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Cited by 109Regulation of Appetite and ObesityDietary Effects on HealthDiabetes Management and Research

Postprandial glycaemic dips predict appetite and energy intake in healthy individuals

Open access
Wyatt, Patrick, Berry, Sarah E., Finlayson, Graham, O’Driscoll, Ruairi, Hadjigeorgiou, George, Drew, David A., Khatib, Haya Al, Nguyen, Long H. +7 more·2021·Nature Metabolism
DOI 10.1038/s42255-021-00383-xPMC PMC7610681
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Abstract

Understanding how to modulate appetite in humans is key to developing successful weight loss interventions. Here, we showed that postprandial glucose dips 2-3 h after a meal are a better predictor of postprandial self-reported hunger and subsequent energy intake than peak glucose at 0-2 h and glucose incremental area under the blood glucose curve at 0-2 h. We explore the links among postprandial glucose, appetite and subsequent energy intake in 1,070 participants from a UK exploratory and US validation cohort, who consumed 8,624 standardized meals followed by 71,715 ad libitum meals, using continuous glucose monitors to record postprandial glycaemia. For participants eating each of the standardized meals, the average postprandial glucose dip at 2-3 h relative to baseline level predicted an increase in hunger at 2-3 h (r = 0.16, P < 0.001), shorter time until next meal (r = -0.14, P < 0.001), greater energy intake at 3-4 h (r = 0.19, P < 0.001) and greater energy intake at 24 h (r = 0.27, P < 0.001). Results were directionally consistent in the US validation cohort. These data provide a quantitative assessment of the relevance of postprandial glycaemia in appetite and energy intake modulation.

Integrity signals

Registry

Crossref · 10.1038/s42255-021-00383-x

Cites

33 of 33 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

2 of 3 cited sources checked · 0 supported · 0 flagged · accuracy not yet measured

  • Interpretationreasoning

    The analysis may partly explain why observational epidemiological studies have shown strong correlations between foods with high glycemic loads and weight gain, as consumption of such foods could lead to glucose dips and subsequent hunger.

    “Our analysis may partly explain why observational epidemiological ((27)(28)) studies have shown strong correlations between foods with high glycemic loads (such as potatoes and sugar sweetened beverages (29)) and weight gain – as consumption of such foods could lead to glucose dips and subsequent hunger.”
    Quote in the paperSubstantial claim2 of 3 sources checked
    • cites [27] Bao, J., Atkinson, F., Petocz, P., Willett, W. C. & Brand-Miller, J. C. Prediction of postprandial glycemia and insulinemia in lean, young, healthy adults: glycemic load compared with carbohydrate content alone. Am. J. Clin. Nutr. 93, 984–996 (2011). source
    • cites [28] Pek, J., Wong, O. & Wong, A. C. M. How to address non-normality: a taxonomy of approaches, reviewed, and illustrated. Front. Psychol. 9, 2104 (2018). source

      The paper’s Example 3: Income and Occupational Prestige examines statistical methods using occupational income data, not diet or weight gain. Searches for glucose dips and for glycemic load, weight gain, and epidemiological studies found no passage addressing the claimed association or proposed hunger mechanism. The cited paper therefore cannot verify this claim on the available text. (LLM, conf=0.77)

      Experimental — accuracy not yet measured
    • cites [29] Berry, S. et al. Personalised REsponses to DIetary Composition Trial (PREDICT): an intervention study to determine inter-individual differences in postprandial response to foods. Preprint at Protocol Exchange https://doi.org/10.21203/rs.2.20798/v1 (2020). source

      The Introduction (page unavailable) links postprandial glucose dysregulation with obesity, supporting a broad connection between glucose responses and weight. The Outcomes section describes measuring responses to test meals, but our copy does not report strong observational correlations between high-glycemic-load foods and weight gain or show that glucose dips lead to hunger. (LLM, conf=0.74)

      Experimental — accuracy not yet measured
  • Findingown data

    Postprandial glucose dips 2-3h after a meal are a better predictor of postprandial self-reported hunger and subsequent energy intake than peak glucose 0-2h and glucose iAUC 0-2h.

    “postprandial glucose dips 2-3h after a meal are a better predictor of postprandial self-reported hunger and subsequent energy intake than peak glucose 0-2h and glucose iAUC 0-2h”
    Quote in the paperSubstantial claim
  • Findingown data

    The effects of glucose dips on hunger and energy intake are consistent for the same individual consuming the same meal on two occasions.

    “We found these effects to be consistent for the same individual consuming the same meal on two occasions - the meals with larger Glucose Dips2-3h have larger subjectively declared hunger, and greater energy intake afterwards.”
    Quote in the paperSubstantial claim
  • Findingown data

    The associations between Glucose Dips2-3h and postprandial measures were strongest with the OGTT set meal.

    “The associations between the Glucose Dips2-3h and the postprandial measures were strongest with the OGTT set meal (which also preceded the largest dips).”
    Quote in the paperNot a substantial claim
  • Findingown data

    In the UK discovery cohort, the average postprandial glucose dip 2-3h relative to baseline predicts greater energy intake 3-4h (r=0.19, P<0.001).

