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Morquecho-Campos P, Bikker FJ, Nazmi K, de Graaf K, Laine ML, Boesveldt S. A stepwise approach investigating salivary responses upon multisensory food cues. Physiol Behav 2020; 226:113116. [PMID: 32750433 DOI: 10.1016/j.physbeh.2020.113116] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 07/02/2020] [Accepted: 07/31/2020] [Indexed: 12/11/2022]
Abstract
Exposure to sensory food cues such as smell, vision, taste and/or texture may trigger anticipatory physiological responses such as salivation, participating on adequate metabolism of the signaled food. However, the individual contribution of each sensory modality as well as the impact of particular food products on salivation and salivary composition remains unclear. Therefore, by systematically varying sensory modalities and nutrient content of food stimuli, we investigated their effect on saliva secretion, α-amylase activity and other salivary characteristics (pH level, buffering capacity, MUC5B concentration, and total protein content). Over 3 sessions, 46 normal-weight healthy participants were exposed to 12 conditions, consisting of 4 levels of sensory stimulation (odor, odor + vision, odor + vision + taste, and odor + vision + taste + mastication) and 3 types of stimuli (bread, high-in-starch; cucumber, low-in-starch; and parafilm as non-food control) during which saliva was collected. Linear mixed models showed a significant increase in salivation with increasing levels of sensory stimulation. α-amylase secretion rate increased upon the highest level of stimulation, which involved mastication, compared to odor and odor + visual level of stimulation. Other salivary characteristics varied with the level of sensory stimulation, which might be related to the total volume of salivation. The type of stimuli did not influence the saliva composition (α-amylase concentration nor other salivary components). Our findings indicate that cumulative sensory information, rather than specific (food) product, play a vital role in anticipatory salivary responses.
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Affiliation(s)
- Paulina Morquecho-Campos
- Division of Human Nutrition and Health, Wageningen University, 6708 WE Wageningen, the Netherlands.
| | - Floris J Bikker
- Department of Oral Biochemistry, Academic Centre for Dentistry Amsterdam, University of Amsterdam and VU University Amsterdam, 1081 LA Amsterdam, the Netherlands
| | - Kamran Nazmi
- Department of Oral Biochemistry, Academic Centre for Dentistry Amsterdam, University of Amsterdam and VU University Amsterdam, 1081 LA Amsterdam, the Netherlands
| | - Kees de Graaf
- Division of Human Nutrition and Health, Wageningen University, 6708 WE Wageningen, the Netherlands
| | - Marja L Laine
- Department of Periodontology, Academic Centre for Dentistry Amsterdam, University of Amsterdam and VU University Amsterdam, 1081 LA Amsterdam, the Netherlands
| | - Sanne Boesveldt
- Division of Human Nutrition and Health, Wageningen University, 6708 WE Wageningen, the Netherlands
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Extrusion cooking of cassava-soy flour with 200 g/kg wheat bran promotes slower oral processing during consumption of the instant porridge and higher derived satiety. Lebensm Wiss Technol 2018. [DOI: 10.1016/j.lwt.2018.07.068] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Nguyen NQ, Debreceni TL, Burgess JE, Bellon M, Wishart J, Standfield S, Malbert CH, Horowitz M. Impact of gastric emptying and small intestinal transit on blood glucose, intestinal hormones, glucose absorption in the morbidly obese. Int J Obes (Lond) 2018; 42:1556-1564. [PMID: 29453463 DOI: 10.1038/s41366-018-0012-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 11/06/2017] [Accepted: 11/27/2017] [Indexed: 02/07/2023]
Abstract
This study evaluated gastric emptying (GE) and small intestinal (SI) transit in people with morbid obesity and their relationships to glycaemia, incretin hormones, and glucose absorption METHODS: GE and caecal arrival time (CAT) of a mixed meal were assessed in 22 morbidly obese (50.2 ± 2.5 years; 13 F:9 M; BMI: 48.6 ± 1.8 kg/m2) and 10 lean (38.6 ± 8.4 years; 5 F:5 M; BMI: 23.9 ± 0.7 kg/m2) subjects, using scintigraphy. Blood glucose, plasma 3-O-methylglucose, insulin, glucagon, glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) were measured. Insulin sensitivity and resistance were also quantified RESULTS: When compared with lean subjects, GE (t50: 60.7 ± 6.5 vs. 41.1 ± 7.3 min; P = 0.04) and CAT (221.5 ± 9.8 vs. 148.0 ± 7.1 min; P = 0.001) of solids were prolonged in morbid obesity. Postprandial rises in GIP (P = 0.001), insulin (P = 0.02), glucose (P = 0.03) and 3-O-methylglucose (P = 0.001) were less. Whereas GLP-1 increased at 45 mins post-prandially in lean subjects, there was no increase in the obese (P = 0.04). Both fasting (P = 0.045) and postprandial (P = 0.012) plasma glucagon concentrations were higher in the obese CONCLUSIONS: GE and SI transit are slower in the morbidly obese, and associated with reductions in postprandial glucose absorption, and glycaemic excursions, as well as plasma GIP and GLP-1.
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Affiliation(s)
- Nam Q Nguyen
- Department of Gastroenterology and Hepatology, Level 7, Royal Adelaide Hospital, North Terrace, Adelaide, SA, 5000, Australia.
