Tasting fat: Cephalic phase hormonal responses and food intake in restrained and unrestrained eaters

Differential effects of nutritive and non-nutritive sweet mouth rinsing on appetite in adults with obesity

BACKGROUND

Excessive added sugar intake has been associated with obesity; however, the effect of dietary sweetness on energy intake (EI) and appetite in adults with and without obesity has not yet been determined.

OBJECTIVE

To assess the effect of mouth rinses with and without energy and sweetness on measures of appetite, and to compare responses between subjects with body mass index (BMI) between 18.5 and 24.9 kg/m2 or ≥30 kg/m2.

METHODS

In this randomized, double-blind crossover study, 39 subjects (age 23±5y; 17 male, 22 female; BMI 18.5-24.9 kg/m2: n = 21; ≥30 kg/m2: n = 18) performed modified sham-feeding (MSF) with a mouth rinse containing either sucrose, sucralose, maltodextrin, or water for 2min before expectorating the solution. Blood sampling and subjective appetite assessments occurred at baseline (-5) and 15, 30, 60, and 90min post-MSF. After, EI was assessed at a buffet meal and post-meal appetite ratings were assessed hourly for 3h.

RESULTS

Post-MSF ghrelin increased for water vs. maltodextrin (water: p = 0.03). Post-MSF cholecystokinin increased following maltodextrin-MSF (p = 0.03) and sucralose-MSF (p = 0.005) vs. sucrose for those with BMI:18.5-24.9 kg/m2 only. There was greater post-MSF desire to eat in response to water vs. sucrose (p = 0.03) and reduced fullness with sucralose for those with BMI≥30 vs. 18.5-24.9 kg/m2 (p < 0.001). There was no difference in EI at the buffet meal by mouth rinse (p = 0.98) or by BMI (p = 0.12). However, there was greater post-meal fullness following sucralose-MSF vs. water (p = 0.03) and sucrose (p = 0.004) for those with BMI≥30 vs. 18.5-24.9 kg/m2.

CONCLUSION

Sucralose rinsing led to greater cephalic phase CCK release in adults with a BMI:18.5-24.9 kg/m2 only; however, ghrelin responses to unsweetened rinses were energy-specific for all adults. As subsequent EI was unaffected, further investigation of cephalic phase appetite is warranted.

The elusive cephalic phase insulin response: triggers, mechanisms, and functions

The cephalic phase insulin response (CPIR) is classically defined as a head receptor-induced early release of insulin during eating that precedes a postabsorptive rise in blood glucose. Here we discuss, first, the various stimuli that elicit the CPIR and the sensory signaling pathways (sensory limb) involved; second, the efferent pathways that control the various endocrine events associated with eating (motor limb); and third, what is known about the central integrative processes linking the sensory and motor limbs. Fourth, in doing so, we identify open questions and problems with respect to the CPIR in general. Specifically, we consider test conditions that allow, or may not allow, the stimulus to reach the potentially relevant taste receptors and to trigger a CPIR. The possible significance of sweetness and palatability as crucial stimulus features and whether conditioning plays a role in the CPIR are also discussed. Moreover, we ponder the utility of the strict classical CPIR definition based on what is known about the effects of vagal motor neuron activation and thereby acetylcholine on the β-cells, together with the difficulties of the accurate assessment of insulin release. Finally, we weigh the evidence of the physiological and clinical relevance of the cephalic contribution to the release of insulin that occurs during and after a meal. These points are critical for the interpretation of the existing data, and they support a sharper focus on the role of head receptors in the overall insulin response to eating rather than relying solely on the classical CPIR definition.

Reduced Fat Taste Sensitivity in Obese Japanese Patients and Its Recovery after a Short-Term Weight Loss Program

Fat taste has recently attracted attention as the 'sixth taste.' However, the relationship between fat and sweet taste in Japanese obesity has not yet been examined, and no reports have ascertained whether improvement of fat taste can be obtained by weight loss. Patients were recruited into obesity group (BMI≥30 kg/m²; n=15) or control group (BMI<25 kg/m²; n=11). They answered a questionnaire on smoking, eating behavior, lifestyle, and food frequency, and their taste thresholds were measured (fat, umami, and sweet). The obesity group was tested twice (on admission and before discharge). They showed several eating behavior abnormalities, higher total energy intake, and less physical activity. There were some gender differences: physical inactivity was more prominent in females, and high total energy intake in males, which correlates with fat taste rank. Fat taste rank was significantly higher in obesity group, whereas taste rank of umami and sweet were not significantly different. Gender-specific analysis of fat taste rank revealed only male obesity showed significant difference. Reduced sensitivity of fat may be specific to male gender or obesity by overeating, but not by physical inactivity. Multiple logistic regression analysis revealed that fat taste was a factor relevant to obesity. Fat taste significantly improved after a weight loss program, with average duration of 11.3 d. Japanese obese people, especially males and those who are obese by overeating, have reduced sensitivity to fat taste. This can be recovered by even a short-term weight loss program.

Cephalic phase insulin release: A review of its mechanistic basis and variability in humans

Cephalic phase insulin release (CPIR) is a transient pulse of insulin that occurs within minutes of stimulation from foods or food-related stimuli. Despite decades of research on CPIR in humans, the body of literature surrounding this phenomenon is controversial due in part to contradictory findings . This has slowed progress towards understanding the sensory and neural basis of CPIR, as well as its overall relevance to health. This review examines up-to-date knowledge in CPIR research and identifies sources of CPIR variability in humans in an effort to guide future research. The review starts by defining CPIR and discussing its presumed functional roles in glucose homeostasis and feeding behavior. Next, the types of stimuli that have been reported to elicit CPIR, as well as the sensory and neural mechanisms underlying the response in rodents and humans are discussed, and areas where knowledge is limited are identified. Finally, factors that may contribute to the observed variability of CPIR in humans are examined, including experimental design, test procedure, and individual characteristics. Overall, oral stimulation appears to be important for eliciting CPIR, especially when combined with other sensory modalities (vision, olfaction, somatosensation). While differences in experimental design and testing procedure likely explain some of the observed inter- and intra-study variability, individual differences also appear to play an important role. Understanding sources of these individual differences in CPIR will be key for establishing its health relevance.

