High Fiber Fat and Protein Contents Lead to Increased Satiety Reduced Sweet Cravings and Decreased Gastrointestinal Symptoms Independently of Anthropometric Hormonal and Metabolic Factors

Background. Satiety and sweet craving are strongly influenced by secretion of gastrointestinal hormones, which are dependent on dietary factors. An Okinawan-based Nordic breakfast with moderately low carbohydrate content and high fat and protein contents has shown increased postprandial satiety, along with improved endocrine and metabol profile. The primary aim of the study was to estimate the degree of satiety, sweet cravings, and gastrointestinal symptoms, during and after dietary intervention, and to correlate these subjective estimates with anthropometric, metabolic, and hormonal parameters and health-related quality of life (HRQoL). Secondary aim was to correlate the Visual Analogue Scale for Irritable Bowel Syndrome (VAS-IBS) against the HRQoL questionnaire RAND-36. Methods. Thirty type 2 diabetes patients were given the Okinawan-based Nordic diet during 12 weeks. Blood sampling, anthropometric measuring, and completion of questionnaires about satiety and sweet cravings, VAS-IBS, and RAND-36 were performed at baseline, after 12 weeks of dietary intervention, and after 16 weeks of follow-up. Results. The satiety was increased after dietary intervention, and sweet craving was decreased, without correlations with any parameters. These changes persisted throughout the study period (p = 0.002). At follow-up, satiety was inversely correlated with GIP (p = 0.041) and Social Functioning (p = 0.044). Sweet craving correlated with leptin levels (p = 0.037), weight (p = 0.048), BMI (p = 0.001), waist circumference (p = 0.006), vitality (p = 0.046), and less abdominal pain (p = 0.034). Psychological improvement was seen during the dietary intervention, and gastrointestinal symptom reduction afterwards, with correlations between the parameters. Conclusions. A diet with moderately low carbohydrate content and high fiber, fat, and protein contents renders an increased satiety and a reduced sweet cravings, independently of anthropometric, hormonal, metabolic or psychological factors. Improved psychological well-being and HRQoL preceeds the reports of decreased gastrointestinal symptoms