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Cited by 140Regulation of Appetite and ObesityFood composition and propertiesNutritional Studies and Diet

Effects of dietary glycemic index on brain regions related to reward and craving in men

Open access
Lennerz, Belinda S, Alsop, David C, Holsen, Laura M, Stern, Emily, Rojas, Rafael, Ebbeling, Cara B, Goldstein, Jill M, Ludwig, David S·2013·The American Journal of Clinical Nutrition
DOI 10.3945/ajcn.113.064113PMC PMC3743729
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Abstract

Background Qualitative aspects of diet influence eating behavior, but the physiologic mechanisms for these calorie-independent effects remain speculative.Objective We examined effects of the glycemic index (GI) on brain activity in the late postprandial period after a typical intermeal interval.Design With the use of a randomized, blinded, crossover design, 12 overweight or obese men aged 18-35 y consumed high- and low-GI meals controlled for calories, macronutrients, and palatability on 2 occasions. The primary outcome was cerebral blood flow as a measure of resting brain activity, which was assessed by using arterial spin-labeling functional magnetic resonance imaging 4 h after test meals. We hypothesized that brain activity would be greater after the high-GI meal in prespecified regions involved in eating behavior, reward, and craving.Results Incremental venous plasma glucose (2-h area under the curve) was 2.4-fold greater after the high- than the low-GI meal (P = 0.0001). Plasma glucose was lower (mean ± SE: 4.7 ± 0.14 compared with 5.3 ± 0.16 mmol/L; P = 0.005) and reported hunger was greater (P = 0.04) 4 h after the high- than the low-GI meal. At this time, the high-GI meal elicited greater brain activity centered in the right nucleus accumbens (a prespecified area; P = 0.0006 with adjustment for multiple comparisons) that spread to other areas of the right striatum and to the olfactory area.Conclusions Compared with an isocaloric low-GI meal, a high-GI meal decreased plasma glucose, increased hunger, and selectively stimulated brain regions associated with reward and craving in the late postprandial period, which is a time with special significance to eating behavior at the next meal. This trial was registered at clinicaltrials.gov as NCT01064778.

AI snapshot

Written from the paper’s full text.

TL;DR

In a randomized, blinded crossover trial in overweight or obese men, a high-glycemic-index meal compared with an isocaloric low-glycemic-index meal produced lower late postprandial plasma glucose, greater hunger, and greater resting activity in the right nucleus accumbens/striatum 4 h later. These findings suggest high-GI meals may stimulate brain reward and craving circuitry during the late postprandial period.

Key findings

  • The 2-h incremental plasma glucose AUC was 2.4-fold greater after the high-GI than low-GI meal (2.9 ± 0.36 vs. 1.2 ± 0.27 mmol·h/L; P = 0.0001), and the 2-h insulin AUC was also greater (127.1 ± 18.1 vs. 72.8 ± 9.78 mU·h/mL; P = 0.003).
  • At 4 h, plasma glucose was lower after the high-GI meal (4.7 ± 0.14 vs. 5.3 ± 0.16 mmol/L; P = 0.005), and hunger was greater (P = 0.04); the 5-h hunger AUC was also greater after the high-GI meal (P = 0.04).
  • Cerebral blood flow was greater 4 h after the high-GI meal in the right nucleus accumbens (mean difference: 4.4 ± 0.56 mL·100 g⁻¹·min⁻¹; range: 2.1–7.3; 8.2% relative difference), remaining significant after Bonferroni correction for 25 prespecified regions (P = 0.0006) and after correction for all 334 nonredundant brain regions (P = 0.009); activity spread to other right striatal areas and the olfactory area.
  • No differences were observed in the contralateral striatum or other prespecified regions of interest; meal palatability did not differ (5.5 ± 0.67 vs. 5.3 ± 0.65 cm; P = 0.7).

