Association between eating speed and metabolic syndrome in a three-year population-based cohort study

A systematic review and meta-analysis of loss-of-control eating in relation to cardiometabolic health components and inflammatory markers

INTRODUCTION

Loss-of-control (LOC) eating, or the subjective experience of being unable to stop eating, is a hallmark feature of binge-eating episodes, which are also characterized by consuming an unusually large amount of food. However, regardless of the size of eating episode, LOC-eating may be a risk factor for adverse health outcomes. This systematic review and meta-analysis comprehensively examine the relationship of LOC-eating with cardiometabolic health components and inflammatory markers.

METHODS

Search procedures were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guidelines in six electronic databases. Studies of adult or youth samples published in English from the year 2000 onward were included. Given heterogeneity in age groups and adjustment for body mass index across studies, these factors were included as meta-regression moderators.

RESULTS

Fifty-eight studies were identified through the literature search. Among individuals with (versus without) LOC-eating, relative risk ratios provided evidence of a greater relative risk for metabolic syndrome, hypertension, and dyslipidemia; standardized mean differences also provided evidence of higher waist circumference and impaired levels of fasting plasma glucose, high-density lipoprotein (HDL)-cholesterol, and triglycerides, but not blood pressure. Age group did not impact cardiometabolic health components. Body mass index differences moderated the effect on waist circumference. A narrative review of inflammatory markers revealed mixed findings linking inflammatory markers to LOC-eating.

DISCUSSION

Overall, evidence for the relationship between LOC-eating and impaired cardiometabolic health underscores LOC-eating as an important early intervention target for prevention of serious adverse health outcomes.

Prevalence and determinants of obesity and its association with upper gastrointestinal diseases in people aged 40-69 years in Yangzhong, southeast China

Several international epidemiological studies have established a link between obesity and upper gastrointestinal cancer (UGC), but Chinese evidence is limited. This study aimed to determine the prevalence of obesity, especially central obesity, while investigating its association with upper gastrointestinal diseases in the high-risk population of Yangzhong, a typical high-risk area for UGC in southeastern China. We conducted a cross-sectional study from November 2017 to June 2021 involving 6736 residents aged 40-69. Multivariate logistic regression was used to assess independent factors influencing overweight/obesity and central obesity. We also analyzed the relationship between obesity and upper gastrointestinal diseases using multinomial logistic regression. The prevalence of overweight, obesity, waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR)-central obesity were 40.6%, 12.0%, 49.9%, 79.4%, and 63.7%, respectively. Gender, age, smoking, tea consumption, sufficient vegetable, pickled food, spicy food, eating speed, physical activity, family history of cancer, and family history of common chronic disease were associated with overweight /obesity and central obesity. Besides, education and missing teeth were only associated with central obesity. General and central obesity were positively associated with UGC, while general obesity was negatively associated with UGC precancerous diseases. There were no significant associations between obesity and UGC precancerous lesions. Subgroup analyses showed that general and central obesity was positively associated with gastric cancer but not significantly associated with esophageal cancer. Obesity is negatively and positively associated with gastric and esophageal precancerous diseases, respectively. In conclusion, general and central obesity were at high levels in the target population in this study. Most included factors influenced overweight/obesity and central obesity simultaneously. Policymakers should urgently develop individualized measures to reduce local obesity levels according to obesity characteristics. Besides, obesity increases the risk of UGC but decreases the risk of UGC precancerous diseases, especially in the stomach. The effect of obesity on the precancerous diseases of the gastric and esophagus appears to be the opposite. No significant association between obesity and upper gastrointestinal precancerous lesions was found in the study. This finding still needs to be validated in cohort studies.

Association of dietary behavior patterns of middle-aged and older adults with their obesity metabolic phenotype: a cross-sectional study

BACKGROUND

Middle-aged and elderly individuals are the most susceptible groups for metabolic diseases, with their dietary behaviors being significant influencing factors. Exploring the association between overall dietary behaviors and obesity metabolic phenotypes is crucial for early prevention and control of chronic diseases, precision treatment and personalized interventions.

METHODS

We conducted a cross-sectional study of 15,160 middle-aged and older adults between June 2019 and August 2021 to collect information on their body mass index (BMI), biochemical indices and disease history. The population was classified into four categories by the criteria of obesity metabolic phenotypes: metabolically healthy non-obesity (MHNO), metabolically unhealthy non-obesity (MUNO), metabolically healthy obesity (MHO) and metabolically unhealthy obesity (MUO). Scores were calculated based on compliance with healthy eating behavior patterns (appropriate or light dietary taste, moderately soft and hard food, slightly hot food temperature, medium or slow eating speed, daily intake of dietary supplements and eating with others), and the population was categorized into subgroups 0-2 (did not meet and met only 1 or 2), 3-4 (met 3 or 4), 5-6 (met 5 or 6). The relationship between dietary behavior patterns and different obesity metabolic phenotypes in middle-aged and elderly people were analyzed by multi-categorical logistic regression model.

RESULTS

Compared with the 5-6 subgroup, the dietary behavior patterns of 0-2 and 3-4 scores were risk factors for MUNO, MHO and MUO (P < 0.05), and the lower the scores of the dietary behavior patterns, the higher the multiplicity of the occurrence of MUNO, MHO and MUO, especially for females and adults between 45-60 years old. Appropriate or light dietary taste, moderately soft and hard food, and slightly hot food temperature were protective factors for MUNO and MUO (P < 0.05); medium or slow eating speed and daily intake of dietary supplements were protective factors for MUNO, MHO and MUO (P < 0.05).

CONCLUSION

Dietary behavior patterns in middle-aged and older adults are associated with different obesity metabolic phenotypes, and healthy dietary behaviors may be beneficial for the prevention and control of MUNO, MHO and MUO.

Rule-based systems to automatically count bites from meal videos

Eating behavior is a key factor for nutritional intake and plays a significant role in the development of eating disorders and obesity. The standard methods to detect eating behavior events (i.e., bites and chews) from video recordings rely on manual annotation, which lacks objective assessment and standardization. Yet, video recordings of eating episodes provide a non-invasive and scalable source for automation. Here, we present a rule-based system to count bites automatically from video recordings with 468 3D facial key points. We tested the performance against manual annotation in 164 videos from 15 participants. The system can count bites with 79% accuracy when annotation is available, and 71.4% when annotation is unavailable. The system showed consistent performance across varying food textures. Eating behavior researchers can use this automated and objective system to replace manual bite count annotation, provided the system's error is acceptable for the purpose of their study. Utilizing our approach enables real-time bite counting, thereby promoting interventions for healthy eating behaviors. Future studies in this area should explore rule-based systems and machine learning methods with 3D facial key points to extend the automated analysis to other eating events while providing accuracy, interpretability, generalizability, and low computational requirements.

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.

The timing of energy intake

The aim of the paper is to review the current evidence on the impact of 'the timing of energy intake' on the risk of developing obesity and obesity-related metabolic diseases. The prevalence of obesity is currently increasing worldwide thus becoming a severe health burden for most countries. Indeed, obesity represents a risk factor for several non-communicable diseases such as cancer, type 2 diabetes, dyslipidaemia, CVD and overall mortality. In order to treat obesity, several pharmacological approaches have been developed and are indicated for subjects with obesity with a BMI ≥ 30 kg/m2 or ≥ 27 kg/m2 and obesity-related comorbidities. For severe obesity (BMI ≥ 40 kg/m2), bariatric surgery represents a promising approach. The most common bariatric surgical procedures are represented by the Roux-en-Y gastric bypass, laparoscopic adjustable band, laparoscopic gastric sleeve and biliopancreatic diversion with duodenal switch. Both anti-obesity pharmacological and surgical treatments require change in lifestyle. When a nutritional plan is established, attention is usually paid to macronutrient composition and energy intake, while 'the time of food' is not taken into account. Chronotype, which is the attitude of a subject to carry out most of their daily activities in the first (morning chronotype) or second half (evening chronotype) of the day, has been reported to have a role in the pathogenesis of obesity and obesity-related cardiometabolic diseases as well as eating speed. Thus, adopting a physiological timing of energy intake could be an additional strategy to potentiate the current anti-obesity approaches.

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.

