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Rashidbeygi E, Tabesh MR, Noormohammadi M, Khalaj A, Saidpour A, Ghods M, Jahromi SR. A Randomized Controlled Trial Investigating the Impact of a Low-Calorie Dietary Approach to Stop Hypertension (DASH) on Anthropometric and Glycemic Measures in Patients Experiencing Weight Regain 2 Years Post Sleeve Surgery. Obes Surg 2024; 34:892-901. [PMID: 38217832 DOI: 10.1007/s11695-024-07057-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 01/06/2024] [Accepted: 01/07/2024] [Indexed: 01/15/2024]
Abstract
PURPOSE To evaluate the effect of a low-calorie dietary approach to stop hypertension (DASH) compared to a low-calorie diet on weight control, body composition and glycemic measures in post sleeve patients with weight regain. MATERIALS AND METHODS Participants were randomly allocated to either the low-calorie DASH diet group (intervention) or the low-calorie diet group (control) for a duration of 16 weeks. Both groups had a prescribed caloric intake of 1000-1200 calories. The DASH diet group made dietary adjustments in accordance with the DASH pattern. RESULTS At the end of the study, both interventions significantly reduced anthropometric and body composition parameters (P-value < 0.001), with a greater decrease observed in the low-calorie DASH diet group (P-value < 0.001). Insulin levels and homeostatic model assessment for insulin resistance (HOMA-IR) decreased significantly in both groups, but the magnitude of these changes was not statistically different between the two groups. After adjusting for confounders, a significant difference was observed in post-intervention values and changes in weight, body mass index, and fat mass and fat-free mass. CONCLUSION In summary, adhering to a calorie-restricted DASH diet for 16 weeks improved weight loss, body mass index, and fat mass reduction in post-bariatric patients who experienced weight regain 2 years after surgery, compared to a calorie-restricted control diet. However, there was no significant difference in the effect on blood glucose, insulin, and HOMA-IR between the two diets.
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Affiliation(s)
- Elahe Rashidbeygi
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Morvarid Noormohammadi
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Alireza Khalaj
- Tehran Obesity Treatment Center, Department of Surgery, Faculty of Medicine, Shahed University, Tehran, Iran
| | - Atoosa Saidpour
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Ghods
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Soodeh Razeghi Jahromi
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Klos B, Cook J, Crepaz L, Weiland A, Zipfel S, Mack I. Impact of energy density on energy intake in children and adults: a systematic review and meta-analysis of randomized controlled trials. Eur J Nutr 2023; 62:1059-1076. [PMID: 36460778 PMCID: PMC10030411 DOI: 10.1007/s00394-022-03054-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Accepted: 11/10/2022] [Indexed: 12/03/2022]
Abstract
PURPOSE The energy density (ED) of a diet can be leveraged to prevent weight gain or treat overweight and obesity. By lowering the ED of the diet, energy intake can be reduced while maintaining portion size. However, a reliable meta-analysis of data from randomized controlled trials (RCTs) is missing. Therefore, this meta-analysis synthesized the evidence of ED manipulation on energy intake in RCTs. METHODS The systematic literature search of multiple databases according to PRISMA criteria considered RCTs investigating the objectively measured energy intake from meals with different ED (lower ED (median 1.1 kcal/g) versus higher ED (median 1.5 kcal/g)) under controlled conditions. Subgroup analyses for age (children versus adults), meal type (preload versus entrée design), and intervention length (1 meal versus > 1 meal) were performed to achieve the most homogeneous result. RESULTS The meta-analysis of 38 included studies demonstrated that lowering ED considerably reduced energy intake - 223 kcal (95% CI: - 259.7, - 186.0) in comparison to the higher ED interventions. As heterogeneity was high among studies, subgroup analyses were conducted. Heterogeneity decreased in subgroup analyses for age and meal type combined, strengthening the results. An extended analysis showed a positive linear relationship between ED and energy intake. Dietary ED did not affect the amount of food intake. CONCLUSION Manipulating ED substantially affects energy intake whereas food intake remains constant. Thus, this approach can be regarded as a powerful tool for weight management through nutrition therapy. Registration on 08/08/2021: CRD42021266653.
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Affiliation(s)
- Bea Klos
- Internal Medicine VI, Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Osianderstr. 5, 72076, Tübingen, Germany
| | - Jessica Cook
- Internal Medicine VI, Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Osianderstr. 5, 72076, Tübingen, Germany
| | - Letizia Crepaz
- Internal Medicine VI, Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Osianderstr. 5, 72076, Tübingen, Germany
| | - Alisa Weiland
- Internal Medicine VI, Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Osianderstr. 5, 72076, Tübingen, Germany
| | - Stephan Zipfel
- Internal Medicine VI, Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Osianderstr. 5, 72076, Tübingen, Germany
| | - Isabelle Mack
- Internal Medicine VI, Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Osianderstr. 5, 72076, Tübingen, Germany.
