Self-reported eating speed in relation to non-alcoholic fatty liver disease in adults

Dietary characteristics associated with the risk of non-alcoholic fatty liver disease and metabolic dysfunction-associated steatotic liver disease in non-obese Japanese participants: A cross-sectional study

Background and Aim

Dietary characteristics associated with non-alcoholic fatty liver disease (NAFLD) and metabolic dysfunction-associated steatotic liver disease (MASLD) in non-obese patients remain to be elucidated. This study examined the association of NAFLD and MASLD with dietary characteristics according to obesity status.

Methods

We performed a cross-sectional study of 15 135 participants (n = 7568 men and 7567 women) aged 35-74 years using data of annual health checks between 2008 and 2020. Obesity was defined as BMI ≥ 25 kg/m2. Diagnosis of fatty liver was based on abdominal ultrasonography. Fatty-liver-related dietary characteristics were assessed using a self-administered questionnaire.

Results

For non-obese participants, NAFLD was found in 31.0% of men and 19.4% of women. Non-obese MASLD was found in 27.6% of men and 18.1% of women. Multivariable-adjusted stepwise logistic regression analysis indicated that, in males, both non-obese NAFLD and non-obese MASLD were significantly and negatively associated with "often eat sesame/nuts", and positively associated with "often eat noodles/rice bowl" and "often eat evening meal" (P < 0.05). For non-obese women, both NAFLD and MASLD were significantly and positively associated with "often eat sweet buns/bread with fillings" (P < 0.05). Adjusted analyses showed that all dietary characteristics were not significantly associated with the risk of NAFLD/MASLD in obese men and women.

Conclusion

This cross-sectional study indicates the existence of sex and obesity differences in the association of NAFLD and MASLD with dietary characteristics. Our findings suggest that some dietary characteristics are associated with NAFLD and MASLD prevalence in non-obese Japanese participants.

Lifestyle factors affecting new-onset nonalcoholic fatty liver disease

Evidence for the influence of lifestyle factors on nonalcoholic fatty liver disease (NAFLD) onset is limited because the association between lifestyle factors and NAFLD has been reported mostly in cross-sectional studies. Our purpose was to elucidate which lifestyle factors are associated with NAFLD onset by performing a longitudinal study. This was a longitudinal study of 1,713 Japanese participants who underwent multiple health checkups from June 2013 to the end of March 2018 and were not diagnosed with NAFLD at the first health checkup at Watari Hospital in Fukushima, Japan. Baseline characteristics, including lifestyle factors, were compared among participants with and without NAFLD. Cox proportional hazards models were used to identify the association between lifestyle factors and NAFLD onset. Among the 1,713 participants, 420 (24.5 %) developed NAFLD during the observation period (median 47 months). There were significant differences in body mass index and hepatobiliary enzyme levels between participants with and without NAFLD. In Cox proportional hazards models, eating between meals (hazard ratio (HR): 2.08, 95 % confidence interval (CI): 1.25-3.45, p < 0.01) and eating fast (HR: 1.59, 95 % CI: 1.26-2.00, p < 0.01) were risk factors for NAFLD onset in men and women, respectively. Moreover, fast walking was a protective factor against NAFLD onset in women (HR: 0.76, 95 % CI: 0.60-0.96, p = 0.02). These findings could help to identify patients at risk and prevent future NAFLD onset.

The Association Between Eating Quickly and Excessive Gestational Weight Gain

Objectives

Maintaining an appropriate gestational weight gain (GWG) is essential for a safe pregnancy and delivery. This study aimed to determine the association between the habit of eating quickly and the risk of excessive GWG.