Relationships of rapid eating with visceral and subcutaneous fat mass and plasma adiponectin concentration

Rapid eating has been demonstrated to be associated with obesity and overweight. However, few studies have characterized the separate relationships of eating speed with visceral and subcutaneous fat mass or circulating adiponectin concentration. We hypothesized that rapid eating is associated with the larger visceral fat tissue (VFT) area and lower adiponectin concentration, but not with the subcutaneous fat tissue (SFT) area in men and women. We performed a cross-sectional study of 712 adults aged 20-86 years (528 men and 184 women; mean ± SD age 59.36 ± 13.61 years). The participants completed a self-reported questionnaire, and underwent anthropometric and laboratory measurements and computed tomographic imaging of the abdomen as a part of annual medical check-ups. Multivariate linear regression analyses revealed that rapid eating was associated with larger visceral (B = 24.74; 95% CI 8.87-40.61, p = 0.002) and subcutaneous fat areas (B = 31.31; 95% CI 12.23-50.38, p = 0.001), lower adiponectin concentration (B =  - 2.92; 95% CI - 4.39- - 1.46, p < 0.001), higher body mass index (BMI) (B = 2.13; 95% CI 1.02-3.25, p < 0.001), and larger waist circumference (B = 5.23; 95% CI 2.16-8.30, p < 0.001) in men, which is partially consistent with the hypothesis. In contrast, rapid eating was found to be associated only with BMI, and not with abdominal adipose area or adiponectin concentration in women, which is a result that is not consistent with the hypothesis. These results suggest that there is no difference in the association of rapid eating with VFT and SFT areas.

Ultraprocessed Foods and Obesity Risk: A Critical Review of Reported Mechanisms

Epidemiologic evidence supports a positive association between ultraprocessed food (UPF) consumption and body mass index. This has led to recommendations to avoid UPFs despite very limited evidence establishing causality. Many mechanisms have been proposed, and this review critically aimed to evaluate selected possibilities for specificity, clarity, and consistency related to food choice (i.e., low cost, shelf-life, food packaging, hyperpalatability, and stimulation of hunger/suppression of fullness); food composition (i.e., macronutrients, food texture, added sugar, fat and salt, energy density, low-calorie sweeteners, and additives); and digestive processes (i.e., oral processing/eating rate, gastric emptying time, gastrointestinal transit time, and microbiome). For some purported mechanisms (e.g., fiber content, texture, gastric emptying, and intestinal transit time), data directly contrasting the effects of UPF and non-UPF intake on the indices of appetite, food intake, and adiposity are available and do not support a unique contribution of UPFs. In other instances, data are not available (e.g., microbiome and food additives) or are insufficient (e.g., packaging, food cost, shelf-life, macronutrient intake, and appetite stimulation) to judge the benefits versus the risks of UPF avoidance. There are yet other evoked mechanisms in which the preponderance of evidence indicates ingredients in UPFs actually moderate body weight (e.g., low-calorie sweetener use for weight management; beverage consumption as it dilutes energy density; and higher fat content because it reduces glycemic responses). Because avoidance of UPFs holds potential adverse effects (e.g., reduced diet quality, increased risk of food poisoning, and food wastage), it is imprudent to make recommendations regarding their role in diets before causality and plausible mechanisms have been verified.

The Association Between Eating Quickly and Excessive Gestational Weight Gain

Objectives

Maintaining an appropriate gestational weight gain (GWG) is essential for a safe pregnancy and delivery. This study aimed to determine the association between the habit of eating quickly and the risk of excessive GWG.

Methods

We administered a questionnaire on eating habits to 1246 pregnant Japanese women in their second to third trimesters. We categorized the participants into three groups according to their answers to the question "Do you eat quickly?" Group 1, "always" or "usually"; Group 2, "sometimes"; and Group 3, "rarely" or "never." We assessed GWG according to the "The Optimal Weight Gain Chart" (Ministry of Health, Labor and Welfare, Japan), and those who exceeded the criteria were considered "excessive." Logistic regression analysis was performed with the risk of excess GWG as the dependent variable and quick food intake as the independent variable, to obtain relevant odds ratios (ORs) and 95% confidence intervals (CIs). Model 1 was unadjusted, and Model 2 was adjusted for age, prepregnancy body mass index, energy intake, mother's educational attainment, household income, exercise habits, and childbearing experience.

Results

The OR (95% CI) for Groups 2 and 3 in Model 1, compared with Group 1, was 0.80 (0.62-1.05) and 0.61 (0.43-0.88), respectively (p for trend = 0.047). In Model 2, the OR (95% CI) for Groups 2 and 3 were 0.73 (0.55-0.96) and 0.59 (0.40-0.86), respectively (p for trend = 0.003).

Conclusion

These results suggest that quick food ingestion increases the risk of excessive GWG.

Associations Between Eating Speed, Diet Quality, Adiposity, and Cardiometabolic Risk Factors

OBJECTIVE

To assess the associations between eating speed, adiposity, cardiometabolic risk factors, and diet quality in a cohort of Spanish preschool-children.

STUDY DESIGN

A cross-sectional study in 1371 preschool age children (49% girls; mean age, 4.8 ± 1.0 years) from the Childhood Obesity Risk Assessment Longitudinal Study (CORALS) cohort was conducted. After exclusions, 956 participants were included in the analyses. The eating speed was estimated by summing the total minutes used in each of the 3 main meals and then categorized into slow, moderate, or fast. Multiple linear and logistic regression models were fitted to assess the β-coefficient, or OR and 95% CI, between eating speed and body mass index, waist circumference, fat mass index (FMI), blood pressure, fasting plasma glucose, and lipid profile.

RESULTS

Compared with participants in the slow-eating category, those in the fast-eating category had a higher prevalence risk of overweight/obesity (OR, 2.9; 95% CI, 1.8-4.4; P < .01); larger waist circumference (β, 2.6 cm; 95% CI, 1.5-3.8 cm); and greater FMI (β, 0.3 kg/m²; 95% CI, 0.1-0.5 kg/m²), systolic blood pressure (β, 2.8 mmHg; 95% CI, 0.6-4.9 mmHg), and fasting plasma glucose levels (β, 2.7 mg/dL, 95% CI, 1.2-4.2 mg/dL) but lower adherence to the Mediterranean diet (β, -0.5 points; 95% CI, -0.9 to -0.1 points).

CONCLUSIONS

Eating fast is associated with higher adiposity, certain cardiometabolic risk factors, and lower adherence to a Mediterranean diet. Further long-term and interventional studies are warranted to confirm these associations.

Association between dietary habits and incident thyroid cancer: A prospective cohort study

Background

In addition to the thyroid cancer (TC) risk from lifestyle and environmental factors such as radiation exposure, some studies have indicated that diet may affect TC development; however, previous findings are inconsistent. The objective of our study was to investigate the association between dietary habits and TC risk in a Korean population.

Materials and methods

A total of 13,973 participants were selected after excluding ineligible subjects from the Cancer Screenee Cohort at National Cancer Center in Korea from October 2007 to December 2021. Participants were followed until May 2022 to identify incident TC cases. Information on dietary habits and general characteristics was collected using a self-report questionnaire administered at enrollment without keeping track of changes in eating habits during the follow-up period. A Cox proportional hazards model was used to determine the hazard ratio (HR) and 95% confidence interval (CI) of TC risk for each dietary factor.

Results

A total of 138 incident TC cases were identified during the median follow-up period of 7.6 years. Of the 12 dietary habits evaluated, only two habits showed significant associations with TC. A significantly decreased TC risk was found among participants who consumed milk and/or dairy products 5 or more days a week [adjusted HR (aHR), 0.58; 95% CI, 0.39-0.85]. Notably, a stronger protective effect of dairy consumption was observed in participants aged ≥ 50 years (aHR, 0.44; 95% CI, 0.26-0.75), in women (aHR, 0.53; 95% CI, 0.35-0.81), and in non-smokers (aHR, 0.60; 95% CI, 0.39-0.92). There was a reduced risk of TC in participants with meal durations longer than 10 min (aHR, 0.58; 95% CI, 0.41-0.83). However, this association was limited to individuals aged ≥ 50 years (aHR, 0.49; 95% CI, 0.31-0.79), women (aHR, 0.61; 95% CI, 0.41-0.90), and non-smokers (aHR, 0.62; 95% CI, 0.41-0.92).

Conclusion

Our findings suggest that consuming milk and/or dairy products 5 or more days a week and having a meal duration longer than 10 min could be protective factors against TC, especially in individuals aged ≥ 50 years, women and non-smokers. Further prospective studies are needed to investigate the association of dietary intake with specific types of TC.

Capturing Eating Behavior from Video Analysis: A Systematic Review

Current methods to detect eating behavior events (i.e., bites, chews, and swallows) lack objective measurements, standard procedures, and automation. The video recordings of eating episodes provide a non-invasive and scalable source for automation. Here, we reviewed the current methods to automatically detect eating behavior events from video recordings. According to PRISMA guidelines, publications from 2010-2021 in PubMed, Scopus, ScienceDirect, and Google Scholar were screened through title and abstract, leading to the identification of 277 publications. We screened the full text of 52 publications and included 13 for analysis. We classified the methods in five distinct categories based on their similarities and analyzed their accuracy. Facial landmarks can count bites, chews, and food liking automatically (accuracy: 90%, 60%, 25%). Deep neural networks can detect bites and gesture intake (accuracy: 91%, 86%). The active appearance model can detect chewing (accuracy: 93%), and optical flow can count chews (accuracy: 88%). Video fluoroscopy can track swallows but is currently not suitable beyond clinical settings. The optimal method for automated counts of bites and chews is facial landmarks, although further improvements are required. Future methods should accurately predict bites, chews, and swallows using inexpensive hardware and limited computational capacity. Automatic eating behavior analysis will allow the study of eating behavior and real-time interventions to promote healthy eating behaviors.

