Eating with a smaller spoon decreases bite size, eating rate and ad libitum food intake in healthy young males

Association between Self-Perception of Chewing, Chewing Behavior, and the Presence of Gastrointestinal Symptoms in Candidates for Bariatric Surgery

Given the changes in the digestive tract post-bariatric surgery, adapting to a new pattern of eating behavior becomes crucial, with special attention to the specifics of chewing mechanics. This study aimed to investigate the association between self-perception of chewing, chewing behavior, and the presence of gastrointestinal symptoms in preoperative patients undergoing bariatric surgery. Sixty adult candidates for bariatric surgery at a public hospital in Belém (Brazil) were analyzed. Participants predominantly exhibited unilateral chewing patterns (91.6%), a fast chewing rhythm (73.3%), a large food bolus (80%), liquid intake during meals (36.7%), and 41.7% reported that chewing could cause some issue. Significant associations were found between the perception of causing problems and chewing scarcity (p = 0.006), diarrhea (p = 0.004), absence of slow chewing (p = 0.048), and frequent cutting of food with front teeth (p = 0.034). These findings reveal a relationship between the perception of chewing problems and chewing scarcity, presence of diarrhea, and fast chewing.

Factors associated with eating rate: a systematic review and narrative synthesis informed by socio-ecological model

Accumulating evidence shows associations between rapid eating and overweight. Modifying eating rate might be a potential weight management strategy without imposing additional dietary restrictions. A comprehensive understanding of factors associated with eating speed will help with designing effective interventions. The aim of this review was to synthesise the current state of knowledge on the factors associated with eating rate. The socio-ecological model (SEM) was utilised to scaffold the identified factors. A comprehensive literature search of eleven databases was conducted to identify factors associated with eating rate. The 104 studies that met the inclusion criteria were heterogeneous in design and methods of eating rate measurement. We identified thirty-nine factors that were independently linked to eating speed and mapped them onto the individual, social and environmental levels of the SEM. The majority of the reported factors pertained to the individual characteristics (n = 20) including demographics, cognitive/psychological factors and habitual food oral processing behaviours. Social factors (n = 11) included eating companions, social and cultural norms, and family structure. Environmental factors (n = 8) included food texture and presentation, methods of consumption or background sounds. Measures of body weight, food form and characteristics, food oral processing behaviours and gender, age and ethnicity were the most researched and consistent factors associated with eating rate. A number of other novel and underresearched factors emerged, but these require replication and further research. We highlight directions for further research in this space and potential evidence-based candidates for interventions targeting eating rate.

Effects of Using a Perforated Spoon on Salt Reduction When Consuming Ramen Noodles: A Randomized Crossover Study of Japanese Male University Students

Salt reduction is a public health priority for the Japanese population. We focused on the effect of salt reduction by changing eating utensils to reduce salt consumption. As a test meal, we used ramen, which is commonly eaten by Japanese individuals and has a high salt content. In this randomized crossover study, we hypothesized that eating ramen with a perforated spoon would reduce the quantity of ramen soup and salt consumed compared to using a regular spoon without holes. Soup intake, after-meal fullness, and deliciousness were compared between eating with chopsticks and a regular spoon, and with chopsticks and a perforated spoon. In total, 36 male university students (mean age, 20.7 [standard deviation, 1.8] years) were included in the analyses. The median salt intake (25th and 75th percentiles) was significantly lower with perforated spoons (1.8 [1.5, 4.3] g) than with regular spoons (2.4 [1.8, 4.8] g; p = 0.019). There were no significant differences in after-meal fullness or deliciousness for both spoon conditions (p > 0.05). For young men, the soup intake when eating ramen with a perforated spoon was lower than that with a regular spoon; this suggests a reduction in salt intake.

Body mass index and variability in meal duration and association with rate of eating

Background

A fast rate of eating is associated with a higher risk for obesity but existing studies are limited by reliance on self-report and the consistency of eating rate has not been examined across all meals in a day. The goal of the current analysis was to examine associations between meal duration, rate of eating, and body mass index (BMI) and to assess the variance of meal duration and eating rate across different meals during the day.

Methods

Using an observational cross-sectional study design, non-smoking participants aged 18–45 years (N = 29) consumed all meals (breakfast, lunch, and dinner) on a single day in a pseudo free-living environment. Participants were allowed to choose any food and beverages from a University food court and consume their desired amount with no time restrictions. Weighed food records and a log of meal start and end times, to calculate duration, were obtained by a trained research assistant. Spearman's correlations and multiple linear regressions examined associations between BMI and meal duration and rate of eating.

Results

Participants were 65% male and 48% white. A shorter meal duration was associated with a higher BMI at breakfast but not lunch or dinner, after adjusting for age and sex (p = 0.03). Faster rate of eating was associated with higher BMI across all meals (p = 0.04) and higher energy intake for all meals (p < 0.001). Intra-individual rates of eating were not significantly different across breakfast, lunch, and dinner (p = 0.96).