Methods

We administered a questionnaire on eating habits to 1246 pregnant Japanese women in their second to third trimesters. We categorized the participants into three groups according to their answers to the question "Do you eat quickly?" Group 1, "always" or "usually"; Group 2, "sometimes"; and Group 3, "rarely" or "never." We assessed GWG according to the "The Optimal Weight Gain Chart" (Ministry of Health, Labor and Welfare, Japan), and those who exceeded the criteria were considered "excessive." Logistic regression analysis was performed with the risk of excess GWG as the dependent variable and quick food intake as the independent variable, to obtain relevant odds ratios (ORs) and 95% confidence intervals (CIs). Model 1 was unadjusted, and Model 2 was adjusted for age, prepregnancy body mass index, energy intake, mother's educational attainment, household income, exercise habits, and childbearing experience.

Results

The OR (95% CI) for Groups 2 and 3 in Model 1, compared with Group 1, was 0.80 (0.62-1.05) and 0.61 (0.43-0.88), respectively (p for trend = 0.047). In Model 2, the OR (95% CI) for Groups 2 and 3 were 0.73 (0.55-0.96) and 0.59 (0.40-0.86), respectively (p for trend = 0.003).

Conclusion

These results suggest that quick food ingestion increases the risk of excessive GWG.

Relationship between Chewing Status and Fatty Liver Diagnosed by Liver/Spleen Attenuation Ratio: A Cross-Sectional Study

This cross-sectional study investigated the relationship between chewing status and fatty liver among Japanese adults. Between April 2018 and March 2021, 450 individuals (352 males, 98 females; mean age 54.7 years) were recruited at the Asahi University Hospital Human Health Center. Chewing status was evaluated using a self-reported questionnaire. Liver/spleen (L/S) attenuation ratio < 0.9 on computed tomography was considered to indicate fatty liver, which was present in 69 participants (15%). Compared with participants without fatty liver, those with fatty liver had higher proportion of 25.0 (kg/m2) ≤ body mass index (BMI) (p < 0.001), higher serum hemoglobin A1c (HbA1c) (p < 0.001), higher systolic blood pressure (p < 0.001), higher diastolic blood pressure (p < 0.001), and lower serum high-density lipoprotein cholesterol (HDL cholesterol) (p = 0.011). Significant differences were also found in chewing status (p < 0.001) and eating speed (p = 0.011). Presence of fatty liver was positively associated with BMI (25.0 ≤; odds ratio [OR], 5.048; 95% confidence interval [CI], 2.550−9.992), serum HbA1c (OR, 1.937; 95% CI, 1.280−2.930), and chewing status (poor; OR, 8.912; 95% CI, 4.421−17.966) after adjusting for sex, age, BMI, serum HbA1c, systolic blood pressure, diastolic blood pressure, serum HDL cholesterol, chewing status, and eating speed. Poor chewing status was positively associated with L/S attenuation ratio. These results indicate a positive relationship between poor chewing status and fatty liver diagnosed by L/S attenuation ratio in Japanese adults.

2019 Global NAFLD Prevalence: A Systematic Review and Meta-analysis

BACKGROUND & AIMS

The increasing rates of obesity and type 2 diabetes mellitus may lead to increased prevalence of nonalcoholic fatty liver disease (NAFLD). We aimed to determine the current and recent trends on the global and regional prevalence of NAFLD.

METHODS

Systematic search from inception to March 26, 2020 was performed without language restrictions. Two authors independently performed screening and data extraction. We performed meta-regression to determine trends in NAFLD prevalence.

RESULTS

We identified 17,244 articles from literature search and included 245 eligible studies involving 5,399,254 individuals. The pooled global prevalence of NAFLD was 29.8% (95% confidence interval [CI], 28.6%-31.1%); of these, 82.5% of included articles used ultrasound to diagnose NAFLD, with prevalence of 30.6% (95% CI, 29.2%-32.0%). South America (3 studies, 5716 individuals) and North America (4 studies, 18,236 individuals) had the highest NAFLD prevalence at 35.7% (95% CI, 34.0%-37.5%) and 35.3% (95% CI, 25.4%-45.9%), respectively. From 1991 to 2019, trend analysis showed NAFLD increased from 21.9% to 37.3% (yearly increase of 0.7%, P < .0001), with South America showing the most rapid change of 2.7% per year, followed by Europe at 1.1%.

