Effect of replacement of fat by nonabsorbable fat (sucrose polyester) in meals or snacks as a function of dietary restraint

Calorie reformulation: a systematic review and meta-analysis examining the effect of manipulating food energy density on daily energy intake

BACKGROUND

Dietary energy density is thought to be a contributor to obesity, but the extent to which different magnitudes and types of reductions to food energy density decreases daily energy intake is unclear. The primary objective was to systematically review and meta-analyse experimental studies that have examined the effect that manipulating energy density of food has on total daily energy intake. Secondary objectives were to examine moderators of the effect that altering energy density has on daily energy intake and effects on body weight.

METHODS

A systematic review and multi-level meta-analysis of studies on human participants that used an experimental design to manipulate the energy density of foods served and measured energy intake for a minimum of 1 day.

RESULTS

Thirty-one eligible studies sampling both children (n = 4) and adults (n = 27) contributed 90 effects comparing the effect of higher vs. lower energy density of served food on daily energy intake to the primary meta-analysis. Lower energy density of food was associated with a large decrease in daily energy intake (SMD = - 1.002 [95% CI: - 0.745 to - 1.266]). Findings were consistent across studies that did vs. did not manipulate macronutrient content to vary energy density. The relation between decreasing energy density and daily energy intake tended to be strong and linear, whereby compensation for decreases to energy density of foods (i.e. by eating more at other meals) was minimal. Meta-analysis of (n = 5) studies indicated that serving lower energy dense food tended to be associated with greater weight loss than serving higher energy dense food, but this difference was not significant (- 0.7 kg difference in weight change, 95% CIs: - 1.34, 0.04).

CONCLUSIONS

Decreasing the energy density of food can substantially reduce daily energy intake and may therefore be an effective public health approach to reducing population level energy intake.

TRIAL REGISTRATION

Registered on PROSPERO ( CRD42020223973 ).

Snack Food, Satiety, and Weight

In today's society, snacking contributes close to one-third of daily energy intake, with many snacks consisting of energy-dense and nutrient-poor foods. Choices made with regard to snacking are affected by a multitude of factors on individual, social, and environmental levels. Social norms, for example, that emphasize healthful eating are likely to increase the intake of nutrient-rich snacks. In addition, satiety, the feeling of fullness that persists after eating, is an important factor in suppressing overconsumption, which can lead to overweight and obesity. Thus, eating snacks between meals has the potential to promote satiety and suppress overconsumption at the subsequent meal. Numerous studies have explored the relation between snack foods and satiety. These studies concluded that whole foods high in protein, fiber, and whole grains (e.g., nuts, yogurt, prunes, and popcorn) enhance satiety when consumed as snacks. Other foods that are processed to include protein, fiber, or complex carbohydrates might also facilitate satiety when consumed as snacks. However, studies that examined the effects of snack foods on obesity did not always account for satiety and the dietary quality and portion size of the snacks consumed. Thus, the evidence concerning the effects of snack foods on obesity has been mixed, with a number of interventional and observational studies not finding a link between snack foods and increased weight status. Although further prospective studies are warranted to conclusively determine the effects of snack foods on obesity risk, the consumption of healthful snacks likely affects satiety and promotes appetite control, which could reduce obesity.

Energy density, energy intake, and body weight regulation in adults

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.

Review of the effects of dilution of dietary energy with olestra on energy intake

