The Effects of Increased Protein Intake on Fullness: A Meta-Analysis and Its Limitations

Published:March 03, 2016DOI:https://doi.org/10.1016/j.jand.2016.01.003

      Abstract

      Background

      Higher protein intake has been implicated in weight management because of its appetitive properties. However, the effects of protein intake on appetitive sensations such as fullness have not been systematically assessed. Meta-analysis is a useful technique to evaluate evidence of an intervention’s effect on testable outcomes, but it also has important limitations.

      Objective

      The primary aim of this study was to synthesize the available evidence on the effect of protein intake on fullness using a quantitative meta-analysis and a secondary directional analysis using the vote-counting procedure. A tertiary aim was to address limitations of meta-analyses as they pertain to findings from this meta-analysis.

      Design

      We searched multiple databases for interventional studies that evaluated the effect of increased protein intake on fullness ratings. Inclusion criteria for both analyses were as follows: healthy human participants, preload studies that utilized intact dietary protein, delivery of protein load orally, and studies reporting fullness as an outcome. For the meta-analysis, an additional criterion was that the studies also needed to report 2- to 4-hour area under the curve value for fullness.

      Results

      Five studies met all criteria for the meta-analysis. Twenty-eight studies met all criteria for the directional analysis. The meta-analysis indicated higher protein preloads have a greater effect on fullness than lower protein preloads (overall effect estimate: 2,435.74 mm.240 min, (95% CI 1,375.18 to 3,496.31 mm.240 min; P<0.0001). The directional analysis also revealed a positive effect on fullness with higher protein preloads (P<0.01). Many related scientifically rigorous studies were excluded from the analysis because analytical criteria required a narrowly focused research question.

      Conclusions

      The present analyses show that higher protein preloads increase fullness ratings more than lower protein preloads under tightly defined conditions. Extrapolation of findings to common conditions outside the specified criteria of this analysis must be made cautiously, as must speculation about the influence of fullness sensations on ingestive behavior, body weight, and various health outcomes.

      Keywords

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      Biography

      J. Dhillon is a PhD candidate, Department of Nutrition Science, Ingestive Behavior Research Center, Purdue University, West Lafayette, IN.

      Biography

      A. Jacobs is a PhD candidate, Department of Nutrition Science, Ingestive Behavior Research Center, Purdue University, West Lafayette, IN.

      Biography

      B. A Craig is a professor, Department of Statistics, Purdue University, West Lafayette, IN.

      Biography

      A. F. Amankwaah is a PhD candidate, Department of Nutrition Science, Purdue University, West Lafayette, IN.

      Biography

      R. L. Rivera is a graduate research assistant, Department of Nutrition Science, Purdue University, West Lafayette, IN.

      Biography

      B. L. Jones is an assistant professor, Department of Human Development and Family Studies, Center on Poverty and Health Inequities, Ingestive Behavior Research Center, Purdue University Public Health Program, Regenstrief Center for Healthcare and Engineering, Purdue University, West Lafayette, IN.

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      C. E. M. Keller is a PhD candidate, Center on Aging and the Life Course, Fisheries and Aquatic Science, Ingestive Behavior Research Center, Interdepartmental Nutrition Program, Purdue University Public Health Program, Regenstrief Center for Healthcare and Engineering, Purdue University, West Lafayette, IN.

      Biography

      J. B. Jones is a PhD graduate, Department of Food Science, Purdue University, West Lafayette, IN.

      Biography

      C. L. Keeler is an MS graduate, Department of Food Science, Purdue University, West Lafayette, IN.

      Biography

      R. D. Mattes is a distinguished professor, Department of Nutrition Science, director of public health, and director of the Ingestive Behavior Research Center, Purdue University, West Lafayette, IN.

      Biography

      H. J. Leidy is an assistant professor, Department of Nutrition & Exercise Physiology, School of Medicine, University of Missouri, Columbia.

      Biography

      K. Osei-Boadi Anguah is an assistant professor of nutrition and dietetics, and Adelaide Murdock Hunt Endowed Professorship, School of Human Ecology, Louisiana Tech University, Ruston.

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      M. A. McCrory is an associate professor, Department of Nutrition, Byrdine F. Lewis School of Nursing and Health Professions, Georgia State University, Atlanta.

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      M. Slebodnik is an associate librarian, University of Arizona Libraries, Tucson.

      Biography

      R. M. Tucker is an assistant professor, Department of Public and Allied Health, Bowling Green State University, Bowling Green, OH.