CONCLUSIONS

Despite regional variation, the global prevalence of NAFLD is increasing overall. Policy makers must work toward reversing the current trends by increasing awareness of NAFLD and promoting healthy lifestyle environments.

Associations of eating speed with fat distribution and body shape vary in different age groups and obesity status

Background

Eating speed has been reported to be associated with energy intake, body weight, waist circumference (WC), and total body fat. However, no study has explored the association between eating speed and body fat distribution, especially its difference among different age or body mass index (BMI) groups.

Methods

4770 participants aged 18–80 years were recruited from the baseline survey of the Lanxi Cohort Study. They were categorized into three groups according to meal duration. Linear regression analyses were performed among all participants and separately by age group and obesity status to evaluate the associations of WC and total and regional fat mass percentages (FM%) with eating speed.

Results

After adjusting for confounding factors, eating slowly was significantly related to lower WC, lower total, trunk, and android FM%, lower android-to-gynoid fat mass ratio, and higher leg and gynoid FM%. After stratification by age or obesity status, the associations were especially prominent among participants aged 18–44 years or those with BMI < 24 kg/m². No significant trends were found for participants aged 65–80 years or those who were overweight/obese.

Conclusions

Eating slowly is closely related with better fat distribution among Chinese adults, especially for those aged 18–44 years and those with BMI < 24 kg/m². If confirmed prospectively, it might be a potential efficient approach to improve fat distribution.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12986-022-00698-w.

"Forever young at the table": metabolic effects of eating speed in obesity

Background

Cardiometabolic diseases (CMD) are recognized as the main causes of morbidity and mortality in developed countries. In recent years eating speed (ES) has been of particular interest since some studies have associated it with the development of obesity and CMD. However, the different impact of the ES at which main meals are eaten on the risk of developing these diseases has not yet been identified. Thus, we aimed to investigate the effect of ES at the main meals (breakfast, lunch, and dinner) on the risk of developing cardiometabolic diseases (type 2 diabetes mellitus, dyslipidaemia and hypertension) in middle-aged Caucasian subjects with obesity.

Methods

For this purpose we carried out a cross-sectional, observational study. One hundred and eighty-seven middle-aged subjects aged 43.6 ± 16 years were enrolled of which anthropometric parameters and lifestyle habits were studied. A dietary interview was performed to collect information about meal duration and eating habits at the main meals. According to median value of meal duration, meals were classified in two groups: fast eating group (FEG) and slow eating group (SEG).

Results

The prevalence of dyslipidaemia was more than twice in FEG compared to SEG at lunch and dinner. For all main meals, FEG had a significantly higher risk of dyslipidaemia than SEG (p < 0.05) in unadjusted model. However, when the model was adjusted for age, BMI, physical activity, smoking and alcohol use and medication, the result remained significant for lunch and dinner (p < 0.05).

Conclusion

The results of our study suggest that fast eating increases at lunch and dinner increase the risk of developing dyslipidaemia in obesity.

Unhealthy Eating, Psychopathology, and Nonalcoholic Fatty Liver Disease in Youth Presenting for Bariatric Surgery

OBJECTIVES

Little is known about the behavioral and psychosocial correlates of pediatric nonalcoholic fatty liver disease (NAFLD). Given diet contributes to the development and persistence of NAFLD, we examined (1) the prevalence of unhealthy eating behaviors (UEB), (2) whether these varied by NAFLD or nonalcoholic steatohepatitis (NASH) presence, and explored (3) the association of psychopathology with NAFLD.