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Flynn AN, Hall KD, Courville AB, Rogers PJ, Brunstrom JM. Time to revisit the passive overconsumption hypothesis? Humans show sensitivity to calories in energy-rich meals. Am J Clin Nutr 2022; 116:581-588. [PMID: 35488870 PMCID: PMC9348985 DOI: 10.1093/ajcn/nqac112] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Accepted: 04/28/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND A possible driver of obesity is insensitivity (passive overconsumption) to food energy density (ED, kcal/g); however, it is unclear whether this insensitivity applies to all meals. OBJECTIVES We assessed the influence of ED on energy intake (kcal) across a broad and continuous range of EDs comprised of noncovertly manipulated, real-world meals. We also allowed for the possibility that the association between energy intake and ED is nonlinear. METHODS We completed a secondary analysis of 1519 meals which occurred in a controlled environment as part of a study conducted by Hall and colleagues to assess the effects of food ultra-processing on energy intake. To establish the generalizability of the findings, the analyses were repeated in 32,162 meals collected from free-living humans using data from the UK National Diet and Nutrition Survey (NDNS). Segmented regressions were performed to establish ED "breakpoints" at which the association between consumed meal ED and mean centered meal caloric intake (kcal) changed. RESULTS Significant breakpoints were found in both the Hall et al. data set (1.41 kcal/g) and the NDNS data set (1.75 and 2.94 kcal/g). Centered meal caloric intake did not increase linearly with consumed meal ED, and this pattern was captured by a 2-component ("volume" and "calorie content" [biologically derived from the sensing of fat, carbohydrate, and protein]) model of physical meal size (g), in which volume is the dominant signal with lower energy-dense foods and calorie content is the dominant signal with higher energy-dense foods. CONCLUSIONS These analyses reveal that, on some level, humans are sensitive to the energy content of meals and adjust meal size to minimize the acute aversive effects of overconsumption. Future research should consider the relative importance of volume and calorie-content signals, and how individual differences impact everyday dietary behavior and energy balance.
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Affiliation(s)
- Annika N Flynn
- Nutrition and Behaviour Unit, School of Psychological Science, University of Bristol, Bristol, United Kingdom
| | - Kevin D Hall
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, USA
| | - Amber B Courville
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, USA
| | - Peter J Rogers
- Nutrition and Behaviour Unit, School of Psychological Science, University of Bristol, Bristol, United Kingdom
- National Institute for Health and Care Research (NIHR) Bristol Biomedical Research Centre: Nutrition Theme, University of Bristol, University Hospitals Bristol Education & Research Centre, Bristol, United Kingdom
| | - Jeffrey M Brunstrom
- Nutrition and Behaviour Unit, School of Psychological Science, University of Bristol, Bristol, United Kingdom
- National Institute for Health and Care Research (NIHR) Bristol Biomedical Research Centre: Nutrition Theme, University of Bristol, University Hospitals Bristol Education & Research Centre, Bristol, United Kingdom
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Dietary energy density and appetite: A systematic review and meta-analysis of clinical trials. Nutrition 2019; 69:110551. [PMID: 31525704 DOI: 10.1016/j.nut.2019.110551] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2018] [Revised: 05/03/2019] [Accepted: 05/28/2019] [Indexed: 12/15/2022]
Abstract
Studies have suggested that dietary energy density (DED) may affect weight gain by altering appetite. Although many studies have investigated the effect of DED on appetite, findings are inconsistent and, to our knowledge, there are no systematic reviews and meta-analyses on this topic. Therefore, the aim of this systematic review and meta-analysis was to summarize the effect of DED on appetite. The current meta-analysis revealed changing the DED had no significant effect on hunger but increased fullness. More high-quality randomized controlled trials are needed to investigate the effects of DED on appetite components. We searched titles, abstracts, and keywords of articles indexed in ScienceDirect, MEDLINE, and Google Scholar databases up to July 2018 to identify eligible RCT studies. Random effects model was used to estimate the pooled effect of DED on appetite. Among the 21 studies identified in the systematic literature search, 11 reports were included in the meta-analysis. Based on the Cochrane Collaboration Risk of Bias tool, 6 studies were considered as good quality, two were fair, and three studies were poor. The mean ± standard deviation for energy density, in studies which assessed fullness, was 1.65 ± 1 in high energy dense (HED) diet and 0.93 ± 0.93 in low energy dense (LED) diet. The corresponding values for hunger were 1.67 ± 0.69 and 0.70 ± 0.32, respectively. Compared with a LED diet, consumption of HED increased fullness (weighed mean difference [WMD] 2.95 mm; 95% CI 0.07-5.82, P = 0.044, I2 98.1%) but had no significant effect on hunger (WMD 1.31 mm; 95% CI -7.20 to 9.82, P = 0.763, I2 99.1%). The current meta-analysis revealed changing the DED had no significant effect on hunger but increased fullness. More high-quality RCTs are needed to investigate the effects of DED on appetite components.
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Rogers PJ. Combating Excessive Eating: A Role for Four Evidence-Based Remedies. Obesity (Silver Spring) 2018; 26 Suppl 3:S18-S24. [PMID: 30290075 DOI: 10.1002/oby.22280] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Accepted: 07/16/2018] [Indexed: 11/07/2022]
Abstract
OBJECTIVE The aim of this study is to review the control of energy balance and outline some causes of and remedies for excessive energy intake. METHODS A narrative review was conducted. RESULTS There is negative feedback control of energy intake and body weight, but, nonetheless, energy intake is only loosely coupled with energy expenditure. Consequently, we are vulnerable to eating in excess of energy requirements. In this context, energy density, portion size, and habitual meal patterns have strong influences on energy intake and, accordingly, can be targeted to reduce energy intake. For example, energy density can be reduced without much affecting food reward (approximately the pleasure gained from eating) because their relationship is such that reward value is affected relatively little by increments in energy density above 1.5 kcal/g. This and other strategies that increase reward per calorie eaten may be superior to increasing the satiety effect of products because fullness is not inherently rewarding. Low-calorie sweeteners provide a means to reduce energy density while largely preserving food or beverage reward value. Consistent with this, consumption of low-calorie sweeteners compared with consumption of sugars has been found to reduce energy intake and body weight. CONCLUSIONS Understanding what causes excessive eating also provides insights into how to combat this problem.