Food anticipatory hormonal responses: A systematic review of animal and human studies

Food anticipatory hormonal responses (cephalic responses) are proactive physiological processes, that allow animals to prepare for food ingestion by modulating their hormonal levels in response to food cues. This process is important for digesting food, metabolizing nutrients and maintaining glucose levels within homeostasis. In this systematic review, we summarize the evidence from animal and human research on cephalic responses. Thirty-six animal and fifty-three human studies were included. The majority (88 %) of studies demonstrated that hormonal levels are changed in response to cues previously associated with food intake, such as feeding time, smell, and sight of food. Most evidence comes from studies on insulin, ghrelin, pancreatic polypeptide, glucagon, and c-peptide. Moreover, impaired cephalic responses were found in disorders related to metabolism and food intake such as diabetes, pancreatic insufficiency, obesity, and eating disorders, which opens discussions about the etiological mechanisms of these disorders as well as on potential therapeutic opportunities.

NIH Workshop Report: sensory nutrition and disease

In November 2019, the NIH held the "Sensory Nutrition and Disease" workshop to challenge multidisciplinary researchers working at the interface of sensory science, food science, psychology, neuroscience, nutrition, and health sciences to explore how chemosensation influences dietary choice and health. This report summarizes deliberations of the workshop, as well as follow-up discussion in the wake of the current pandemic. Three topics were addressed: A) the need to optimize human chemosensory testing and assessment, B) the plasticity of chemosensory systems, and C) the interplay of chemosensory signals, cognitive signals, dietary intake, and metabolism. Several ways to advance sensory nutrition research emerged from the workshop: 1) refining methods to measure chemosensation in large cohort studies and validating measures that reflect perception of complex chemosensations relevant to dietary choice; 2) characterizing interindividual differences in chemosensory function and how they affect ingestive behaviors, health, and disease risk; 3) defining circuit-level organization and function that link and interact with gustatory, olfactory, homeostatic, visceral, and cognitive systems; and 4) discovering new ligands for chemosensory receptors (e.g., those produced by the microbiome) and cataloging cell types expressing these receptors. Several of these priorities were made more urgent by the current pandemic because infection with sudden acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the ensuing coronavirus disease of 2019 has direct short- and perhaps long-term effects on flavor perception. There is increasing evidence of functional interactions between the chemosensory and nutritional sciences. Better characterization of this interface is expected to yield insights to promote health, mitigate disease risk, and guide nutrition policy.

Greater self-reported preference for fat taste and lower fat restraint are associated with more frequent intake of high-fat food

The determinants of the intake of high-fat products are not well recognized, but fat preference may be one of them. The aim of this study was thus to determine whether intake of different types of high-fat food is associated with fat preference in people with normal and increased body weight. Participants aged 20-40 years [n = 421] were enrolled in Poznań, Poland in 2016-2018. Fat preference was measured using the Fat Preference Questionnaire. Self-reported preference for fat taste (TASTE) and fat restraint (DIFF) scores were calculated. The frequency of consuming high-fat food was measured with an application for mobile devices using ecological momentary assessment. TASTE was positively associated with calorie intake and total frequency of eating high-fat food in both the normal weight and the overweight/obese groups. Overweight and obese people had lower DIFF (p < 0.001) than normal weight people. DIFF was negatively associated with total calorie intake and total intake of high-fat food, but only in normal weight people (β = -0.16, p < 0.01 and β = -0.26, p < 0.001, respectively). DIFF was negatively associated with the frequency of eating sweet (β = -0.33, p < 0.000) and meat high-fat food (β = -0.25, p < 0.001) in the normal weight group. The frequency of consumption of high-fat food and calorie intake are positively associated with self-reported preference for fat taste. In normal weight subjects fat restraint is negatively associated with calorie intake and total frequency of high-fat food intake, as well as with intake of different types of fatty food. Fat preference measures are thus associated with high-fat food intake, but these associations differ by body weight status.

Endocrine Cephalic Phase Responses to Food Cues: A Systematic Review

Cephalic phase responses (CPRs) are conditioned anticipatory physiological responses to food cues. They occur before nutrient absorption and are hypothesized to be important for satiation and glucose homeostasis. Cephalic phase insulin responses (CPIRs) and pancreatic polypeptide responses (CPPPRs) are found consistently in animals, but human literature is inconclusive. We performed a systematic review of human studies to determine the magnitude and onset time of these CPRs. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used to develop a search strategy. The terms included in the search strategy were cephalic or hormone response or endocrine response combined with insulin and pancreatic polypeptide (PP). The following databases were searched: Scopus (Elsevier), Science Direct, PubMed, Google Scholar, and The Cochrane Library. Initially, 582 original research articles were found, 50 were included for analysis. An insulin increase (≥1μIU/mL) was observed in 41% of the treatments (total n = 119). In 22% of all treatments the increase was significant from baseline. The median (IQR) insulin increase was 2.5 (1.6-4.5) μIU/mL, 30% above baseline at 5± 3 min  after food cue onset (based on study treatments that induced ≥1 μIU/mL insulin increase). A PP increase (>10 pg/mL) was found in 48% of the treatments (total n = 42). In 21% of the treatments, the increase was significant from baseline. The median (IQR) PP increase was 99 (26-156) pg/mL, 68% above baseline at 9± 4 min  after food cue onset (based on study treatments that induced ≥1 μIU/mL insulin increase). In conclusion, CPIRs are small compared with spontaneous fluctuations. Although CPPPRs are of a larger magnitude, both show substantial variation in magnitude and onset time. We found little evidence for CPIR or CPPPR affecting functional outcomes, that is, satiation and glucose homeostasis. Therefore, CPRs do not seem to be biologically meaningful in daily life.