The non-absorbable substitute for dietary triacylglycerol, olestra, has been marketed in the United States for fifteen years. Olestra is comprised of sucrose with six to eight of its hydroxyl groups forming ester links with long-chain fatty acids. Because olestra is not hydrolyzed by fat-splitting enzymes in the small intestine, it is not absorbed from the small intestine into blood and tissues, and therefore provides no energy that can be utilized by the body. The hedonic properties of olestra with a specific fatty acid composition are similar to those of a triacylglycerol with the same fatty acid composition. Its use by consumers has been restricted by federal regulation to the commercial preparation of savory snack food items, principally as a frying medium for potato chips. An important question about the substitution of olestra for absorbable fat in the diet is whether the consumer will sense that a smaller amount of energy has been ingested. If it is sensed, thereby providing no satiation, then consuming additional energy in later meals will compensate for the removal of absorbable energy from the diet. If it is not sensed at all, then there is no compensation, and the person reduces caloric intake. This review first summarizes studies with olestra that have focused on its effect on the physiology of appetite. In general these studies have demonstrated that olestra does not influence signals of satiation including cholecystokinin and stomach emptying. The review then discusses studies of food consumption in experimental animals in which olestra was substituted for fat in the diet. Rodents have been repeatedly observed to compensate completely for the substitution of olestra for normal fat by eating more total diet. Most studies of the effect of olestra on human satiation have found incomplete or no compensation through additional energy consumption when olestra was substituted for dietary fat. In two clinical studies, however, complete compensation was observed, suggesting that experimental conditions and individual variability influence the ability to sense the substitution of olestra for absorbable fat. There is no evidence that dietary olestra causes consumption of more energy than would have been consumed without olestra in the diet. The data from animals and humans strongly suggest that the rodent is not a satisfactory model for the human in the determination of the extent of compensation by substitution of olestra for dietary fat.

Losing weight without dieting. Use of commercial foods as meal replacements for lunch produces an extended energy deficit

High-protein liquid meal replacements have proven to be effective in reducing caloric intake and body weight. Recently, substituting high fiber breakfast cereals for the more expensive high-protein drinks has been found to be equally effective to reduce weight. The following study tested the hypothesis that the mechanism responsible for the reduced intake was not the dietary composition of the meal replacement, but the controlled portion sized meals. Seventeen volunteers ate all of their meals and snacks from foods provided by the research unit from Monday to Friday for five consecutive weeks. For the first week, all participants selected their food from a buffet where each food was weighed before and after eating. For the next two weeks, half of the group selected their lunch by choosing one food from a selection of six commercially available portion controlled foods. They could eat as much as they wished at other meals or snacks. For final weeks four and five, the conditions were reversed for the two groups. Consuming the portion controlled lunches resulted in about a 250 kcal reduction in energy intake. More importantly, no sign of caloric compensation was evident across the 10 days of testing, an observation substantiated by a significant loss of body weight. The results suggest that the mere substitution of one smaller portioned meal each day is sufficient to cause reduction in daily energy intake and a significant amount of weight.

Effects of red pepper on appetite and energy intake

Two studies were conducted to investigate the effects of red pepper (capsaicin) on feeding behaviour and energy intake. In the first study, the effects of dietary red pepper added to high-fat (HF) and high-carbohydrate (HC) meals on subsequent energy and macronutrient intakes were examined in thirteen Japanese female subjects. After the ingestion of a standardized dinner on the previous evening, the subjects ate an experimental breakfast (1883 kJ) of one of the following four types: (1) HF; (2) HF and red pepper (10 g); (3) HC; (4) HC and red pepper. Ad libitum energy and macronutrient intakes were measured at lunch-time. The HC breakfast significantly reduced the desire to eat and hunger after breakfast. The addition of red pepper to the HC breakfast also significantly decreased the desire to eat and hunger before lunch. Differences in diet composition at breakfast time did not affect energy and macronutrient intakes at lunch-time. However, the addition of red pepper to the breakfast significantly decreased protein and fat intakes at lunch-time. In Study 2, the effects of a red-pepper appetizer on subsequent energy and macronutrient intakes were examined in ten Caucasian male subjects. After ingesting a standardized breakfast, the subjects took an experimental appetizer (644 kJ) at lunch-time of one of the following two types: (1) mixed diet and appetizer; (2) mixed diet and red-pepper (6 g) appetizer. The addition of red pepper to the appetizer significantly reduced the cumulative ad libitum energy and carbohydrate intakes during the rest of the lunch and in the snack served several hours later. Moreover, the power spectral analysis of heart rate revealed that this effect of red pepper was associated with an increase in the ratio sympathetic: parasympathetic nervous system activity. These results indicate that the ingestion of red pepper decreases appetite and subsequent protein and fat intakes in Japanese females and energy intake in Caucasian males. Moreover, this effect might be related to an increase in sympathetic nervous system activity in Caucasian males.