Emotional eating experiences of individuals with severe mental disorders: A qualitative study

PURPOSE

The aim of this study is to understand the emotional eating experiences of individuals with severe mental disorders.

DESIGN AND METHODS

The study used a descriptive qualitative design. Data were collected from 19 individuals who displayed emotional eating behavior and a severe mental disorder.

FINDINGS

The main themes of this study are "Triggers," "Emotional Eating Process," and "Feelings after Emotional Eating." Participants stated that negative emotions and certain initiating factors were the triggers of their emotional eating; they also experienced feelings of regret and guilt after emotional eating.

PRACTICE IMPLICATIONS

It was concluded that programs for regulating the eating behaviors of individuals with severe mental disorders should be organized and that psychosocial interventions to prevent emotional eating among these individuals should be integrated into the programs' contents.

Associations of eating speed with fat distribution and body shape vary in different age groups and obesity status

Background

Eating speed has been reported to be associated with energy intake, body weight, waist circumference (WC), and total body fat. However, no study has explored the association between eating speed and body fat distribution, especially its difference among different age or body mass index (BMI) groups.

Methods

4770 participants aged 18–80 years were recruited from the baseline survey of the Lanxi Cohort Study. They were categorized into three groups according to meal duration. Linear regression analyses were performed among all participants and separately by age group and obesity status to evaluate the associations of WC and total and regional fat mass percentages (FM%) with eating speed.

Results

After adjusting for confounding factors, eating slowly was significantly related to lower WC, lower total, trunk, and android FM%, lower android-to-gynoid fat mass ratio, and higher leg and gynoid FM%. After stratification by age or obesity status, the associations were especially prominent among participants aged 18–44 years or those with BMI < 24 kg/m². No significant trends were found for participants aged 65–80 years or those who were overweight/obese.

Conclusions

Eating slowly is closely related with better fat distribution among Chinese adults, especially for those aged 18–44 years and those with BMI < 24 kg/m². If confirmed prospectively, it might be a potential efficient approach to improve fat distribution.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12986-022-00698-w.

Lifestyle Factors Associated with Metabolic Syndrome in Urban Cambodia

This study aimed to identify lifestyle factors associated with metabolic syndrome (MetS) in urban Cambodia. In this cross-sectional study, we used existing health checkup data from a private hospital in Phnom Penh, Cambodia. The participants comprised 5459 Cambodians aged ≥20 years who underwent health checkups between 2017 and 2019. The harmonized diagnostic definition was used as the MetS criteria. The prevalence of MetS was 56.6% overall, 60.4% in men and 52.6% in women. The lifestyle factor significantly associated with MetS in both sexes were "eating quicker than others", (men: odds ratio [OR]= 2.25, 95% confidence interval [CI] = 1.68-3.03, women: OR = 1.92, 95%CI = 1.41-2.60), "walking faster than others", (men: OR = 0.78, 95% CI = 0.67-0.92, women: OR = 0.75, 95% CI = 0.62-0.89) and "drinking alcohol" (men: OR = 1.33, 95% CI = 1.10-1.61, women: OR = 1.33, 95% CI = 1.09-1.62). Other significant associations with MetS for men was "eating speed is normal", (OR = 1.73, 95%CI = 1.30-2.31), and, for women, "eating food after dinner at least 3 days a week", (OR = 1.25, 95%CI = 1.01-1.55), "skipping breakfast at least 3 days a week", (OR = 0.83, 95%CI = 0.69-0.99) and "getting enough rest from sleep" (OR = 1.19, 95% CI = 1.01-1.42) were significantly associated with MetS. Lifestyle interventions through health education and guidance may be effective in preventing MetS in Cambodia.

Effects of Developmental Failure of Swallowing Threshold on Obesity and Eating Behaviors in Children Aged 5-15 Years

Background: The aim of the present study was to identify factors related to developmental failure of swallowing threshold in children aged 5−15 years. Methods: A total of 83 children aged 5−15 years were included in this study. A self-administered lifestyle questionnaire was completed, along with hand grip strength and oral function tests. Swallowing threshold was determined based on the concentration of dissolved glucose obtained from gummy jellies when the participants signaled that they wanted to swallow the chewed gummy jellies. Developmental failure of swallowing threshold was defined as glucose concentrations in the lowest 20th percentile. After univariate analysis, multivariate binary logistic regression analysis was used to identify factors associated with developmental failure of swallowing threshold. Results: Hand grip strength was significantly correlated with masticatory performance (r = 0.611, p < 0.01). Logistic regression analysis revealed factors related to developmental failure of swallowing threshold, i.e., overweight/obesity (Odds ratio) (OR) = 5.343, p = 0.031, 95% CI = 1.168−24.437) and eating between meals at least once a day (OR = 4.934, p = 0.049, 95% CI = 1.004−24.244). Conclusions: Developmental failure of swallowing threshold was closely associated with childhood obesity in 5- to 15-year-old children.

Self-reported eating speed is associated with overweight among Chinese schoolchildren: a cross-sectional survey

PURPOSE

This study aimed to examine the association between eating speed and overweight in Chinese schoolchildren.

METHODS

In all, 664 schoolchildren (10-12 years) from three primary schools participated in this study in China. Their height and body weight were measured. Information about eating speed and other lifestyle behaviors were collected using a self-administered questionnaire. Multivariable logistic regression model was used to estimate the odds ratio (OR) and 95% confidence interval (95% CI) for overweight.

RESULTS

Data from 629 students were analyzed. 26.2% of participants reported they were eating fast. The prevalence of overweight (including obesity) was 22.9%, and the mean of sleep duration was 9.69 (SD = 0.63) hours (Table 1). In the multiple linear regression analysis, slower eating speed was independently associated with lower BMI (B = - 0.70, 95% CI - 1.26 to - 0.14) and TG (B = - 0.16, 95% CI - 0.28 to - 0.04). In addition, participants who ate fast were more likely to be overweight (OR 1.81, 95% CI 1.19-2.75) after adjusting for potential confounding factors.

CONCLUSIONS

This study indicates that eating fast is associated with overweight among Chinese school children.

LEVEL OF EVIDENCE

Cross-section descriptive study, Level V.

Impact of Masticatory Behaviors Measured With Wearable Device on Metabolic Syndrome: Cross-sectional Study

Background

It has been widely recognized that mastication behaviors are related to the health of the whole body and to lifestyle-related diseases. However, many studies were based on subjective questionnaires or were limited to small-scale research in the laboratory due to the lack of a device for measuring mastication behaviors during the daily meal objectively. Recently, a small wearable masticatory counter device, called bitescan (Sharp Co), for measuring masticatory behavior was developed. This wearable device is designed to assess objective masticatory behavior by being worn on the ear in daily life.

Objective

This study aimed to investigate the relation between mastication behaviors in the laboratory and in daily meals and to clarify the difference in mastication behaviors between those with metabolic syndrome (MetS) and those without (non-MetS) measured using a wearable device.

Methods

A total of 99 healthy volunteers (50 men and 49 women, mean age 36.4 [SD 11.7] years) participated in this study. The mastication behaviors (ie, number of chews and bites, number of chews per bite, and chewing rate) were measured using a wearable ear-hung device. Mastication behaviors while eating a rice ball (100 g) in the laboratory and during usual meals for an entire day were monitored, and the daily energy intake was calculated. Participants’ abdominal circumference, fasting glucose concentration, blood pressure, and serum lipids were also measured. Mastication behaviors in the laboratory and during meals for 1 entire day were compared. The participants were divided into 2 groups using the Japanese criteria for MetS (positive/negative for MetS or each MetS component), and mastication behaviors were compared.

Results

Mastication behaviors in the laboratory and during daily meals were significantly correlated (number of chews r=0.36; P<.001; number of bites r=0.49; P<.001; number of chews per bite r=0.33; P=.001; and chewing rate r=0.51; P<.001). Although a positive correlation was observed between the number of chews during the 1-day meals and energy intake (r=0.26, P=.009), the number of chews per calorie ingested was negatively correlated with energy intake (r=–0.32, P=.002). Of the 99 participants, 8 fit the criteria for MetS and 14 for pre-MetS. The number of chews and bites for a rice ball in the pre-MetS(+) group was significantly lower than the pre-MetS(–) group (P=.02 and P=.04, respectively). Additionally, scores for the positive abdominal circumference and hypertension subgroups were also less than the counterpart groups (P=.004 and P=.01 for chews, P=.006 and P=.02 for bites, respectively). The number of chews and bites for an entire day in the hypertension subgroup were significantly lower than in the other groups (P=.02 and P=.006). Furthermore, the positive abdominal circumference and hypertension subgroups showed lower numbers of chews per calorie ingested for 1-day meals (P=.03 and P=.02, respectively).

