Comparison of oral and gastric administration of sucrose and maltose on gastric emptying rate and appetite

Metabolic Effects of Selected Conventional and Alternative Sweeteners: A Narrative Review

Sugar consumption is known to be associated with a whole range of adverse health effects, including overweight status and type II diabetes mellitus. In 2015, the World Health Organization issued a guideline recommending the reduction of sugar intake. In this context, alternative sweeteners have gained interest as sugar substitutes to achieve this goal without loss of the sweet taste. This review aims to provide an overview of the scientific literature and establish a reference tool for selected conventional sweeteners (sucrose, glucose, and fructose) and alternative sweeteners (sucralose, xylitol, erythritol, and D-allulose), specifically focusing on their important metabolic effects. The results show that alternative sweeteners constitute a diverse group, and each substance exhibits one or more metabolic effects. Therefore, no sweetener can be considered to be inert. Additionally, xylitol, erythritol, and D-allulose seem promising as alternative sweeteners due to favorable metabolic outcomes. These alternative sweeteners replicate the benefits of sugars (e.g., sweetness and gastrointestinal hormone release) while circumventing the detrimental effects of these substances on human health.

Analysis of Complex Absorption After Multiple Dosing: Application to the Interaction Between the P-glycoprotein Substrate Talinolol and Rifampicin

PURPOSE

In order to clarify the effect of rifampicin on the bioavailability of the P-glycoprotein substrate talinolol, its absorption kinetics was modeled after multiple-dose oral administration of talinolol in healthy subjects.

METHODS

A sum of two inverse Gaussian functions was used to calculate the time course of the input rate into the systemic circulation.

RESULTS

The estimated rate of drug entry into the systemic circulation revealed two distinct peaks at 1 and 3.5 h after administration. Rifampicin did not affect bioavailability of talinolol, but did shift the second peak of the input function by 1.3 h to later times. Elimination clearance and one of the intercompartmental distribution clearances increased significantly under rifampicin treatment.

CONCLUSIONS

Rifampicin changes the time course of absorption rate but not the fraction absorbed of talinolol. The model suggests the existence of two intestinal absorption windows for talinolol.

Processing Apples to Puree or Juice Speeds Gastric Emptying and Reduces Postprandial Intestinal Volumes and Satiety in Healthy Adults

BACKGROUND

Whole apples produce greater satiety than processed apples, but the underlying mechanisms remain unclear.

OBJECTIVE

Our aim was to assess the intragastric processing of apple preparations and the associated small and large bowel contents using MRI.

METHODS

An open label, 3-way crossover, randomized, controlled trial. Eighteen healthy adults (mean ± SD age, 25 ± 4 y; BMI, 22.7 ± 3.5 kg/m2) underwent serial MRI scans on 3 occasions separated by 7 d, after consumption of isocaloric (178 kcal) portions of either whole apples, apple puree, or apple juice. Gastric emptying, small bowel water content (SBWC; primary endpoint), were measured at baseline and at 45 min intervals (0-270 min) postmeal ingestion. Fullness and satiety were also assessed at each time point. Treatment effects between groups were analyzed using ANOVA.

RESULTS

Gastric emptying half-time (GE t50) was greater (P < 0.0001) after participants consumed whole apple (mean ± SEM), 65 (3.3) min compared with when they consumed apple puree (41 [2.8] min) or apple juice (38 [2.9] min), times that did not differ. Postprandial area under the curve (AUC) (135-270 min) SBWC was also greater for whole apples than puree (P = 0.025) and juice (P = 0.0004) but juice and puree did not differ. AUC for fullness and satiety (0-270 min) postingestion was also greater (P = 0.002 and 0.004, respectively) for whole apple compared with juice but juice and puree did not differ.

CONCLUSIONS

Gastric emptying is slower after whole apple consumption causing a greater sensation of fullness and satiety than puree or juice in healthy adults. Whole apples increased small bowel and colonic contents during the later phase of the study which may be relevant for subsequent food consumption.This study was registered at clinicaltrials.gov as NCT03714464.