Energy density and weight of food effect short-term caloric compensation in men

OBJECTIVE

The purpose of the study was to examine the effect of energy density and food weight (volume) on subsequent intake.

DESIGN

Sixteen lean men were each studied four times during a 2-d protocol at the Rowett's Human Nutrition Unit. On day 1, subjects were fed a mandatory diet at 1.6 x resting metabolic rate (RMR). On day 2, during the mandatory morning period (08.30-12.30) subjects consumed a fixed breakfast (08.30) plus a snack (10.30) in one of four treatments [with values in weight (kg), ED (kJ/100g), Energy (MJ)]: (i) zero intake, 0:0:0 (ii) low energy density (LED), 0.615: 400: 2.46; (iii) high energy density (HED), 0.615: 800: 4.92; (iv) 2 x LED, 1.225: 400: 4.91. From 12.30, throughout the remainder of the day, subjects had ad libitum access to 15 high-protein, 15 high-fat and 15 high-carbohydrate foods. Motivation to eat was tracked hourly using 100 mm line scales.

RESULTS

ANOVA showed subjects were hungrier after the zero and LED treatments in the mandatory period (p<0.001). Lunch time EI was 5.0, 3.1, 4.2 and 3.2 MJ on the zero, HED, LED and 2 x LED treatments, respectively (p<0.001). Total ad libitum EI was 11.7, 9.6, 10.3 and 9.5 MJ/d, respectively (p=0.033). Total ad libitum plus mandatory intakes amounted to 11.7, 14.5, 12.6 and 14.4 MJ/d, respectively (p=0.001). Corresponding food intakes were 2.18, 2.39, 2.51 and 3.06 kg/d, respectively (p<0.001).

CONCLUSIONS

The present study showed that subjects respond to both the amount of food eaten in the morning and to the energy density of those foods. However, compensation was only partial and short-term. Subjects only compensated EI by approximately 40% and that compensation only occurred at the next meal.

Consistent relationships between sensory properties of savory snack foods and calories influence food intake in rats

OBJECTIVE

Determine the influence of experience with consistent or inconsistent relationships between the sensory properties of snack foods and their caloric consequences on the control of food intake or body weight in rats.

DESIGN

Rats received plain and BBQ flavored potato chips as a dietary supplement, along with ad lib rat chow. For some rats the potato chips were a consistent source of high fat and high calories (regular potato chips). For other rats, the chips provided high fat and high calories on some occasions (regular potato chips) and provided no digestible fat and fewer calories at other times (light potato chips manufactured with a fat substitute). Thus, animals in the first group were given experiences that the sensory properties of potato chips were strong predictors of high calories, while animals in the second group were given experiences that the sensory properties of potato chips were not predictors of high calories.

SUBJECTS

Juvenile and adult male Sprague-Dawley rats.

MEASUREMENTS

Following exposure to varying potato chip-calorie contingencies, intake of a novel, high-fat snack food and subsequent chow intake were assessed. Body weight gain and body composition as measured by DEXA were also measured.

RESULTS

In juvenile animals, exposure to a consistent relationship between potato chips and calories resulted in reduced chow intake, both when no chips were provided and following consumption of a novel high-fat, high-calorie snack chip. Long-term experience with these contingencies did not affect body weight gain or body composition in juveniles. In adult rats, exposure to an inconsistent relationship between potato chips and calories resulted in increased consumption of a novel high-fat, high-calorie snack chip premeal along with impaired compensation for the calories contained in the premeal.

CONCLUSION

Consumption of foods in which the sensory properties are poor predictors of caloric consequences may alter subsequent food intake.

