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Background: Wholegrain consumption is suggested to improve short-term appetite sensation. This may occur immediately after wholegrain intake but also after a second meal. The latter may potentially be mediated by short-chain fatty acids (SCFA) that are generated during colonic fermentation of wholegrain components. Little is, however, known how regular wholegrain intake influences appetite sensation. Hypothetically, an increase in satiety-inducing gut hormones, due to steady colonic fermentation upon regular wholegrain intake, may lead to an improvement of the overall appetite sensation. In the long run, regular wholegrain intake may also reduce body weight due to reoccurring short- and long-term effects on appetite. Aim: This PhD thesis investigates the effects of selected wholegrain products on appetite after a second meal, as well as the effects of sustained wholegrain intake on overall appetite sensation with special attention to the role of colonic fermentation. Further, the impact of regular wholegrain intake on body weight is investigated. Methods: In a second meal study we studied the effects of two coarse wholegrain rye evening meals on subjective appetite after a standardized breakfast and on ad libitum energy intake at lunch at the subsequent day compared to white wheat bread. In a human intervention study we investigated the effects of 8-week ad libitum consumption of a mixed wholegrain diet on appetite after a standardized, non-wholegrain breakfast, on ad libitum energy intake at a subsequent lunch, and on body weight compared to 8-week refined grain consumption. Furthermore, in a crosssectional study we studied the associations between habitual wholegrain intake and appetite after a standardized, non-wholegrain breakfast, ad libitum energy intake at lunch and body weight. In the three studies we approximated colonic fermentation by measuring the excretion of hydrogen in the breath. Moreover, we de

Baggrund: Type 2 diabetes (T2D) er et stigende globalt problem. Kosten spiller en væsentlig rolle i udviklingen af T2D, og et højt indtag af fuldkorn er blevet stærkt associeret med en nedsat risiko for at udvikle T2D og insulinresistens (IR). Der er dog brug for randomiserede kontrollerede studier (RCT) til at undersøge kausaliteten imellem indtag af fuldkorn og udviklingen af T2D og IR. Abdominal fedme og specielt visceral fedt er blevet associeret med udvikling af T2D og IR. Det er endvidere blevet vist, at indtag af fuldkorn er omvendt associeret med abdominal fedme. Det er blevet foreslået, at sagittal abdominal diameter (SAD) kan bruges som en præcis og pålidelig målemetode af visceral fedme til brug i epidemiologiske studier. Målemetoden skulle endda være endnu bedre end den mere almindelig anvendte metode, talje omkreds (WC). Formålet: Det første formål med dette speciale er at undersøge, om indtag af fuldkornsprodukter kan nedsætte IR sammenlignet med indtag af raffinerede kornprodukter. Dette bliver målt ved at bruge en homeostatisk model til vurdering af insulinresistens (HOMA-IR). Det andet formål med forsøget er, at undersøge om SAD er en bedre markør for IR end WC. Det bliver også undersøgt om fuldkornsprodukter kan nedsætte abdominal fedme målt som SAD, og dermed nedsætte IR. Design: Studiet er designet som et ikke blindet RCT med et parallelt design. Nitten overvægtige eller fede, mænd og kvinder, med en metabolisk risikomarkør, blev randomiseret til enten at modtage fuldkornsprodukter (>75 g fuldkorn/dag) eller raffinerede kornprodukter(<10 g fuldkorn/dag) i 8 uger. Antropometriske målinger, blodtryk og fastende blodprøver blev foretaget i begyndelsen og slutningen af interventionsperioden. Resultater: Forsøgspersonerne i studiet havde en høj indtag af interventionskosten. Begge grupper havde et højt indtag af forsøgsprodukter (Fuldkornsgruppen (WGG):282±36.4 vs. R, Background: Type 2 diabetes (T2D) is an increasing problem worldwide. The diet influences the development of T2D and consumption of whole grain has been strongly associated with a decreased risk for developing T2D and insulin resistance (IR). However, there is a need for randomized controlled trials (RCT) for examining the causality between intake of whole grain foods and development of T2D and IR. Abdominal fat and especially visceral fat is also associated with development of T2D and is inversely associated with whole grain intake. Sagittal abdominal diameter (SAD) has been proposed to be a precise and reliable measurement of visceral fat for use in epidemiological settings. The measurement could be even better compared to the commonly used method, waist circumference (WC). Objective: The first objective of this master thesis was to investigate whether whole grain foods compared to refined grain foods