Sweet Taste Antagonist Lactisole Administered in Combination with Sucrose, But Not Glucose, Increases Energy Intake and Decreases Peripheral Serotonin in Male Subjects

Knowledge regarding the involvement of sweetness perception on energy intake is scarce. Here, the impact of glucose and sucrose sweetness, beyond their caloric load, on subsequent food intake and biomarkers of satiation was evaluated by co-administration of the sweet taste receptor inhibitor lactisole. A total of 27 healthy, male subjects received solutions of either 10% glucose w/o 60 ppm lactisole or 10% sucrose w/o 60 ppm lactisole. Subsequent food intake from a standardized breakfast was evaluated 2 h after receiving the respective test solution. Changes in postprandial plasma concentrations of cholecystokinin, ghrelin, and serotonin were determined over a period of 120 min, as was the body temperature. Administration of lactisole to the sucrose solution increased the energy intake from the subsequent standardized breakfast by 12.9 ± 5.8% (p = 0.04), led to a decreased Δ AUC of the body core temperature by 46 ± 20% (p = 0.01), and time-dependently reduced Δ serotonin plasma concentrations (−16.9 ± 6.06 ng/mL vs. −0.56 ± 3.7 ng/mL after sucrose administration, p = 0.03). The present study shows that lactisole increases energy intake and decreases plasma serotonin concentrations as well as body core temperature induced by sucrose, but not glucose. This finding may be associated with the different binding affinities of sucrose and glucose to the sweet taste receptor.

Knowledge, attitudes, and practices toward added sugar consumption among female undergraduate students in Madinah, Saudi Arabia: A cross-sectional study

OBJECTIVES

This study aimed to evaluate knowledge, attitudes, and practices toward added sugar intake and the associations with nutrient intakes and weight status.

METHODS

This cross-sectional study was conducted among 190 healthy female undergraduate students at Taibah University, Madinah, Saudi Arabia. Demographic, knowledge and attitudes toward added sugar, dietary intake, and anthropometric data (i.e., height, weight, and waist circumference) were collected during face-to-face interviews.

RESULTS

Approximately half of the students (n = 106; 55.8%) were aware of the health consequences of excessive intake of added sugar, but only 32.6% (n = 62) reported making an effort to reduce their added sugar intake. The data indicated that 8.42% of the students (n = 16) consumed carbonated soft drinks daily, 15.8% (n = 30) consumed fruit drinks daily, and 45.8% (n = 87) consumed sweets daily. Underweight students consumed higher quantities of added sugar (expressed as percent of total energy intake) compared with students in all other weight status groups. Results showed negative associations between percentage of added sugar intake and intakes of fiber, iron, zinc, vitamin D, body mass index, and waist circumference.

CONCLUSIONS

Our findings indicated that a large proportion of young women had limited knowledge on the health consequences of excessive added sugar intakes. The observed inverse relationships between added sugar and micronutrient intakes and the weight status highlight the urgent need for expanded efforts to improve added sugar-related knowledge and promote the reduction of added sugar intake among young women.

Acute Effects of Nutritive and Non-Nutritive Sweeteners on Postprandial Blood Pressure

Postprandial hypotension (PPH) is under-recognised, but common, particularly in the elderly, and is of clear clinical importance due to both the independent association between PPH and an increase in mortality and lack of effective management for this condition. Following health concerns surrounding excessive consumption of sugar, there has been a trend in the use of low- or non-nutritive sweeteners as an alternative. Due to the lack of literature in this area, we conducted a systematic search to identify studies relevant to the effects of different types of sweeteners on postprandial blood pressure (BP). The BP response to ingestion of sweeteners is generally unaffected in healthy young subjects, however in elderly subjects, glucose induces the greatest decrease in postprandial BP, while the response to sucrose is less pronounced. The limited studies investigating other nutritive and non-nutritive sweeteners have demonstrated minimal or no effect on postprandial BP. Dietary modification by replacing high nutritive sweeteners (glucose, fructose, and sucrose) with low nutritive (d-xylose, xylitol, erythritol, maltose, maltodextrin, and tagatose) and non-nutritive sweeteners may be a simple and effective management strategy for PPH.

