Recent advances in possible effects of bread types and enrichment on appetite during Ramadan fasting

Recent Advances in Possible Effects of Bread Types and Enrichments on Appetite during Ramadan Fasting Sara Movahed1, Mohsen Nematy 2, Sara Baghban Taraghdari 3, Mohammad Reza Amiryousefi4* 1. 2. 3. 4. MD, PhD candidate, Department of Nutrition, School of Medicine, Mashhad University of Medical Sciences (MUMS), Mashhad, Iran Department of Nutrition, School of Medicine, Biochemistry and Nutrition, Endoscopic & Minimally Invasive Surgery, and Cancer Research Centers, Mashhad University of Medical Sciences (MUMS), Mashhad, Iran Graduate Student of Clinical Pharmacy, Department of Nutrition, School of Medicine, Mashhad University of Medical Sciences (MUMS), Mashhad, Iran PhD in Food Engineering, Post-doctoral Researcher in Nutrition, Department of Nutrition, School of Medicine, Mashhad University of Medical Sciences (MUMS), Mashhad, Iran ARTICLEINFO ABSTRACT Article type: Original article Introduction: Bread is the staple food of most Muslims and can be considered to be a component with a remarkable effect on satiety and appetite during Ramadan fasting. This study aimed to present the recent advances in investigating the effect of different types of bread and enrichments on satiety and appetite. Methods: In this paper, articles focusing on the effect of various bread types (including enriched bread) on satiety and appetite, particularly during fasting were reviewed. Articles were found in databases such as ISI, PubMed and Google Scholar. Results: Different bread types with lower glycemic index are recommended for Ramadan fasting, especially for the Sahur meal, due to better satiety and sglycemic control. In addition, fermentable dietary fibers, such as arabinoxylans, β-glucan, fructans, and resistant starch, can influence appetite through fermentation in the colon by saccharolytic bacteria and gastrointestinal tract releasing hormones changes. Consumption of wholemeal bread results in the moderation of satiety and starvation. Barely, oat and rye breads demonstrate the better improvement of satiety compared to white wheat bread due to their higher fiber content, probiotic ingredients and steadier glycemia. On the other hand, use of protein-rich breads can result in delayed gastric emptying, steadier insulin levels and higher satiety. Beta-glucan enrichment shows similar significant results in terms of reducing hunger and increasing satiety by influencing the appetite and satiety and regulating hormones such as insulin, ghrelin and PYY. Fiber enrichment and probiotics (Fructo-oligosaccharides/Inulin) could also be considered in this regard. Conclusion: During Ramadan fasting, barley bread, oat bread and wholegrain wheat bread could be suggested as the preferred bread types to be incorporated into the main meals to improve satiety and decrease hunger feeling. Article History: Received: 08 Jul 2017 Accepted: 28 Jul 2017 Published: 30 Jul 2017 Keywords: Appetite Bread Enrichment Fasting Satiety Please cite this paper as: Movahed S, Nematy M, Baghban Taraghdari S, Amiryousefi MR. Recent Advances in Possible Effects of Bread Types and Enrichments on Appetite during Ramadan Fasting. J Fasting Health. 2017; 5(2): 87-98. Doi: 10.22038/jfh.2017.25045.1092 Introduction Different types of bread, such as white, whole wheat buttermilk, wholegrain, rye, barley, chickpea, Burgen wholemeal and Lupin bread are consumed as the staple food by most people in their daily meals (1-5). Wholegrains are composed of endosperm, germ and bran (6). Wholemeal wheat products contain a high amount of non-viscous dietary fibers, which are associated with many health benefits (7). Fasting is a religious practice among Muslims, which prohibits eating, drinking and smoking from dawn till dusk (7). When Ramadan and summer coincide, fasting may take as long as 17 hours a day. The main complaint of individuals while fasting is the feeling of thirst and hunger. Apparently, diet, particularly the consumption of bread as the staple food of most Muslims, influences the appetite and satiety of fasting individuals. This article aimed to review the * Corresponding author: Mohammad Reza Amiryousefi, Department of Nutrition, School of Medicine, Mashhad University of Medical Sciences (MUMS), Mashhad, Iran. Email: © 2017 mums.ac.ir All rights reserved. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Movahed S et al recent advances regarding the effects of consuming different types of bread and enrichments on satiety and appetite for recommendation in Ramadan fasting. Material and methods As the number of related articles on association between different types of breads, enrichments and appetite and satiety during fasting in research database was few, this review article investigated this association using related keywords such as the "glycemic", "insulinemic", "ghrelin", "leptin" and "PYY" in research databases including ISI, PubMed and Google Scholar. Results Satiety is defined as the feeling of fullness and is basically induced by neural and hormonal signaling throughout the gastrointestinal tract, with the purpose of regulating further intake and optimizing digestion and nutrient absorption (8). Multiple factors affect satiety and appetite, including environmental (such as culture, social conditions, availability of food), personal (physical and psychological factors) and food-related factors (high protein, high fiber, low GI carbohydrates, highly viscous beverages, unchangeable diet and excessive food portion sizes) (9). Satiety is commonly measured within 0.5-3 hours, and the associated long-term effects are rarely explored (10). Appetite and satiety are mostly assessed by subjective tools, such as the visual analogue scale (VAS), the scale proposed by Haber et al., SI (recording and weighing food portions) and measuring the level of related hormones (leptin, ghrelin and PYY), which might help in the assessment of appetite changes (11). Ghrelin and leptin are two appetite-regulating gastric hormones with counteractive functions. Ghrelin is an orexigenic hormone, whereas leptin is involved in the long-term balance of caloric intake, fat deposition and energy balance (12, 13). Competitive action of ghrelin and leptin in the regulation of food intake has been demonstrated in several studies (14, 15). Serum leptin follows a circadian rhythm, which reaches its peak during 22:00-3:00. After the first meal in the morning, the plasma levels diminish drastically and reach the lowest level before 17:00. It is also notable that changing the meal time shifts the diurnal rhythm of leptin (16, 17). Some animal studies have claimed that food 88 Possible Effects of Bread on Appetite during Fasting intake and fasting can affect the serum levels of ghrelin and leptin (18). On the other hand, (...truncated)