Changes in Salivary Proteome in Response to Bread Odour

It is widely recognized that smelling food results in a mouth-watering feeling and influences appetite. However, besides changes in volume, little is known about the effects that food odours have on the composition of saliva. The aim of the present study was to access the effects that smelling bread has on saliva proteome and to compare such effects with those of chewing and ingesting it. Besides a significant increase in saliva flow rate, together with a decrease in total protein concentration, bread odour induced changes in the proportion of different salivary proteins. The expression levels of two spots of cystatins and two spots of amylase increased due to olfactory stimulation, similar to what happened with bread mastication, suggesting that odour can allow anticipation of the type of food eaten and consequently the physiological oral changes necessary to that ingestion. An interesting finding was that bread odour increased the expression levels of several protein spots of immunoglobulin chains, which were decreased by both bread or rice mastication. This may be of clinical relevance since food olfactory stimulation of salivary immunoglobulins can be used to potentiate the oral immune function of saliva. Moreover, the effects of bread odour in the levels of salivary proteins, previously observed to be involved in oral food processing led to the hypothesis of an influence of this odour in the sensory perception of foods further ingested. Further studies are needed to elucidate this point, as well as whether the changes observed for bread odour are specific, or if different food odours lead to similar salivary proteome responses.

Contribution of parasympathetic muscarinic augmentation of insulin secretion to olanzapine-induced hyperinsulinemia

Atypical antipsychotic drugs have been associated with the development of obesity and diabetes. In particular, olanzapine can induce peripheral insulin resistance and compensatory hyperinsulinemia independent of weight gain or psychiatric disease. To determine if this compensatory increase in insulin is mediated by parasympathetic muscarinic stimulation, we randomized 15 healthy subjects 2:1 to receive double-blind olanzapine or placebo for 9 days under diet- and activity-controlled inpatient conditions. Before and after 7 days of study drug administration, subjects underwent frequently sampled intravenous glucose tolerance tests with either saline or atropine infused on subsequent days to assess insulin secretion and hepatic insulin extraction in the absence or presence of muscarinic blockade. We found that olanzapine led to an increase in the acute insulin response to glucose, which was not seen with placebo, and was attenuated in the olanzapine group by atropine. Deconvolution of C-peptide data confirmed an increase in insulin secretion with olanzapine, which was blocked by atropine, with a modest reduction in hepatic insulin extraction with olanzapine. These results support the contribution of muscarinic augmentation of insulin secretion to olanzapine-induced hyperinsulinemia, and provide a mechanism for the compensatory hyperinsulinemia that normally serves to prevent deterioration of glucose tolerance under conditions of metabolic challenge.

Exacting Responses: Lack of Endocrine Cephalic Phase Responses Upon Oro-Sensory Exposure

Oro-sensory exposure (OSE) to food plays an important role in the regulation of food intake. One proposed underlying mechanism is the occurrence of cephalic phase responses (CPRs). CPRs include the pre-digestive endocrine responses induced by food-related sensory input. Yet, whether OSE duration or sweetness intensity affects CPRs is unknown. The objective of this study was to determine the independent and interactive effects of oro-sensory duration (chewing) and stimulation intensity (sweetness) on endocrine CPRs and satiation. Eighteen males (22 ± 2 years, BMI 22 ± 2 kg/m2) participated in a 2 × 2 randomized study with a control condition. Each session participants performed modified sham feeding (MSF) with one of the four gel-based model foods. During the control session no MSF was performed. Model foods differed in chewing duration (hard or soft texture) and sweetness (low or high intensity). During each session, eight blood samples were collected up till 25 min after MSF onset. Subsequently, food intake from an ad libitum lunch was measured. No typical CPR was found for insulin, pancreatic polypeptide (PP), and ghrelin. However, the overall PP response was 1.1 times greater for the hard sweet MSF condition compared to control (p = 0.02). Overall ghrelin responses were 1.1 times greater for the hard model food compared to the soft model food conditions (p = 0.003). These differences in endocrine response were not associated with differences in food intake at the subsequent meal. Exploratory sub-analysis of the responsive insulin curves showed that after 2.5 min of MSF the hard texture model foods insulin concentrations were 1.2 greater compared to the soft texture. These findings indicate that texture hardness and sweetness increase the overall PP response and that MSF on hard texture increases the overall ghrelin response compared to soft texture model foods. However, MSF on model foods does not lead to a typical CPR. This study, among others, shows that there are major dissimilarities in the endocrine responses to food stimulation between individuals. This emphasizes the importance of considering cephalic responders and non-responders. More research is needed to understand CPRs in relation to food texture and taste properties.

Restoration of enteroendocrine and pancreatic function after internal hernia and short bowel syndrome in a young woman with gastric bypass - a 2-year follow-up

A serious complication to the laparoscopic Roux‐en‐Y gastric bypass (RYGB) is internal hernia, which can lead to massive bowel necrosis that may result in short bowel syndrome. We determined postprandial enteropancreatic hormonal responses and metabolites in a 22‐year‐old nondiabetic woman with a history of RYGB experiencing severe internal herniation with widespread bowel necrosis. Extensive resections were performed leaving her with a saliva fistula from the pouch‐enteric anastomosis, an intact duodenum, 15 cm of jejunum, 35 cm of ileum, and intact colon. Parenteral nutrition was initiated and 10 months after the bowel resection, intestinal continuity was re‐established. After 6 weeks the patient reached parenteral nutrition independence. She underwent standardized liquid mixed meal tests before, 3 months after and 2 years after intestinal continuity was re‐established. Gut hormone responses were completely restored postoperatively leading to very high concentrations in plasma. After 2 years, plasma concentrations had, however, decreased markedly, suggesting desensitization of the gut ostensibly in response to chronic hyperstimulation. There was no evidence of cephalic phase insulin secretion.

