study change in daily intake over the course of the 12-week study is shown in Figure 5. No significant Pre vs.

Post-study changes in daily intake were found within the CON or NP groups. However, the HP group exhibited a

voluntary reduction in daily intake (-412 ± 228 kcal, p=0.08) from pre to post-study (Figure 5). When comparing

pre/post changes between groups (Table 4), the HP group tended to have reduced intake vs. CON (p=0.10) and NP

(p=0.10). When specifically examining macronutrient composition between groups (Table 4), the HP group consumed

fewer carbohydrates vs. CON (p<0.03) and NP (p<0.03).

Figure 5: Pre/Post change in daily intake in the controls (CON), Normal Protein (NP), and High Protein (HP) groups

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Table 4: Daily intake changes over the 12-week period

Pre/Post Changes Breakfast Skipping

(CON)



Daily Intake (kcal) +112 ± 304a +17 ± 84a -412 ± 228b (p=0.10)

Protein (g) +10.8 ± 14.3 +16.1 ± 14.0 +2.2 ± 12.9

Carbohydrates (g) +26.1 ± 19.2a +31.1 ± 15.7a -50.7 ± 23.7b

Fat (g) +3.0 ± 17.9 -10.0 ± 6.5 -24.4 ± 11.6


Afternoon/Evening Snacking:

Afternoon and evening snacking were also assessed throughout the 12-week period using the ad libitum packout.

Although no pre vs. post-changes were observed within each group, differences between groups existed. As shown in

Table 5, the HP group reduced snacking on high fat/high sugar foods vs. CON (p<0.05). No differences were observed

between the HP and NP groups.

Table 5: Afternoon/evening snacking changes over the 12-week period

Pre/Post Changes in Snack Foods

Breakfast Skipping

(CON)



High Fat (g) -114 ± 86 -12 ± 50 -216 ± 188

High Sugar (g) +201 ± 228 -123 ± 127 -427 ± 340

High Fat/High Sugar (g) +104 ± 33a +4 ± 27a,b -70 ± 50b


Appetite Control & Satiety:

Within group, pre vs. post-study change in indices of appetite and satiety over the 12-week study are shown in Figures 6-

9. No significant changes in hunger, fullness, desire to eat, or prospective food consumption were observed within the

CON group. The NP group displayed reduced morning (i.e. post-breakfast) hunger (p=0.09); increased morning (p<0.05),

pre-lunch (p=0.07), and daily (p=0.06) fullness; reduced morning desire to eat (p=0.08); and reduced morning (p=0.09)

and daily (p=0.1) prospective food consumption over the 12 week period. The HP group displayed reduced morning

(i.e., post-breakfast), pre-lunch, and daily hunger (all, p<0.05); increased morning (i.e., post-breakfast; p<0.05)) and daily

(p=0.09) fullness; reduced morning (i.e., post-breakfast) and pre-lunch desire to eat (both, p<0.05); and reduced

morning (i.e., post-breakfast, pre-lunch, and daily prospective food consumption (all, p<0.05) over the 12 week period.

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Figure 6: Pre/Post change in daily hunger in the Controls (CON), Normal Protein (NP), a High Protein (HP) groups

Time Pts Pre-study Post-study

Morning -8 ± 5 -12 ± 6 Mid-day -20 ± 13 -17 ± 8

Daily 8 ± 7 8 ± 8


Morning 17 ± 8 21 ± 3 Mid-day 38 ± 18 48 ± 9

Daily 1 ± 8 12 ± 3


Morning 14 ± 4a -15 ± 10b (p=0.09) Mid-day 38 ± 3 8 ± 14

Daily 1 ± 2 -20 ± 11


Morning 14 ± 5a -21 ± 6b Mid-day 35 ± 7a -1 ± 8b

Daily -5 ± 8a -25 ± 6b

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Figure 7: Pre/Post change in daily fullness in the Controls (CON), Normal Protein (NP), a High Protein (HP) groups


Morning -8 ± 5 -12 ± 6 Mid-day -20 ± 13 -17 ± 8

Daily 8 ± 7 8 ± 8


Morning -13 ± 7a 18 ± 5b Mid-day -28 ± 10a -4 ± 8b (p=0.07)

Daily 5 ± 6a 26 ± 5b (p=0.06)


Morning -6 ± 3a 22 ± 4b Mid-day -11 ± 7 4 ± 7

Daily 17 ± 6a 28 ± 5b (p=0.09)

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Figure 8: Pre/Post change in daily desire to eat in the Controls (CON), Normal Protein (NP), a High Protein (HP) groups


Morning 21 ± 9 22 ± 6 Mid-day 39 ± 18 41 ± 10

Daily 12 ± 12 13 ± 2



Daily 10 ± 5 -5 ± 11


Morning 13 ± 5a -12 ± 5b Mid-day 33 ± 7a 5 ± 8b

Daily -5 ± 8 -16 ± 6

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Figure 9: Pre/Post change in daily prospective food consumption in the Controls (CON), Normal Protein (NP), a High

