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Alpana Shukla Part 4, Does Food Order Work For Weight Management?

In part 4 of this Exclusive Interview, Alpana Shukla talks with Diabetes in Control Medical Editor Joy Pape about the effects of food order on satiety and weight management.

Alpana Shukla, MD, MRCP (UK) is Assistant Professor of Research in the Division of Endocrinology, Diabetes & Metabolism at Weill Cornell Medical College in New York.


Transcript of this video segment:

Pape: Does this intervention have any implications for satiety or weight management?

Shukla: So, that’s a very good question, Joy. And as you know at our center, weight management is at the very heart of what we do. And we’re constantly looking for innovative ways to change behavior or make it easier for patients to actually manage energy intake. And I think that in that range, the result of the study are very interesting because in addition to what I’ve already shown, the glucose and insulin responses, we also measured GLP-1 and we also measured ghrelin. And what we found was that when the carbohydrate is eaten at the end of the meal, you stimulate a greater GLP-1 response. And a very interesting finding was that the ghrelin levels remain suppressed for much longer when the carbohydrates is consumed last. When patients consume the carbohydrate first, ghrelin levels were suppressed as you would expect. But by the end of three hours, it had rebounded back to preprandial levels. So, we think taken together with the glucose, the lower insulin response, the increased GLP response and creating a suppression of ghrelin. I think all of these findings suggest that this intervention would have implications with satiety and possibly for weight management. We are certainly planning to investigate this further and we do use this as part of our clinical practice. And I think we believe it works, but we want to show the evidence that it does. In fact, in a randomized control design.  

Pape: Yeah. I’m thinking about my patients who come in before they learn this technique —

Shukla: Yes.

Pape: –and they’re telling us they’re hungry all the time or they’re hungry in two or three hours. And we work with them on this, which really isn’t that difficult.  

Shukla: Yes.  

Pape: And I’m not hearing as much that, “I’m hungry all the time,” or, “I’m hungry right away,” so it makes sense from what you’re saying.

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