The Macronutrients, Appetite, and Energy Intake

Each of the macronutrients-carbohydrate, protein, and fat-has a unique set of properties that influences health, but all are a source of energy. The optimal balance of their contribution to the diet has been a long-standing matter of debate. Over the past half century, thinking has progressed regarding the mechanisms by which each macronutrient may contribute to energy balance. At the beginning of this period, metabolic signals that initiated eating events (i.e., determined eating frequency) were emphasized. This was followed by an orientation to gut endocrine signals that purportedly modulate the size of eating events (i.e., determined portion size). Most recently, research attention has been directed to the brain, where the reward signals elicited by the macronutrients are viewed as potentially problematic (e.g., contribute to disordered eating). At this point, the predictive power of the macronutrients for energy intake remains limited.

Cephalic phase secretion of insulin and other enteropancreatic hormones in humans

Enteropancreatic hormone secretion is thought to include a cephalic phase, but the evidence in humans is ambiguous. We studied vagally induced gut hormone responses with and without muscarinic blockade in 10 glucose-clamped healthy men (age: 24.5 ± 0.6 yr, means ± SE; body mass index: 24.0 ± 0.5 kg/m(2); HbA1c: 5.1 ± 0.1%/31.4 ± 0.5 mmol/mol). Cephalic activation was elicited by modified sham feeding (MSF, aka "chew and spit") with or without atropine (1 mg bolus 45 min before MSF + 80 ng·kg(-1)·min(-1) for 2 h). To mimic incipient prandial glucose excursions, glucose levels were clamped at 6 mmol/l on all days. The meal stimulus for the MSF consisted of an appetizing breakfast. Participants (9/10) also had a 6 mmol/l glucose clamp without MSF. Pancreatic polypeptide (PP) levels rose from 6.3 ± 1.1 to 19.9 ± 6.8 pmol/l (means ± SE) in response to MSF and atropine lowered basal PP levels and abolished the MSF response. Neither insulin, C-peptide, glucose-dependent insulinotropic polypeptide (GIP), nor glucagon-like peptide-1 (GLP-1) levels changed in response to MSF or atropine. Glucagon and ghrelin levels were markedly attenuated by atropine prior to and during the clamp: at t = 105 min on the atropine (ATR) + clamp (CLA) + MSF compared with the saline (SAL) + CLA and SAL + CLA + MSF days; baseline-subtracted glucagon levels were -10.7 ± 1.1 vs. -4.0 ± 1.1 and -4.7 ± 1.9 pmol/l (means ± SE), P < 0.0001, respectively; corresponding baseline-subtracted ghrelin levels were 303 ± 36 vs. 39 ± 38 and 3.7 ± 21 pg/ml (means ± SE), P < 0.0001. Glucagon and ghrelin levels were unaffected by MSF. Despite adequate PP responses, a cephalic phase response was absent for insulin, glucagon, GLP-1, GIP, and ghrelin.

Controversies in fat perception

Nutritional fat is one of the most controversial topics in nutritional research, particularly against the background of obesity. Studies investigating fat taste perception have revealed several associations with sensory, genetic, and personal factors (e.g. BMI). However, neuronal activation patterns, which are known to be highly sensitive to different tastes as well as to BMI differences, have not yet been included in the scheme of fat taste perception. We will therefore provide a comprehensive survey of the sensory, genetic, and personal factors associated with fat taste perception and highlight the benefits of applying neuroimaging research. We will also give a critical overview of studies investigating sensory fat perception and the challenges resulting from multifaceted methodological approaches. In conclusion, we will discuss a multifactorial approach to fat perception to gain a better understanding of the underlying mechanisms that cause varying fat sensitivity which could be responsible for overeating. Such knowledge might be beneficial in new treatment strategies for obesity and overweight.

Food Liking Enhances the Plasma Response of 2-Arachidonoylglycerol and of Pancreatic Polypeptide upon Modified Sham Feeding in Humans

BACKGROUND

Food palatability increases food intake and may lead to overeating. The mechanisms behind this observation are still largely unknown.

OBJECTIVES

The aims of this study were the following: 1) to elucidate the plasma responses of endocannabinoids, N-acylethanolamines, and gastrointestinal peptides to a palatable (sweet), unpalatable (bitter), and sensory-acceptable (tasteless control) food, and 2) to verify whether some of these bioactive compounds can serve as plasma biomarkers of food liking in humans.

METHODS

Three puddings providing 60 kcal (35% from proteins, 62% from carbohydrates, and 3% from fats) but with different taste were developed. Twenty healthy subjects (11 women and 9 men; mean age 28 y and BMI 22.7 kg/m(2)), selected because they liked the puddings in the order sweet > control > bitter, participated in a randomized crossover study based on a modified sham feeding (MSF) protocol. Blood samples at baseline and every 5 min up to 20 min after the MSF were analyzed for gastrointestinal peptides, endocannabinoids, and N-acylethanolamines. Thirty minutes after the MSF, energy intake at an ad libitum breakfast was measured.

RESULTS

After the MSF, no response was observed in 7 of 9 gastrointestinal peptides measured. The plasma ghrelin concentration at 20 min after the sweet and bitter puddings was 25% lower than after the control pudding (P = 0.04), and the pancreatic polypeptide response after the sweet pudding was 23% greater than after the bitter pudding (P = 0.02). The plasma response of 2-arachidonoylglycerol after the sweet pudding was 37% and 15% higher than after the bitter (P < 0.001) and control (P = 0.03) puddings, respectively. Trends for greater responses of anandamide (P = 0.06), linoleoylethanolamide (P = 0.07), palmitoylethanolamide (P = 0.06), and oleoylethanolamide (P = 0.09) were found after the sweet pudding than after the bitter pudding. No differences in subsequent energy intake were recorded.

CONCLUSIONS

The data demonstrated that food palatability influenced some plasma endocannabinoid and N-acylethanolamine concentrations during the cephalic phase response and indicated that 2-arachidonoylglycerol and pancreatic polypeptide can be used as biomarkers of food liking in humans.

Obesity interferes with the orosensory detection of long-chain fatty acids in humans

BACKGROUND

The association between the orosensory detection of lipids, preference for fatty foods, and body mass index (BMI; in kg/m(2)) is controversial in humans.