Protein (HP) groups


Morning 18 ± 7 18 ± 4 Mid-day 33 ± 15 34 ± 8

Daily 8 ± 8 8 ± 2



Daily 5 ± 3a -6 ± 8b (p=0.1)


Morning 16 ± 3a -15 ± 5b Mid-day 32 ± 6a -3 ± 7b

Daily -2 ± 6a -18 ± 6b

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When comparing pre/post changes between groups (Table 6), the HP group displayed greater reductions in morning,

pre-lunch, and daily hunger vs. CON (all, p<0.05) and greater reductions in morning hunger vs. NP (p<0.05). The HP

group displayed greater increases in morning fullness vs. the CON (p<0.05) and NP (p<0.05) groups. Morning and pre-

lunch desire to eat were reduced in the HP group vs. CON (both, p<0.05) and NP (both, p<0.05). Lastly, morning and

pre-lunch prospective food consumption were reduced in the HP group vs. CON (both, p<0.05).

Table 6: Afternoon/evening snacking changes over the 12-week period

Pre/Post Changes in Indices of Appetite Control

and Satiety

Breakfast Skipping

(CON)



Hunger Morning (mm) Mid-day (mm)

Daily (mm)

-3 ± 9a

10 ± 17a 11 ± 17a

-9 ± 14a

-18 ± 20a,b -11 ± 15a,b

-35 ± 6b -36 ± 9b

-20 ± 9b (p=0.06)

Fullness Morning (mm) Mid-day (mm)

Daily (mm)

-3 ± 9a 3 ± 16 1 ± 12

-9 ± 14a -18 ± 12 29 ± 12

51 ± 8b 16 ± 10 12 ± 6

Desire to Eat Morning (mm) Mid-day (mm)

Daily (mm)

-2 ± 5a 1 ± 13a 1 ± 11

18 ± 14a 14 ± 9a

-33 ± 12

-38 ± 11b -28 ± 6b -11 ± -9

Prospective Food Consumption

Morning (mm) Mid-day (mm)

Daily (mm)

-3 ± 3a 1 ± 11a -1 ± 7

-24 ± 20a,b -16 ± 10a,b -25 ± 11

-45 ± 9b -35 ± 8b -16 ± 7


Glucose Control:

Although all participants completed the continuous glucose monitoring (CGMS) procedures, several problems (i.e.,

sensor malfunction, non-compliance to the procedures, early removal of the sensor due to discomfort, etc.) led to

reduction in available, accurate data. Specifically, there were only n=3 CON, n=5 NP, and n=14 HP participants with

usable, accurate Pre and Post-study data. Thus, only the Pre vs. Post-study data in the HP group was analyzed and is

shown in Figure 10. The long-term consumption of the HP breakfast meals led to reductions in morning (i.e., post-

breakfast) (p=0.08), mid-day (p=0.06), and daily (i.e., 7 am -5 pm; p=0.05) glucose concentrations.

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Figure 10: Pre/Post change in daily glucose control in the High Protein (HP) group

Discussion: The daily addition of a high protein breakfast:

Prevented the increase in fat mass

Reduced daily intake, particularly through a reduction in carbohydrate consumption

Reduced afternoon and evening snacking of high fat and high sugar foods

Reduced morning and mid-day hunger, desire to eat, and prospective food consumption

Increased morning and mid-day fullness

Reduced morning, mid-day, and daily glucose responses

in overweight/obese ‘breakfast skipping’ adolescents. When comparing the daily addition of a normal protein vs. high protein breakfast in overweight/obese ‘breakfast

skipping’ adolescents, the high protein breakfast led to greater:

Reductions in daily intake, particularly through a reduction in carbohydrate consumption

Reductions in morning hunger and desire to eat

Increases in morning fullness. These data suggest that the daily addition of breakfast, particularly a protein-rich, pork-based breakfast, beneficially

improves appetite control and satiety; glucose control; and food intake regulation in overweight/obese ‘breakfast

skipping’ adolescents. Further, this dietary strategy may improve body weight management through the prevention of

weight/body fat gain in young people.

The study findings provide the pork industry with novel, practical evidence supporting the role of a protein-rich

breakfast including high-quality lean pork as a key component of daily healthy eating, leading to improved body weight

management in young people.


Morning 96.2 ± 3.0a 89.3 ± 2.7b (p=0.08) Mid-day 97.7 ± 3.1a 90.6 ± 2.0b (p=0.06)

Daily 96.7 ± 8.4a 91.1 ± 2.0b

18

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title: ontrol, and ody weight danagement in overweight ...€¦ · investigator: heather j. leidy,...

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