Conclusions

These results suggest a relationship between masticatory behaviors in the laboratory and those during daily meals and that masticatory behaviors are associated with MetS and MetS components.

Trial Registration

University Hospital Medical Information Network Clinical Trials Registry R000034453; https://tinyurl.com/mwzrhrua

Effect of side switch frequency on masticatory performance and rhythm in adults with natural dentition: A randomized crossover trial

BACKGROUND

The relationships between the frequency of masticatory side switches (MSS) and other aspects of masticatory function are not clear.

OBJECTIVES

In this study, we determined the effect of MSS frequency on masticatory performance and rhythm in dentate adults and explored the between-subject relationships among side switch frequency, masticatory rhythm, and laterality.

METHODS

In this crossover study, subjects performed six masticatory patterns of five trials each, chewing bagged silicone for 20 cycles. The six patterns were freestyle, unilateral right, unilateral left, and switching sides one, three, and five times. Masticatory performance and rhythm were determined for each style by median particle size (MPS) and chewing cycle duration, respectively. In the freestyle mastication pattern, masticatory laterality was assessed by the unilateral chewing index and the frequency of MSS was assessed by the MSS Index. Data were analyzed using Friedman's test and repeated-measures analysis of variance.

RESULTS

We included 29 participants (15 women; median age, 23 years). No significant between-subjects differences in the MPS were detected obtained by switching one, three, or five times per trial. Chewing cycle duration increased with the MSS number per trial. During freestyle mastication, the MSS Index was inversely correlated with the unilateral chewing index (Rho -0.569; 95%CI -0.25 to -0.78; P=0.001; Spearman test), but not with the MPS or chewing cycle duration.

CONCLUSION

Differences in MSS frequency do not affect masticatory performance, but they do alter the masticatory rhythm. Individuals with a higher MSS frequency also have a more symmetrical chewing pattern.

Incidence and prediction nomogram for metabolic syndrome in a middle-aged Vietnamese population: a 5-year follow-up study

PURPOSE

We aimed to determine the incidence and prediction nomogram for new-onset metabolic syndrome (MetS) in a middle-aged Vietnamese population.

METHODS

A population-based prospective study was conducted in 1150 participants aged 40-64 years without MetS at baseline and followed-up for 5 years. Data on lifestyle factors, socioeconomic status, family diabetes history, and anthropometric measures were collected. MetS incidence was estimated in general population and subgroup of age, gender, and MetS components. A Cox proportional hazards regression was used to estimate hazard ratios (HRs) with 95% confidence intervals (CI) for MetS. A prediction nomogram was developed and checked for discrimination and calibration.

RESULTS

During median follow-up of 5.14 years, the accumulate MetS incidence rate was 23.4% (95% CI: 22.2-24.7). The annual incidence rate (95% CI) was 52.9 (46.7-60.1) per 1000 person-years in general population and higher in women [56.6 (48.7-65.9)] than men [46.5 (36.9-59.3)]. The HRs (95% CI) for developing MetS were gender [females vs males: 2.04 (1.26-3.29)], advanced age [1.02 (1.01-1.04) per one year], waist circumference [1.08 (1.06-1.10) per one cm] and other obesity-related traits, and systolic blood pressure [1.02 (1.01-1.03) per one mmHg]. The prediction nomogram for MetS had a good discrimination (C-statistics = 0.742) and fit calibration (mean absolute error = 0.009) with a positive net benefit in the predicted probability thresholds between 0.13 and 0.70.

CONCLUSIONS

The study is the first to indicate an alarmingly high incidence of MetS in a middle-aged population in Vietnam. The nomogram with simply applicable variables would be useful to qualify individual risk of developing MetS.

Chewing increases postprandial diet-induced thermogenesis

Slow eating, which involves chewing food slowly and thoroughly, is an effective strategy for controlling appetite in order to avoid being overweight or obese. Slow eating also has the effect of increasing postprandial energy expenditure (diet-induced thermogenesis). It is still unclear whether this is due to oral stimuli; that is, the duration of tasting food in the mouth and the duration of chewing. To investigate the effects of oral stimuli on diet-induced thermogenesis in 11 healthy normal weight males, we conducted a randomized crossover study comprising three trials: (1) drinking liquid food normally, (2) drinking liquid food after tasting, and (3) adding chewing while tasting. Oral stimuli (i.e., the duration of tasting liquid food in the mouth and the duration of chewing) significantly increased diet-induced thermogenesis after drinking liquid food. This result demonstrates that the increase in diet-induced thermogenesis is due to oral stimuli rather than the influence of the food bolus. Increased diet-induced thermogenesis induced by chewing and taste stimuli may help to prevent overweight and obesity.

Clinical practice advice on lifestyle modification in the management of nonalcoholic fatty liver disease in Japan: an expert review

Nonalcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver diseases worldwide, including in Japan. The Japanese Society of Gastroenterology (JSGE) and the Japanese Society of Hepatology (JSH) have established the Japanese NAFLD/NASH guidelines in 2014 and revised these guidelines in 2020. As described in these guidelines, weight reduction by diet and/or exercise therapy is important for the treatment of NAFLD patients. The I148M single nucleotide polymorphism (rs738409 C > G) of PNPLA3 (patatin-like phospholipase domain-containing 3 protein) is widely known to be associated with the occurrence and progression of NAFLD. In the Japanese, the ratio of PNPLA3 gene polymorphisms found is approximately 20%, which is higher than that found in Westerners. In addition, the ratio of lean NAFLD patients is also higher in Japan than in Western countries. Therefore, the method for lifestyle guidance for the NAFLD patients in Japan would be different from that for the people in Western countries. The problems in the treatment of NAFLD patients include alcohol consumption and sarcopenia. Therefore, guidelines that can help clinicians treat Japanese patients with NAFLD are needed. In this expert review, we summarize evidence-based interventions for lifestyle modification (diet, exercise, alcohol, and sarcopenia) for the treatment of patients with NAFLD, especially from Japan and Asian countries.

Self-Reported Eating Speed Is Associated with Indicators of Obesity in Adults: A Systematic Review and Meta-Analysis

Eating speed (ES) as a dietary behaviour has become a widely discussed factor for weight management and obesity. This study analysed the relationship between ES and anthropometric indicators of obesity, including BMI and waist circumference (WC) in adults. A search conducted of PubMed, Web of Science, Science Direct and Scopus found six longitudinal studies and fifteen cross-sectional studies published for further analysis. A quality assessment was performed with the MINORS checklist. Eight studies were included in the meta-analysis and almost all reviewed studies showed that ES was associated with BMI, and non-fast eaters had significantly lower BMI than fast eaters. Therefore, it was assumed that slowing down the ES may be an effective strategy for weight management and lowering obesity risk. There was also an association between WC and ES. Assessment of eating speed can be included in nutrition surveys to analyse obesity risk. More broadly, research is also needed to establish a validated and standardised methodology to determine eating speed. Further research needs to examine the links between eating speed, obesity, ethnicity, sex, food culture and chronic diseases.

Association Between Eating Speed and Metabolic Syndrome: A Systematic Review and Meta-Analysis

Objective: This review aimed to systematically summarize and meta-analyze the association between eating speed and metabolic syndrome (MetS). Methods: Following the Preferred Reporting Items for Systematic Reviews, and Meta Analyses (PRISMA) guidelines, four electronic databases (PubMed, Web of Science, MEDLINE, and EMBASE) were searched until March 2021 to identify eligible articles based on a series of inclusion and exclusion criteria. Heterogeneity was examined using I ² statistics. Using random-effects models, the pooled odds ratios (ORs), and 95% CIs were calculated to evaluate the association between eating speed with MetS and its components, including central obesity, blood pressure (BP), high-density lipoprotein cholesterol (HDL), triglyceride (TG), and fasting plasma glucose (FPG). Results: Of the 8,500 original hits generated by the systematic search, 29 eligible studies with moderate-to-high quality were included, involving 465,155 subjects. The meta-analysis revealed that eating faster was significantly associated with higher risks of MetS (OR = 1.54, 95% CI: 1.27-1.86), central obesity (OR = 1.54, 95% CI: 1.37-1.73), elevated BP (OR = 1.26, 95% CI: 1.13-1.40), low HDL (OR = 1.23, 95% CI: 1.15-1.31), elevated TG (OR = 1.29, 95% CI: 1.18-1.42), and elevated FPG (OR = 1.16, 95% CI: 1.06-1.27) compared to eating slowly. Conclusions: The results of the review indicated that eating speed was significantly associated with MetS and its components. Interventions related to decreasing eating speed may be beneficial for the management of MetS. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021242213, identifier: CRD42021242213.