OBJECTIVE

We explored the oral lipid-sensing system and the orosensory-induced autonomic reflex system in lean and obese subjects.

DESIGN

Lean (BMI: 19 to <25; n = 30) and obese (BMI >30; n = 29) age-matched men were enrolled. Their oral threshold sensitivity to linoleic acid (LA) was determined by using a 3-alternative forced-choice ascending procedure, and their eating habits were established by the analysis of 4 consecutive 24-h food-consumption diaries. The effect of brief oral lipid stimulations on plasma triglyceride [(TG)pl] concentrations was analyzed in overnight-fasted lean and obese individuals subjected to a whole-mouth stimulation (sip-and-spit procedure) with a control or 1% LA emulsions for 5 min according to a within-subject randomized design.

RESULTS

A large distribution of LA detection was shown in both groups. Mean detection thresholds were 0.053% (wt:wt) and 0.071% (wt:wt) in lean and obese subjects, respectively. No relation between the LA detection threshold and BMI was observed. The 5 subjects who detected only the higher concentration of LA (5% wt:wt) or were unable to distinguish properly between control and LA emulsions were obese. An analysis of dietary habits showed that these obese LA nontasters consumed more lipids and energy than did all other subjects. Brief whole-mouth stimulations (sip-and-spit procedure) with a control or 1% LA emulsion revealed an LA-mediated rise in (TG)pl concentrations in overnight-fasted, lean subjects. The origin of this change seemed to be hepatic. This (TG)pl upregulation was not shown in obese subjects, which suggested that obesity led to disturbances in the oral-brainstem-periphery loop.

CONCLUSION

Altogether, these data strongly suggest that obesity may interfere with the orosensory system responsible for the detection of free long-chain fatty acids in humans. This trial was registered at clinicaltrials.gov as NCT02028975.

Mechanisms and effects of "fat taste" in humans

Evidence supporting a "taste" cue from fat in the oral cavity continues to accrue. The proposed stimuli for fat taste, non-esterified fatty acids (NEFA), are released from food through hydrolytic rancidity and lipase activity derived from foods or saliva. NEFA must then be released from the food matrix, negotiate the aqueous environment to reach taste cell surfaces, and interact with receptors such as CD36 and GPR120 or diffuse across cell membranes to initiate a taste signal. Knowledge of these processes in non-gustatory tissues should inform understanding of taste responses to NEFA. Additionally, downstream effects of oral triglyceride exposure have been observed in numerous studies. Data specific to effects of NEFA versus triglyceride are scarce, but modified sham feeding trials with triglyceride document cephalic phase responses including elevations in serum lipids and insulin as well as potential, but debated, effects on gut peptides, appetite, and thermogenesis. In this review, we highlight the mechanisms by which NEFA migrate to and interact with taste cells, and then we examine physiological responses to oral fat exposure.

Cell signaling mechanisms of oro-gustatory detection of dietary fat: advances and challenges

CD36 and two G-protein coupled receptors (GPCR), i.e., GPR120 and GPR40, have been implicated in the gustatory perception of dietary fats in rodents. These glycoproteins are coupled to increases in free intracellular Ca²⁺ concentrations, [Ca²⁺](i), during their activation by dietary long-chain fatty acids (LCFA). The transient receptor potential type M5 (TRPM5) channel, activated by [Ca²⁺](i), participates in downstream signaling in taste bud cells (TBC). The mice, knocked-out for expression of CD36, GPR120, GPR40 or TRPM5 have a reduced spontaneous preference for fat. The delayed rectifying K⁺ (DRK) channels believed to lie downstream of these receptors are also important players in fat taste transduction. The trigeminal neurons by triggering increases in [Ca²⁺](i) may influence the taste signal to afferent nerve fibers. Why are there so many taste receptor candidates for one taste modality? We discuss the recent advances on the role of CD36, GPR120, GPR40, TRPM5 and DRK channels, in signal transduction in TBC. We shed light on their cross-talk and delineate their roles in obesity as a better understanding of the molecular mechanisms behind their regulation could eventually lead to new strategies to fight against this condition.

Functionality of fatty acid chemoreception: a potential factor in the development of obesity?

Excess dietary fat consumption is recognized as a strong contributing factor in the development of overweight and obesity. Understanding why some individuals are better than others at regulating fat intake will become increasingly important and emerging associative evidence implicates attenuated fatty acid sensing in both the oral cavity and gastrointestinal (GI) tract in the development of obesity. Functional implications of impaired fatty acid chemoreception include diminished activation of the gustatory system, the cephalic response and satiety. This review will focus on knowledge from animal and human studies supporting the existence of oral fatty acid chemoreception including putative oral detection mechanisms, and how sensitivity to fatty acids is associated with fat consumption and fatty food preference.

The role of T1r3 and Trpm5 in carbohydrate-induced obesity in mice

We examined the role of T1r3 and Trpm5 taste signaling proteins in carbohydrate-induced overeating and obesity. T1r3, encoded by Tas1r3, is part of the T1r2+T1r3 sugar taste receptor, while Trpm5 mediates signaling for G protein-coupled receptors in taste cells. It is known that C57BL/6 wild-type (WT) mice are attracted to the tastes of both Polycose (a glucose polymer) and sucrose, whereas Tas1r3 KO mice are attracted to the taste of Polycose but not sucrose. In contrast, Trpm5 KO mice are not attracted to the taste of sucrose or Polycose. In Experiment 1, we maintained the WT, Tas1r3 KO and Trpm5 KO mice on one of three diets for 38days: lab chow plus water (Control diet); chow, water and 34% Polycose solution (Polycose diet); or chow, water and 34% sucrose solution (Sucrose diet). The WT and Tas1r3 KO mice overconsumed the Polycose diet and became obese. The WT and Tas1r3 KO mice also overconsumed the Sucrose diet, but only the WT mice became obese. The Trpm5 KO mice, in contrast, showed little or no overeating on the Sucrose and Polycose diets, and gained less weight than WT mice on these diets. In Experiment 2, we asked whether the Tas1r3 KO mice exhibited impaired weight gain on the Sucrose diet because it was insipid. To test this hypothesis, we maintained the WT and Tas1r3 KO mice on one of two diets for 38 days: chow, water and a dilute (1%) but highly palatable Intralipid emulsion (Control diet); or chow, water and a 34% sucrose+1% Intralipid solution (Suc+IL diet). The WT and Tas1r3 KO mice both exhibited little or no overeating but became obese on the Suc+IL diet. Our results suggest that nutritive solutions must be highly palatable to cause carbohydrate-induced obesity in mice, and that palatability produces this effect in part by enhancing nutrient utilization.