Methods

  • Randomized, blinded, crossover study in 12 overweight or obese men aged 18–35 y (BMI ≥25) who consumed high- and low-GI liquid test meals on 2 occasions separated by 2–8 wk; meals were controlled for calories (25% of estimated daily energy requirements), macronutrients, ingredient sources, and palatability, with predicted GI values of 84% and 37%.
  • The primary outcome was resting cerebral blood flow measured by arterial spin-labeling fMRI 4 h after test meals; secondary outcomes included plasma glucose, serum insulin, and hunger over the 5-h postprandial period.
  • Analyses used prespecified brain regions of interest, paired 2-tailed t tests adjusted for order effect with Bonferroni correction for 25 regions, and voxel-wise general linear model analysis at P ≤ 0.002; imaging data were usable for 11 participants because of a data-storage error.

Limitations

  • The paper states the main limitations: small sample size and exclusive focus on overweight and obese men, with no lean controls, women, or pre- and post-weight-loss participants; hedonic responses and food cravings were not directly assessed; and liquid test meals limit generalizability to solid meals.
  • The paper states that venous rather than arterialized blood sampling could have caused error in measuring arterial blood glucose concentrations above and below fasting, especially for the high-GI meal.
  • The paper notes an unanticipated right-hemisphere-only effect and that lack of differences in other prespecified regions could reflect insufficient power or true absence of effects at 4 h; it also states that the small size increases risk of a false-negative but not false-positive finding.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.3945/ajcn.113.064113

Cites

53 of 53 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 40 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    Incremental 2-h area under the curve for plasma glucose was 2.4-fold greater after the high-GI meal than after the low-GI meal.

    “Incremental venous plasma glucose (2-h area under the curve) was 2.4-fold greater after the high-than the low-GI meal (P = 0.0001).”
    • Also stated in: § Subjective and biochemical responses to test meals · plain
      “Consistent with the predicted GI (Table 1), the incremental 2-h AUC for glucose was 2.4-fold greater after the high-than low-GI test meal (2.9 6 0.36 compared with 1.2 6 0.27 mmol $ h/L, respectively; P = 0.0001) (Figure 2).”
    Quote in the paperSubstantial claim
  • Findingown data

    The high-GI meal-related brain activity spread from the right nucleus accumbens to other areas of the right striatum and to the olfactory area.

    “At this time, the high-GI meal elicited greater brain activity centered in the right nucleus accumbens (a prespecified area; P = 0.0006 with adjustment for multiple comparisons) that spread to other areas of the right striatum and to the olfactory area.”
    • Also stated in: § Brain imaging · plain
      “An image-based analysis showed a single region in the right nucleus accumbens at Montreal Neurologic Institute/International Consortium for Brain Mapping coordinates 8, 8, 210 (peak t = 9.34) and another local maximum at coordinates 12, 12, 2 (t = 5.16), which spread to other areas of the right striatum (caudate, putamen, and globus pallidus) and olfactory area (Figure 3).”
    Quote in the paperSubstantial claim
  • Findingown data

    Cerebral blood flow was greater 4 h after the high-GI meal than after the low-GI meal in the right nucleus accumbens.

    “At this time, the high-GI meal elicited greater brain activity centered in the right nucleus accumbens (a prespecified area; P = 0.0006 with adjustment for multiple comparisons) that spread to other areas of the right striatum and to the olfactory area.”
    • Also stated in: § Brain imaging · plain
      “Cerebral blood flow was greater 4 h after the high-than low-GI meal in the right nucleus accumbens (mean difference: 4.4 6 0.56 mL $ 100 g 21 $ min 21 ; range: 2.1-7.3 mL $ 100 g 21 $ min 21 ; an 8.2% relative difference).”
    Quote in the paperSubstantial claim
  • Findingown data

    No differences in cerebral blood flow were observed in the contralateral striatum or other prespecified regions of interest.