    “greater energy intake 3-4h (r=0.19 P=<0.001)”
    • Also stated in: § Glucose Dips2-3hpredict subsequent hunger and calorie intake · plain
      “Energy intake3-4h (r=0.19 P=<0.001; US: r=0.24 P=0.032)”
    Quote in the paperSubstantial claim
  • May combine two claims. 14
  • The quote only partly states this claim. 1
  • Classified as probably not a substantial claim. 13

  • May combine two claims. The quote only partly states this claim.

    Findingown data

    In the US validation cohort, the associations between postprandial glucose dip 2-3h and postprandial measures were directionally consistent with the UK results, though not all were statistically significant.

    “Results aredirectionally consistent in the US validation cohort.”
    • Also stated in: § Discussion · plain
      “These results were directionally consistent with those in the US validation cohort, although not all results were significant in this smaller cohort.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Within-person, the association between Glucose Dip2-3h and change in Alertness2-3h was directional but not significant.

    “The association with change in Hunger2-3hr (r=0.04 P=0.232) and change in Alertness2-3hr (r=-0.06 P=0.076) was directional, but not significant.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Even when holding constant both the food and the individual, Glucose Dips2-3h were modestly but significantly correlated with time until next meal, Energy intake3-4h, and Energy intake24h.

    “Even when holding constant both the food and the individual, Glucose Dips2-3h were modestly but significantly correlated with time until next meal (r=-0.06 P=<0.001), Energy intake3-4h (r=0.08 P=<0.001), and Energy intake24h (r=0.06 P=<0.001).”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Glucose Dips2-3h were associated with lower fasting levels of Insulin and C-Peptide.

    “Glucose Dips2-3h were associated with lower fasting levels of Insulin and C-Peptide, as measured in clinic; Plasma Glucose (r=-0.05 P=0.186; US: r=-0.12 P=0.321), Insulin (r=-0.10 P=0.008; US: r=0.02 P=0.883), C-Peptide (r=-0.14 P=<0.001; US: r=-0.11 P=0.357).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Glucose dips2-3h were associated with Glucose Rise0-2h but not with Glucose iAUC0-2h.

    “Glucose dips2-3h were associated with the Glucose Rise0-2 h, but not with Glucose iAUC0-2 ; Glucose iAUC0-2h (r=0.05 P=0.166; US: r=-0.15 P=0.189), Glucose Rise0-2h (r=0.12 P=0.003; US: r=0.07 P=0.557)”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    The key postprandial glycemic measure linked to hunger and subsequent food intake is the Glucose Dip2-3h, not the Glucose Rise0-2h nor the glucose iAUC0-2h.

    “We report that the key postprandial glycemic measure linked to hunger and subsequent food intake is the Glucose Dip2-3h, not the Glucose Rise0-2h nor the glucose iAUC0-2h.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    The degree of association between glucose dips and appetite variables is relatively small and therefore contributes only partly to postprandial satiety.

    “It should be noted that the degree of association (correlation values) between glucose dips and appetite variables is relatively small, and therefore contributes only partly to postprandial satiety.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Within-person, the association between Glucose Dip2-3h and change in Hunger2-3h was directional but not significant.

    “The association with change in Hunger2-3hr (r=0.04 P=0.232) and change in Alertness2-3hr (r=-0.06 P=0.076) was directional, but not significant.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    Glucose Dips2-3h had modest and non-significant correlations with age, weight and BMI, except for sex, where males had slightly larger dips.

    “Glucose Dips2-3h had modest and non-significant correlations with individual characteristics, such as age, weight and BMI - except for sex, where males (P=0.005) had slightly larger dips.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    The study could not monitor whether participants compensated for short-term changes in energy intake over weeks or months.

    “Fourthly, whilst we were able to study energy intake immediately after a meal and total energy intake over 24 hours, we were not able to monitor if participants compensated for short term changes in energy intake over a period of weeks or months.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Adjustments to free-living meal calorie records did not affect the significance of the results.

    “These adjustments did not affect the significance of the results.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    For ad libitum meals, meal content is self-reported.

    “Secondly, for the ad libitum meals the meal content is self-reported.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Study design and conductnone given

    Only test meals that were completed according to instructions were included in analyses.

    “Only test meals that were completed according to instructions were included in analyses.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    The trial was registered at ClinicalTrials.gov (NCT03479866).

    “The trial is registered at ClinicalTrials.gov (registration number: NCT03479866)”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    The study population had limited ethnic diversity (97% white).

    “In addition, there was limited ethnic diversity in our study population (97% white).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductreasoning

    The study did not measure appetite hormones, insulin sensitivity directly, or insulin dynamics for at-home meals.

    “Firstly, given the scale, it was not practical to measure appetite hormones for any of the participants nor measure insulin sensitivity directly with a euglycemic clamp, nor to record insulin dynamics for the at home meals.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationown data

    Both individual characteristics and dietary factors are likely important causes of Glucose Dips.

    “We have not fully explored all the possible causes of Glucose Dips in this study; but the findings suggest that both individual characteristics and dietary factors are likely important.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Study design and conductnone given

    Linear regressions were adjusted for age, sex, BMI and weight.