Are free fatty acids effective taste stimuli in humans? Presented at the symposium "The Taste for Fat: New Discoveries on the Role of Fat in Sensory Perception, Metabolism, Sensory Pleasure and Beyond" held at the iNstitute of Food Technologists 2011 Annual Meeting, New Orleans, LA, June 12, 2011

The popularity of low- and reduced-fat foods has increased as consumers seek to decrease their energy consumption. Fat replacers may be used in fat-reduced products to maintain their sensory properties. However, these ingredients have been largely formulated to replicate nongustatory properties of fats to foods and have only achieved moderate success. There is increasing evidence that fats also activate the taste system and uniquely evoke responses that may influence product acceptance. Work supporting a taste component of fat has prompted questions about whether fat constitutes an additional "primary" or "basic" taste quality. This review briefly summarizes this evidence, focusing on human studies, when possible. Effective stimuli, possible receptors, and physiological changes due to oral fat exposure are discussed. Some studies suggest that there are fatty acid tasters and nontasters and if verified could have implications for targeted product development.

Accumulating evidence supports a taste component for free fatty acids in humans

The requisite criteria for what constitutes a taste primary have not been established. Recent advances in understanding of the mechanisms and functions of taste have prompted suggestions for an expanded list of unique taste sensations, including fat, or more specifically, free fatty acids (FFA). A set of criteria are proposed here and the data related to FFA are reviewed on each point. It is concluded that the data are moderate to strong that there are: A) adaptive advantages to FFA detection in the oral cavity; B) adequate concentrations of FFA to serve as taste stimuli; C) multiple complimentary putative FFA receptors on taste cells; D) signals generated by FFA that are conveyed by gustatory nerves; E) sensations generated by FFA that can be detected and scaled by psychophysical methods in humans when non-gustatory cues are masked; and F) physiological responses to oral fat/FFA exposure. On no point is there strong evidence challenging these observations. The reviewed findings are suggestive, albeit not definitive, that there is a taste component for FFA.

How neural mediation of anticipatory and compensatory insulin release helps us tolerate food

Learned anticipatory and compensatory responses allow the animal and human to maintain metabolic homeostasis during periods of nutritional challenges, either acutely within each meal or chronically during periods of overnutrition. This paper discusses the role of neurally-mediated anticipatory responses in humans and their role in glucoregulation, focusing on cephalic phase insulin and pancreatic polypeptide release as well as compensatory insulin release during the etiology of insulin resistance. The necessary stimuli required to elicit CPIR and vagal activation are discussed and the role of CPIR and vagal efferent activation in intra-meal metabolic homeostasis and during chronic nutritional challenges are reviewed.

Why liquid energy results in overconsumption

Liquids have been shown to have a low satiating efficiency. The may be related to the high rate of consumption for liquids which may be higher than 200 g/min. In a number of studies, we showed that the positive relationship between eating rate and energy intake is mediated by oro-sensory exposure time. Longer sensory exposure times are consistently associated with lower food intakes. This observation maybe linked to the role of cephalic phase responses to foods. Cephalic phase responses are a set of physiological responses, which are conceived to prepare the digestive system for the incoming flow of nutrients after ingestion, with the aim of maintaining homeostasis. Results from various studies suggest that cephalic phase responses are much smaller (absent) for liquids compared to solids. It is hypothesised that the absence of cephalic phase responses to liquid foods may be one of the causes why liquid energies enter the body undetected and lead to weak energy intake compensation. This idea fits with the concept of the taste system as a nutrient-sensing system that informs the brain and the gastro-intestinal system about what is coming into our body. With liquids, this system is bypassed. Slower eating may help the human body to associate the sensory signals from food with their metabolic consequences. Foods that are eaten quickly may impair this association, and may therefore lead to overconsumption of energy, and ultimately to weight gain.

Oral fatty acid signaling and intestinal lipid processing: support and supposition

There is increasing recognition that specialized processes once thought to be relatively isolated to the oral cavity (e.g., taste) and intestine (e.g., nutrient absorption) are better characterized as common and continuous. This is exemplified by accumulating evidence linking oral detection of dietary fats to their intestinal processing. This review first summarizes this literature focusing on purported gustatory signaling by free fatty acid stimulation and enterocyte lipid storage and mobilization in humans. It then willfully speculates on the possible functions of this integrated system. It is proposed that it may aid absorption of fat soluble nutrients, enhance acute energy intake, sustain intestinal function during long inter-meal intervals, modulate appetite and/or detoxify ingested compounds including free fatty acids.

'Expected satiety' changes hunger and fullness in the inter-meal interval

Previously, we have shown that foods differ markedly in the satiety that they are expected to confer (compared calorie-for-calorie). In the present study we tested the hypothesis that 'expected satiety' plays a causal role in the satiety that is experienced after a food has been consumed. Before lunch, participants (N=32) were shown the ingredients of a fruit smoothie. Half were shown a small portion of fruit and half were shown a large portion. Participants then assessed the expected satiety of the smoothie and provided appetite ratings, before, and for three hours after its consumption. As anticipated, expected satiety was significantly higher in the 'large portion' condition. Moreover, and consistent with our hypothesis, participants reported significantly less hunger and significantly greater fullness in the large-portion condition. Importantly, this effect endured throughout the test period (for three hours). Together, these findings confirm previous reports indicating that beliefs and expectations can have marked effects on satiety and they show that this effect can persist well into the inter-meal interval. Potential explanations are discussed, including the prospect that satiety is moderated by memories of expected satiety that are encoded around the time that a meal is consumed.