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Affiliation(s)
- Peter J Rogers
- Nutrition and Behaviour Unit, School of Psychological Science, University of Bristol, UK
- National Institute for Health Research, Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust, University of Bristol, UK
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Mattes RD. Evidence on the "normalizing" effect of reducing food-portion sizes. Am J Clin Nutr 2018; 107:501-503. [PMID: 29635509 DOI: 10.1093/ajcn/nqy054] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Richard D Mattes
- Department of Nutrition Science, Purdue University, West Lafayette, IN
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Gould NJ, Zandstra EH, Yeomans MR. Knowing too much: Knowledge of energy content prevents liking change through flavour-nutrient associations. Q J Exp Psychol (Hove) 2018; 71:1939-1948. [PMID: 28854854 DOI: 10.1080/17470218.2017.1373360] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Associations between flavours and the consequences of ingestion can lead to changes in flavour liking depending on nutrient content, an example of flavour-nutrient learning (FNL). Expectations about the consequences of ingestion can be modified by information at the point of ingestion, such as nutritional labelling. What is unknown is the extent to which these label-based expectations modify FNL. Since nutrient information can alter expectations about how filling a product would be, we hypothesised that labels predicting higher energy (HE) content would enhance satiety and so promote more rapid flavour learning. To test this, participants consumed either a lower energy (LE: 164 kcal) or HE (330 kcal) yoghurt breakfast on four separate days, either with no product label or with labels displaying either the actual energy content (Congruent label) or inaccurate energy (Incongruent label). Participants rated liking on all four days: on Days 1 and 4, they could also consume as much as they liked, but consumed a fixed amount (300 g) on Days 2 and 3. Both liking and intake increased with exposure in the HE, and decreased in the LE, condition when unlabelled in line with FNL. In contrast, no significant changes were seen in either the Congruent or Incongruent label conditions. Contrary to predictions, these data suggest that FNL occurs when there is an absence of explicit expectations of actual nutrient content, with both accurate and inaccurate information on nutrient content disrupting learning.
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Kahathuduwa CN, Boyd LA, Davis T, O'Boyle M, Binks M. Brain regions involved in ingestive behavior and related psychological constructs in people undergoing calorie restriction. Appetite 2016; 107:348-361. [PMID: 27565377 DOI: 10.1016/j.appet.2016.08.112] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Revised: 08/09/2016] [Accepted: 08/22/2016] [Indexed: 11/16/2022]
Abstract
Human food intake is regulated by physiological energy homeostatic mechanisms and hedonic mechanisms. These are affected by both very short-term and longer-term calorie restriction (CR). To date, there are parallel discussions in the literature that fail to integrate across these disciplines and topics. First, much of the available neuroimaging research focusses on specific functional paradigms (e.g. reward, energy homeostasis). These paradigms often fail to consider more complex and inclusive models that examine how potential brain regions of interest interact to influence ingestion. Second, the paradigms used focus primarily on short-term CR (fasting) which has limited generalizability to clinical application. Finally, the behavioral literature, while frequently examining longer-term CR and related psychological constructs in the context of weight management (e.g. hedonic restraint, 'liking', 'wanting' and food craving), fails to adequately tie these phenomena to underlying neural mechanisms. The result is a less than complete picture of the brain's role in the complexity of the human experience of ingestion. This disconnect highlights a major limitation in the CR literature, where attempts are persistently made to exert behavioral control over ingestion, without fully understanding the complex bio behavioral systems involved. In this review we attempt to summarize all potential brain regions important for human ingestion, present a broad conceptual overview of the brain's multifaceted role in ingestive behavior, the human (psychological) experiences related to ingestion and to examine how these factors differ according to three forms of CR. These include short-term fasting, extended CR, and restrained eating. We aim to bring together the neuroimaging literature with the behavioral literature within a conceptual framework that may inform future translational research.
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Affiliation(s)
- Chanaka N Kahathuduwa
- Behavioral Medicine and Translational Research Lab, Department of Nutritional Sciences, Texas Tech University, Lubbock, TX, USA; Department of Physiology, Faculty of Medicine, University of Peradeniya, Sri Lanka
| | - Lori A Boyd
- Behavioral Medicine and Translational Research Lab, Department of Nutritional Sciences, Texas Tech University, Lubbock, TX, USA
| | - Tyler Davis
- Department of Psychological Sciences, Texas Tech University, Lubbock, TX, USA
| | - Michael O'Boyle
- Department of Human Development and Family Studies, Texas Tech University, Lubbock, TX, USA; Department of Pharmacology and Neuroscience, School of Medicine, Texas Tech University, Health Sciences Center, Lubbock, TX, USA
| | - Martin Binks
- Behavioral Medicine and Translational Research Lab, Department of Nutritional Sciences, Texas Tech University, Lubbock, TX, USA.
