A pre-meal of whey proteins induces differential effects on glucose and lipid metabolism in subjects with the metabolic syndrome: a randomised cross-over trial

• Published in: European journal of nutrition Vol. 58; no. 2; pp. 755 - 764
• Main Authors: Bjørnshave, Ann, Holst, Jens Juul, Hermansen, Kjeld
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.03.2019; Springer Nature B.V
• Subjects: acetaminophen; Apolipoprotein B; apolipoprotein B-48; Apolipoprotein B-48 - blood; Appetite; Blood glucose; Blood Glucose - metabolism; Cardiovascular diseases; Chemistry; Chemistry and Materials Science; Clinical trials; Cross-Over Studies; Evidence-based medicine; Fat metabolism; Fatty acids; Feeding Behavior - physiology; Female; free fatty acids; Gastric emptying; Glucagon; Glucagon-like peptide 1; Glucose; Glucose metabolism; Humans; hyperlipidemia; Insulin; Lipid metabolism; Lipid Metabolism - drug effects; Lipids - blood; Male; Metabolic syndrome; Metabolic Syndrome - blood; Middle Aged; Nutrition; Original Contribution; Paracetamol; placebos; Postprandial Period; risk factors; Secretion; triacylglycerols; Triglycerides - blood; Whey protein; Whey Proteins - administration & dosage; Whey Proteins - blood; Whey Proteins - pharmacology; Dose–response; Whey proteins; Metabolic syndrome; Postprandial lipaemia; Pre-meal
• ISSN: 1436-6207; 1436-6215; 1436-6215
• DOI: 10.1007/s00394-018-1684-3

Purpose Postprandial lipaemia (PPL), an independent risk factor for cardiovascular disease, is affected by composition and timing of meals. We evaluated if whey proteins (WP) consumed as a pre-meal before a fat-rich meal reduce postprandial triglyceride (TG) and apolipoprotein B-48 (ApoB-48) responses in subjects with the metabolic syndrome (MeS). Methods An acute, randomised, cross-over trial was conducted. 20 subjects with MeS consumed a pre-meal of 0, 10 or 20 g WP 15 min prior to a fat-rich meal. The responses of TG and ApoB-48 were assessed. We also analysed postprandial responses of free fatty acids (FFA), glucose, insulin, glucagon, glucagon-like peptide 1 (GLP-1), glucose-dependent insulinotropic peptide (GIP) and paracetamol (reflecting gastric emptying rates). Results WP pre-meal did not alter the TG or ApoB-48 responses. In contrast, the insulin response was more pronounced after a pre-meal of 20 g WP than with 10 g WP ( P  = 0.0005) and placebo ( P  < 0.0001). Likewise, the postprandial glucagon response was greater with a pre-meal of 20 g WP than with 10 g WP ( P  < 0.0001) and 0 g WP ( P  < 0.0001). A pre-meal with 20 g of WP generated lower glucose ( P  = 0.0148) and S-paracetamol responses ( P  = 0.0003) and a higher GLP-1 response ( P  = 0.0086) than placebo. However, the pre-meal did not influence responses of GIP, FFA or appetite assessed by a Visual Analog Scale. Conclusions Consumption of a WP pre-meal prior to a fat-rich meal did not affect TG and chylomicron responses. In contrast, the WP pre-meal stimulates insulin and glucagon secretion and reduces blood glucose as expected, and delays gastric emptying. Consequently, our study points to a differential impact of a WP pre-meal on lipid and glucose metabolism to a fat-rich meal in subjects with MeS.