Conclusion

Shorter beakfast and a faster rate of eating across all meals were associated with higher BMI in a pseudo free-living environment. An individual's rate of eating is constant over all meals in a day. These data support weight reduction interventions focusing on the rate of eating at all meals throughout the day and provide evidence for specifically directing attention to breakfast eating behaviors.

The carbohydrate-insulin model: a physiological perspective on the obesity pandemic

According to a commonly held view, the obesity pandemic is caused by overconsumption of modern, highly palatable, energy-dense processed foods, exacerbated by a sedentary lifestyle. However, obesity rates remain at historic highs, despite a persistent focus on eating less and moving more, as guided by the energy balance model (EBM). This public health failure may arise from a fundamental limitation of the EBM itself. Conceptualizing obesity as a disorder of energy balance restates a principle of physics without considering the biological mechanisms that promote weight gain. An alternative paradigm, the carbohydrate-insulin model (CIM), proposes a reversal of causal direction. According to the CIM, increasing fat deposition in the body-resulting from the hormonal responses to a high-glycemic-load diet-drives positive energy balance. The CIM provides a conceptual framework with testable hypotheses for how various modifiable factors influence energy balance and fat storage. Rigorous research is needed to compare the validity of these 2 models, which have substantially different implications for obesity management, and to generate new models that best encompass the evidence.

Increased oral processing and a slower eating rate increase glycaemic, insulin and satiety responses to a mixed meal tolerance test

PURPOSE

Variations in specific oral processing behaviours may contribute to differences in glucose, insulin and satiety responses to a standardised test meal. This study tested how natural variations in oral processing between slower and faster eaters contribute to differences in post-prandial glucose (PP glucose), insulin response (PP insulin) and post-meal satiety for a standardised test meal.

METHODS

Thirty-three participants with higher risk for type 2 diabetes consumed a standardised test-meal while being video recorded to derive specific oral processing behaviours. Plasma glucose, insulin and satiety measures were collected at baseline, during and post meal. Participants were split into slower and faster eaters using median split based on their eating rates and individual bolus properties were analysed at the point of swallow.

RESULTS

There were large variations in eating rate (p < 0.001). While there was no significant difference in PP glucose response (p > 0.05), slower eaters showed significantly higher PP insulin between 45 and 60 min (p < 0.001). Slower eaters had longer oro-sensory exposure and increased bolus saliva uptake which was associated with higher PP glucose iAUC. Faster eating rate and larger bolus particle size at swallow correlated with lower PP glucose iAUC. A slower eating rate with greater chews per bite significantly increased insulin iAUC. Faster eaters also consistently rated their hunger and desire to eat higher than slower eaters (p < 0.05).

CONCLUSIONS

Natural variations in eating rate and the associated oral processing contributed to differences in PP glucose, PP insulin and satiety responses. Encouraging increased chewing and longer oral-exposure time during consumption, may promote early glucose absorption and greater insulin and satiety responses, and help support euglycaemia.

TRIAL REGISTRATION

ClinicalTrials.gov identifier: NCT04522063.

Impact of Portion Control Tools on Portion Size Awareness, Choice and Intake: Systematic Review and Meta-Analysis

Portion control utensils and reduced size tableware amongst other tools, have the potential to guide portion size intake but their effectiveness remains controversial. This review evaluated the breadth and effectiveness of existing portion control tools on learning/awareness of appropriate portion sizes (PS), PS choice, and PS consumption. Additional outcomes were energy intake and weight loss. Published records between 2006–2020 (n = 1241) were identified from PubMed and WoS, and 36 publications comparing the impact of portion control tools on awareness (n = 7 studies), selection/choice (n = 14), intake plus related measures (n = 21) and weight status (n = 9) were analyzed. Non-tableware tools included cooking utensils, educational aids and computerized applications. Tableware included mostly reduced-size and portion control/calibrated crockery/cutlery. Overall, 55% of studies reported a significant impact of using a tool (typically smaller bowl, fork or glass; or calibrated plate). A meta-analysis of 28 articles confirmed an overall effect of tool on food intake (d = –0.22; 95%CI: –0.38, –0.06; 21 comparisons), mostly driven by combinations of reduced-size bowls and spoons decreasing serving sizes (d = –0.48; 95%CI: –0.72, –0.24; 8 comparisons) and consumed amounts/energy (d = –0.22; 95%CI: –0.39, –0.05, 9 comparisons), but not by reduced-size plates (d = –0.03; 95%CI: –0.12, 0.06, 7 comparisons). Portion control tools marginally induced weight loss (d = –0.20; 95%CI: –0.37, –0.03; 9 comparisons), especially driven by calibrated tableware. No impact was detected on PS awareness; however, few studies quantified this outcome. Specific portion control tools may be helpful as potentially effective instruments for inclusion as part of weight loss interventions. Reduced size plates per se may not be as effective as previously suggested.