Role of Bitter Taste Receptors in Regulating Gastric Accommodation in Guinea Pigs

Taste stimulants play important roles in triggering digestion and absorption of nutrients and in toxin detection, under the control of the gut-brain axis. Bitter compounds regulate gut hormone secretion and gastrointestinal motility through bitter taste receptors (TAS2Rs) located in the taste buds on the tongue and in the enteroendocrine cells. Gastric accommodation (GA) is an important physiologic function. However, the role of TAS2R agonists in regulating GA remains unclear. To clarify whether GA is influenced by bitter stimulants, we examined the effect of TAS2R agonist denatonium benzoate (DB), administered intraorally and intragastrically, by measuring the consequent intrabag pressure in the proximal stomach of guinea pigs. Effects of the Kampo medicine rikkunshito (RKT) and its bitter components liquiritigenin and naringenin on GA were also examined. Intraoral DB (0.2 nmol/ml) administration enhanced GA. Intragastric DB administration (0.1 and 1 nmol/kg) promoted GA, whereas higher DB doses (30 μmol/kg) inhibited it. Similar changes in GA were observed with intragastric (1000 mg/kg) and intraoral (200 mg/ml) RKT administration. Liquiritigenin and naringenin also promoted GA. These findings suggest that GA is affected by the stimulation of TAS2Rs in the oral cavity or gut in guinea pigs.

The effect of dairy products consumed with high glycemic carbohydrate on subjective appetite, food intake, and postprandial glycemia in older adults

The objective was to compare the effect of liquid, semi-solid, and solid dairy products and a nondairy beverage when consumed with glycemic carbohydrate on subjective appetite, food intake (FI), and post-prandial glycemia (PPG) in healthy older adults. Thirty healthy men and women (14 males and 16 females; age: 64.6 ± 2.4 y; BMI: 25.6 ± 2.5 kg/m²) participated in a randomized crossover study. Treatments were one of 250 mL of 2% fat milk and soy beverage, 175 g of 2% Greek yogurt, and 30 g of Cheddar cheese consumed as part of an isocaloric (380 kcal) meal with bread and jam. Water alone served as the energy-free control for subjective appetite. At 180 min after consumption, the participants were fed an ad libitum meal to measure FI. Subjective appetite, blood glucose, and insulin were measured at baseline and at intervals both before (post-treatment) and after the meal (postmeal). Cheese and yogurt resulted in lower post-treatment blood glucose than milk and soy beverage when consumed with carbohydrate (p < 0.0001), but no differences among any treatments were observed postmeal. Treatments led to similar insulin concentrations. Post-treatment appetite was lower than after the water control for all treatments but suppressed more by cheese and yogurt compared with milk (p < 0.0001). There were no differences in FI among treatments. Cheese and yogurt increase satiety and lower PPG more than milk or a soy beverage when consumed with carbohydrate.

The effect of dairy and nondairy beverages consumed with high glycemic cereal on subjective appetite, food intake, and postprandial glycemia in young adults

The objective was to compare the effect of dairy and nondairy beverages when consumed with carbohydrate at breakfast on subjective appetite, food intake (FI), and postprandial glycemia (PPG) in healthy young adults. Twenty-six healthy males and females (13 males and 13 females; 23.0 ± 2.6 years; BMI: 22.3 ± 1.5 kg/m²) participated in a randomized crossover study. They consumed nonisocaloric amounts (250 mL) of almond beverage, soy beverage, 1% fat milk, yogurt beverage, and water (control) with cereal and 120 min later, an ad libitum meal. Subjective appetite, PPG, and insulin were measured at baseline and at intervals before and after the meal at which FI was measured. Post-treatment blood glucose was lowest following soy beverage compared with all treatments but was not different from milk (p = 0.0002). There were no differences between any other treatments. However, over the first hour, PPG for all treatments was 27% lower compared with water (p < 0.0001). Milk and yogurt beverage led to the highest insulin concentrations post-treatment (p < 0.0001) but there were no differences between treatments postmeal. All treatments reduced appetite and led to lower FI at the meal compared with water, but FI was lower after milk compared with all treatments except yogurt beverage (p < 0.0001). Both dairy and nondairy beverages consumed with a high glycemic cereal at breakfast increased satiety and decreased FI compared with water with cereal. Despite higher carbohydrate content, all beverages led to similar or lower PPG than the water breakfast, but dairy beverages increased insulin more than nondairy beverages.