METHODS

Before metabolic and bariatric surgery (MBS), adolescents (N = 159; Mage = 16.4; MBMI = 53.7 kg/m2, 73% girls, 62.3% white) self-reported presence/absence of 10 UEB (Questionnaire on Eating and Weight Patterns-Revised, Night Eating Questionnaire, Look AHEAD). NAFLD and NASH presence was assessed by intraoperative liver biopsy. Height/weight, blood pressure, and blood specimens were obtained. A medical comorbidity index was created (prediabetes/diabetes, dyslipidemia, elevated blood pressure). Psychopathology was assessed in a subgroup completing the Youth Self-Report (N = 98).

RESULTS

Binge eating disorder symptomatology was associated with higher odds of NAFLD whereas frequent eating out was associated with lower odds of NAFLD. Among those with NAFLD frequent eating out was associated with higher odds of NASH while nocturnal eating was associated with lower odds of NASH. Separate models identified internalizing psychopathology as associated with higher odds of NAFLD after controlling for demographics, number of UEB, and medical comorbidities.

CONCLUSIONS

Results suggest potential phenotypical differences between adolescents presenting for MBS with/without NAFLD, with implications for behavioral/psychosocial targets for screening and intervention. Replication should occur in a sample with greater gender and ethnic diversity to improve generalizability. Understanding differences in the context of surgical weight loss and comorbidity resolution is indicated.

Clinical practice advice on lifestyle modification in the management of nonalcoholic fatty liver disease in Japan: an expert review

Nonalcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver diseases worldwide, including in Japan. The Japanese Society of Gastroenterology (JSGE) and the Japanese Society of Hepatology (JSH) have established the Japanese NAFLD/NASH guidelines in 2014 and revised these guidelines in 2020. As described in these guidelines, weight reduction by diet and/or exercise therapy is important for the treatment of NAFLD patients. The I148M single nucleotide polymorphism (rs738409 C > G) of PNPLA3 (patatin-like phospholipase domain-containing 3 protein) is widely known to be associated with the occurrence and progression of NAFLD. In the Japanese, the ratio of PNPLA3 gene polymorphisms found is approximately 20%, which is higher than that found in Westerners. In addition, the ratio of lean NAFLD patients is also higher in Japan than in Western countries. Therefore, the method for lifestyle guidance for the NAFLD patients in Japan would be different from that for the people in Western countries. The problems in the treatment of NAFLD patients include alcohol consumption and sarcopenia. Therefore, guidelines that can help clinicians treat Japanese patients with NAFLD are needed. In this expert review, we summarize evidence-based interventions for lifestyle modification (diet, exercise, alcohol, and sarcopenia) for the treatment of patients with NAFLD, especially from Japan and Asian countries.

Beyond the Paradigm of Weight Loss in Non-Alcoholic Fatty Liver Disease: From Pathophysiology to Novel Dietary Approaches

Current treatment recommendations for non-alcoholic fatty liver disease (NAFLD) rely heavily on lifestyle interventions. The Mediterranean diet and physical activity, aiming at weight loss, have shown good results in achieving an improvement of this liver disease. However, concerns related to compliance and food accessibility limit the feasibility of this approach, and data on the long-term effects on liver-related outcomes are lacking. Insulin resistance is a central aspect in the pathophysiology of NAFLD; therefore, interventions aiming at the improvement of insulin sensitivity may be preferable. In this literature review, we provide a comprehensive summary of the available evidence on nutritional approaches in the management of NAFLD, involving low-calorie diets, isocaloric diets, and the novel schemes of intermittent fasting. In addition, we explore the harmful role of single nutrients on liver-specific key metabolic pathways, the role of gene susceptibility and microbiota, and behavioral aspects that may impact liver disease and are often underreported in clinical setting. At present, the high variability in terms of study populations and liver-specific outcomes within nutritional studies limits the generalizability of the results and highlights the urgent need of a tailored and standardized approach, as seen in regulatory trials in Non-Alcoholic Steatohepatitis (NASH).