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Does an early socialization into a food culture condition lifelong food preferences? Evidence from a retrospective study. Appetite 2016; 101:95-103. [PMID: 26921489 DOI: 10.1016/j.appet.2016.02.147] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Revised: 02/18/2016] [Accepted: 02/22/2016] [Indexed: 10/22/2022]
Abstract
The influence of early formed dietary practices on food choices and preferences during adulthood has often been assumed but rarely adequately demonstrated given the difficulty of studying the subject matter with conventional laboratory or observational research designs. This article examines this assumption by analyzing the information from 31 structured interviews on the respondents' current preferences for combinations of six side dishes with bread or mămăligă (boiled cornmeal mush, similar to polenta). All the respondents had consumed mămăligă in their childhood but in their adulthood had switched to bread following the social and economic upheavals from 1960s Romania. The results show that a) for specific combinations, physiological factors and/or cultural norms that defined bread as a 'prestigious' food have been capable of overriding the effects of early socialization with mămăligă as the accompanying food and b) that consumers continue to prefer certain side dishes with mămăligă even after decades of predominant consumption of bread although confounding factors might account for such preferences. These findings qualify the expectation that an early familiarization with healthy eating habits will promote this desired lifestyle during adulthood by showing that physiological and socio-cultural factors are capable of overriding its effects on hedonic preferences.
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Hollands GJ, Shemilt I, Marteau TM, Jebb SA, Lewis HB, Wei Y, Higgins JPT, Ogilvie D. Portion, package or tableware size for changing selection and consumption of food, alcohol and tobacco. Cochrane Database Syst Rev 2015; 2015:CD011045. [PMID: 26368271 PMCID: PMC4579823 DOI: 10.1002/14651858.cd011045.pub2] [Citation(s) in RCA: 144] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Overeating and harmful alcohol and tobacco use have been linked to the aetiology of various non-communicable diseases, which are among the leading global causes of morbidity and premature mortality. As people are repeatedly exposed to varying sizes and shapes of food, alcohol and tobacco products in environments such as shops, restaurants, bars and homes, this has stimulated public health policy interest in product size and shape as potential targets for intervention. OBJECTIVES 1) To assess the effects of interventions involving exposure to different sizes or sets of physical dimensions of a portion, package, individual unit or item of tableware on unregulated selection or consumption of food, alcohol or tobacco products in adults and children.2) To assess the extent to which these effects may be modified by study, intervention and participant characteristics. SEARCH METHODS We searched CENTRAL, MEDLINE, EMBASE, PsycINFO, eight other published or grey literature databases, trial registries and key websites up to November 2012, followed by citation searches and contacts with study authors. This original search identified eligible studies published up to July 2013, which are fully incorporated into the review. We conducted an updated search up to 30 January 2015 but further eligible studies are not yet fully incorporated due to their minimal potential to change the conclusions. SELECTION CRITERIA Randomised controlled trials with between-subjects (parallel-group) or within-subjects (cross-over) designs, conducted in laboratory or field settings, in adults or children. Eligible studies compared at least two groups of participants, each exposed to a different size or shape of a portion of a food (including non-alcoholic beverages), alcohol or tobacco product, its package or individual unit size, or of an item of tableware used to consume it, and included a measure of unregulated selection or consumption of food, alcohol or tobacco. DATA COLLECTION AND ANALYSIS We applied standard Cochrane methods to select eligible studies for inclusion and to collect data and assess risk of bias. We calculated study-level effect sizes as standardised mean differences (SMDs) between comparison groups, measured as quantities selected or consumed. We combined these results using random-effects meta-analysis models to estimate summary effect sizes (SMDs with 95% confidence intervals (CIs)) for each outcome for size and shape comparisons. We rated the overall quality of evidence using the GRADE system. Finally, we used meta-regression analysis to investigate statistical associations between summary effect sizes and variant study, intervention or participant characteristics. MAIN RESULTS The current version of this review includes 72 studies, published between 1978 and July 2013, assessed as being at overall unclear or high risk of bias with respect to selection and consumption outcomes. Ninety-six per cent of included studies (69/72) manipulated food products and 4% (3/72) manipulated cigarettes. No included studies manipulated alcohol products. Forty-nine per cent (35/72) manipulated portion size, 14% (10/72) package size and 21% (15/72) tableware size or shape. More studies investigated effects among adults (76% (55/72)) than children and all studies were conducted in high-income countries - predominantly in the USA (81% (58/72)). Sources of funding were reported for the majority of studies, with no evidence of funding by agencies with possible commercial interests in their results.A meta-analysis of 86 independent comparisons from 58 studies (6603 participants) found a small to moderate effect of portion, package, individual unit or tableware size on consumption of food (SMD 0.38, 95% CI 0.29 to 0.46), providing moderate quality evidence that exposure to larger sizes increased quantities of food consumed among children (SMD 0.21, 95% CI 0.10 to 0.31) and adults (SMD 0.46, 95% CI 0.40 to 0.52). The size of this effect suggests that, if sustained reductions in exposure to larger-sized food portions, packages and tableware could be achieved across the whole diet, this could reduce average daily energy consumed from food by between 144 and 228 kcal (8.5% to 13.5% from a baseline of 1689 kcal) among UK children and adults. A meta-analysis of six independent comparisons from three studies (108 participants) found low quality evidence for no difference in the effect of cigarette length on consumption (SMD 0.25, 95% CI -0.14 to 0.65).One included study (50 participants) estimated a large effect on consumption of exposure to differently shaped tableware (SMD 1.17, 95% CI 0.57 to 1.78), rated as very low quality evidence that exposure to shorter, wider bottles (versus taller, narrower bottles) increased quantities of water consumed by young adult participants.A meta-analysis of 13 independent comparisons from 10 studies (1164 participants) found a small to moderate effect of portion or tableware size on selection of food (SMD 0.42, 95% CI 0.24 to 0.59), rated as moderate quality evidence that exposure to larger sizes increased the quantities of food people selected for subsequent consumption. This effect was present among adults (SMD 0.55, 95% CI 0.35 to 0.75) but not children (SMD 0.14, 95% CI -0.06 to 0.34).In addition, a meta-analysis of three independent comparisons from three studies (232 participants) found a very large effect of exposure to differently shaped tableware on selection of non-alcoholic beverages (SMD 1.47, 95% CI 0.52 to 2.43), rated as low quality evidence that exposure to shorter, wider (versus taller, narrower) glasses or bottles increased the quantities selected for subsequent consumption among adults (SMD 2.31, 95% CI 1.79 to 2.83) and children (SMD 1.03, 95% CI 0.41 to 1.65). AUTHORS' CONCLUSIONS This review found that people consistently consume more food and drink when offered larger-sized portions, packages or tableware than when offered smaller-sized versions. This suggests that policies and practices that successfully reduce the size, availability and appeal of larger-sized portions, packages, individual units and tableware can contribute to meaningful reductions in the quantities of food (including non-alcoholic beverages) people select and consume in the immediate and short term. However, it is uncertain whether reducing portions at the smaller end of the size range can be as effective in reducing food consumption as reductions at the larger end of the range. We are unable to highlight clear implications for tobacco or alcohol policy due to identified gaps in the current evidence base.
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Affiliation(s)
- Gareth J Hollands
- University of CambridgeBehaviour and Health Research UnitForvie SiteRobinson WayCambridgeUKCB2 0SR
| | - Ian Shemilt
- University College LondonEPPI‐Centre10 Woburn SquareLondonUKWC1H 0NR
| | - Theresa M Marteau
- University of CambridgeBehaviour and Health Research UnitForvie SiteRobinson WayCambridgeUKCB2 0SR
| | - Susan A Jebb
- University of OxfordNuffield Department of Primary Care Health SciencesRadcliffe Observatory QuarterWoodstock RoadOxfordOxfordshireUKOX2 6GG
| | - Hannah B Lewis
- MRC Human Nutrition ResearchElsie Widdowson Laboratory, 120 Fulbourn RoadCambridgeUKCB1 9NL
| | - Yinghui Wei
- University of PlymouthCentre for Mathematical Sciences, School of Computing, Electronics and MathematicsPlymouthUK
| | - Julian P T Higgins
- University of BristolPopulation Health Sciences, Bristol Medical SchoolCanynge Hall39 Whatley RoadBristolUKBS8 2PS
| | - David Ogilvie
- University of CambridgeMRC Epidemiology UnitBox 285Cambridge Biomedical CampusCambridgeUKCB2 0QQ
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Karl JP, Roberts SB. Energy density, energy intake, and body weight regulation in adults. Adv Nutr 2014; 5:835-50. [PMID: 25398750 PMCID: PMC4224224 DOI: 10.3945/an.114.007112] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The role of dietary energy density (ED) in the regulation of energy intake (EI) is controversial. Methodologically, there is also debate about whether beverages should be included in dietary ED calculations. To address these issues, studies examining the effects of ED on EI or body weight in nonelderly adults were reviewed. Different approaches to calculating dietary ED do not appear to alter the direction of reported relations between ED and body weight. Evidence that lowering dietary ED reduces EI in short-term studies is convincing, but there are currently insufficient data to determine long-term effectiveness for weight loss. The review also identified key barriers to progress in understanding the role of ED in energy regulation, in particular the absence of a standard definition of ED, and the lack of data from multiple long-term clinical trials examining the effectiveness of low-ED diet recommendations for preventing both primary weight gain and weight regain in nonobese individuals. Long-term clinical trials designed to examine the impact of dietary ED on energy regulation, and including multiple ED calculation methods within the same study, are still needed to determine the importance of ED in the regulation of EI and body weight.
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Affiliation(s)
| | - Susan B. Roberts
- Address correspondence to S. B. Roberts, 711 Washington St., Rm 1313, Boston, MA 02111. E-mail:
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12
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Temple JL. Factors that influence the reinforcing value of foods and beverages. Physiol Behav 2014; 136:97-103. [PMID: 24793218 DOI: 10.1016/j.physbeh.2014.04.037] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2013] [Revised: 04/22/2014] [Accepted: 04/23/2014] [Indexed: 11/28/2022]
Abstract
Behavioral economic principles state that as the cost of a product increases, purchasing or consumption of that product will decrease. To understand the impact of behavioral economics on ingestive behavior, our laboratory utilizes an operant behavior paradigm to measure how much work an individual will engage in to get access to foods and beverages. This task provides an objective measure of the reinforcing value. We have shown that consumption of the same high fat snack food every day for two weeks reduces its reinforcing value in lean individuals, but increases its reinforcing value in a subset of obese individuals. This increase in the reinforcing value of food predicts future weight gain. Similarly, we have shown that repeated intake of caffeinated soda increases its reinforcing value in boys, but not in girls. This increase in reinforcing value is not related to usual caffeine consumption, but may be associated with positive, subjective effects of caffeine that are more likely to be reported by boys than by girls. Because food and beverage reinforcement relates to real-world consumption, it is important to determine factors that increase or decrease the reinforcing value and determine the consequences of these responses. We are especially interested in determining ways to shift the behavioral economic curve in order to develop novel strategies to decrease the reinforcing value of less healthy snack foods and beverages, such as soda, potato chips and candy and to increase the reinforcing value of healthier foods and beverages, such as water, fruits, and vegetables.