Dynamics of fat absorption and effect of sham feeding on postprandial lipema

BACKGROUND & AIMS

Given the importance of postprandial hyperlipidemia to increase risk for atherosclerosis, in the present study, stable isotope-labeled meals were fed to healthy subjects (7 males and 3 females) to investigate the kinetics chylomicron synthesis and the effect of sensory exposure to lipid on metabolism.

METHODS

Subjects performed two, 24-hour inpatient studies that entailed consumption of a liquid formula evening meal containing 30 g of oil (+ (13)C(2) triolein) on day 1. Breakfast (day 2) consisted of triacylglycerols (TAGs) fed as capsules (30 g oil + (13)C(7) triolein) to avoid activation of mouth taste receptors. Next, modified sham feeding of cream cheese occurred over 2 hours. In the 2 trials, the stimulus was either higher fat (HF) or lower fat (LF) cream cheese. A liquid meal was consumed at lunch. Blood sampling occurred intermittently, and chylomicron particles S(f) >400 TAGs were analyzed by gas chromatography-mass spectrometry.

RESULTS

(13)C(2)-Label was found in fasting-state lipoproteins, and persons with higher body fat percentages showed greater dilution of meal TAGs from endogenous sources. For both trials, 13% ± 4% of lipoprotein TAGs oleic acid was derived from the previous evening meal. Incremental area under the curve for TAGs during HF was ∼2.5 times higher than after LF exposure (46 ± 15 vs 17 ± 5 μmol/L/h; P = .04). The greater HF morning lipemia occurred with elevated glucose, insulin, and nonesterified fatty acids peak after lunch.

CONCLUSIONS

These data support a connection between enteral lipid metabolism and oral fat exposure, resulting in elevated postprandial lipemia. The results suggest that the intestine may participate in a mechanism coordinating oral fat signaling with control of subsequent macronutrient disposal in the body.

Oral and gastrointestinal sensing of dietary fat and appetite regulation in humans: modification by diet and obesity

Dietary fat interacts with receptors in both the oral cavity and the gastrointestinal (GI) tract to regulate fat and energy intake. This review discusses recent developments in our understanding of the mechanisms underlying the effects of fat, through its digestive products, fatty acids (FAs), on GI function and energy intake, the role of oral and intestinal FA receptors, and the implications that changes in oral and small intestinal sensitivity in response to ingested fat may have for the development of obesity.

Oral sensory and cephalic hormonal responses to fat and non-fat liquids in bulimia nervosa

Sensory evaluation of food involves endogenous opioid mechanisms. Bulimics typically limit their food choices to low-fat "safe foods" and intermittently lose control and binge on high-fat "risk foods". The aim of this study was to determine whether the oral sensory effects of a fat versus a non-fat milk product (i.e., traditional versus non-fat half-and-half) resulted in different subjective and hormonal responses in bulimic women (n=10) compared with healthy women (n=11). Naltrexone (50mg PO) or placebo was administered 1h before, and blood sampling began 30 min prior to and 29 min after, a 3 min portion controlled modified sham-feeding trial. Following an overnight fast, three morning trials (fat, naltrexone; fat, placebo; and non-fat, placebo) were administered in a random double-blind fashion separated by at least 3 days. Overall, there were no differences between Fat and Non-Fat trials. Hunger ratings (p<0.001) and pancreatic polypeptide levels (p<0.05) were higher for bulimics at baseline. Bulimics also had overall higher ratings for nausea (p<0.05), fatty taste (p<0.01), and fear of swallowing (p<0.005). Bulimics had approximately 40% higher total ghrelin levels at all time points (p<0.001). Hormones and glucose levels were not altered by the modified sham-feeding paradigm. Naltrexone, however, resulted in an overall increase in blood glucose and decrease in ghrelin levels in both groups (p<0.05, for both). These data suggest that bulimic women have different orosensory responses that are not influenced by opioid receptor antagonism, evident in hormonal responses, or dependent on the fat content of a similarly textured liquid.

Cephalic phase pancreatic polypeptide responses to liquid and solid stimuli in humans

The hormone, pancreatic polypeptide (PP) is postulated to be involved in body weight regulation. PP release is dependent on vagal activation and is a marker of vagal efferent activity. Because vagal activity plays a role in glucose homeostasis, elucidating the conditions of activation has important implications for nutrient metabolism. In humans, modified sham-feeding is known to elicit vagally-mediated hormonal responses. We present results of 3 studies in which healthy human subjects tasted various stimuli including sweet and salty liquids, unflavored and flavored gum and mixed nutrient foods flavored with either sweet or salt and rendered palatable or unpalatable. We examined the effects of these stimuli on PP levels relative to fasting. We found that liquids flavored with either glucose or salt, did not elicit an increase in PP levels greater than fasting. Similarly, chewing gum, whether unflavored or flavored with a non-nutritive sweetener or the sweetener paired with a mint flavor, did not significantly increase PP levels. In contrast, when subjects tasted mixed nutrient foods, these reliably elicited increases in PP levels at 4 min post-stimulus (sweet palatable, p<0.002; sweet unpalatable, p<0.001; salty, palatable, p<0.05, salty unpalatable, p<0.05). The magnitude of release was influenced by the flavor, i.e. a sweet palatable stimulus (320.1+/-93.7 pg/ml/30 min) elicited the greatest increase in PP compared with a salty palatable stimulus (142.4+/-88.7 pg/ml/30 min; p<0.05). These data suggest that liquids and chewing gum do not provide adequate stimulation for vagal efferent activation in humans and that mixed nutrient foods are the optimal stimuli.