The Impact of Post-Prandial Delay Periods on Ad Libitum Consumption of a Laboratory Breakfast Meal

This study examined the impact of varying the holding time following an ad libitum laboratory breakfast on acute dietary behaviour and subsequent intake. 24 participants (20 females (age: 23.4±6.3 y; BMI: 23.9±3.9 kg·m-2, mean±SD)) completed three trials following a quasi-randomized, crossover design. Each trial (seven day separation) incorporated a defined post-prandial delay (DPD) period of either zero (no delay), one or three hours following a buffet breakfast consumed over 30-minutes. Dietary intake outcomes included energy, macronutrient and core food group intakes. On completion of the DPD period, participants left the laboratory and recorded all food/beverages consumed for the remainder of the day. One-way repeated-measures ANOVA assessed all outcomes, with post hoc analysis conducted on significant main effects. Energy and carbohydrate intakes were significantly lower on no delay vs one hour (p = 0.014) and three hour (p = 0.06) DPD trials (EI: 1853±814 kJ vs. 2250±1345 kJ vs. 1948±1289 kJ; CHO: 68±34 g vs. 77±44 vs. 69±43 g; respectively). DPD periods did not influence the time to consume next meal or energy, macronutrient and core food group intakes for the remainder of the day. Delaying participants from leaving a laboratory alters dietary intake at an ad libitum test meal. The post-meal holding period is an important methodological consideration when planning laboratory studies to assess appetite. Novelty Bullets: 1. Delaying participants from leaving a laboratory alters dietary intake at ad libitum breakfast meals. 2. The length of the delay period did not affect dietary intake at ad libitum breakfast meals.

Negative energy balance during military training: The role of contextual limitations

During multiday training exercises, soldiers almost systematically face a moderate-to-large energy deficit, affecting their body mass and composition and potentially their physical and cognitive performance. Such energy deficits are explained by their inability to increase their energy intake during these highly demanding periods. With the exception of certain scenarios in which rations are voluntarily undersized to maximize the constraints, the energy content of the rations are often sufficient to maintain a neutral energy balance, suggesting that other limitations are responsible for such voluntary and/or spontaneous underconsumption. In this review, the overall aim was to present an overview of the impact of military training on energy balance, a context that stands out by its summation of specific limitations that interfere with energy intake. We first explore the impact of military training on the various components of energy balance (intake and expenditure) and body mass loss. Then, the role of the dimensioning of the rations (total energy content above or below energy expenditure) on energy deficits are addressed. Finally, the potential limitations inherent to military training (training characteristics, food characteristics, timing and context of eating, and the soldiers' attitude) are discussed to identify potential strategies to spontaneously increase energy intake and thus limit the energy deficit.

How Important Is Eating Rate in the Physiological Response to Food Intake, Control of Body Weight, and Glycemia?

The link between eating rate and energy intake has long been a matter of extensive research. A better understanding of the effect of food intake speed on body weight and glycemia in the long term could serve as a means to prevent weight gain and/or dysglycemia. Whether a fast eating rate plays an important role in increased energy intake and body weight depends on various factors related to the studied food such as texture, viscosity and taste, but seems to be also influenced by the habitual characteristics of the studied subjects as well. Hunger and satiety quantified via test meals in acute experiments with subsequent energy intake measurements and their association with anorexigenic and orexigenic regulating peptides provide further insight to the complicated pathogenesis of obesity. The present review examines data from the abundant literature on the subject of eating rate, and highlights the main findings in people with normal weight, obesity, and type 2 diabetes, with the aim of clarifying the association between rate of food intake and hunger, satiety, glycemia, and energy intake in the short and long term.

Cracker shape modifies ad libitum snack intake of crackers with cheese dip

Food and energy intake can be effectively lowered by changing food properties, but little is known whether modifying food shape is sufficient to influence intake. This study investigated the influence of cracker shape and cheese viscosity on ad libitum intake of cracker–cheese combinations. Forty-four participants (thirteen males, 23 (sd 3) years, BMI 21 (sd 2) kg/m2) participated in four late afternoon snack sessions (2 × 2 randomised crossover design). Iso-energetic crackers were baked into flat squares and finger-shape cylindrical sticks and combined with a cheese dip varying in viscosity. Approximately eighty crackers and 500 g cheese dip were served in separate large bowls. Participants consumed crackers with cheese dip ad libitum while watching a movie of 30 min. Dipping behaviour and oral processing behaviour were measured simultaneously by hidden balances under the cheese bowls and video recordings. Cracker intake (28 (sem 1) crackers) of cracker–cheese combinations was not influenced by cracker shape. Cheese intake of cracker–cheese combinations was 15 % higher for flat-squared than finger-shape crackers (131 kJ, P = 0·016), as a larger amount of cheese was scooped with flat-squared crackers (2·9 (sem 0·2) v. 2·3 (sem 0·1) g cheese per dip, P < 0·001) and showed higher eating rate and energy intake rate (P < 0·001). Eating rate over snacking time decreased by reducing bite frequency (P < 0·001) while cheese dip size remained fairly constant (P = 0·12). Larger energy intake from condiments was facilitated by increased cracker surface, and this did not trigger earlier satiation. Changing food carrier surface may be a promising approach to moderate energy intake of often high energy dense condiments, sauces and toppings.