Introduction Interest in carbohydrate-restricted diets in the treatment of obesity has … One main purpose of this study was to assess the role of the maintenance diet (South Beach … The Journalof Nutrition Nutrition and Disease A Carbohydrate-Restricted Diet Alters Gut Peptides and Adiposity Signals in Men and Women with Metabolic Syndrome 1,2 MatthewR. Hayes, 3 Carla K. Miller, 3,4 JanS. Ulbrecht, 4,5 Joanna L. Mauger, 6 Lynn Parker-Klees, 7 Melissa Davis Gutschall, 3 Diane C. Mitchell, 3 Helen Smiciklas-Wright, 3 and …

In addition to CCK, various other short-term meal controlling signals also work in concert withleptinto control energy balance. The meal-initiating peptide, ghrelin, an endogenous ligand for the growth hormone secretagogue receptor, is one such signal. Ghrelin, an acylated peptide secreted primarily by the stomach (15,16), has been shown to rapidly stimulate food intake in both laboratory animals (17,18) and humans (19) when exogenously administered. Concurrent with a decrease in circulatingleptin, plasma ghrelin concentrations increase following weight loss from an energy-restricted diet (20). This reduction in hypothalamicleptin signaling and subsequent increase in ghrelin is thought to elicit a robust increase in appetite. It is known that each macronutrient present in the diet can affect these body weight signaling pathways differently. For example, Burton-Freeman et al. (21) have shown that meals higher in fat and fiber result in greater feelings of satiety and postprandial rise in CCK than high-carbohydrate, low-fiber meals. Therefore, differing macronutrient compositions of a diet have been shown to significantly alter satiation signaling (3,22,23), circulating energy fuels (24-26), and body composition (24,25,27); dietary modifications involving both reductions in total daily energy intake and alterations in macronutrient composition are appealing strategies for combating obesity and subsequentcomorbidities. In particular, the metabolic syndrome, associated with abdominal obesity and insulin resistance, increases health concern for overweight/obese individuals due to its characterized risk factors (28) associated with the develop- mentof cardiovascular disease and type 2 diabetes mellitus (29). The current study was designed as a correlational, observational investigation to assess changes in circulatingleptin, insulin, ghrelin, and CCK concentrations following maintenance of a carbohydrate-restricted diet (elevated in protein and monounsaturated fatty acids) and its subsequent effects on weight and body fat in overweight/obese patients with metabolic syndrome. Changes in subjective measures of appetite (hunger and fullness) were also examined.

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