Impact of income and eating speed on new-onset diabetes among men: a retrospective cohort study

OBJECTIVE

To examine the impact of income and eating speed on new-onset diabetes among men.

DESIGN

This was a retrospective cohort study.

SETTING

We used the administrative claims and health check-up data for fiscal years 2010-2015 obtained from the Fukuoka branch of the Japan Health Insurance Association.

PARTICIPANTS

Participants were 15 474 non-diabetic male employees, aged between 40 and 74 years. They were categorised based on their eating speeds (ie, fast, normal and non-fast).

PRIMARY AND SECONDARY OUTCOME MEASURES

To calculate the OR of the development of diabetes, we created generalised linear regression models with diabetes onset as the dependent variable and eating speed and income as covariates and calculated corresponding 95% CI values. The analyses were performed after adjusting the data for age, obesity and comorbidities.

RESULTS

Of the total participants, 620 developed diabetes during the 5-year study period. A univariate analysis using the generalised linear regression model revealed that eating fast (OR: 1.35, 95% CI 1.17 to 1.55) and having a low income wereincome (OR: 1.47, 95% CI 1.24 to 1.74) were significantly associated with the onset of diabetes. After adjusting for age, obesity and comorbidities, both eating fast (OR: 1.17, 95% CI 1.02 to 1.35) and having a low income (OR: 1.24, 95% CI 1.03 to 1.50) were recognised as independent risk factors for diabetes onset.

CONCLUSIONS

The study revealed that eating fast and having a low income were independent risk factors, leading to the development of diabetes. While it is difficult to address income differences, it may be possible to address the factors that contribute to income differences to manage diabetes appropriately and at low healthcare costs. However, eating speed can be controlled. Hence, the provision of education and coaching on dietary habits, including eating speed, may be effective in preventing diabetes onset.

Eating Speed, Eating Frequency, and Their Relationships with Diet Quality, Adiposity, and Metabolic Syndrome, or Its Components

Excess body weight is a major global health concern, particularly due to its associated increased health risks. Several strategies have been proposed to prevent overweight and obesity onset. In the past decade, it has been suggested that eating speed/rate and eating frequency might be related to obesity. The main aim of this narrative review was to summarize existing evidence regarding the impact of eating speed/rate and eating frequency on adiposity, metabolic syndrome (MetS), or diet quality (DQ). For this purpose, a literature search of observational and interventional trials was conducted between June and September 2020 in PubMed and Web of Sciences databases, without any data filters and no limitations for publication date. Results suggest that children and adults with a faster eating speed/rate may be associated with a higher risk of developing adiposity, MetS or its components. Furthermore, a higher eating frequency could be associated with diet quality improvement, lower adiposity, and lower risk of developing MetS or its components. Further interventional trials are warranted to clarify the mechanism by which these eating behaviors might have a potential impact on health.

Eating Speed and Incidence of Diabetes in a Japanese General Population: ISSA-CKD

Background: We investigated whether eating speed was associated with the incidence of diabetes in a Japanese general population. Methods: A total of 4853 Japanese individuals without diabetes at baseline were analyzed. Self-reported eating speed was categorized as slow, medium, and fast on the basis of questionnaire responses. The study outcome was the incidence of diabetes. Results: After an average follow-up period of 5.1 years, 234 individuals developed diabetes. The incidence of diabetes per 1000 person-years was 4.9 in the slow eating speed group, 8.8 in the medium eating speed group, and 12.5 in the fast eating speed group, respectively (*** p < 0.001 for trend). The HRs were 1.69 (95%CI 0.94–3.06) for the medium eating speed and 2.08 (95%CI 1.13–3.84) for the fast eating speed, compared to the slow eating speed (* p = 0.014 for trend) after adjustment for age, gender, smoking status, drinking, exercise, obesity, hypertension, and dyslipidemia. Conclusion: Faster eating speed increased a risk for the incidence of diabetes in a general Japanese population.

Association between lifestyle habits and the prevalence of abdominal obesity after the Great East Japan Earthquake: The Fukushima Health Management Survey

BACKGROUND

The proportion of overweight individuals living in the evacuation zone of Fukushima increased after the Great East Japan Earthquake. However, the change in the prevalence of abdominal obesity has not been reported. Lifestyle habits and changes in these habits after the disaster might have affected the onset of abdominal obesity; however, the association between the two is unclear.

METHODS

This study evaluated 19,673 Japanese participants of the Fukushima Health Management Survey. We used data from general health check-ups conducted in 13 municipalities between 2008 and 2010. Follow-up examinations were performed from June 2011 to March 2013. Changes in the proportion of individuals with abdominal obesity before and after the disaster were compared. Then, lifestyle habits affecting these changes were assessed.

RESULTS

We found that 34.2% and 36.6% of participants (P < 0.001), both evacuees (37.0% and 42.1% (P < 0.001)) and non-evacuees (32.8% and 34.0% (P < 0.001)), had abdominal obesity before and after the disaster, respectively. Abdominal obesity was positively associated with smoking cessation, snacking after dinner and non-breakfast skipping after the disaster and alcohol drinking before and after the disaster (all P < 0.05). Smoking cessation was positively associated with abdominal obesity in both evacuees and non-evacuees and in both men and women (all P < 0.01).

CONCLUSIONS

The prevalence of abdominal obesity increased among residents in the area affected by nuclear disaster. It might be associated with not only lifestyle habits before the disaster but also changes in these habits after the disaster, especially smoking cessation.

Eating Fast Has a Significant Impact on Glycemic Excursion in Healthy Women: Randomized Controlled Cross-Over Trial

Epidemiological studies have shown that self-reported fast eating increases the risk of diabetes and obesity. Our aim was to evaluate the acute effect of fast eating on glycemic parameters through conducting a randomized controlled cross-over study with young healthy women. Nineteen healthy women wore a flash glucose monitoring system for 6 days. Each participant consumed identical test meals with a different eating speed of fast eating (10 min) or slow eating (20 min) on the 4th or the 5th day. The daily glycemic parameters were compared between the 2 days. The mean amplitude of glycemic excursion (MAGE; fast eating 3.67 ± 0.31 vs. slow eating 2.67 ± 0.20 mmol/L, p < 0.01), incremental glucose peak (IGP; breakfast 2.30 ± 0.19 vs. 1.71 ± 0.12 mmol/L, p < 0.01, lunch 4.06 ± 0.33 vs. 3.13 ± 0.28 mmol/L, p < 0.01, dinner 3.87 ± 0.38 vs. 2.27 ± 0.27 mmol/L, p < 0.001), and incremental area under the curve for glucose of dinner 2 h (IAUC; 256 ± 30 vs. 128 ± 18 mmol/L × min, p < 0.001) for fast eating were all significantly higher than those for slow eating. The results suggest that fast eating is associated with higher glycemic excursion in healthy women.

Eating speed and risk of metabolic syndrome among Japanese workers: The Furukawa Nutrition and Health Study

OBJECTIVES

Evidence from prospective studies on the association between eating speed and metabolic syndrome is limited. We prospectively investigated the association between eating speed and metabolic syndrome in a Japanese working population.

METHODS

Participants were 1018 workers (ages 19-68 y) without metabolic syndrome at baseline who completed both baseline and 3-y follow-up surveys. Eating speed was self-reported and categorized as slow, medium, or fast. Metabolic syndrome was defined using criteria recommended in a joint interim statement from several international societies. A multiple logistic regression was used to estimate the odds ratio of metabolic syndrome according to eating speed with adjustment for covariates, including total energy intake.

RESULTS

At the 3-y follow-up, 67 workers (6.6%) were newly identified as having metabolic syndrome. Fast eating speed was significantly associated with increased odds of developing metabolic syndrome, with multivariable-adjusted odds ratios for eating fast of 2.13 (95% confidence intervals, 1.23-3.68) compared with medium eating speed with an adjustment for covariates, including total energy intake. The association remained statistically significant after an additional adjustment for body mass index (BMI) and BMI change between baseline and follow-up surveys (odds ratio: 1.95; 95% confidence interval, 1.06-3.56).

CONCLUSIONS

Fast eating speed was associated with an increased likelihood of developing metabolic syndrome independently of total energy intake, BMI at baseline, and BMI change during the follow-up period.

Eating speed and the risk of type 2 diabetes: explorations based on real-world evidence

Metabolic syndrome, especially diabetes, has gained global attention over the past few decades and became one of the major public health concerns. Alongside known and well-established risk factors, eating behaviors, mainly eating speed has shown the potential as one of the novel risk factors that could supplement the development of diabetes. However, there is a paucity in evidence, and only a few studies have addressed this question so far. In this review, with a focus on eating speed and the risk of developing diabetes, authors attempted to shed some light on the high-quality studies that were conducted around the world using real-world data in drawing inferences, which could add-on to the literature and assist public in making informed decisions.