Physiopathology of Lifestyle Interventions in Non-Alcoholic Fatty Liver Disease (NAFLD)

Non-alcoholic fatty liver disease (NAFLD) is a major health problem, and its prevalence has increased in recent years. Diet and exercise interventions are the first-line treatment options, with weight loss via a hypocaloric diet being the most important therapeutic target in NAFLD. However, most NAFLD patients are not able to achieve such weight loss. Therefore, the requisite is the investigation of other effective therapeutic approaches. This review summarizes research on understanding complex pathophysiology underlying dietary approaches and exercise interventions with the potential to prevent and treat NAFLD.

Association between eating speed and newly diagnosed nonalcoholic fatty liver disease among the general population

Fast eating speed is a risk factor for obesity, which is also closely related to nonalcoholic fatty liver disease (NAFLD), suggesting that fast eating speed may contribute to the development of NAFLD. But the extent to which obesity may mediate the association between eating speed and NAFLD is uncertain. We hypothesized that obesity plays a mediating role in the association between eating speed and prevalence of NAFLD in the general population. A cross-sectional study (n = 23,611) was conducted in a general population sample from Tianjin, China. We measured anthropometrics and biochemical variables. The self-reported eating speed per meal was recorded and classified into 4 categories: slow, medium, relatively fast, and very fast. NAFLD was diagnosed by liver ultrasonography. Multiple logistic regression analysis was used to assess the associations between the eating speed and the prevalence of NAFLD, as well as the mediation effects of obesity on the association between eating speed and NAFLD. The prevalence of newly diagnosed NAFLD was 19.0%. After adjusting for potentially confounding factors, the odds ratios (95% confidence interval) of NAFLD across categories of eating speed were 1.00 (reference), 1.39 (1.18-1.64), 1.71 (1.45-2.01), and 2.04 (1.70-2.46). All these significant odds ratios were attenuated to be nonsignificant by adjustment for body mass index and/or waist circumference. This is the first study to demonstrate that eating speed is not independently associated with increased risk of NAFLD.

Eating Fast Is Associated with Nonalcoholic Fatty Liver Disease in Men But Not in Women with Type 2 Diabetes: A Cross-Sectional Study

Non-alcoholic fatty liver disease (NAFLD), often complicated by type 2 diabetes mellitus (T2DM), is reported to be associated with diet habits, including eating speed, in the general population. However, the association between eating speed and NAFLD in patients with T2DM, especially sex difference, has not been reported so far. This cross-sectional study included 149 men and 159 women with T2DM. Eating speed was evaluated by a self-reported questionnaire and divided into three groups: fast, moderate, and slow eating. Nutrition status was evaluated by a brief-type self-administered diet history questionnaire. NAFLD was defined as the hepatic steatosis index ≥36 points. Body mass index and carbohydrate/fiber intake in the fast-eating group were higher than those in the slow-eating group in men, whereas this difference was absent in women. In men, compared with eating slowly, eating fast had an elevated risk of the presence of NAFLD after adjusting for covariates (odds ratio (OR) 4.48, 95% confidence interval (CI) 1.09–18.5, p = 0.038). In women, this risk was not found, but fiber intake was found to be negatively associated with the presence of NAFLD (OR 0.85, 95% Cl 0.76–0.96, p = 0.010). This study indicates that eating speed is associated with the presence of NAFLD in men but not in women.

Association Between Self-Reported Eating Rate, Energy Intake, and Cardiovascular Risk Factors in a Multi-Ethnic Asian Population

