title: The effect of slow spaced eating on hunger and satiety in overweight and obese patients with type 2 diabetes mellitus.
abstract: BACKGROUND
  Slow spaced eating is associated with improved satiety and gut hormone responses in normal-weight participants. This crossover study compared the effect of slow and rapid eating patterns on hunger, fullness, glucose, insulin, and the appetite-related gut hormones peptide YY (PYY), glucagon-like peptide-1 (GLP-1), and ghrelin in overweight and obese participants with type 2 diabetes mellitus (T2DM).
  
  
  METHODS
  20 overweight and obese participants with T2DM on metformin were recruited. A test meal of 300 mL ice-cream was consumed in random order in two different sessions by each participant; meal duration was 5 or 30 min. Fullness and hunger as assessed by visual analog scales (VAS), and glucose, insulin, PYY, GLP-1, and ghrelin were measured at baseline and at 30 min intervals after meal termination for 3 h.
  
  
  RESULTS
  Fullness VAS ratings were significantly higher at the 90', 120', 150', and 180' time points and hunger ratings were lower at 90', 150', and 180' for the 30 min meal. The area under the curve (AUC) for fullness was higher after the 30 min meal than after the 5 min meal (11 943.7±541.2 vs 10 901.0±568.8 mm min, p=0.003) whereas the hunger AUC was lower (4442.9±328 vs 4966.7±347.5 mm min, p=0.012). There were no differences in glucose, insulin, PYY, GLP-1, and ghrelin responses.
  
  
  CONCLUSIONS
  Slow spaced eating increased fullness and decreased hunger ratings in overweight and obese participants with T2DM, without the improvement in gut hormone responses found in normal-weight participants. Slow spaced eating may be a useful prevention strategy, but might also help curb food intake in those already suffering from obesity and diabetes.
authors.affiliation: First Department of Propaedeutic Medicine , Athens University Medical School, Laiko General Hospital , Athens , Greece.
authors.forename: Theodoros
authors.initials: T
authors.lastname: Angelopoulos
authors.affiliation: First Department of Propaedeutic Medicine , Athens University Medical School, Laiko General Hospital , Athens , Greece.
authors.forename: Alexander
authors.initials: A
authors.lastname: Kokkinos
authors.affiliation: First Department of Propaedeutic Medicine , Athens University Medical School, Laiko General Hospital , Athens , Greece.
authors.forename: Christos
authors.initials: C
authors.lastname: Liaskos
authors.affiliation: First Department of Propaedeutic Medicine , Athens University Medical School, Laiko General Hospital , Athens , Greece.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Tentolouris
authors.affiliation: First Department of Propaedeutic Medicine , Athens University Medical School, Laiko General Hospital , Athens , Greece.
authors.forename: Kleopatra
authors.initials: K
authors.lastname: Alexiadou
authors.affiliation: Department of Metabolic Medicine , Hammersmith Hospital, Imperial College , London , UK.
authors.forename: Alexander Dimitri
authors.initials: AD
authors.lastname: Miras
authors.affiliation: Department of Pharmacology , Athens University Medical School , Athens , Greece.
authors.forename: Iordanis
authors.initials: I
authors.lastname: Mourouzis
authors.affiliation: Laboratory of Experimental Surgery and Surgical Research "N.S. Christeas" , Athens University Medical School , Athens , Greece.
authors.forename: Despoina
authors.initials: D
authors.lastname: Perrea
authors.affiliation: Department of Pharmacology , Athens University Medical School , Athens , Greece.
authors.forename: Constantinos
authors.initials: C
authors.lastname: Pantos
authors.affiliation: First Department of Propaedeutic Medicine , Athens University Medical School, Laiko General Hospital , Athens , Greece.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Katsilambros
authors.affiliation: Department of Metabolic Medicine , Hammersmith Hospital, Imperial College , London , UK.
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Bloom
authors.affiliation: Department of Metabolic Medicine , Hammersmith Hospital, Imperial College , London , UK.
authors.forename: Carel Wynard
authors.initials: CW
authors.lastname: le Roux
keywords: Eating Behavior(s); Gut Peptides; Satiety