    “We did not observe differences in the contralateral striatum or other prespecified regions of interest.”
    Quote in the paperNot a substantial claim
  • Findingown data

    Plasma glucose concentration was lower 4 h after the high-GI meal than after the low-GI meal.

    “Plasma glucose was lower (mean 6 SE: 4.7 6 0.14 compared with 5.3 6 0.16 mmol/L; P = 0.005) and reported hunger was greater (P = 0.04) 4 h after the high-than the low-GI meal.”
    • Also stated in: § Subjective and biochemical responses to test meals · plain
      “At 4 h into the postprandial period, the blood glucose concentration was lower (4.7 6 0.14 compared with 5.3 6 0.16 mmol/L, P = 0.005), and the change in hunger from baseline was greater (1.65 6 0.79 compared with 20.01 cm 6 0.92; P = 0.04) after the high-than low-GI test meal, respectively.”
    Quote in the paperSubstantial claim
  • May combine two claims. 23
  • Classified as probably not a substantial claim. 24

  • May combine two claims.

    Findingown data

    The right nucleus accumbens blood flow difference remained significant after Bonferroni correction for the 25 prespecified regions and after correction for all 334 nonredundant brain regions.

    “This difference remained significant after Bonferroni correction for the 25 prespecified anatomic regions of interest (P = 0.0006) and after correction for all 334 nonredundant brain regions (P = 0.009).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    All variables related to plasma glucose, serum insulin, and hunger were significantly related to blood flow in the right nucleus accumbens, whereas palatability was not.

    “All variables related to plasma glucose, serum insulin, and hunger were significantly related to blood flow in the right nucleus accumbens, whereas the palatability of meals was not.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Differences between high- and low-GI meals were significant at 4 h for plasma glucose, serum insulin, and hunger.

    “Differences between high-and low-GI meals were significant at 4 h (the time point of interest) for all 3 outcomes by using paired t tests.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    The increased brain activity was coincident with lower blood glucose and greater hunger.

    “which was coincident with lower blood glucose and greater hunger.”
    Quote in the paperSubstantial claim

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

    Study design and conductcitation

    The use of venous blood could have caused an error in the measurement of arterial blood glucose concentrations above and below fasting concentrations, especially for the high-GI meal, which was a study limitation.

    “The use of venous blood could have caused an error in the measurement of arterial blood glucose concentrations above and below fasting concentrations, especially for the high-GI meal, which comprised a study limitation (22).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [22] Brouns, 2005, Glycaemic index methodology, Nutr Res Rev source

      Not checked in the free run.

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

    Study design and conductown data

    Adjustment for the order effect did not materially affect the outcomes.

    “Adjustment for the order effect did not materially affect these outcomes.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    A decrease in blood glucose, often falling below fasting concentrations by 4 h after a high-GI meal, may lead to excessive hunger, overeating, and a preference for foods that rapidly restore blood glucose to normal, propagating cycles of overeating.

    “The decrease in blood glucose, which often falls below fasting concentrations by 4 h after a high-GI meal, may lead to excessive hunger, overeating, and a preference for foods that rapidly restore blood glucose to normal (ie, high GI) (15)(16)(17), propagating cycles of overeating.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites (15)(16)(17)

      Not checked in the free run.

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

    Premisecitation

    The nucleus accumbens is crucially involved in substance abuse and dependence.

    “Beyond reward and craving, the nucleus accumbens is crucially involved in substance abuse and dependence (36-38)”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [36] Di Chiara, 1999, Drug addiction as a disorder of associative learning. Role of nucleus accumbens shell/extended amygdala dopamine, Ann N Y Acad Sci source

      Not checked in the free run.

    • cites [37] Feltenstein, 2008, The neurocircuitry of addiction: an overview, Br J Pharmacol source

      Not checked in the free run.

    • cites [38] Kalivas, 2005, The neural basis of addiction: a pathology of motivation and choice, Am J Psychiatry source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Study design and conductcitation

    Women were not included in this initial study to avoid confounding that might have arisen from the menstrual cycle.