    “Linear regressions were adjusted for age, sex, BMI and weight.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Study design and conductown data

    Using an average baseline improved the repeatability of glycemic responses and strengthened associations between Glucose Dip2-3h and postprandial measures.

    “By taking a more stable baseline, we were able to improve the repeatability of the glycemic responses that were studied, and observe stronger associations between the Glucose Dip2-3h and the postprandial measures.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductnone given

    The study relied on self-reported compliance with fasting protocols, and 109 meals were excluded from participants who ate before the end of the specified fasting period.

    “Thirdly, we relied on the self-reported compliance of the participants with the fasting protocols - 109 meals were excluded from participants that ate before the end of the specified fasting period.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: Participants complied with the fasting protocols.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductreasoning

    The study had 80% power to detect a correlation effect size of r=0.124 for between-individual analyses and r=0.061 for within-person duplicate meal analyses at alpha 0.01.

    “The necessary correlation effect size needed to achieve 80% power with p<0.01 for this sample size is r= 0.124. For the correlations for (ii) to achieve 80% power at the same alpha level the Pearson’s coefficient needs to be r=0.061 or higher.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    The models did not include some potential confounders, including sleep and physical activity.

    “In addition, we have not included some potential confounders in the models, including sleep and physical activity.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductown data

    The choice of average baseline does not affect the direction or significance of the main results.

    “This choice of baseline does not affect the direction or significance of the main results of this study.”
    Quote in the paperNot a substantial claim
23 of 23

  • The paper relies on this without support.

    The role of glucose in appetite expression is not resolved and has not been investigated in free-living conditions.

    “To date, the role of glucose in appetite expression is not resolved and has not been investigated in free-living conditions.”

  • The paper relies on this without support.

    The study population is representative of the general population.

    “healthy individuals representative of the general population”

  • The paper relies on this without support.

    Participants complied with the fasting protocols.

    “we relied on the self-reported compliance of the participants with the fasting protocols”
3 of 3

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Second meal behavior (hunger, timing, and energy intake) is significantly associated with 2-3 h glucose dip, whereby greater dips in blood glucose predicts higher hunger, shorter time until next meal, and greater energy intake in the next meal.

    “Second meal behavior (hunger, timing, and energy intake) is significantly associated with 2-3 h glucose dip (19), whereby greater dips in blood glucose predicts higher hunger, shorter time until next meal, and greater energy intake in the next meal.”

    From Prebiotic soda lowers postprandial glucose compared to traditional soda pop: a randomized controlled trial (2025) · cites this paper as [19]

    Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.

    Experimental — accuracy not yet measured

  • Spontaneous transient declines in blood glucose predict hunger, meal initiation or requests, and energy intake.

    “Furthermore, spontaneous transient declines in blood glucose predict hunger, meal initiation or requests, and energy intake (82–84).”

    From The carbohydrate-insulin model: A physiological perspective on the obesity pandemic (2021) · cites this paper as [84]

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Related

Authors
Wyatt, P., Berry, S. E., Finlayson, G., O’Driscoll, R., Hadjigeorgiou, G., Drew, D. A., Khatib, H. A., Nguyen, L. H., Linenberg, I., Chan, A. T., Spector, T. D., Franks, P. W., Wolf, J., Blundell, J., & Valdes, A. M.
Affiliations
  • ZOE (United Kingdom) (GB)
  • King's College London (GB)
  • University of Leeds (GB)
  • Harvard University (US)
  • Lund University (SE)
  • University of Nottingham (GB)
Corresponding author
Valdes, Ana M.
ORCID
Venue
Nature Metabolism
Publisher
Springer Science and Business Media LLC
Published
2021-04-12
Volume
3
Issue
4
Pages
523-529
ISSN
2522-5812 (ISSN-L)
DOI
10.1038/s42255-021-00383-x
PMC
PMC7610681
OpenAlex
W3154586049
Cited by
109
References
34
Citations by year
2026: 21 · 2025: 18 · 2024: 19 · 2023: 23 · 2022: 14 · 2021: 11
FWCI
6.49
Type
journal article
Language
en
Update notices
correction (2021-07-13)
Open access
Licence
Locations
  • Nature Metabolism (publishedVersion)
  • PubMed (publishedVersion)
  • White Rose Research Online (University of Leeds, The University of Sheffield, University of York) (acceptedVersion)
  • PubMed Central (submittedVersion)
  • Research Portal (King's College London) (submittedVersion)
  • Lund University Publications (Lund University) (submittedVersion)
  • Repository@Nottingham (University of Nottingham) (submittedVersion, cc-by)
Funders
  • Zoe Global Ltd
  • Wellcome Trust
  • DH | National Institute for Health Research (GSTT BRC, Nottingham BRC)
Topics
  • Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Regulation of Appetite and Obesity
  • Health Sciences › Medicine › Physiology › Dietary Effects on Health
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
Keywords
postprandial blood glucose, appetite, hunger, energy intake, continuous glucose monitoring, ad libitum meal, weight loss interventions
MeSH terms
Adult, Appetite, Blood Glucose, Energy Intake, Diet, Female, Humans

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