Oral Fat Exposure Pattern and Lipid Loading Effects on the Serum Triacylglycerol Concentration of Humans

Orosensory exposure to dietary fat elicits an early, transient spike (first phase; minutes 0-60) and augmented, more sustained postprandial (second phase; minutes 120-360) elevation of serum triacylglycerol (TAG) in humans. To assess the physiological significance of these effects, TAG concentrations were monitored following manipulation of the oral exposure pattern and accompanying lipid load. Fifteen healthy adults participated in a randomized, 6-arm, crossover design study. Conditions consisted of ingestion of 30-g loads of safflower oil, provided as capsules to bypass oral stimulation, followed by 15 min of oral stimulation (mastication and expectoration) with full-fat or nonfat cream cheese (conditions 1 and 2); the same oral load ingested intermittently with oral stimulation by both food forms (conditions 3 and 4); and 10-g lipid loads ingested with intermittent oral stimulation by both food forms (conditions 5 and 6). Blood was collected via an indwelling catheter and TAG was measured at minutes -15, 0, 10, 20, 30, 40, 50, 60, 120, 240, and 360 relative to the onset of sensory stimulation. Testing was conducted weekly. Sequential (lipid loading followed by oral stimulation) and intermittent (intermixed lipid loading and oral stimulation) conditions led to comparable TAG responses. Significant first- and second-phase TAG concentration increases were observed with the 30-g loads, but not the 10-g loads. TAG responses to the full-fat and nonfat stimuli were similar. These data support the veracity of the earlier literature based on sequential oral exposure regimens and indicate that TAG responses reflect an interaction between oral fat signaling and gut lipid content. The augmentation of TAG associated specifically with dietary fat exposure, as compared to a nonfat food matched on other sensory properties, may only occur with higher fat loads.

Is there a fatty acid taste?

Taste is a chemical sense that aids in the detection of nutrients and guides food choice. A limited number of primary qualities comprise taste. Accumulating evidence has raised a question about whether fat should be among them. Most evidence indicates triacylglycerol is not an effective taste stimulus, though it clearly contributes sensory properties to foods by carrying flavor compounds and altering texture. However, there is increasing anatomical, electrophysiological, animal behavior, imaging, metabolic, and psychophysical evidence that free fatty acids are detectable when non-taste cues are minimized. Free fatty acids varying in saturation and chain length are detectable, suggesting the presence of multiple transduction mechanisms and/or a nonspecific mechanism in the oral cavity. However, confirmation of "fatty" as a taste primary will require additional studies that verify these observations are taste specific. Oral exposure to free fatty acids likely serves as a warning signal to discourage intake and influences lipid metabolism.

Linking peripheral taste processes to behavior

The act of eating and drinking brings food-related chemicals into contact with taste cells. Activation of these taste cells, in turn, engages neural circuits in the central nervous system that help animals identify foods and fluids, determine what and how much to eat, and prepare the body for digestion and assimilation. Analytically speaking, these neural processes can be divided into at least three categories: stimulus identification, ingestive motivation, and digestive preparation. This review will discuss recent advances in peripheral gustatory mechanisms, primarily from rodent models, in the context of these three major categories of taste function.

Brief oral stimulation, but especially oral fat exposure, elevates serum triglycerides in humans

Oral exposure to dietary fat results in an early initial spike, followed by a prolonged elevation, of serum triglycerides in humans. The physiological and pathophysiological implications remain unknown. This study sought to determine the incidence of the effect, the required fat exposure duration, and its reliability. Thirty-four healthy adults participated in four to six response-driven trials held at least a week apart. They reported to the laboratory after an overnight fast, a catheter was placed in an antecubital vein, and a blood sample was obtained. Participants then ingested 50 g of safflower oil in capsules with 500 ml of water within 15 min to mimic a high fat meal but without oral fat exposure. Blood was collected 0, 10, 20, 30, 40, 50, 60, 120, 240, 360, and 480 min after capsule ingestion with different forms (full fat, nonfat, none) and durations of oral fat exposures (10 s, 5 min, 20 min, and/or 2 h). A triglyceride response (increase of triglyceride >10 mg/dl within 30 min) was observed in 88.2%, 70.5%, and 50% of participants with full-fat, nonfat, and no oral exposure, respectively. Test-retest reliability was 75% with full-fat exposure but only 45.4% with nonfat exposure. Full-fat and nonfat exposures led to comparable significant elevations of triglyceride over no oral stimulation with 10-s exposures, but full fat led to a greater rise than nonfat with 20 min of exposure. These data indicate that nutritionally relevant oral fat exposures reliably elevate serum triglyceride concentrations in most people.

Orosensory perception of dietary lipids in mammals

Obesity constitutes a major public health problem for the twenty-first century, with its epidemic spread worldwide, particularly in children. The overconsumption of fatty foods greatly contributes to this phenomenon. Rodents and humans display a spontaneous preference for lipid-rich foods. However, the molecular mechanisms underlying this pattern of eating behaviour in mammals remain unclear. The orosensory perception of dietary lipids was long thought to involve only textural and olfactory cues. Recent findings challenge this limited viewpoint, strongly suggesting that the sense of taste also plays a significant role in dietary lipid perception and might therefore be involved in the preference for fatty foods and obesity. This minireview analyses recent data relating to the molecular mechanisms and physiological consequences of this means of orosensory lipid perception.

Molecular mechanisms of fat preference and overeating

Obesity is recognized as a worldwide health problem. Overconsumption of fatty foods contributes significantly to this phenomenon. Rodents, like humans, display preferences for lipid-rich foods. Rodents thus provide useful models to explore the mechanisms responsible for this complex feeding behavior resulting from the integration of multiple oral and postoral signals. Over the last decades, the lipid-mediated regulation of food intake has received considerable attention. By contrast, orosensory lipid perception was long thought to involve only textural and olfactory cues. Recent findings have challenged this limited viewpoint. These recent data strongly suggest that the sense of taste also plays significant roles in the spontaneous preference for fatty foods. This paper provides a brief overview of postoral regulation of food intake by lipids and then highlights recent data suggesting the existence of a "fatty taste" which might contribute to lipid overeating and hence to the risk of obesity.