    “Women were not included in this initial study to avoid the confounding that might have arisen from the menstrual cycle (19).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [19] Frank, 2010, Effect of menstrual cycle phase on corticolimbic brain activation by visual food cues, Brain Res source

      Not checked in the free run.

  • Classified as probably not a substantial claim. May combine two claims.

    Study design and conductown data

    Brain regions of interest were prespecified and analyses corrected for multiple comparisons.

    “Statistical treatments included the prespecification of brain regions of interest and correction for multiple comparisons.”
    • Also stated in: § Statistical analyses · plain
      “Of a total 334 nonredundant anatomic regions throughout the brain, prespecified areas of interest encompassed 25 separate regions (see Supplemental Table 1 under “Supplemental data” in the online issue).”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Premisecitation

    The glycemic index describes how carbohydrate-containing foods affect blood glucose in the postprandial state.

    “The GI describes how carbohydrate-containing foods affect blood glucose in the postprandial state (12,13).”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [12] Atkinson, 2008, International tables of glycemic index and glycemic load values: 2008, Diabetes Care source

      Not checked in the free run.

    • cites [13] Ludwig, 2002, The glycemic index: physiological mechanisms relating to obesity, diabetes, and cardiovascular disease, JAMA source

      Not checked in the free run.

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

    Premisecitation

    Chemical manipulation of the nucleus accumbens in rats resulted in stimulation of orexigenic neurons and inhibition of anorexigenic neurons in the hypothalamus.

    “the chemical manipulation of the nucleus accumbens in rats resulted in the stimulation of orexigenic neurons and inhibition of anorexigenic neurons in the hypothalamus (35)”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [35] Zheng, 2003, Peptides that regulate food intake: appetite-inducing accumbens manipulation activates hypothalamic orexin neurons and inhibits POMC neurons, Am J Physiol Regul Integr Comp Physiol source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    The mesolimbic dopaminergic system converges on the nucleus accumbens and plays a central role in reward and craving, and this system appears to mediate hedonic food responses.

    “The mesolimbic dopaminergic system of the brain, which converges on the nucleus accumbens (part of the striatum), plays a central role in reward and craving, and this system appears to mediate hedonic food responses (1)(2)(3).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites (1)(2)(3)

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S4 (based).

    Study design and conductnone given

    The study, despite its size, had robust power to test the a priori hypothesis with adjustment for multiple comparisons.

    “Our study, despite its size, had robust power to test the a priori hypothesis with adjustment for multiple comparisons.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductown data

    The study had a small size and an exclusive focus on overweight and obese men.

    “Main study limitations included the small size and an exclusive focus on overweight and obese men.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: Small studies limit generalizability and increase risk of a false-negative (but not false-positive) finding.

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

    Study design and conductown data

    Imaging data for one participant were incomplete because of a data-storage error; the other participants completed the protocol uneventfully.

    “Imaging data for one participant were incomplete because of a data-storage error; the other participants completed the protocol uneventfully.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductnone given

    The study used ASL, a novel imaging technique that provides a quantitative measure of cerebral blood flow.

    “we used ASL, which is a novel imaging technique that provides a quantitative measure of cerebral blood flow.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Premisenone given

    Conventional BOLD fMRI assesses acute changes in brain activity, not absolute differences, which typically limits observations to a few minutes after a physiologic perturbation.

    “The conventional method (blood oxygenation level-dependent fMRI) assesses acute changes in brain activity, not absolute differences, which typically limits observations to a few minutes after a physiologic perturbation.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationcitation

    The combination of these physiologic events may foster food cravings with a special preference for high-GI carbohydrates, thereby propagating cycles of overeating.

    “This combination of physiologic events may foster food cravings with a special preference for high-GI carbohydrates (16, 17), thereby propagating cycles of overeating.”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [16] Thompson, 1977, Hunger in humans induced by 2-deoxy-D-glucose: glucoprivic control of taste preference and food intake, Science source

      Not checked in the free run.

