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High Protein Breakfast May Help Energy Balance In Overweight Teen Girls

High Protein Breakfast  May Help Energy Balance In Overweight Teen Girls 

Breakfast can alter appetite hormones and key brain regions

Written by Nalin Siriwardhana, Ph.D, Editor In Chief for Nutrition Remarks, Solon, OH, USA

Reviewed by Dr. Heather Leidy, PhD, Assistant Professor, Dept. of Nutrition & Exercise Physiology, University of Missouri, Columbia, MO. USA

Nutrition Remarks Health News Highlights (April  26, 2013) Print PDF of High Protein Breakfast May Help Energy Balance In Overweight Teen Girls

There are many reasons why many Americans skip breakfast. But the consequences can be detrimental, particularly for teens who are overweight/obese. Breakfast skipping might increase the desire to eat larger dinner meals, eat in-between meals, or even eat unhealthy snacks throughout the evening. Thus, the addition of breakfast might play a significant role in obesity treatment and/or prevention.

Obese youngsters are likely to be at high risk for heart diseases, diabetes and even some types of cancer.

An interesting study led by Prof. Leidy at the University of Missouri and published in American Journal of Nutrition, revealed the potential of  high protein breakfast meals in reducing unhealthy snacking in overweight/obese ‘breakfast skipping’ teens.


Brain regions which displayed reduced activation eight hours after the consumption of the high protein breakfast

Brain regions which displayed reduced activation eight hours after the consumption of the high protein breakfast

In the study,  20 late-adolescent overweight/obese ‘breakfast skipping’ girls ate, on separate weeks, normal protein ready-to-eat cereal-based breakfast meals or  high protein egg and lean beef-based breakfast meals or continued to skip breakfast  The study findings reveal that the high protein breakfast increases satiety, reduces food motivation and reward, and reduces unhealthy evening snacking (on high fat and high sugar foods) compared to skipping breakfast or eating a normal protein cereal breakfast.

Though the study is limited for 20 girls for only 7 days/pattern, the study focused both on physiologic and non-physiologic aspects and used detailed blood sample analysis and brain fMRI imaging. Compared to the normal protein breakfast, the high protein breakfast led to reduced dinner-time brain activation in the hippocampus and parahippocampus areas-which are brain regions controlling food reward/cravings. Authors anticipate that if the same eating pattern continues more than 7 days and for up to a longer period of time, there may be a significant reduction in daily energy intake leading to weight loss. This hypothesis is further supported by other previous studies that described breakfast skipping is associated with weight gain. A study published in 2010, in the International Journal of Obesity by Dr. Tasi’s group (Buddhist Tzu Chi General Hospital, Taipei Branch, Taipei, Taiwan), reported that breakfast plays a potential role in obesity prevention. Another recent study published in Public Health Nutrition journal by Dr. Manios’s group (Harokopio University of Athens, Greece), highlights that higher dairy consumption with a more adequate breakfast is one of the important initiatives to be considered for childhood obesity prevention.

Though further comprehensive studies are required to better describe exact mechanisms, this study from Dr. Leidy’s group and other related studies highlight the importance of breakfast with optimal protein for energy intake regulation and weight management specifically in overweight/obese youngsters.

This information is primarily based on the following article published by . Dr. Heather Leidy, PhD. Additional information abstracted from PubMed, CDC , USDA and other reliable sources.

Leidy et al. Beneficial effects of a higher-protein breakfast on the appetitive, hormonal, and neural signals controlling energy intake regulation in overweight/obese, “breakfast-skipping,” late-adolescent girls. American Journal of Nutrition.

Copyright © 2013 Nutrition Remarks. All rights reserved          



Neurosurgeons Began to Test Deep Brain Stimulation (DBS) against Obesity

Neurosurgeons Began to Test Deep Brain Stimulation (DBS) against Obesity

Deep Brain Stimulation (DBS): A Novel Brain Surgery for Refractory Obesity

Frontier Voice of Nutrition Remarks (February 05, 2012)

Nalin Siriwardhana, PhD, interviewed Dr. Nestor D. Tomycz, MD, from Department of Neurosurgery, University of Pittsburgh, Pittsburgh, PA, USA.

The first ever clinical study on Deep Brain Stimulation (DBS) for intractable obesity has begun at West Virginia University, USA. This study has been initiated by two expert neurosurgeons from Allegheny General Hospital Pittsburgh, PA: Dr. Donald M. Whiting MD and Dr. Michael Y. Oh.