Effects of aroma and taste, independently or in combination, on appetite sensation and subsequent food intake

Food flavour is important in appetite control. The effects of aroma and taste, independently or in combination, on appetite sensation and subsequent food intake, were studied. Twenty-six females (24 ± 4 years, 20.9 ± 1.9 kg⋅m-2) consumed, over 15 min period, one of four sample drinks as a preload, followed by an ad libitum consumption of a pasta meal (after 65 min). Sample drinks were: water (S1, 0 kcal), water with strawberry aroma (S2, 0 kcal), water with sucrose and citric acid (S3, 48 kcal) and water with strawberry aroma, sucrose and citric acid (S4, 48 kcal). Appetite sensation did not differ between the S1 (water), S2 (aroma) and S3 (taste) conditions. Compared with S1 (water), S2 (aroma) and S3 (taste), S4 (aroma + taste) suppressed hunger sensation over the 15 min sample drink consumption period (satiation) (p < 0.05). S4 (aroma + taste) further reduced hunger sensation (satiety) more than S1 at 5, 20 and 30 min after the drink was consumed (p < 0.05), more than S2 (aroma) at 5 and 20 min after the drink was consumed (p < 0.05), and more than S3 (taste) at 5 min after the drink was consumed (p < 0.05). Subsequent pasta energy intake did not vary between the sample drink conditions. S4 (aroma + taste) had the strongest perceived flavour. This study suggests that the combination of aroma and taste induced greater satiation and short-term satiety than the independent aroma or taste and water, potentially via increasing the perceived flavour intensity or by enhancing the perceived flavour quality and complexity as a result of aroma-taste cross-modal perception.

Oral processing effort, appetite and acute energy intake in lean and obese adults

Chewing reportedly contributes to satiation and satiety signals. Attempts to document and quantify this have led to small and inconsistent effects. The present trial manipulated oral processing effort though required chewing of gums of different hardness and measured appetitive sensations, energy intake, gastric emptying, GI transit time, and concentrations of glucose, insulin, GLP-1, ghrelin and pancreatic polypeptide. Sixty adults classified by sex and BMI (15 each of lean females, obese females, lean males and obese males) were tested in a randomized, controlled, cross-over trial with three arms. They chewed nothing, soft gum or hard gum for 15 min while sipping grape juice (10% of individual energy needs) containing acetaminophen and lactulose on one day each separated by 7 days. Electromyographic recordings and self-reports were obtained during and after chewing to quantify oral processing effort. Blood was sampled through an indwelling catheter and appetite ratings were obtained at baseline and at 0, 15, 30, 45, 60, 90, 120, 180 and 240 min after chewing initiation. Breath samples were collected at 10 min intervals for the first 2h and at 30 min intervals for the next 2h. No effects of chewing were observed for appetitive sensations or gut peptide concentrations. Energy intake tended to decline in lean and increase in obese participants so that daily energy intake differed significantly between the two groups when chewing either gum, while no difference was observed on the non-chewing day. Serum glucose and insulin were significantly lower at selected time points 90-240 min after chewing compared to baseline and the non-chewing day. These data indicate chewing effort does not affect appetitive sensations or gut peptide secretion, but may exert a small differential effect on acute energy intake in lean and obese individuals and lead to greater post-prandial declines of serum glucose and insulin. The efficacy of gum chewing as a substitute for eating for weight management remains uncertain.

Consumption with large sip sizes increases food intake and leads to underestimation of the amount consumed

BACKGROUND

A number of studies have shown that bite and sip sizes influence the amount of food intake. Consuming with small sips instead of large sips means relatively more sips for the same amount of food to be consumed; people may believe that intake is higher which leads to faster satiation. This effect may be disturbed when people are distracted.

OBJECTIVE

The objective of the study is to assess the effects of sip size in a focused state and a distracted state on ad libitum intake and on the estimated amount consumed.