    • cites [17] Strachan, 2004, Food cravings during acute hypoglycaemia in adults with Type 1 diabetes, Physiol Behav source

      Not checked in the free run.

  • May combine two claims.

    Study design and conductreasoning

    The study used a crossover intervention rather than a cross-sectional comparison between groups, which provided increased statistical power and evidence for causal direction.

    “Second, we used a crossover intervention rather than a cross-sectional comparison between groups (eg, lean compared with obese), which provided increased statistical power and evidence for causal direction.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Study design and conductreasoning

    The two test meals were designed and documented to have similar palatability, which helped disentangle metabolic effects from immediate hedonic responses.

    “Fourth, the 2 test meals were designed and documented to have a similar palatability, which helped to disentangle metabolic effects from immediate hedonic responses.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Study design and conductnone given

    All participants and research staff involved in data collection were masked to the intervention sequence.

    “All participants and research staff involved in data collection were masked to the intervention sequence.”
    Quote in the paperSubstantial claim

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

    Premisecitation

    Recent studies using BOLD fMRI have shown selective overactivity in the nucleus accumbens and related brain areas in subjects who scored high on a measure of food addiction.

    “and in subjects who scored high on a measure of food addiction (39).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [39] Gearhardt, 2011, Neural correlates of food addiction, Arch Gen Psychiatry source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

    Premisecitation

    The validity of the concept of food addiction remains vigorously debated.

    “Nevertheless, the validity of the concept of food addiction remains vigorously debated (41)(42)(43)(44)(45)(46)(47).”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [41] Benton, 2010, The plausibility of sugar addiction and its role in obesity and eating disorders, Clin Nutr source

      Not checked in the free run.

    • cites [42] Blumenthal, 2010, Neurobiology of food addiction, Curr Opin Clin Nutr Metab Care source

      Not checked in the free run.

    • cites [43] Corwin, 2009, Symposium overview–food addiction: fact or fiction?, J Nutr source

      Not checked in the free run.

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

    Study design and conductnone given

    The trial was registered at clinicaltrials.gov as NCT01064778.

    “This trial was registered at clinicaltrials.govas NCT01064778.”
    • Also stated in: § SUBJECTS AND METHODS · plain
      “The trial was registered at clinicaltrials.gov as NCT01064778, and participants provided written informed consent.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductown data

    The study did not assess hedonic responses to the meals or food cravings directly, and therefore could not explore the relation between these subjective values and brain activation.

    “We did not assess hedonic responses to the meals or food cravings directly, and therefore, we could not explore the relation between these subjective values and brain activation.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Premisecitation

    The blood glucose nadir after a high-GI meal is expected at 4 h.

    “Neuroimaging was performed at 4 h after the test meal, when the blood glucose nadir after the high-GI meal was expected (14), by using a GE 3Tesla whole-body scanner (GE Healthcare).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [14] Ludwig, 1999, High glycemic index foods, overeating, and obesity, Pediatrics source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Recurrent activation of the striatum may downregulate dopamine receptor availability and further heighten the drive to overeat.

    “In addition, the recurrent activation of the striatum may downregulate dopamine receptor availability and further heighten the drive to overeat (11).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [11] Wang, 2001, Brain dopamine and obesity, Lancet source

      Not checked in the free run.

  • Classified as probably not a substantial claim. May combine two claims.

    Study design and conductnone given

    The study used mixed meals with a macronutrient composition and dietary glycemic load within prevailing ranges.

    “Sixth, we used mixed meals with a macronutrient composition and dietary glycemic load within prevailing ranges.”
    Quote in the paperSubstantial claim

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

    Premisecitation

    A study comparing insulin-sensitive with insulin-resistant men showed a differential effect of systemic insulin administration on glucose metabolism for the right, but not left, ventral striatum.