Fat intake and energy-balance effects

This paper focuses on the effects of dietary fats or fatty acids on key targets of metabolic intermediates for body-weight control, i.e. satiety, thermogenesis, fat oxidation and body composition. With respect to sensory satiety, it appeared, e.g. that linoleic acid tasters showed a different mechanism for meal termination than non-tasters did. They stopped eating linoleic acid containing food based upon satiety, whereas the non-tasters stopped eating based upon the change in pleasantness of taste. Moreover, in the normal range of body mass index, an inverse relationship was shown between % 'tasters' and BMI. In a high fat diet vs. a low fat high protein high carbohydrate diet, metabolic satiety appeared to be continuously lower and correlated positively to diet-induced energy expenditure. However, with respect to the intermeal interval, satiety appeared to be more sustained following a high fat vs. a high CHO preload, resulting in a lower meal frequency. Covert fat replacement during breakfast by sucrose polyester was successful in combination with dietary restraint, yet overt fat replacement in snacks was successful in the dietary-unrestrained subjects, i.e. those who habitually ate snacks. With respect to fat oxidation, from a respiration-chamber experiment on the effects of diacylglycerol compared (DG) to triacylglycerol (TG) intake, it was concluded that consumption of DG increased fat oxidation and beta-hydroxy-butyrate levels, but did not affect energy metabolism or triacylglycerol level. Parameters of appetite were all lowered by DG compared to TG. With respect to body composition, the effects of 13 weeks CLA supplementation in overweight subjects during weight regain were assessed. Although CLA did not affect %body-weight regain, the regain of fat-free mass was increased by CLA, independently of %body-weight regain and physical activity, and as a consequence resting metabolic rate was increased. At the same time, appetite was reduced and satiety and fullness were increased. In conclusion, we also determined bright sports with respect to fat intake.

Authors' financial relationships with the food and beverage industry and their published positions on the fat substitute olestra

OBJECTIVES

This study examined the association between authors' published positions on the safety and efficacy in assisting with weight loss of the Procter & Gamble (P&G) fat substitute olestra and their financial relationships with the food and beverage industry.

METHODS

Journal articles about olestra, and their authors, were classified as supportive, critical, or neutral with respect to its use. Authors not known to have industry affiliations were surveyed about their financial relationships.

RESULTS

Supportive authors were significantly more likely than critical or neutral authors to have financial relationships with P&G (80% vs 11% and 21%, respectively; P <.0001). All authors disclosing an affiliation with P&G were supportive.

CONCLUSIONS

Because authors' published opinions were associated with their financial relationships, obtaining noncommercial funding may be more essential to maintaining objectivity than disclosing personal financial interests.

A role for olestra in body weight management

Olestra is a fat substitute made from fatty acids esterified to sucrose and can be used in the preparation of virtually any food made with fat. Foods made with olestra retain the mouthfeel, palatability and satiating effects of their full-fat counterparts without providing any digestible energy. Because olestra provides no energy, it has the potential to be a useful tool in weight loss and weight maintenance. Short-term studies of olestra replacement in foods demonstrate that fat replacement leads to a net reduction in fat intake. When excess total energy is available, fat replacement also reduces total energy intake in lean and obese men and women. In longer-term studies in which olestra is incorporated into the daily diet, there is an incomplete compensation for the fat energy replaced by olestra. When overweight men consumed olestra as part of a varied diet over nine months, weight loss continued for the duration of the study, whereas individuals receiving a typical low-fat diet regained most of the initial weight lost. Other studies are underway to examine the usefulness of olestra in long-term weight maintenance following weight loss. Post-marketing surveillance of olestra foods in the United States indicates that substitution of olestra for only 1-2 g of fat d-1 may be sufficient to prevent the average weight gain reported in adults of 0.5-1.0 kg year-1.

