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Human Nutrition and Metabolism

Interstitial Glucose Level Is a Significant Predictor of Energy Intake in Free-Living Women with Healthy Body Weight^1,2

Anastassios G. Pittas^*,3, Radhika Hariharan^*, Paul C. Stark, Cheryl L. Hajduk^**, Andrew S. Greenberg^*,** and Susan B. Roberts^**

^* Division of Endocrinology, Diabetes and Metabolism, and Institute for Clinical Research and Health Policy Studies, Tufts-New England Medical Center, Boston, MA 02111 and ^** Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, MA 02111

³To whom correspondence should be addressed. E-mail: apittas{at}tufts-nemc.org.

The relative contribution of circulating glucose to meal-to-meal variability in energy intake is not known. In 8 free-living young (median age 26.5 y) women with healthy body weight (median BMI 22.2 kg/m²), we measured glucose in the interstitial space by an automated monitoring procedure (continuous glucose monitoring system, CGMS^TM) for up to 3 consecutive days (mean 706 glucose readings per subject). We examined the association between interstitial glucose (which lags blood glucose by 10 min), self-reported hunger, satiety, desire for a meal, and nutrient intakes. Participants reported consuming a typical Western diet (59% carbohydrate, 27% fat, 14% protein). Median (interquartile range) interstitial glucose was 5.2 mmol/L (4.7–5.8). Using repeated-measures techniques in univariate analyses, desire for a meal (r = 0.45, P < 0.0001), hunger (r = 0.37, P = 0.0002), satiety (r = –0.40, P < 0.0001), low interstitial absolute mean glucose up to 25 min before eating (r = –0.23, P = 0.02), and a large decline in glucose between 40 and 5 min before eating (r = –0.17, P = 0.08) were all associated with meal energy intake. In multivariate regression analyses, desire for a meal (P < 0.0001) and hunger (P = 0.02) were the strongest independent contributors to meal energy intake, whereas absolute mean glucose measured in the period 15 to 0 min before eating was marginally significant (P = 0.08). In conclusion, absolute glucose level is a significant predictor of energy intake in nonobese women. However, desire for a meal and hunger are quantitatively more important, emphasizing the importance of both glucose signals and nonglucose (internal or environmental) factors in within-subject variability in energy intake. In addition, the CGMS may have utility in understanding the role of circulating glucose in energy regulation in free-living subjects under a wide range of different nutritional conditions.

KEY WORDS: • glucose • energy • hunger • satiety • free-living