Incidence of Metabolic Syndrome in Young Japanese Adults in a 6-Year Cohort Study: The Uguisudani Preventive Health Large-Scale Cohort Study (UPHLS)

INTRODUCTION

To clarify the incidences of metabolic syndrome (MS) and risks in young Japanese adults by gender.

METHODS

A total of 58,901 adults who had undergone annual health check-ups in 2010 without a diagnosis of MS or missing data were divided into three age groups (20s through 40s) by gender. Participants were followed up for 6 years for new-onset MS according to Japanese criteria. The incidences of MS and risks were analyzed using the Cox proportional hazards model to adjust for confounding factors.

RESULTS

The incidences of MS per 1,000 person-years were 2.2, 5.5, and 10.2 for women aged in their 20s, 30s, and 40s, respectively, and 26.3, 40.5, and 57.4 in the respective men groups. Compared with the group aged in their 40s, the hazard ratios of new MS were 0.19 (95% confidence interval [CI], 0.13-0.29) for women in their 20s and 0.50 (95% CI, 0.41-0.61) for women in their 30s, and 0.46 (95% CI, 0.42-0.50) and 0.70 (95% CI, 0.66-0.73) for men in their 20s and 30s, respectively, after adjustment for lifestyle factors. For women, MS was associated with smoking in their 20s and 30s, and eating speed in their 30s, and for men, was associated with physical activity, eating speed, alcohol intake in their 20s and 30s, and smoking in their 30s.

CONCLUSION

Our findings suggest that the incidences of MS in the 20s and 30s are lower, but account for about 20-50% of women with MS and 50-70% of men with MS in their 40s. However, the data are not negligible and early lifestyle intervention for MS is necessary in young adults.

Self-Reported Eating Speed and Incidence of Gestational Diabetes Mellitus: the Japan Environment and Children's Study

There is little evidence linking eating speed to gestational diabetes mellitus (GDM) incidence. We therefore aimed to evaluate the prospective association of eating speed with GDM incidence. Overall, 97,454 pregnant women were recruited between January 2011 and March 2014. Singleton pregnant women who did not have GDM, heart disease, stroke, cancer, type 1 diabetes, and/or type 2 diabetes at the time of study enrollment were eligible. Each woman was asked about her eating speed at that time via a questionnaire. Odds ratios of GDM in relation to eating speed were obtained using logistic regression. Among the 84,811 women eligible for analysis, 1902 cases of GDM were identified in medical records. Compared with women who reported slow eating speed, the age-adjusted odds ratios (95% confidence interval) of GDM for women who reported medium, relatively fast, or very fast eating speed were 1.03 (0.90, 1.18), 1.07 (0.94, 1.23), and 1.28 (1.05, 1.58), respectively. Adjustment for demographic, lifestyle-related, and dietary factors including dietary fat, dietary fiber, and energy intakes yielded similar results. The association was attenuated and no longer significant after further adjustment for pre-pregnancy body mass index. The mediation analysis showed that being overweight accounted for 64% of the excess risk of GDM associated with eating speed. In conclusion, women who reported very fast eating speed, compared with those reporting slow eating speed, were associated with an increased incidence of GDM, which may be largely mediated by increased body fat.

Association Between Self-Reported Eating Rate, Energy Intake, and Cardiovascular Risk Factors in a Multi-Ethnic Asian Population

Eating faster is associated with greater body mass index (BMI), but less is known about the relationships between eating rate, energy intake, body composition, and cardio-metabolic risk factors in different Asian ethnic groups. Using data from the Singapore Multi-Ethnic Cohort (n = 7011; 21-75 y), we investigated associations between self-reported eating rate (SRER), with energy intake, body composition, blood pressure, and blood lipids. SRER and lifestyle was assessed using interviewer-administered questionnaires. Multivariable models were used to examine the associations of SRER with energy intake, body composition, blood pressure, and blood lipids after adjusting for covariates. General and abdominal overweight were defined as BMI ≥ 23 kg/m² and waist circumference > 90cm (men) and > 80cm (women), respectively. On average, faster eaters (vs. slower eaters) consumed 105kcal/day more (p = 0.034), had ~5kg higher body weight (p < 0.001), 1.3 kg/m² higher BMI (p < 0.001), and 3.1cm larger waist-circumference (p < 0.001). Faster eaters had significantly higher blood pressure, circulating triglycerides, and total-to-high-density lipoprotein cholesterol ratio than slower eaters. Faster eaters were twice as likely to develop general (multivariable-OR: 2.2;95%CI,1.8-2.6; p < 0.001), and abdominal (OR:1.8;95%CI, 1.5-2.2; p < 0.001) overweight than slower eaters. This association was observed across all subgroups by age, sex, and ethnicity. Findings suggest that SRER is a robust behavioral marker for increased risk of higher energy intake, obesity, and poor cardio-metabolic health, and a modifiable behavioral risk-factor for obesity prevention.

Relationship of sociodemographic and lifestyle factors and diet habits with metabolic syndrome (MetS) among three ethnic groups of the Malaysian population

Objectives

Literature shows a high prevalence of MetS among Malaysians, varying across the major ethnicities. Since sociodemographic characteristics, lifestyle factors and diet habits of such communities have been reported to be diverse, the objective of this study was to investigate the association of various sociodemographic characteristics, lifestyle factors and diet habits with MetS overall, as well as with the three major ethnic communities in Malaysia, specifically.

Materials and methods

We conducted a cross-sectional study among 481 Malaysians of ages 18 years and above living in the state of Johor, Malaysia. Information on demographics, lifestyle and diet habits were collected using a structured questionnaire. Harmonized criteria were used to assess the status of MetS. Multiple logistic regression was employed to determine any associations between sociodemographic and lifestyle factors and dietary behaviours with MetS.

Results

MetS was found among 32.2% of the respondents and was more prevalent among the Indians (51.9%), followed by the Malays (36.7%) and the Chinese (20.2%). Overall, increasing age (AOR = 2.44[95%CI = 1.27–4.70] at 40–49 years vs. AOR = 4.14[95%CI = 1.97–8.69] at 60 years and above) and Indian ethnicity (AOR = 1.95[95%CI = 1.12–3.38)] increased the odds of MetS, while higher education (AOR = 0.44[95%CI = 0.20–0.94] decreased the odds of MetS in this population. Quick finishing of meals (AOR = 2.17[95%CI = 1.02–4.60]) and low physical activity (AOR = 4.76[95%CI = 1.49–15.26]) were associated with increased odds of MetS among the Malays and the Chinese, respectively.

Conclusion

The population of Johor depicts a diverse lifestyle and diet behaviour, and some of these factors are associated with MetS in certain ethnic groups. In the light of such differences, ethnic specific measures would be needed to reduce the prevalence of MetS among those in this population.

Comparison of Self-Reported Speed of Eating with an Objective Measure of Eating Rate

Slow eating may be beneficial in reducing energy intake although there is limited research quantifying eating rate. Perceived speed of eating was self-reported by 78 adults using a standard question “On a scale of 1–5 (very slow–very fast), how fast do you believe you eat?” Timing the completion of meals on three occasions was used to assess objective eating rate. The mean (SD) speeds of eating by self-reported categories were 49 (13.7), 42 (12.2), and 35 (10.5) g/min for fast, medium, and slow eaters, respectively. Within each self-reported category, the range of timed speed of eating resulted in considerable overlap between self-identified ‘fast’, ‘medium’ and ‘slow’ eaters. There was 47.4% agreement (fair) between self-reported speed of eating and the objective measure of eating rate (κ = 0.219). Self-reported speed of eating was sufficient at a group level to detect a significant difference (10.9 g/min (95% CI: 2.7, 19.2 g/min, p = 0.009)) between fast and slow; and fast and medium eaters (6.0 g/min (0.5, 11.6 g/min p = 0.033)). The mean difference (95% CI) between slow and medium eaters was 4.9 (−3.4, 12.2) g/min (p = 0.250). At an individual level, self-report had poor sensitivity. Compared to objectively measured speed of eating, self-reported speed of eating was found to be an unreliable means of assessing an individual’s eating rate. There are no standard protocols for assessing speed of eating or eating rate. Establishing such protocols would enable the development of population reference ranges across various demographic groups that may be applicable for public health messages and in clinical management.

One-year follow-up study on associations between dental caries, periodontitis, and metabolic syndrome

There have been few prospective studies on the relationship between oral health conditions and the development of metabolic syndrome (MetS). This prospective cohort study was performed at a Japanese company over one year. Routine medical health examinations, oral health examinations, and a questionnaire pertaining to education, job type, and health behaviors was administered. Participants aged ≥35 years who had no MetS components at baseline were re-examined after one year. Modified Poisson regression analyses were performed to calculate the relative risks (RRs) associated with oral health variables, including periodontitis, decayed and missing teeth, and decayed, missing, and filled teeth (DMFT) in relation to the development of MetS. Of 152 eligible participants, 136 were re-examined after one year; 30 exhibited one or more newly developed MetS components upon re-examination. Decayed teeth at baseline were significantly associated with development of at least one MetS component (adjusted RR 3.25, 95% confidence interval 1.59-6.63). There were no associations between periodontitis, missing teeth, or DMFT and the development of MetS. The association between decayed teeth and MetS was independent of other risk factors, including age and body mass index; therefore, decayed teeth may be associated with the development of MetS.