DESIGN

In this 3×2 cross-over design, 53 healthy subjects consumed ad libitum soup with small sips (5 g, 60 g/min), large sips (15 g, 60 g/min), and free sips (where sip size was determined by subjects themselves), in both a distracted and focused state. Sips were administered via a pump. There were no visual cues toward consumption. Subjects then estimated how much they had consumed by filling soup in soup bowls.

RESULTS

Intake in the small-sip condition was ∼30% lower than in both the large-sip and free-sip conditions (P<0.001). In addition, subjects underestimated how much they had consumed in the large-sip and free-sip conditions (P<0.03). Distraction led to a general increase in food intake (P = 0.003), independent of sip size. Distraction did not influence sip size or estimations.

CONCLUSIONS

Consumption with large sips led to higher food intake, as expected. Large sips, that were either fixed or chosen by subjects themselves led to underestimations of the amount consumed. This may be a risk factor for over-consumption. Reducing sip or bite sizes may successfully lower food intake, even in a distracted state.

Effects of oral and gastric stimulation on appetite and energy intake

Appetite is regulated by many factors, including oro-sensory and gastric signals. There are many studies on contributions of and possible interaction between sensory and gastric stimulation, but there are few studies in humans using simultaneous oral and gastric stimulation. We investigated the effect of simultaneous, but independently manipulated, oral and gastric stimulation on appetite ratings and energy intake. We hypothesized that compared with no stimulation, oral and gastric stimulation would equally and additively decrease appetite ratings and energy intake. Healthy men (n = 26, 21 ± 2 years, BMI 22 ± 3 kg/m(2)) participated in a randomized crossover trial with four experimental conditions and a control condition. Experimental conditions consisted of oral stimulation, with either 1 or 8 min modified sham feeding (MSF), and gastric stimulation, with either 100 or 800 ml intragastrically infused liquid (isocaloric, 99 kcal, 100 ml/min). The control condition consisted of no oral or gastric stimulation. Outcome measures were energy intake 30 min after the treatment and appetite ratings. Compared with the control condition, energy intake decreased significantly after the 8 min/100 ml (19% lower, P = 0.001) and 8 min/800 ml conditions (15% lower, P = 0.02), but not after the 1 min/100 ml (14% lower, P = 0.06) and 1 min/800 ml conditions (10% lower, P = 0.39). There was no interaction of oral and gastric stimulation on energy intake. Hunger and fullness differed across all conditions (P ≤ 0.01). In conclusion, duration of oral exposure was at least as important in decreasing energy intake as gastric filling volume. Oral and gastric stimulation did not additively decrease energy intake. Longer oro-sensory stimulation, therefore, may be an important contributor to a lower energy intake.

Both longer oral sensory exposure to and higher intensity of saltiness decrease ad libitum food intake in healthy normal-weight men

Orosensory exposure to sweetness has been shown to be important in satiation, whereas the effect of exposure to a salty taste on satiation is not known. The primary objective was to investigate the effect of orosensory exposure time to and intensity of saltiness in soup on ad libitum intake. The secondary objective was to investigate the effect of intensity on bite size. Fifty-five healthy men consumed ad libitum from both a low-salt (LS) and a high-salt (HS) creamy tomato soup in 2 exposure time conditions ("long" and "short") and a free condition ("free"). Bites were administered and controlled via a pump. In the long condition, bites of 5 g were administered in 2 s at intervals of 5 s (exposure time: 24 s/min). In the short condition, bites of 15 g were administered in 3 s at intervals of 15 s (exposure time: 12 s/min). The eating rate was equal in the long and short conditions (60 g/min). In the free condition, participants adjusted their bite sizes at intervals of 15 s. The short condition resulted in ~34% higher ad libitum intake compared to the long condition (P < 0.001); there was no interaction with intensity. Ad libitum intake of HS soup was ~9% lower than LS soup (P < 0.001). The free condition showed that HS soup was consumed with smaller bite sizes during the first half of the intake period (P < 0.05). Longer orosensory exposure and higher saltiness intensity both decreased food intake, although orosensory exposure had more impact than intensity. Prolonging the orosensory exposure per food unit may be helpful to reduce food intake.

