Poster - #VH-62273 - Keywords: Nutrition Therapy, GLP-1 Activation, Weight Loss

Specialized Nutrient Formulations Modulate GLP-1 and Metabolic Response

John P. Troup, Ph.D. Megan Koscinski, MS, RD
Blueroot Health Institute, Inc

ABSTRACT:
Introduction
DIet has long been known to modulate hormonal and metabolic response that can influence body weight regulation. Recently its been observed that in conditions as diabetes and obesity, the typical American Diet nutrient profile may not adequately balance metabolic systems such that GLP1 response and cascade are altered and may be leading to obesity. The purpose of this study was to assess whether a macronutrient caloric profile of 40% protein : 40% carbohydrates and use of fermentable fibers can more effectively activate and sustain the GLP1 cascade resulting in improved body weight profile.
Methods
During a 12-week study ((n=22) patients with T2D (mean age 62.3 ± 6.8 years, A1C 6.8 ± 0.7%, body weight 97.4 ± 21.3 kg, and BMI 33.2 ± 5.9 kg/m²) were given one of two nutrient formulas (American Diet (AD) >50% carbs or Specialized Diet (SD 40%cal each of carb and protein) twice daily of 200 kcal each. At the start and end of 12wk, the selected nutrient supplement profile was given on separate days. Blood samples for GLP1, insulin, glucagon, leptin, and peptide-YY (PYY) were collected at baseline and 30, 60, 90, 120, 180, and 240 min after the start of each product.. Incremental area under the curve (iAUC0-240) for each hormone was calculated. The ability of each nutrient profile to inhibit DPP-IV enzyme activity was also measured.in a subsample of 8 subjects. Primary objectives were GLP1 and insulin response and pre vs post 12wk body weight..
Results
Over the course of the study patients using SD lost an average of 12.5% b.w (p< 0.05) vs 6.0% b.w. lost on AD (p< 0.05 SD v AD). No change in muscle mass was observed in SD but 5% loss in AD (p< 0.05). Levels and (iAUC-240) of GLP1, insulin, glucagon and PYY were higher in SD vs AD (p< 0.05) and for glucose lower in SD vs AD (p< 0.05). Repeat of the supplement challenge post 12 wk of the diet intervention, GLP1 was higher and insulin peak higher and earlier in SD vs AD as was glucagon and PYY with glucose lower in SD vs AD (p< 0.05). In the subpopulation patient group, DPP-IV activity was reduced and GLP1 sustainability was longer in the SD group. Self reporting survey of a decrease in food cravings and increased satiation was indicated in the SD group but not the AD group (p< 0.05).
Conclusion
These results suggest that a specialized nutrient formula shifting the macronutrient profile to a higher percent of protein (40%) and lower percent of carbohydrates (40%) vs a typical AD nutrient profile is able to activate GLP1 release resulting in higher circulating satiating hormones resulting better metabolic balance (glucose, insulin glucagon; p< 0.05) and lower body weight (p< 0.05). The inclusion of fermentable fibers in SD and demonstration of DPP-IV inhibition helps explain prolonged availability of GLP1 levels post 12 weeks and vs AD (p< 0.05) and supports positive health impact on SD