Eating faster is associated with greater body mass index (BMI), but less is known about the relationships between eating rate, energy intake, body composition, and cardio-metabolic risk factors in different Asian ethnic groups. Using data from the Singapore Multi-Ethnic Cohort (n = 7011; 21-75 y), we investigated associations between self-reported eating rate (SRER), with energy intake, body composition, blood pressure, and blood lipids. SRER and lifestyle was assessed using interviewer-administered questionnaires. Multivariable models were used to examine the associations of SRER with energy intake, body composition, blood pressure, and blood lipids after adjusting for covariates. General and abdominal overweight were defined as BMI ≥ 23 kg/m² and waist circumference > 90cm (men) and > 80cm (women), respectively. On average, faster eaters (vs. slower eaters) consumed 105kcal/day more (p = 0.034), had ~5kg higher body weight (p < 0.001), 1.3 kg/m² higher BMI (p < 0.001), and 3.1cm larger waist-circumference (p < 0.001). Faster eaters had significantly higher blood pressure, circulating triglycerides, and total-to-high-density lipoprotein cholesterol ratio than slower eaters. Faster eaters were twice as likely to develop general (multivariable-OR: 2.2;95%CI,1.8-2.6; p < 0.001), and abdominal (OR:1.8;95%CI, 1.5-2.2; p < 0.001) overweight than slower eaters. This association was observed across all subgroups by age, sex, and ethnicity. Findings suggest that SRER is a robust behavioral marker for increased risk of higher energy intake, obesity, and poor cardio-metabolic health, and a modifiable behavioral risk-factor for obesity prevention.

Association between Eating Speed and Classical Cardiovascular Risk Factors: A Cross-Sectional Study

Cardiovascular disease (CVD) is one of the main causes of morbidity and mortality around the world. Lifestyle is recognized as a key factor in the development of metabolic disorders and CVD. Recently, eating speed has been of particular interest since some studies have associated it with the development of obesity and other cardiometabolic disorders. We aimed to assess the association between eating speed and various cardiovascular risk factors. We conducted a cross-sectional analysis within the framework of the PREDIMED (Prevención con Dieta Mediterránea) study with 792 participants from the Reus-Tarragona center. Eating speed was self-reported according to participant perception and categorized as slow, medium, or fast. The association between eating speed and cardiovascular risk factors was assessed using Cox regression models with constant time of follow-up for all individuals. Compared to participants in the slow eating speed category, those in the faster eating speed category were 59% more likely to have the hypertriglyceridemia component of the metabolic syndrome (MetS) (Hazard Ratio, (HR) 1.59; 95% Confidence Interval (CI) 1.16–2.17), even after adjustment for potential confounders (HR 1.47; 95% CI 1.08–2.02). No other significant differences were observed. Eating speed was positively associated with the prevalence of the hypertriglyceridemia component of the MetS in a senior population at high cardiovascular risk.

Association between self-reported eating speed and metabolic syndrome in a Beijing adult population: a cross-sectional study

Background

Research on the relationship between metabolic syndrome (MetS), its components and eating speed is limited in China. The present study aimed to clarify the association between MetS, its components and eating speed in a Beijing adult population.

Methods

This cross-sectional study included 7972 adults who were 18–65 years old and who received health check-ups at the Beijing Physical Examination Center in 2016. Logistic regression was conducted to explore the associations between MetS, its components and eating speed.

Results

The prevalence of MetS in this population was 24.65% (36.02% for males and 10.18% for females). Eating speed was significantly associated with a high risk for MetS, elevated blood pressure, and central obesity for both genders. Eating speed was associated with a high risk for elevated triglycerides and with a reduction in high-density lipoprotein in males, and eating speed was associated with a high risk for elevated fasting plasma glucose in females. Compared with slow eating speed, the multivariate-adjusted odds ratios of medium eating speed and fast eating speed for MetS were 1.65 (95% confidence interval 1.32–2.07) and 2.27 (95% confidence interval 1.80–2.86) for all subjects, 1.58 (95% confidence interval 1.21–2.07) and 2.21 (95% confidence interval 1.69–2.91) for males, and 1.75 (95% confidence interval 1.15–2.68) and 2.27 (95% confidence interval 1.46–3.53) for females, respectively.

Conclusions

Eating speed is positively associated with MetS and its components. Future recommendations aiming to prevent MetS and its components may focus on eating speed.