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.

Gastrointestinal targets of appetite regulation in humans

The aim of this paper is to describe and discuss relevant aspects of the assessment of physiological functions - and related biomarkers - implicated in the regulation of appetite in humans. A short introduction provides the background and the present state of biomarker research as related to satiety and appetite. The main focus of the paper is on the gastrointestinal tract and its functions and biomarkers related to appetite for which sufficient data are available in human studies. The first section describes how gastric emptying, stomach distension and gut motility influence appetite; the second part describes how selected gastrointestinal peptides are involved in the control of satiety and appetite (ghrelin, cholecystokinin, glucagon-like peptide, peptide tyrosin-tyrosin) and can be used as potential biomarkers. For both sections, methodological aspects (adequacy, accuracy and limitation of the methods) are described. The last section focuses on new developments in techniques and methods for the assessment of physiological targets involved in appetite regulation (including brain imaging, interesting new experimental approaches, targets and markers). The conclusion estimates the relevance of selected biomarkers as representative markers of appetite regulation, in view of the current state of the art.

Effect of bite size and oral processing time of a semisolid food on satiation

BACKGROUND

Food texture plays an important role in food intake regulation. In previous studies we showed a clear effect of viscosity on ad libitum food intake and found indications that eating rate, bite size, and oral processing time (OPT) could play a role.

OBJECTIVE

The objective was to determine the effect of bite size and OPT of a food on satiation, defined as ad libitum food intake.

DESIGN

Twenty-two healthy subjects participated in all 7 test conditions. Bite sizes were free or fixed to small bite sizes ( approximately 5 g) or large bite sizes ( approximately 15 g). OPT was free (only in combination with free bite size) or fixed to 3 or 9 s. Subjects consumed chocolate custard through a tube, which was connected to a peristaltic pump. Sound signals indicated OPT duration.

RESULTS

Subjects consumed significantly more when bite sizes were large than when they were small (bite size effect: P < 0.0001) and when OPT was 3 s rather than 9 s (OPT effect: P = 0.008). Under small bite size conditions, mean (+/-SD) ad libitum intakes were 382 +/- 197 g (3-s OPT) and 313 +/- 170 g (9-s OPT). Under large bite size conditions, ad libitum intakes were much higher: 476 +/- 176 g (3-s OPT) and 432 +/- 163 g (9-s OPT). Intakes during the free bite size conditions were 462 +/- 211 g (free OPT), 455 +/- 197 g (3-s OPT), and 443 +/- 202 g (9-s OPT).

CONCLUSION

This study shows that greater oral sensory exposure to a product, by eating with small bite sizes rather than with large bite sizes and increasing OPT, significantly decreases food intake.

Nonnutritive sweetener consumption in humans: effects on appetite and food intake and their putative mechanisms

Nonnutritive sweeteners (NNS) are ecologically novel chemosensory signaling compounds that influence ingestive processes and behavior. Only about 15% of the US population aged >2 y ingest NNS, but the incidence is increasing. These sweeteners have the potential to moderate sugar and energy intakes while maintaining diet palatability, but their use has increased in concert with BMI in the population. This association may be coincidental or causal, and either mode of directionality is plausible. A critical review of the literature suggests that the addition of NNS to non-energy-yielding products may heighten appetite, but this is not observed under the more common condition in which NNS is ingested in conjunction with other energy sources. Substitution of NNS for a nutritive sweetener generally elicits incomplete energy compensation, but evidence of long-term efficacy for weight management is not available. The addition of NNS to diets poses no benefit for weight loss or reduced weight gain without energy restriction. There are long-standing and recent concerns that inclusion of NNS in the diet promotes energy intake and contributes to obesity. Most of the purported mechanisms by which this occurs are not supported by the available evidence, although some warrant further consideration. Resolution of this important issue will require long-term randomized controlled trials.