    “a study that compared insulin-sensitive compared with insulinresistant men showed a differential effect of systemic insulin administration on glucose metabolism for the right, but not left, ventral striatum (34).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [34] Anthony, 2006, Attenuation of insulin-evoked responses in brain networks controlling appetite and reward in insulin resistance: the cerebral basis for impaired control of food intake in metabolic syndrome?, Diabetes source

      Not checked in the free run.

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

    Premisecitation

    Microinjections of opiate into the nucleus accumbens increased food intake and the reward value of food.

    “Furthermore, microinjections of opiate into the nucleus accumbens increased food intake and the reward value of food (5).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [5] Peciña, 2000, Opioid site in nucleus accumbens shell mediates eating and hedonic ’liking’ for food: map based on microinjection Fos plumes, Brain Res source

      Not checked in the free run.

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

    Study design and conductown data

    The study was designed to provide 80% power with a 5% type I error rate to detect a difference in cerebral blood flow of 11.8%, assuming 12 participants, residual SD of 11%, and intrasubject correlation of 0.6.

    “The study was designed to provide 80% power by using a 5% type I error rate to detect a difference in cerebral blood flow of 11.8%, assuming a sample size of 12 participants, residual SD of 11% for a single measurement, and intrasubject correlation of 0.6.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductown data

    Both test meals were composed of similar ingredients and had the same macronutrient distribution.

    “As shown in Table 1, both test meals were composed of similar ingredients and had the same macronutrient distribution (ProNutra Software, version 3.3.0.10;Viocare Technologies Inc).”
    Quote in the paperSubstantial claim

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

    Premisecitation

    Recent studies using BOLD fMRI have shown selective overactivity in the nucleus accumbens and related brain areas in obese compared with lean individuals when shown images of highly palatable food.

    “Recent studies that used the conventional blood oxygenation level-dependent fMRI have shown selective overactivity in the nucleus accumbens and related brain areas in obese compared with lean individuals when shown imagines of highly palatable food (6)(7)(8)(9)(10)(11)”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [6] Bruce, 2010, Obese children show hyperactivation to food pictures in brain networks linked to motivation, reward and cognitive control, Int J Obes (Lond) source

      Not checked in the free run.

    • cites [7] Holsen, 2012, Importance of reward and prefrontal circuitry in hunger and satiety: Prader-Willi syndrome vs simple obesity, Int J Obes (Lond) source

      Not checked in the free run.

    • cites [8] Rothemund, 2007, Differential activation of the dorsal striatum by high-calorie visual food stimuli in obese individuals, Neuroimage source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Study design and conductown data

    Enrolled participants were randomly assigned to the order of test meals by using randomly permuted blocks of 4.

    “Enrolled participants were entered sequentially onto a list of random assignments (prepared by the Clinical Research Center at Boston Children's Hospital) for the order of test meals by using randomly permuted blocks of 4.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Study design and conductnone given

    Both test meals had a similar appearance, smell, and taste.

    “Both test meals had a similar appearance, smell, and taste.”
    Quote in the paperSubstantial claim

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

    Premisecitation

    Food intake is regulated by hedonic and homeostatic systems that historically served to maintain mean BMI within a healthy range under widely varying environmental conditions.

    “Food intake is regulated by hedonic and homeostatic systems (3) that historically served to maintain mean BMI within a healthy range under widely varying environmental conditions.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [3] Lutter, 2009, Homeostatic and hedonic signals interact in the regulation of food intake, J Nutr source

      Not checked in the free run.

  • Classified as probably not a substantial claim. May combine two claims.

    Study design and conductnone given

    The study used test meals of similar palatability and ASL methods to examine unstimulated brain activity after 4 h.

    “In contrast to previous research, our study used test meals of similar palatability and ASL methods to examine unstimulated brain activity after 4 h.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationcitation

    These neurophysiologic findings, together with longer feeding studies of weight-loss maintenance, suggest that reduced consumption of high-GI carbohydrates may ameliorate overeating and facilitate maintenance of a healthy weight in overweight and obese individuals.

