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Increased Salivary Cortisol Reliably Induced by a Protein-Rich Midday Meal

From the Health Behaviour Unit, Department of Epidemiology and Public Health (E.L.G., J.W.), University College, London; Institute of Psychiatry (S.C.), DeCrespigny Park, London; Bethlem and Maudsley NHS Trust (A.P., L.P.), Beckenham, Kent; London Hospital Medical School (S.D.), Whitechapel, London, United Kingdom.

Address reprint requests to: E. L. Gibson, PhD, Health Behaviour Unit, Department of Epidemiology and Public Health, University College London, 2–16 Torrington Place, London WC1E 6BT, UK. E-mail: l.gibson{at}ucl.ac.uk

OBJECTIVE: This study was conducted to determine whether an increase in salivary free cortisol would be reliably elicited by a midday meal, thus providing a convenient physiological challenge to the hypothalamic-pituitary-adrenal (HPA) axis, and whether this cortisol release depended on the protein content of the meal.

METHOD: In healthy men, free cortisol was measured in saliva samples taken before and after two identical protein-rich midday meals (39% energy as protein) and compared with a day on which no meal was eaten. Next, in healthy women in a nonclinical setting, salivary cortisol was measured before and after a protein-rich meal (32% energy as protein) on one day and a low-protein meal (5% energy as protein) on another day. Measures of mood, appetite, and psychological well-being were also taken.

RESULTS: An acute meal-dependent increase in salivary cortisol occurred, which was reliable over 2 test days. This increase in cortisol depended on the proportion of protein in the meal, increasing after the high-protein but not the low-protein meal. The extent of this increase in cortisol correlated significantly with poor psychological well-being in women. Some postmeal improvement of mood (positive affect) was associated with the high- but not the low-protein meal.

CONCLUSIONS: The cortisol response to meals may have implications for the effects of meal composition on mood, cognitive function, and food choice. The measurement of free cortisol in saliva provides a psychologically stress-free and reliable technique to assess the cortisol response to a standard protein-rich meal, ie, a physiological challenge to the HPA axis in men and women that could be investigated in naturalistic settings outside the laboratory.

Key Words: cortisol, • hypothalamic-pituitary-adrenal axis, • protein, • nutrition, • appetite, • saliva.

Abbreviations: HPA = hypothalamic-pituitary-adrenal;; BMI = body mass index;; CBG = corticosteroid-binding globulin;; GHQ-12 = 12-item General Health Questionnaire;; DEBQ = Dutch Eating Behavior Questionnaire;; AUC = area under the curve;; ANOVA = analysis of variance;; TRP = tryptophan;; LNAA = large neutral amino acids;; 5-HT = 5-hydroxytryptamine;; PANAS = Positive and Negative Affect Schedule.

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