Disintegration of solid foods in human stomach

Knowledge of the disintegration of solid foods in human stomach is essential to assess the bioavailability of nutrients in the gastrointestinal (GI) tract. A comprehensive review of food gastric digestion, focusing on disintegration of solid foods, is presented. Most of the research reviewed in this paper is contained in the medical, pharmaceutical, food, and nutritional literature. Stomach physiology is briefly introduced, including composition and rheological properties of gastric contents, stomach wall motility in fed/fasted states, and hydrodynamic and mechanical forces that act on the ingested food. In vivo and in vitro methods used for studying food and drug digestion in GI are summarized. Stomach emptying rate, which controls the rate of absorption of nutrients, is highly related to the disintegration of foods. This topic is highlighted with focus on the important mechanisms and the influence of chemical and physical properties of foods. Future research in this area is identified to increase our fundamental understanding of the food digestion process in the stomach as related to the food composition, material properties such as texture and microstructure, and chemical characteristics. This information is necessary to develop new guidelines for seeking innovative processing methods to manufacture foods specifically targeted for health.

Effects of appetite, BMI, food form and flavor on mastication: almonds as a test food

OBJECTIVES

To investigate the effects of appetitive sensations, body mass index (BMI) and physical/sensory properties of food (almonds) on masticatory indices and resultant pre-swallowing particle sizes.

SUBJECTS/METHODS

Twelve lean (BMI=22.2+/-0.3) and 12 obese (BMI=34.3+/-0.6) adults. After collecting appetitive ratings, electromyographic recordings were used to assess participants' microstructure of eating for five almond products (raw, dry unsalted roasted, natural sliced, roasted salted and honey roasted) under fasted and satiated conditions. Duplicate samples were masticated to the point of deglutition and then were expectorated and size sorted.

RESULTS

No statistically significant effects of BMI were detected for any of the mastication measures. Maximum and mean bite forces were greater under the fasted condition. Sliced almonds required lower bite force than did the other almond varieties. The pre-swallowing particle sizes were significantly greater for the sliced almonds than all other varieties. Both the number of chews and mastication time were negatively correlated with particle size. There were no significant effects of almond form or flavor on particle size.

CONCLUSIONS

These results do not support differences in masticatory performance between lean and obese individuals, nor effects of sensory properties. Instead, the physical form of foods as well as an individuals' appetitive state may have a greater influence on masticatory behavior. The health implications of these observations warrant further investigation.

Effects of dietary fat and carbohydrate on appetite vary depending upon site and structure

The present review summarises the effects of different carbohydrate and fat structures on food intake and appetite and the differences in response at various levels of processing of macronutrients. Several physico-chemical properties of carbohydrate and fat molecules appear to influence the short-term satiating properties. However, long-term substantiation of these findings expressed in terms of food intake or body weight is not currently available. Such studies will be required to make clear recommendations regarding dietary composition to aid satiety.

Appetite: measurement and manipulation misgivings

Humans appear to have a genotype that permits, or even encourages, an energy intake that is greater than energy expenditure when food is available. This was functional throughout most of human evolution but is less so in the current environment of inexpensive, palatable, and readily available foods. To achieve dietary goals of weight loss or maintenance, attempts have been made to influence appetitive sensations through the manipulation of the physical properties of foods, their composition, or their pattern of consumption. This has led to limited success, in part, because measurement of appetitive sensations is difficult but, more fundamentally, because the association between appetite and food choice or intake is not robust. This article critically reviews the most common methods for assessment of appetite and the effects of selected food constituents on appetitive sensations. Translation of current knowledge to dietetic practice must be made cautiously.

Investigation into the role of cephalic stimulation of acid secretion on gastric emptying and appetite following a soup meal using the gastric acid inhibitor omeprazole

We previously showed that oral administration of a liquid soup preload was associated with a slower rate of gastric emptying and suppressed appetite more compared with intragastric administration of the same soup [Appetite 31(1998)377]. The present study was designed to investigate whether these results could be explained by the cephalic stimulation of acid secretion induced by oral administration. Eight healthy male subjects took part in a double-blind placebo controlled study comparing the effects of omeprazole and placebo on gastric emptying, appetite ratings and subsequent food intake following the ingestion of a liquid soup. Subjects were administered with a single oral dose of 80 mg omeprazole or placebo 3 h prior to ingesting the radiolabelled soup preload (400 kcal; 425 ml) over 15 min. Ratings of hunger, desire to eat and fullness were recorded over 135 min and gastric emptying was measured by scintigraphy. Food intake was evaluated from a test meal (yoghurt drink) given 120 min after the end of the soup ingestion. Analysis of data showed that there was no significant difference between omeprazole and placebo in gastric emptying, appetite or subsequent energy intake from the test meal. The results suggest that gastric acid secretion is not responsible for the differences in gastric emptying and appetite observed between intragastrically infused and orally administered soup preloads.