    “These neurophysiologic findings, together with longer feeding studies of weight-loss maintenance (48,49), suggest that a reduced consumption of high-GI carbohydrates (specifically, highly processed grain products, potatoes, and concentrated sugar) may ameliorate overeating and facilitate maintenance of a healthy weight in overweight and obese individuals.”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [48] Larsen, 2010, Diets with high or low protein content and glycemic index for weight-loss maintenance, N Engl J Med source

      Not checked in the free run.

    • cites [49] Ebbeling, 2012, Effects of dietary composition on energy expenditure during weight-loss maintenance, JAMA source

      Not checked in the free run.

39 of 39

  • The paper relies on this without support.

    The late postprandial period is a time with special significance to eating behavior at the next meal.

    “Compared with an isocaloric low-GI meal, a high-GI meal decreased plasma glucose, increased hunger, and selectively stimulated brain regions associated with reward and craving in the late postprandial period, which is a time with special significance to eating behavior at the next meal.”

  • The paper relies on this without support.

    The US food supply has changed radically, with rapidly increasing consumption of highly processed food products derived primarily from grain commodities.

    “the food supply has changed radically, with the rapidly increasing consumption of highly processed food products derived primarily from grain commodities.”

  • The paper relies on this without support.

    Small studies limit generalizability and increase risk of a false-negative (but not false-positive) finding.

    “Small studies limit generalizability and increase risk of a false-negative (but not falsepositive) finding.”
3 of 3

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Authors
Lennerz, B. S., Alsop, D. C., Holsen, L. M., Stern, E., Rojas, R., Ebbeling, C. B., Goldstein, J. M., & Ludwig, D. S.
Affiliations
Brigham and Women's Hospital (US)
Corresponding author
Ludwig, David S
ORCID
Venue
The American Journal of Clinical Nutrition
Publisher
Elsevier BV
Published
2013-09
Volume
98
Issue
3
Pages
641-647
ISSN
0002-9165 (ISSN-L)
DOI
10.3945/ajcn.113.064113
PMC
PMC3743729
OpenAlex
W2164163218
Semantic Scholar
a012f8c995e712b5a007ecf44a8941ef88859b6b
Cited by
140
References
53
Citations by year
2026: 9 · 2025: 8 · 2024: 6 · 2023: 7 · 2022: 8 · 2021: 8 · 2020: 9 · 2019: 9 · 2018: 14 · 2017: 12 · 2016: 12 · 2015: 18 · 2014: 13 · 2013: 6 · 2012: 1
FWCI
8.83
Type
journal article
Language
en
Open access
Licence
Locations
  • American Journal of Clinical Nutrition (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • Harvard University
  • Harvard Catalyst (UL1-RR025758, UL1 RR025758-01, RR025758)
  • Pediatric Endocrine Society
  • Endocrine Fellows Foundation
  • National Institutes of Health (UL1RR02575801, RR025758, RR025758-01)
  • National Institute of Mental Health (R01MH080729)
  • National Institute of Diabetes and Digestive and Kidney Diseases (K24DK082730)
  • National Center for Research Resources (UL1RR025758, RR025758, RR 025758-01)
Topics
  • Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Regulation of Appetite and Obesity
  • Health Sciences › Nursing › Nutrition and Dietetics › Food composition and properties
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
Keywords
glycemic index, cerebral blood flow, nucleus accumbens, striatum, olfactory cortex, reward, craving, hunger, postprandial blood glucose, dietary habits, obesity, overweight men, arterial spin labeling
MeSH terms
Adult, Appetite, Blood Glucose, Brain, Brain Mapping, Female, Humans, Hunger, Male, Obesity, Regional Blood Flow, Reward, Postprandial Period, Area Under Curve, Glycemic Index, Young Adult

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Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-10.

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