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Affiliation(s)
- Jennifer L Temple
- Departments of Exercise and Nutrition Sciences and Community Health and Health Behavior, School of Public Health and Health Professions, University at Buffalo, 3435 Main Street, 1 Farber Hall, Buffalo, NY 14214, United States.
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Rocha J, Paxman J, Dalton C, Winter E, Broom D. Effects of an acute bout of aerobic exercise on immediate and subsequent three-day food intake and energy expenditure in active and inactive men. Appetite 2013; 71:369-78. [DOI: 10.1016/j.appet.2013.09.009] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2013] [Revised: 09/09/2013] [Accepted: 09/12/2013] [Indexed: 02/01/2023]
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14
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Griffioen-Roose S, Smeets PAM, Weijzen PLG, van Rijn I, van den Bosch I, de Graaf C. Effect of replacing sugar with non-caloric sweeteners in beverages on the reward value after repeated exposure. PLoS One 2013; 8:e81924. [PMID: 24312382 PMCID: PMC3842969 DOI: 10.1371/journal.pone.0081924] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2013] [Accepted: 10/28/2013] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The reward value of food is partly dependent on learned associations. It is not yet known whether replacing sugar with non-caloric sweeteners in food is affecting long-term acceptance. OBJECTIVE To determine the effect of replacing sugar with non-caloric sweeteners in a nutrient-empty drink (soft drink) versus nutrient-rich drink (yoghurt drink) on reward value after repeated exposure. DESIGN We used a randomized crossover design whereby forty subjects (15 men, 25 women) with a mean ± SD age of 21 ± 2 y and BMI of 21.5 ± 1.7 kg/m(2) consumed a fixed portion of a non-caloric sweetened (NS) and sugar sweetened (SS) versions of either a soft drink or a yoghurt drink (counterbalanced) for breakfast which were distinguishable by means of colored labels. Each version of a drink was offered 10 times in semi-random order. Before and after conditioning the reward value of the drinks was assessed using behavioral tasks on wanting, liking, and expected satiety. In a subgroup (n=18) fMRI was performed to assess brain reward responses to the drinks. RESULTS Outcomes of both the behavioral tasks and fMRI showed that conditioning did not affect the reward value of the NS and SS versions of the drinks significantly. Overall, subjects preferred the yoghurt drinks to the soft drinks and the ss drinks to the NS drinks. In addition, they expected the yoghurt drinks to be more satiating, they reduced hunger more, and delayed the first eating episode more. Conditioning did not influence these effects. CONCLUSION Our study showed that repeated consumption of a non-caloric sweetened beverage, instead of a sugar sweetened version, appears not to result in changes in the reward value. It cannot be ruled out that learned associations between sensory attributes and food satiating capacity which developed preceding the conditioning period, during lifetime, affected the reward value of the drinks.
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Affiliation(s)
| | - Paul A. M. Smeets
- Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands
- Image Sciences Institute, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Pascalle L. G. Weijzen
- Research Department Sensory & Consumer Science, FrieslandCampina, Amersfoort, The Netherlands
| | - Inge van Rijn
- Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands
| | - Iris van den Bosch
- Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands
| | - Cees de Graaf
- Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands
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15
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Tellez LA, Ren X, Han W, Medina S, Ferreira JG, Yeckel CW, de Araujo IE. Glucose utilization rates regulate intake levels of artificial sweeteners. J Physiol 2013; 591:5727-44. [PMID: 24060992 DOI: 10.1113/jphysiol.2013.263103] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
It is well established that animals including humans attribute greater reinforcing value to glucose-containing sugars compared to their non-caloric counterparts, generally termed 'artificial sweeteners'. However, much remains to be determined regarding the physiological signals and brain systems mediating the attribution of greater reinforcing value to sweet solutions that contain glucose. Here we show that disruption of glucose utilization in mice produces an enduring inhibitory effect on artificial sweetener intake, an effect that did not depend on sweetness perception or aversion. Indeed, such an effect was not observed in mice presented with a less palatable, yet caloric, glucose solution. Consistently, hungry mice shifted their preferences away from artificial sweeteners and in favour of glucose after experiencing glucose in a hungry state. Glucose intake was found to produce significantly greater levels of dopamine efflux compared to artificial sweetener in dorsal striatum, whereas disrupting glucose oxidation suppressed dorsal striatum dopamine efflux. Conversely, inhibiting striatal dopamine receptor signalling during glucose intake in sweet-naïve animals resulted in reduced, artificial sweetener-like intake of glucose during subsequent gluco-deprivation. Our results demonstrate that glucose oxidation controls intake levels of sweet tastants by modulating extracellular dopamine levels in dorsal striatum, and suggest that glucose utilization is one critical physiological signal involved in the control of goal-directed sweetener intake.