Validation of a Deep Learning System for the Full Automation of Bite and Meal Duration Analysis of Experimental Meal Videos

Eating behavior can have an important effect on, and be correlated with, obesity and eating disorders. Eating behavior is usually estimated through self-reporting measures, despite their limitations in reliability, based on ease of collection and analysis. A better and widely used alternative is the objective analysis of eating during meals based on human annotations of in-meal behavioral events (e.g., bites). However, this methodology is time-consuming and often affected by human error, limiting its scalability and cost-effectiveness for large-scale research. To remedy the latter, a novel "Rapid Automatic Bite Detection" (RABiD) algorithm that extracts and processes skeletal features from videos was trained in a video meal dataset (59 individuals; 85 meals; three different foods) to automatically measure meal duration and bites. In these settings, RABiD achieved near perfect agreement between algorithmic and human annotations (Cohen's kappa κ = 0.894; F1-score: 0.948). Moreover, RABiD was used to analyze an independent eating behavior experiment (18 female participants; 45 meals; three different foods) and results showed excellent correlation between algorithmic and human annotations. The analyses revealed that, despite the changes in food (hash vs. meatballs), the total meal duration remained the same, while the number of bites were significantly reduced. Finally, a descriptive meal-progress analysis revealed that different types of food affect bite frequency, although overall bite patterns remain similar (the outcomes were the same for RABiD and manual). Subjects took bites more frequently at the beginning and the end of meals but were slower in-between. On a methodological level, RABiD offers a valid, fully automatic alternative to human meal-video annotations for the experimental analysis of human eating behavior, at a fraction of the cost and the required time, without any loss of information and data fidelity.

Assessment of the relationship between metabolic syndrome and obstructive sleep apnea in male drivers of Shahroud city in 2018: a cross sectional study

BACKGROUND

Metabolic syndrome involves a set of metabolic risk factors that directly increases the risk of atherosclerotic cardiovascular disease. Physical inactivity due to driving can increase the risk of metabolic syndrome. It is also known that sleep disorders (sleep apnea) can result in MetS. Driving in Iran is considered a very popular but risky occupation, so paying attention to this profession is of special importance. Therefore, the researchers aimed to investigate the association between sleep disorders and metabolic syndrome in drivers in Shahroud city in 2018.

METHODS

This cross-sectional study was carried out on 948 drivers from Shahroud city in 2018. After obtaining consent from participants, 3 questionnaires including demographic, Epworth Sleepiness Scale and STOP-BANG were completed. Clinical and anthropometric measurements were assessed, including blood pressure, waist circumference, hip circumference, weight, height, and body mass index. In addition, blood was drawn to measure High Density Lipoprotein, Low Density Lipoprotein, Triglyceride, cholesterol, and Fasting Blood Sugar levels. The relationship between metabolic syndrome and sleep disorders was then studied. In this study, statistical analyses were performed using SPSS software version 23 at a significance level of 0.05.

RESULTS

Mean age of drivers was 44.15 ± 11.66 (years). The mean waist circumference and mean hip circumference in subjects with a Class 1 Driver's License (a certificate for trucks and buses) were higher than those with a Class 2 Driver's License (a certificate for motorcars, minibuses, vans, etc. (seating< 20)) (P = 0.01 and P = 0.003, respectively). Moreover, the BMI in subjects with a Class 1 Driver's License was higher compared to subjects with a Class 2 Driver's License. The correlation between metabolic syndrome with sleep apnea based on STOP-BANG questionnaire was significant (p < 0.001) irrespective of definition (ATP and IDF).

CONCLUSIONS

According to the results of this study, there was a bi-directional association between sleep disorders and Mets, so this group should pass periodic medical examinations and training courses. Moreover, their families should be informed of prevention and treatment of this syndrome.

Relationship between objectively measured lifestyle factors and health factors in patients with knee osteoarthritis: The STROBE Study

The purpose of this study was to investigate the association between objectively-measured lifestyle factors and health factors in patients with knee osteoarthritis (OA).In this cross-sectional study, 52 patients with knee OA were examined. Lifestyle factors were measured using a wearable smartwatch (step counts, walking distance, calorie consumption, sleep hours) and by self-report (eating speed). Body mass index (BMI), waist circumference, blood pressure, muscle strength of knee extensor and hip abductor, knee pain, symptoms, daily living function, sports recreation function, quality of life by knee injury and OA outcome score (KOOS) were measured to obtain data on health factors. Correlations and regression analysis were used to analyze the relationship between lifestyle factors and health factors.KOOS subscales (pain, symptom, daily living function) and hip abductor strength were positively correlated with daily step count, which was the only independently contributing lifestyle factor. Additionally, knee pain duration and diastolic blood pressure were negatively correlated with daily step count. BMI and waist circumference showed no correlation with physical activity data, but were negatively correlated with sleep duration and eating speed.The findings of this study contribute to expanding the knowledge on how lifestyle habits of older patients with knee OA contribute to their health status. Daily step counts were associated with knee OA-related pain, symptom, function in daily living, duration of knee pain, blood pressure, and strength of hip abductor. BMI and waist circumference were associated with sleep duration and eating speed.

Systematic estimation of BMI: A novel insight into predicting overweight/obesity in undergraduates

The prevalence of overweight-obesity has increased sharply among undergraduates worldwide. In 2016, approximately 52% of adults were overweight-obese. This cross-sectional study aimed to investigate the prevalence of overweight-obesity and explore in depth the connection between eating habits and overweight-obesity among Chinese undergraduates.The study population included 536 undergraduates recruited in Shijiazhuang, China, in 2017. They were administered questionnaires for assessing demographic and daily lifestyle characteristics, including sex, region, eating speed, number of meals per day, and sweetmeat habit. Anthropometric status was assessed by calculating the body mass index (BMI). The determinants of overweight-obesity were investigated by the Pearson χ test, Spearman rho test, multivariable linear regression, univariate/multivariate logistic regression, and receiver operating characteristic curve analysis.The prevalence of undergraduate overweight-obesity was 13.6%. Sex [male vs female, odds ratio (OR): 1.903; 95% confidence interval (95% CI): 1.147-3.156], region (urban vs rural, OR: 1.953; 95% CI: 1.178-3.240), number of meals per day (3 vs 2, OR: 0.290; 95% CI: 0.137-0.612), and sweetmeat habit (every day vs never, OR: 4.167; 95% CI: 1.090-15.933) were significantly associated with overweight-obesity. Eating very fast was positively associated with overweight-obesity and showed the highest OR (vs very slow/slow, OR: 5.486; 95% CI: 1.622-18.553). However, the results of multivariate logistic regression analysis indicated that only higher eating speed is a significant independent risk factor for overweight/obesity (OR: 17.392; 95% CI, 1.614-187.363; P = .019).Scoremeng = 1.402 × scoresex + 1.269 × scoreregion + 19.004 × scoreeatin speed + 2.546 × scorenumber of meals per day + 1.626 × scoresweetmeat habit and BMI = 0.253 × Scoremeng + 18.592. These 2 formulas can help estimate the weight status of undergraduates and predict whether they will be overweight or obese.

Association between eating behavior and poor glycemic control in Japanese adults

This study investigated the relationship between eating behavior and poor glycemic control in 5,479 Japanese adults with hemoglobin A1c (HbA1c) <6.5% who participated in health checks. Respondents to a 2013 baseline survey of eating behavior, including skipping breakfast and how quickly they consumed food were followed up until 2017. We defined poor glycemic control after follow-up as HbA1c ≥6.5%, or increases in HbA1c of ≥0.5% and/or being under medication to control diabetes. We identified 109 (2.0%) respondents who met these criteria for poor glycemic control. After adjusting for sex, age, smoking status, body mass index (BMI), and eating behavior, the risk of poor glycemic control was increased in males (odds ratio [OR], 2.38; 95% confidence interval [CI] 1.37–4.12; p < 0.01), and associated with being older (OR, 1.07; 95% CI, 1.04–1.11; p < 0.001), having a higher BMI (OR, 1.29; 95% CI 1.23–1.35; p < 0.001), skipping breakfast ≥3 times/week (OR, 2.44; 95% CI, 1.35–4.41; p < 0.01), and changing from eating slowly or at medium speed to eating quickly (OR, 2.11; 95% CI, 1.04–4.26; p < 0.05). In conclusion, Japanese adults who were male, older, had a high BMI, skipped breakfast ≥3 times/week and ate quickly were at increased risk for poor glycemic control.