can decrease IR measured with the homeostatic model assessment for insulin resistance (HOMA-IR). The second aim was to examine if SAD is a better marker of IR than WC. Furthermore, the effect of whole grain foods on abdominal obesity, measured by SAD, was compared to refined grain foods. Design: The present study was conducted as an open-labeled RCT with a parallel design. Nineteen overweight or obese, men and women, with one metabolic risk marker, were randomized to receive either whole grain foods (>75 g whole grain/day) or refined grain foods (<10 g whole grain/day) for 8 weeks. Anthropometric measurements, blood pressure, and fasting blood samples were collected at the beginning and end of the intervention period. Results: A high compliance was seen in both intervention groups for total product intake (Whole graingroup (WGG):282±36.4 vs. Refined Grain-group (RGG): 258±33.0 g/day, p=0.147) as well as total whole grain intake (WGG: 190.0±26.8 vs. RGG: 8.33±3.4 g/day, p<0.001). Over

Baggrund: Type 2 diabetes (T2D) er et stigende globalt problem. Kosten spiller en væsentlig rolle i udviklingen af T2D, og et højt indtag af fuldkorn er blevet stærkt associeret med en nedsat risiko for at udvikle T2D og insulinresistens (IR). Der er dog brug for randomiserede kontrollerede studier (RCT) til at undersøge kausaliteten imellem indtag af fuldkorn og udviklingen af T2D og IR. Abdominal fedme og specielt visceral fedt er blevet associeret med udvikling af T2D og IR. Det er endvidere blevet vist, at indtag af fuldkorn er omvendt associeret med abdominal fedme. Det er blevet foreslået, at sagittal abdominal diameter (SAD) kan bruges som en præcis og pålidelig målemetode af visceral fedme til brug i epidemiologiske studier. Målemetoden skulle endda være endnu bedre end den mere almindelig anvendte metode, talje omkreds (WC). Formålet: Det første formål med dette speciale er at undersøge, om indtag af fuldkornsprodukter kan nedsætte IR sammenlignet med indtag af raffinerede kornprodukter. Dette bliver målt ved at bruge en homeostatisk model til vurdering af insulinresistens (HOMA-IR). Det andet formål med forsøget er, at undersøge om SAD er en bedre markør for IR end WC. Det bliver også undersøgt om fuldkornsprodukter kan nedsætte abdominal fedme målt som SAD, og dermed nedsætte IR. Design: Studiet er designet som et ikke blindet RCT med et parallelt design. Nitten overvægtige eller fede, mænd og kvinder, med en metabolisk risikomarkør, blev randomiseret til enten at modtage fuldkornsprodukter (>75 g fuldkorn/dag) eller raffinerede kornprodukter(<10 g fuldkorn/dag) i 8 uger. Antropometriske målinger, blodtryk og fastende blodprøver blev foretaget i begyndelsen og slutningen af interventionsperioden. Resultater: Forsøgspersonerne i studiet havde en høj indtag af interventionskosten. Begge grupper havde et højt indtag af forsøgsprodukter (Fuldkornsgruppen (WGG):282±36.4 vs. R, Background: Type 2 diabetes (T2D) is an increasing problem worldwide. The diet influences the development of T2D and consumption of whole grain has been strongly associated with a decreased risk for developing T2D and insulin resistance (IR). However, there is a need for randomized controlled trials (RCT) for examining the causality between intake of whole grain foods and development of T2D and IR. Abdominal fat and especially visceral fat is also associated with development of T2D and is inversely associated with whole grain intake. Sagittal abdominal diameter (SAD) has been proposed to be a precise and reliable measurement of visceral fat for use in epidemiological settings. The measurement could be even better compared to the commonly used method, waist circumference (WC). Objective: The first objective of this master thesis was to investigate whether whole grain foods compared to refined grain foods can decrease IR measured with the homeostatic model assessment for insulin resistance (HOMA-IR). The second aim was to examine if SAD is a better marker of IR than WC. Furthermore, the effect of whole grain foods on abdominal obesity, measured by SAD, was compared to refined grain foods. Design: The present study was conducted as an open-labeled RCT with a parallel design. Nineteen overweight or obese, men and women, with one metabolic risk marker, were randomized to receive either whole grain foods (>75 g whole grain/day) or refined grain foods (<10 g whole grain/day) for 8 weeks. Anthropometric measurements, blood pressure, and fasting blood samples were collected at the beginning and end of the intervention period. Results: A high compliance was seen in both intervention groups for total product intake (Whole graingroup (WGG):282±36.4 vs. Refined Grain-group (RGG): 258±33.0 g/day, p=0.147) as well as total whole grain intake (WGG: 190.0±26.8 vs. RGG: 8.33±3.4 g/day, p<0.001). Over