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Affiliation(s)
- Luis A Tellez
- I. E de Araujo: The John B. Pierce Laboratory & Yale University School of Medicine, 290 Congress Avenue, New Haven, CT 06519, USA. or
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de Araujo IE, Lin T, Veldhuizen MG, Small DM. Metabolic regulation of brain response to food cues. Curr Biol 2013; 23:878-83. [PMID: 23643837 DOI: 10.1016/j.cub.2013.04.001] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2013] [Revised: 03/06/2013] [Accepted: 04/02/2013] [Indexed: 11/20/2022]
Abstract
Identification of energy sources depends upon the ability to form associations between food cues and nutritional value. As such, cues previously paired with calories elicit neuronal activation in the nucleus accumbens (NAcc), which reflects the reinforcing value of food. The identity of the physiological signals regulating this response remains elusive. Using fMRI, we examined brain response to noncaloric versions of flavors that had been consumed in previous days with either 0 or 112.5 calories from undetected maltodextrin. We report a small but perceptually meaningful increase in liking for the flavor that had been paired with calories and find that change in liking was associated with changes in insular responses to this beverage. In contrast, NAcc and hypothalamic response to the calorie-paired flavor was unrelated to liking but was strongly associated with the changes in plasma glucose levels produced by ingestion of the beverage when consumed previously with calories. Importantly, because each participant ingested the same caloric dose, the change in plasma glucose depended upon individual differences in glucose metabolism. We conclude that glucose metabolism is a critical signal regulating NAcc and hypothalamic response to food cues, and that this process operates independently from the ability of calories to condition liking.
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Small DM. Flavor is in the brain. Physiol Behav 2012; 107:540-52. [PMID: 22542991 DOI: 10.1016/j.physbeh.2012.04.011] [Citation(s) in RCA: 163] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2012] [Revised: 04/10/2012] [Accepted: 04/12/2012] [Indexed: 11/25/2022]
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18
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Yeomans MR. Flavour–nutrient learning in humans: An elusive phenomenon? Physiol Behav 2012; 106:345-55. [DOI: 10.1016/j.physbeh.2012.03.013] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2011] [Revised: 03/11/2012] [Accepted: 03/12/2012] [Indexed: 10/28/2022]
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19
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de Araujo IE, Ferreira JG, Tellez LA, Ren X, Yeckel CW. The gut-brain dopamine axis: a regulatory system for caloric intake. Physiol Behav 2012; 106:394-9. [PMID: 22406348 DOI: 10.1016/j.physbeh.2012.02.026] [Citation(s) in RCA: 81] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2011] [Revised: 02/21/2012] [Accepted: 02/26/2012] [Indexed: 01/29/2023]
Abstract
Post-ingestive factors are known to strongly modulate feeding behavior by providing feedback signals to the central nervous system on the current physiological state of the organism. Of particular interest is the identification of the physiological pathways that permit the brain to sense post-ingestive signals. We will review recent evidence supporting the concept that direct stimulation of the gastrointestinal tract with nutrients induces release of the catecholamine neurotransmitter dopamine. In addition, changes in dopamine efflux produced by direct stimulation of the gastrointestinal tract were found to reflect the caloric load of the infusates, suggesting that dopamine signaling may function as a central caloric sensor that mediates adjustments in intake according to the caloric density of a meal. Consistent with the above, blockade of dopamine signaling disrupts flavor-nutrient associations and impairs the regulatory capacity to maintain constant caloric intake during intra-gastric feeding. Future research must determine the exact pathways linking gut nutrient administration to dopamine efflux. Current evidence points to parallel contributions by pre- and post-absorptive pathways, indicating that dopamine systems constitute a site of convergence through which distinct physiological signals can exert control over ingestive behaviors.
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Hall AC, Fairclough AC, Mahadevan K, Paxman JR. Ascophyllum nodosum enriched bread reduces subsequent energy intake with no effect on post-prandial glucose and cholesterol in healthy, overweight males. A pilot study. Appetite 2012; 58:379-86. [PMID: 22100188 DOI: 10.1016/j.appet.2011.11.002] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2011] [Revised: 08/12/2011] [Accepted: 11/03/2011] [Indexed: 10/15/2022]
Abstract
It is well recognised that the consumption of seaweed isolates (such as alginate) successfully reduce energy intake and modulate glycaemic and cholesterolaemic responses. However, to date, the effect of adding whole seaweed to bread has not been widely investigated. Hence, this study aims to investigate the acceptability of Ascophyllum nodosum enriched bread as part of a meal, and measure its effect on energy intake and nutrient absorption in overweight, healthy males to see if it has a similar impact. Results from the acceptability study, (79 untrained sensory panellists) indicated that it is acceptable to incorporate seaweed (A. nodosum) into a staple food such as bread at concentrations of up to 4% per 400 g wholemeal loaf. A single blind cross over trial (n=12 males, aged 40.1±12.5 years; BMI 30.8±4.4 kg/m(2)) was used to compare energy intake and nutrient uptake after a breakfast meal using the enriched bread (4% A. nodosum) against the control bread (0% A. nodosum). Consumption of the enriched bread at breakfast led to a significant reduction (16.4%) in energy intake at a test meal 4 h later. Differences between treatment arms for area under the curve, peak values, and time of peak for blood glucose and cholesterol were not significant. Further investigation of potential mechanisms of action is warranted.
