Medical Department, UGTO, Guanajuato, Mexico.
LEGRAC, Guanajuato, Mexico.
Ann Nutr Metab. 2023;79(4):355-360. doi: 10.1159/000532125. Epub 2023 Aug 3.
Protein leverage (PL) is the phenomenon whereby a dominant appetite for protein drives overconsumption of energy with a decline in the ratio of protein to fat and carbohydrate in the diet. PL has been independently verified in several randomized control trials, and its predictions are supported by diet surveillance data. Our aim in the present study was to test whether surgical intervention through gastric bypass will ameliorate the PL effect.
Ten patients with gastric bypass (2-5 years postsurgical time) were given ad libitum access to study food comprising 10%, 15%, or 25% protein and no access to other foods for 3 days while controlling food palatability and variety. Food intake was measured, and energy and nutrient intakes were calculated. Body weight, blood chemistry, lipid profile, hormones (insulin, leptin, and ghrelin), and creatinine were determined before and after each experimental period.
The gastric bypass patients in our study did not show evidence for protein intake regulation as predicted under PL but ate to constant total energy intake on the 10%, 15%, and 25% protein diets with protein intake varying significantly. Patients lost weight in the three study periods, but significant weight loss was observed only on the 15% protein diet.
Our results suggest that gastric bypass might disengage the PL mechanism, thus ameliorating an appetite-specific mechanism that drives energy overconsumption in modern food environments.
蛋白质撬动（PL）是指一种主要的蛋白质食欲会导致能量摄入过多，同时饮食中的蛋白质与脂肪和碳水化合物的比例下降。PL 已在多项随机对照试验中得到独立验证，其预测结果也得到饮食监测数据的支持。本研究的目的是检验胃旁路手术干预是否能改善 PL 效应。
10 名接受胃旁路手术（术后 2-5 年）的患者在 3 天内随意摄入含有 10%、15%或 25%蛋白质的研究食物，同时控制食物的美味和多样性，禁止食用其他食物。测量食物摄入量，并计算能量和营养素摄入量。在每个实验期间前后测定体重、血液化学、血脂谱、激素（胰岛素、瘦素和胃饥饿素）和肌酐。
我们研究中的胃旁路患者没有表现出 PL 预测的蛋白质摄入调节的证据，而是在 10%、15%和 25%蛋白质饮食中以恒定的总能量摄入进食，蛋白质摄入有显著差异。患者在三个研究期间体重均减轻，但仅在 15%蛋白质饮食时体重减轻显著。
我们的结果表明，胃旁路手术可能会解除 PL 机制，从而改善在现代食物环境中驱动能量摄入过多的特定食欲机制。