DBS, which involves placing small wire-like electrodes in the brain to stimulate deep brain structures, has become a well-established therapy for patients suffering from Parkinson’s disease, essential tremor, and dystonia.

Obesity has become one of the greatest health issues in the world. Current popular obesity treatments such as dietary interventions, drugs, and gastric bypass surgery may sometimes fail or be less effective due to various reasons including the characteristic complexity of obesity and patient’s food habits. In the 1950’s, animal experiments first demonstrated that lesioning specific brain regions in the hypothalamus would lead to changes in the feeding behavior and body weight. The FDA approved three patients for a pilot study designed to study DBS for intractable obesity. Nutrition Remarks interviewed Dr. Nestor Tomycz, a neurosurgeon and a co-investigator on the study trained as a fellow under Drs. Whiting and Oh. A simplified version of the conversation is as follows:

Question from Nutrition Remarks: Can you describe DBS in general?

Answer from Dr. Tomycz: DBS is an electrical stimulation of a specific area of the brain. DBS involves surgically placing one or two electrodes into the brain. This electrode, via wires, is connected to a battery that is implanted under the skin (most of the time in the chest area like a pacemaker). The electrode transmits electrical signals/impulses to the target area of the brain and modulates these areas. There are thousands of different flavors of electrical impulses that can be sent by the electrode. By changing the impulse patterns, we can modify brain function and treat several disease conditions.

Question: What are the common applications of DBS?

Answer: The Food and Drug Administration (FDA) has currently approved DBS for three neurological diseases: Parkinson’s disease, essential tremor (involuntary shaking movement) and dystonia (involuntary muscle contractions).

Question: How effective is DBS?

Answer: With proper patient selection, DBS is generally very effective. However, programming DBS to optimize control of symptoms often takes multiple sessions post-surgery and additional programming changes are often necessary as the disease progresses. DBS is not a cure for any of the aforementioned diseases; however, it is an excellent way to control symptoms.

Question: How safe is DBS and what are the known after effects?

Answer: DBS is a minimally invasive surgery. It is usually performed while the patient is awake and involves drilling two small holes in the skull. The main risks of DBS surgery include infection, seizures, and brain hemorrhage. The risk of such complications, in experienced hands, is less than 5-10%.

Question: Why do you think that the DBS will be useful to treat obesity?

Answer: By directly targeting the brain, DBS may be able to reduce appetite and change metabolism. We know that overeating is a major cause of refractory obesity; however, metabolism (the way our bodies store and use energy), also plays a role in the maintenance and recurrence of obesity.

Question: How will DBS treat obesity?

Answer: DBS may work to treat obesity in two ways: (1) by reducing the craving for food and (2) by accelerating metabolism. By definition, total energy equals energy in minus energy out. Obesity results from a net positive energy balance and thus DBS may be able to help patients with obesity by not only reducing energy in (appetite), but also by increasing calories burned (metabolism).

Question: Can you explain your pilot study in brief?

Answer: With a multidisciplinary team and FDA and IRB approval, three patients with refractory obesity, despite gastric bypass, have been enrolled. DBS electrodes were placed bilaterally in the lateral hypothalamic nucleus or the “feeding center.” The patients have been followed for the past two years to examine for adverse events. Within a metabolic chamber, the patients underwent non-blinded stimulation studies to determine how DBS affected their metabolism. The formal results of this study will be published in 2012. However, thus far it appears that DBS of the lateral hypothalamus for obesity is safe and early metabolic and efficacy data are promising. A larger study is planned for future experiments.

This information is primarily based on the following article published by Dr. Nestor D. Tomycz, MD, in Neurosurgical Review journal. Some general background information was acquired from PubMed and NIH sources.

Original work; Tomycz et al., Deep brain stimulation for obesity-from theoretical foundations to designing the first human pilot study. Neurosurgical Review 2012 Jan;35(1):37-43. Epub 2011 Oct 15.

Dr. Nestor D. Tomycz, MD, is a graduate from Harvard College (2001) and Harvard Medical School (2005). He is completing his neurosurgical residency from the University of Pittsburgh in June of 2012 and will be joining the neurosurgical faculty at Allegheny General Hospital. His main academic focus is in functional neurosurgery which includes pain and movement disorders.

More about Dr. Tomycz and his work


Dr. Tomycz acknowledges Support for this research from West Virginia University and Medtronic Co.


Written by Nalin Siriwardhana, PhD. and Amanda Fields


Copyright © 2011 Nutrition Remarks. All rights reserved