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Journal of Nutrition and Metabolism
Volume 2010 (2010), Article ID 286952, 7 pages
Research Article

Sustained Self-Regulation of Energy Intake: Initial Hunger Improves Insulin Sensitivity

1Unit of Preventive Gastroenterology, Department of Paediatrics, Università di Firenze, 50132 Florence, Italy
2Department of General Practice and Primary Health Care, University of Auckland, Auckland, New Zealand
3Department of Physiology and Pharmacology, Robert F. Furchgott Center for Neural and Behavioral Sciences, State University of New York Downstate Medical Center, Brooklyn, NY, USA
4AMC, 1100 DD Amsterdam, The Netherlands
5Department of Statistics, Università di Firenze, Florence, Italy
6Paediatric Unit, Università di Verona, Verona, Italy

Received 4 January 2010; Revised 28 April 2010; Accepted 10 May 2010

Academic Editor: Peter Clifton

Copyright © 2010 Mario Ciampolini et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. Excessive energy intake has been implicated in diabetes, hypertension, coronary artery disease, and obesity. Dietary restraint has been unsuccessful as a method for the self-regulation of eating. Recognition of initial hunger (IH) is easily learned, can be validated by associated blood glucose (BG) concentration, and may improve insulin sensitivity. Objective. To investigate whether the initial hunger meal pattern (IHMP) is associated with improved insulin sensitivity over a 5-month period. Methods. Subjects were trained to recognize and validate sensations of IH, then adjust food intake so that initial hunger was present pre-meal at each meal time (IHMP). The purpose was to provide meal-by-meal subjective feedback for self-regulation of food intake. In a randomised trial, we measured blood glucose and calculated insulin sensitivity in 89 trained adults and 31 not-trained controls, before training in the IHMP and 5 months after training. Results. In trained subjects, significant decreases were found in insulin sensitivity index, insulin and BG peaks, glycated haemoglobin, mean pre-meal BG, standard deviation of diary BG (BG as recorded by subjects' 7-day diary), energy intake, BMI, and body weight when compared to control subjects. Conclusion. The IHMP improved insulin sensitivity and other cardiovascular risk factors over a 5-month period.