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Affiliation(s)
- A C Hall
- Centre for Food Innovation, Sheffield Business School, City Campus, Howard Street, Sheffield S1 1WB, United Kingdom.
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Ferreira JG, Tellez LA, Ren X, Yeckel CW, de Araujo IE. Regulation of fat intake in the absence of flavour signalling. J Physiol 2012; 590:953-72. [PMID: 22219333 DOI: 10.1113/jphysiol.2011.218289] [Citation(s) in RCA: 83] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Animals, including humans, can achieve precise regulation of caloric intake by adjusting consumption in response to covert changes in energy density. It remains unknown, however, whether the presence of flavour cues are required for the ability to maintain constant caloric intake. Also unknown are the brain circuits that may function as the central calorie monitors that control adaptive adjustments in energy intake. Here we show that mice trained to lick a dry spout in order to receive intra-gastric infusions of a fat emulsion maintained constant hourly caloric intake by adjusting the number of dry licks in response to changes in caloric density. Animals also increased dry licking according to hunger levels, and developed conditioned preferences for dry sippers associated with high calorie infusions. Importantly, striatal dopamine levels were closely associated with the amount of calories ingested, rather than with the number of dry licks produced. Dopamine levels in dorsal and ventral striatum also reflected caloric density in mice passively receiving intra-gastric infusions of fat emulsions. Consistent with the above, systemic administration of the dopamine receptor blocker haloperidol markedly increased the production of dry licks needed to obtain high-calorie infusions, as if the caloric density of the infusions had been diluted. Conversely, haloperidol markedly decreased the production of dry licks needed to obtain low-calorie infusions. Taken together, our results support the proposition that brain dopamine circuits function as one central sensor of calorie ingestion, since (1) extracellular striatal dopamine levels fluctuate in proportion to the caloric density of nutrients infused in the gut; and (2) inhibiting dopamine receptor signalling disrupts the animals' ability to maintain constant caloric intake across experimental sessions.
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Yeomans MR. Short term effects of alcohol on appetite in humans. Effects of context and restrained eating. Appetite 2010; 55:565-73. [DOI: 10.1016/j.appet.2010.09.005] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2009] [Revised: 07/23/2010] [Accepted: 09/08/2010] [Indexed: 11/26/2022]
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The satiety effect of disguised liquid preloads administered acutely and differing only in their nutrient content tended to be weaker for lipids but did not differ between proteins and carbohydrates in human subjects. Br J Nutr 2010; 104:1406-14. [DOI: 10.1017/s0007114510002126] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Whether protein is the macronutrient with the strongest satiety effect remains a matter of debate because of the diversity of study designs employed. The aim of the present study was to compare the effect of different liquid preloads made up of proteins, fats or carbohydrates only, under stringently controlled conditions, on satiety. Fifty-six subjects participated in the present study which consisted of four randomised test days, i.e. 1 d per macronutrient and one control day. During each test day, the subjects were required to consume the preload in full, and then their subsequent food intake was measured. The volunteers were divided into two groups: the first (T0) group, which consumed the preload immediately before lunch, and the second (T1) group, which consumed it 1 h beforehand. The main results showed that the participants consumed significantly less at lunch following the consumption of all three preloads than on the no-preload day, and consumed less after the consumption of the carbohydrate preload than after the consumption of the lipid preload. When energy from the preload was included, overall energy intake was significantly greater in all the three preload conditions than in the situation involving no preload, with only partial compensation for preload energy in all conditions. Total daily energy intake was highest after the lipid preload ingestion, but this could be a chance finding since it was not significantly higher than that observed after protein or carbohydrate preload ingestion. No significant effects of the interval between the preload and test meal ingestion were found. These results do not confirm the greater satiety effect of proteins than of carbohydrates, but partially confirm the weaker effect of fats.
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Solah VA, Kerr DA, Adikara CD, Meng X, Binns CW, Zhu K, Devine A, Prince RL. Differences in satiety effects of alginate- and whey protein-based foods. Appetite 2010; 54:485-91. [DOI: 10.1016/j.appet.2010.01.019] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2009] [Revised: 12/29/2009] [Accepted: 01/30/2010] [Indexed: 10/19/2022]
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Booth DA. Learnt reduction in the size of a meal. Measurement of the sensory-gastric inhibition from conditioned satiety. Appetite 2009; 52:745-749. [PMID: 19501774 DOI: 10.1016/j.appet.2009.02.008] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2009] [Accepted: 02/12/2009] [Indexed: 12/28/2022]
Abstract
Many experiments on the role of learning in the amount eaten at a distinctive test meal have been claimed to observe "conditioned satiety." None published from outside this author's group has used either the necessary design of the contingencies to be learnt or the measurements that distinguish a sating effect from other loss of interest in food. One experiment has just been published without an adequate design but giving the best evidence yet from another group for the conditioning of sensory-gastric satiety; yet the authors conclude for changes in sensory preference with no learnt gastric involvement in the meal size response. To encourage correct use of the demonstrations in rats, monkeys and people of conditioned satiety and its mechanism, this paper briefly reviews publications that attribute control of meal size to learnt satiety.
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Affiliation(s)
- David A Booth
- School of Psychology, College of Life and Environmental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.
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