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
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).
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).
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.
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.
KeywordsPre-meal Whey proteins Dose–response Metabolic syndrome Postprandial lipaemia
- Apolipoprotein B-48
Free fatty acids
Glucose-dependent insulinotropic peptide
Glucagon-like peptide 1
Incremental area under the curve
Total area under the curve
Visual analog scale
We thank Eva Mølgaard Jensen Lene Trudsø Jensen and Lene Bruss Albæk for outstanding technical assistance. Furthermore, we would like thank Anne Marie Kruse, Peter Reiter, Mette Bohl, and Anne Grethe Schioldan for assistance during the meal tests. This work was supported by grants from The Danish Dairy Research Foundation, Arla Foods Ingredients Group P/S, and Innovation Fund Denmark—MERITS (4105-00002B). AB was supported by research grants from The Danish Diabetes Academy supported by the Novo Nordisk Foundation, Aarhus University and The Research Foundation of the Department of Endocrinology and Internal Medicine, Aarhus University Hospital. Protein powder was kindly provided by Arla Foods Ingredients Group P/S.
Compliance with ethical standards
Conflict of interest
Ann Bjørnshave, Jens Juul Holst and Kjeld Hermansen have no conflicts of interest and other funding disclosures to declare.
- 5.Masuda D, Sugimoto T, Tsujii K, Inagaki M, Nakatani K, Yuasa-Kawase M, Tsubakio-Yamamoto K, Ohama T, Nishida M, Ishigami M, Kawamoto T, Matsuyama A, Sakai N, Komuro I, Yamashita S (2012) Correlation of fasting serum apolipoprotein B-48 with coronary artery disease prevalence. Eur J Clin Invest 42:992–999CrossRefGoogle Scholar
- 12.Staub H (1921) Untersuchungen uber den zuckerstoffwechsel des munchen. Z Klin Med 91:44–48Google Scholar
- 17.Mortensen LS, Hartvigsen ML, Brader LJ, Astrup A, Schrezenmeir J, Holst JJ, Thomsen C, Hermansen K (2009) Differential effects of protein quality on postprandial lipemia in response to a fat-rich meal in type 2 diabetes: comparison of whey, casein, gluten, and cod protein. Am J Clin Nutr 90:41–48CrossRefGoogle Scholar
- 20.Alberti KG, Eckel RH, Grundy SM, Zimmet PZ, Cleeman JI, Donato KA, Fruchart JC, James WP, Loria CM, Smith SC Jr, International Diabetes Federation Task Force on Epidemiology and Prevention, Hational Heart, Lung, and Blood Institute, American Heart Association, World Heart Federation, International Atherosclerosis Society, International Association for the Study of Obesity (2009) Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation 120:1640–1645CrossRefGoogle Scholar
- 21.Bohl M, Bjornshave A, Rasmussen KV, Schioldan AG, Amer B, Larsen MK, Dalsgaard TK, Holst JJ, Herrmann A, O’Neill S, O’Driscoll L, Afman L, Jensen E, Christensen MM, Gregersen S, Hermansen K (2015) Dairy proteins, dairy lipids, and postprandial lipemia in persons with abdominal obesity (DairyHealth): a 12-wk, randomized, parallel-controlled, double-blinded, diet intervention study. Am J Clin Nutr 101:870–878CrossRefGoogle Scholar
- 29.Martins IJ, Mortimer BC, Miller J, Redgrave TG (1996) Effects of particle size and number on the plasma clearance of chylomicrons and remnants. J Lipid Res 37:2696–2705Google Scholar
- 31.Deane AM, Nguyen NQ, Stevens JE, Fraser RJ, Holloway RH, Besanko LK, Burgstad C, Jones KL, Chapman MJ, Rayner CK, Horowitz M (2010) Endogenous glucagon-like peptide-1 slows gastric emptying in healthy subjects, attenuating postprandial glycemia. J Clin Endocrinol Metab 95:215–221CrossRefGoogle Scholar