Influence of repeated consumption of beverages containing sucrose or intense sweeteners on food intake

OBJECTIVE

To investigate the influence of ingestion of beverages with sucrose or with intense sweeteners on food intake (FI) and on hunger ratings in before and after a month of daily consumption of beverages.

DESIGN

Experimental study.

SETTING

Department of Physiology, University Hospital, Dijon, France.

SUBJECTS

In all, 12 men and 12 women, aged 20-25 y.

INTERVENTION

Four beverages contained either sucrose (E+:100 g/l, 1672 kJ) or intense sweeteners (E-: null energy content) and were flavoured with either orange (O) or raspberry (R). FI was measured in the lab during two 2-consecutive-day periods, carried out on 2 successive weeks (session 1). The subjects drank 2 l of either E+ or E- beverages on the first day of both weekly periods, according to a balanced randomised design. E+ was paired with O for 50% of subjects and with R for the other 50%. Subjects were then habituated over a 4-week period to both beverages, consuming 1 l of E+ beverage on odd days and 1 l of E- drink on even days. After this period, the measurements of session 1 were repeated (session 2, weeks 7-8). Finally, FI was measured for two more 2-day periods (weeks 9-10) after the association between flavour and energy content was reversed (session 3).

RESULTS

The E- drinks were less palatable than the E+ drinks. Besides, we observed that FI was not reduced in response to a liquid extra caloric load and there was no change in hunger ratings after the beverages in any of the sessions.

CONCLUSION

Ingestion of caloric beverages induced a positive energy balance and the continuous exposure phase to these beverages over 1 month did not improve FI adaptation in response to the extra energy provided by the beverages.

Consumption of sugars and the regulation of short-term satiety and food intake

This review examines the relation between the consumption of sugars and their effects on short-term (ie, to 2 h) satiety and food intake in humans. Many factors need to be considered in the evaluation of reported studies and the conclusions derived from this body of literature. These factors include evaluation of the dose and form (solid or liquid) of the treatments, time of day administered, characteristics of the subjects, sample size, and approaches used to measure satiety and food intake. Mechanisms by which sugars may signal regulatory systems for food intake need to be considered when evaluating both study designs and conclusions. For this reason, the relation between the blood glucose response to sugar consumption and subsequent feeding behavior is also examined. It is concluded that sugars stimulate satiety mechanisms and reduce food intake in the short term and that the mechanisms by which this response occurs cannot be attributed solely to their effect on blood glucose.

An investigation of the role of oro-sensory stimulation in sugar satiety?

OBJECTIVE

To investigate whether oral factors stimulated by the presence of sucrose in the mouth are involved in the suppression of appetite following sucrose ingestion.

DESIGN

Ten male and 10 female healthy volunteers participated in four experimental conditions designed to provide differing levels of oro-sensory stimulation. Appetite and energy intake from a test meal were measured after subjects chewed and ingested sucrose-containing pastilles over a 10 min period, consumed a sucrose-containing jelly over a 5 min period, consumed a sucrose-containing drink within 2 min and drank plain water within 2 min. The three sucrose-containing preloads were similar in nutrient composition, each containing 251 kJ.

RESULTS

Ratings of hunger and fullness did not differ between the four conditions following ingestion of the preloads. However, energy intake from a test lunch was significantly reduced after consuming the pastilles when compared with the plain water and equicaloric sweet drink conditions.

CONCLUSION

These results suggest that enhanced oro-sensory stimulation from chewing the sweet food was involved in the suppression of food intake.