Diet and physical activity in the association between depression and metabolic syndrome: Constances study

BACKGROUND

The association between depression and the metabolic syndrome remains poorly understood. Diet and physical activity may partly explain this association.

METHODS

Baseline data on 64,861 subjects from the French population-based Constances cohort was analyzed. Depressive symptoms were determined with the Center of Epidemiologic Studies Depression (CES-D) scale. A CES-D score ≥ 19 combined with self-reported limitations related to depressive symptoms was used to define depression. The metabolic syndrome was defined according to the International Diabetes Federation criteria. Dietary patterns were determined with a food frequency questionnaire and a principal component analysis. Physical activity was measured with 3 questions resulting in a composite 6-point scale. Associations between depression and the metabolic syndrome were estimated through logistic regression and path analysis.

RESULTS

The odds-ratios (95% confidence interval) for the association between depression and the metabolic syndrome, adjusting for age, sex, education and income, was 1.75 (1.57-1.96). The path analysis showed that 23% of this association was explained by diet and physical activity, 67% being attributed to physical activity.

LIMITATIONS

The cross-sectional nature of the analyses warrants the results to be confirmed by longitudinal analyses.

CONCLUSION

Diet and physical activity might partially explain the association between depressive symptoms and metabolic syndrome but other factors (e.g. inflammatory factors) are involved.

Effect of a 2-hour interval between dinner and bedtime on glycated haemoglobin levels in middle-aged and elderly Japanese people: a longitudinal analysis of 3-year health check-up data

Introduction

There is a need for evidence-based measures to examine the risk factors for lifestyle-related diseases. In Japan, a 2-hour interval between dinner and sleep is recommended as a healthy practice. However, the effect of an appropriate duration between dinner and bedtime on glycated haemoglobin (HbA1c) levels remains unclear. This study aimed to identify the effect of a duration of 2 hours or shorter between dinner and bedtime on HbA1c levels in middle-aged and elderly Japanese individuals.

Methods

A longitudinal analysis of health check-up data (2012, 2013 and 2014) was performed. Lifestyle and anthropometric data of individuals aged 40–74 years who did not have any pre-diabetic and diabetic conditions were collected for multilevel analysis. Univariate analysis was performed to assess the influence of each lifestyle variable. Then, two-level random intercept models were created using statistical software SAS 9.3 (SAS Institute Inc, Cary, NC, USA).

Results

The cohort comprised 1573 individuals in 2012, two-thirds of whom were women. The mean HbA1c level was 5.20% in 2012 and 5.58% in 2013 and 2014. A total of 83 (16.1%) men and 70 (7.5%) women fell asleep within 2 hours after dinner. The influence of ensuring a 2-hour interval between dinner and bedtime did not have a remarkable effect on increasing HbA1c levels. The regression coefficient of 2-hour interval and HbA1c levels over time was −0.02 (p=0.45). Smoking (p=0.013), alcohol consumption (p=0.010) and higher body mass index (BMI) (p<0.001) may have influenced HbA1c trends.

Conclusion

Durations of 2 hours or shorter between dinner and bedtime did not influence HbA1c changes in middle-aged and elderly Japanese people. Instead, the focus should be on maintaining a normal BMI and abstaining from smoking and consuming alcohol to ensure stable HbA1c patterns in the long term.

Association between Eating Speed and Classical Cardiovascular Risk Factors: A Cross-Sectional Study

Cardiovascular disease (CVD) is one of the main causes of morbidity and mortality around the world. Lifestyle is recognized as a key factor in the development of metabolic disorders and CVD. Recently, eating speed has been of particular interest since some studies have associated it with the development of obesity and other cardiometabolic disorders. We aimed to assess the association between eating speed and various cardiovascular risk factors. We conducted a cross-sectional analysis within the framework of the PREDIMED (Prevención con Dieta Mediterránea) study with 792 participants from the Reus-Tarragona center. Eating speed was self-reported according to participant perception and categorized as slow, medium, or fast. The association between eating speed and cardiovascular risk factors was assessed using Cox regression models with constant time of follow-up for all individuals. Compared to participants in the slow eating speed category, those in the faster eating speed category were 59% more likely to have the hypertriglyceridemia component of the metabolic syndrome (MetS) (Hazard Ratio, (HR) 1.59; 95% Confidence Interval (CI) 1.16–2.17), even after adjustment for potential confounders (HR 1.47; 95% CI 1.08–2.02). No other significant differences were observed. Eating speed was positively associated with the prevalence of the hypertriglyceridemia component of the MetS in a senior population at high cardiovascular risk.

Association between family dinner and BMI in adults: data from the 2013 to 2015 Korean National Health and Nutrition Examination Survey

Objective

People who eat alone, which is becoming a new trend owing to the increasing proportion of one-person households in Korea, are more likely to become overweight and obese. Therefore, we investigated the association between having a dinner companion and BMI.

Design

A linear regression model adjusted for covariates was utilized to examine the association between having a dinner companion and BMI. Subgroup analyses were performed, stratified by age group, gender, household income, educational level and occupation.

Setting

We used the data from the Korean Health and Nutrition Examination Survey VI. Our primary independent variable was having a dinner companion while the dependent variable was BMI.

Subjects

In total, 13303 individuals, aged 20 years or over, were analysed.

Results

Compared with the solo eating group, BMI was lower in the family dinner group (β=−0·39, P<0·01) but not in the non-family dinner group (β=−0·06, P=0·67). The subgroup analysis revealed that the difference in BMI was most significant in young generations, such as those aged 20–29 years (β=−1·15, P<0·01) and 30–39 years (β=−0·78, P=0·01).

Conclusions

We found that people who eat dinner alone are more likely to become overweight and obese than those who eat with their family. This association was stronger in males and young adults than their counterparts. Considering the increasing trends in the proportion of single-person households and solo eating, appropriate intervention is needed.

Association between self-reported eating speed and metabolic syndrome in a Beijing adult population: a cross-sectional study

Background

Research on the relationship between metabolic syndrome (MetS), its components and eating speed is limited in China. The present study aimed to clarify the association between MetS, its components and eating speed in a Beijing adult population.

Methods

This cross-sectional study included 7972 adults who were 18–65 years old and who received health check-ups at the Beijing Physical Examination Center in 2016. Logistic regression was conducted to explore the associations between MetS, its components and eating speed.

Results

The prevalence of MetS in this population was 24.65% (36.02% for males and 10.18% for females). Eating speed was significantly associated with a high risk for MetS, elevated blood pressure, and central obesity for both genders. Eating speed was associated with a high risk for elevated triglycerides and with a reduction in high-density lipoprotein in males, and eating speed was associated with a high risk for elevated fasting plasma glucose in females. Compared with slow eating speed, the multivariate-adjusted odds ratios of medium eating speed and fast eating speed for MetS were 1.65 (95% confidence interval 1.32–2.07) and 2.27 (95% confidence interval 1.80–2.86) for all subjects, 1.58 (95% confidence interval 1.21–2.07) and 2.21 (95% confidence interval 1.69–2.91) for males, and 1.75 (95% confidence interval 1.15–2.68) and 2.27 (95% confidence interval 1.46–3.53) for females, respectively.

Conclusions

Eating speed is positively associated with MetS and its components. Future recommendations aiming to prevent MetS and its components may focus on eating speed.

Electronic supplementary material

The online version of this article (10.1186/s12889-018-5784-z) contains supplementary material, which is available to authorized users.

Number of Teeth, Oral Self-care, Eating Speed, and Metabolic Syndrome in an Aged Japanese Population

BACKGROUND

Many studies have reported that oral health status is associated with various systemic health issues. This study examined the correlations among oral health, lifestyle factors, and metabolic syndrome (MetS) in aged participants.

METHODS

We analyzed cross-sectional oral and medical health checkup data from 2,379 participants aged 75 and 80 years. MetS was diagnosed according to the Harmonization criteria, with the exception of the criterion for central obesity, and body mass index was used instead of waist circumference. Logistic regression analyses were performed to evaluate the correlation between oral health status and lifestyle factors and MetS in both sexes and by sex.

RESULTS

In both sexes, the odds ratio (OR) for MetS was 1.54 (95% confidence interval [CI], 1.10-2.17) among those who had 0-9 teeth compared with those with 20-28 teeth. MetS was significantly more likely for those eating quickly than those eating slowly (OR 2.06; 95% CI, 1.35-3.16). Participants using secondary oral hygiene products every day had a significantly lower OR (0.71; 95% CI, 0.55-0.92) for MetS than did those who did not. Participants with 0-9 teeth who ate quickly had a significantly higher OR (2.48; 95% CI, 1.06-5.78) for MetS compared with those with 20-28 teeth who ate slowly.

CONCLUSION

These results suggest that maintaining teeth, eating slowly, and using secondary oral hygiene products every day are associated with a lower likelihood of MetS in the aged population.