Electronic supplementary material

The online version of this article (10.1186/s12889-018-5784-z) contains supplementary material, which is available to authorized users.

The Association between Food Group Consumption Patterns and Early Metabolic Syndrome Risk in Non-Diabetic Healthy People

We investigated the association between dietary habits/food group consumption patterns and early risk of metabolic syndrome (MetS), a main cause for metabolic disease. Study participants were recruited from the health promotion center in Dong-A University Hospital and public advertisement. Study subjects (n = 243, 21-80 years) were categorized into three groups: Super-healthy (MetS risk factor [MetS RF] = 0, n = 111), MetS-risk carriers (MetS RF = 1-2, n = 96), and MetS (MetS RF ≥ 3, n = 27). Higher regularity in dietary habits (breakfast-everyday, regular eating time, non-frequent overeating, and non-frequent eating-out) was observed in the Super-healthy group than in the MetS-risk carriers, and particularly in the MetS subjects. The relationship between food group consumption patterns and MetS-risk related parameters were investigated with adjustment for confounding factors. Fruit consumption was positively associated with HDL-cholesterol, and tended to be negatively associated with waist circumference, triglyceride, LDL-cholesterol, and insulin resistance (IR). The consumption of low-fat meats and fish, and vegetables was negatively associated with hs-CRP. Specifically, the consumption of sea-foods belonging to the low-fat fish was negatively associated with fasting glucose, hs-CRP, and interleukin (IL)-6. Anchovy/dried white baits consumption was negatively associated with fasting insulin and IR. Green-yellow vegetables consumption was negatively associated with fasting insulin, IR, and hs-CRP. On the other hand, sugars and fast-foods were positively associated with LDL-cholesterol. Additionally, fast-foods consumption was positively associated with hs-CRP and IL-6 levels. In conclusion, dietary habits/food group consumption patterns are closely associated with MetS-risk related parameters in Koreans. It may suggest useful information to educate people to properly select healthy foods for early prevention of MetS.

Faster eating rates are associated with higher energy intakes during an ad libitum meal, higher BMI and greater adiposity among 4·5-year-old children: results from the Growing Up in Singapore Towards Healthy Outcomes (GUSTO) cohort

Faster eating rates are associated with increased energy intake, but little is known about the relationship between children's eating rate, food intake and adiposity. We examined whether children who eat faster consume more energy and whether this is associated with higher weight status and adiposity. We hypothesised that eating rate mediates the relationship between child weight and ad libitum energy intake. Children (n 386) from the Growing Up in Singapore Towards Healthy Outcomes cohort participated in a video-recorded ad libitum lunch at 4·5 years to measure acute energy intake. Videos were coded for three eating-behaviours (bites, chews and swallows) to derive a measure of eating rate (g/min). BMI and anthropometric indices of adiposity were measured. A subset of children underwent MRI scanning (n 153) to measure abdominal subcutaneous and visceral adiposity. Children above/below the median eating rate were categorised as slower and faster eaters, and compared across body composition measures. There was a strong positive relationship between eating rate and energy intake (r 0·61, P<0·001) and a positive linear relationship between eating rate and children's BMI status. Faster eaters consumed 75 % more energy content than slower eating children (Δ548 kJ (Δ131 kcal); 95 % CI 107·6, 154·4, P<0·001), and had higher whole-body (P<0·05) and subcutaneous abdominal adiposity (Δ118·3 cc; 95 % CI 24·0, 212·7, P=0·014). Mediation analysis showed that eating rate mediates the link between child weight and energy intake during a meal (b 13·59; 95 % CI 7·48, 21·83). Children who ate faster had higher energy intake, and this was associated with increased BMI z-score and adiposity.

Fast or slow-foods? Describing natural variations in oral processing characteristics across a wide range of Asian foods

The structural properties of foods have a functional role to play in oral processing behaviours and sensory perception, and also impact on the meal size and the experience of fullness.