The actual, but not labelled, fat content of a soup preload alters short-term appetite in healthy men

The effects of the actual and labelled fat content of a soup preload on appetite at a test meal 30 min later were assessed in 16 healthy men. Each participant ate lunch on four occasions, combining two levels of fat energy (Low, 265 kJ or High, 1510 kJ) and two types of label (Low-fat or High-fat), presented as fictitious soup brand names. Preliminary work established that the Low-fat labels produced an expectation of reduced fat content and lower anticipated hedonic ratings, whereas the High-fat labels generated expectations of a high-fat content and above average hedonic ratings. These expectancies were confirmed in the main experiment, with the soups labelled as high fat rated as both more pleasant and creamy than those labelled low-fat, independent of actual fat content. However, intake at the test meal was unaffected by the preload label, but instead reflected the actual fat (hence, energy) content of the soup, with significantly lower food intake after the high-fat soup regardless of the food label. Rated hunger was lower, and fullness higher, at the start of the meal after the high-fat preloads regardless of how they were labelled, while the pattern of appetite change during the test meal was unaffected by preload. These results suggest that realistic food labels can modify the immediate experience of a consumed food, but do not alter appetite 30 min later in healthy men.

Analysis of energy density of food in relation to energy intake regulation in human subjects

The relationship between energy density (ED) of food and drink consumption ad libitum and energy intake (EI) was analysed. EI was taken as average daily EI over the long term, and as EI during a single meal. Moreover, the distribution of EI over three ED categories was analysed. Average daily EI was related to ED of the food and drinks when ED was strongly influenced by specific macronutrients. When ED was strongly influenced by the weight of water, it was not related to EI. During a meal subjects monitored mainly weight, and to a lesser extent, the energy content of the food ingested. Therefore, covertly manipulated ED of a meal affected EI directly. The impact of ED on EI was modulated by dietary behaviours such as restraint. Overt manipulation of ED for 6 months showed that EI was adjusted to a decreased but not to an increased ED in dietary-unrestrained subjects, and that EI was adjusted to an increased but not to a decreased ED in dietary-restrained subjects. Knowledge of ED was shown to lead to an inverse relationship between portion sizes and ED during a meal. Average daily EI consisted of a distribution of EI over the three different categories of ED, so that obese women ate more of foods with a high ED and less of foods with a low ED compared with normal weight women (and nutritional guidelines). In conclusion, ED affected daily EI by means of macronutrient specific effects. EI from a meal with an unknown ED can become inversely related to EI through learning or conditioning. Therefore, the effect of ED on EI during a single meal observation cannot be extrapolated directly to the 24 h effect on EI. With regard to the treatment of obesity, a conscious decreased consumption of foods high in ED and an increase in consumption of low-ED food is necessary to decrease and subsequently maintain body weight, particularly in subjects with a sedentary lifestyle.

Functional food science and behaviour and psychological functions

The impact of ingesting various foods on psychological and behavioural functions is a topic of both interest and concern to the general public. In this article, the scientific literature concerning demonstrated cause-and-effect relationships is reviewed, beginning with methodological considerations specific to the quantification of particular behaviours and psychological events. The essential function of food is to satisfy hunger and the need for essential nutrients. The contributions of macronutrients to appetite and satiety are described, as well as their impact on metabolism and energy balance. Functional properties of macronutrient substitutes (high-intensity sweeteners, fat replacers) and flavour enhancers are examined in relation to their contribution to hunger, satiety, and energy balance. The effects of foods and individual nutrients on the performance of diverse psychomotor tasks are studied with consideration given to the various validated quantitative tools used to assess behaviour. The effects of food components on activation, sedation, and affective states such as dysphoria are also reviewed, with special attention given to brain function and neuroactive substances such as serotonin and the endorphins. The case of hyperactivity in children is given special emphasis with reference to the potential influence of sugar and food additives. Safety issues related to food constituents and additives are discussed. Finally, a set of criteria is proposed for the evaluation and elaboration of studies in the behavioural and psychological fields, along with suggestions for future research.

The role of reduced fat diets and fat substitutes in the regulation of energy and fat intake and body weight

The suggested link between a high intake of dietary fat and obesity has led to a proliferation on the market of reduced fat foods. The preceding year has seen the publication of more long-term studies investigating the effects of reduced fat and fat substituted foods on energy intake, fat intake and body weight. Effects on the proportion of the diet consumed as fat are encouraging (with most studies showing a decrease towards dietary recommendations), whilst effects on energy intake and body weight remain equivocal.