- Discipline of Medicine, University of Adelaide, Royal Adelaide Hospital, Level 6 Eleanor Harrold Building, North Terrace, Adelaide, SA, 5000, Australia.
| | - Tamara L Debreceni
- Department of Gastroenterology and Hepatology, Level 7, Royal Adelaide Hospital, North Terrace, Adelaide, SA, 5000, Australia
| | - Jenna E Burgess
- Department of Gastroenterology and Hepatology, Level 7, Royal Adelaide Hospital, North Terrace, Adelaide, SA, 5000, Australia
| | - Max Bellon
- Nuclear Medicine, PET and Bone Densitometry, Royal Adelaide Hospital, Adelaide, SA, Australia
| | - Judith Wishart
- Discipline of Medicine, University of Adelaide, Royal Adelaide Hospital, Level 6 Eleanor Harrold Building, North Terrace, Adelaide, SA, 5000, Australia
| | - Scott Standfield
- Discipline of Medicine, University of Adelaide, Royal Adelaide Hospital, Level 6 Eleanor Harrold Building, North Terrace, Adelaide, SA, 5000, Australia
| | | | - Michael Horowitz
- Discipline of Medicine, University of Adelaide, Royal Adelaide Hospital, Level 6 Eleanor Harrold Building, North Terrace, Adelaide, SA, 5000, Australia
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Camps G, Veit R, Mars M, de Graaf C, Smeets PA. Just add water: Effects of added gastric distention by water on gastric emptying and satiety related brain activity. Appetite 2018; 127:195-202. [PMID: 29730186 DOI: 10.1016/j.appet.2018.04.023] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Revised: 03/22/2018] [Accepted: 04/26/2018] [Indexed: 12/14/2022]
Abstract
BACKGROUND Gastric distention contributes to meal termination. There is little research on the neural correlates of gastric distention by food. To date, neural measures have not been obtained concurrently with measurements of gastric distention. OBJECTIVES 1) To study how offering a small versus a large water load following a standardized nutrient load affects gastric distention over time. 2) To assess associations between satiety experiences and brain activity and the degree of gastric distention. METHOD 19 healthy males (age 22.2 ± 2.5 y, BMI 21.8 ± 1.5 kg/m2) participated in a randomized crossover study with two treatments: ingestion of a 500-kcal 150-mL liquid meal shake followed by a low (LV, 50 mL) or a high volume (HV, 350 mL) water load. At baseline and three times after ingestion satiety was scored, MRI scans were made to determine total gastric content volume (TGV) and functional MRI scans were made to measure cerebral blood flow (CBF). RESULTS TGV was significantly higher for HV compared to LV at all time points (p < 0.001) with relative differences between HV and LV of 292 ± 37 mL after ingestion, 182 ± 83 mL at t = 15 min and 62 ± 57 mL at t = 35 min. Hunger decreased (p = 0.023) and fullness increased (p = 0.030) significantly more for HV compared to LV. Ingestion increased CBF in the inferior frontal gyrus and the anterior insula, but there were no differences between treatments. There were no significant correlations between appetite ratings and CBF values. CONCLUSION Performing concurrent gastric MRI and CBF measurements can be used to investigate neural correlates of gastric distention. Increased distention did not induce significantly greater brain activation. Future research should further examine the role of the inferior frontal gyrus in satiety.
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Affiliation(s)
- Guido Camps
- Division of Human Nutrition, Wageningen University & Research, P.O. Box 8129, 6700 EV Wageningen, The Netherlands.
| | - Ralf Veit
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Otfried-Müller-Str. 10, 72076 Tübingen, Germany; Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Otfried-Müller-Str. 47, 72076 Tübingen, Germany
| | - Monica Mars
- Division of Human Nutrition, Wageningen University & Research, P.O. Box 8129, 6700 EV Wageningen, The Netherlands
| | - Cees de Graaf
- Division of Human Nutrition, Wageningen University & Research, P.O. Box 8129, 6700 EV Wageningen, The Netherlands
| | - Paul Am Smeets
- Division of Human Nutrition, Wageningen University & Research, P.O. Box 8129, 6700 EV Wageningen, The Netherlands; Image Sciences Institute, University Medical Center Utrecht, Utrecht University, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
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Camps G, Mars M, Witteman BJM, de Graaf C, Smeets PAM. Indirect vs direct assessment of gastric emptying: A randomized crossover trial comparing C-isotope breath analysis and MRI. Neurogastroenterol Motil 2018; 30:e13317. [PMID: 29473700 DOI: 10.1111/nmo.13317] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Accepted: 01/25/2018] [Indexed: 02/08/2023]
Abstract
BACKGROUND Indirect methods to assess gastric emptying (GE), such as 13 C breath tests (BT), are commonly used. However, BT usually use a sampling time of 4+ hours. The current study aims to assess the validity of BT for four liquid meals differing in physicochemical properties. To this aim, we compared them to MRI GE-measurements. METHODS Fifteen healthy males (age 22.6 ± 2.4 years, BMI 22.6 ± 1.8 kg/m2 ) participated in a randomized 2 × 2 crossover experiment. Test foods were liquid meals, which were either thin/thick and 100/500 kcal, labeled with 100 mg of 13 C-octanoate. GE was measured with MRI and assessed by 13 C recovery from breath. Participants were scanned every 10 minutes and at six time points breath samples were collected up to t = 90 minutes. Two curves were fitted to the data to estimate emptying halftime (t50 Ghoos and t50 Bluck ). T50 times were ranked per participant and compared between methods. KEY RESULTS On average, MRI and BT showed similar t50 rankings for the four liquid meals. In comparison to MRI, t50 Ghoos overestimated, while t50 Bluck underestimated GE time. Moreover, more viscous foods were overestimated. In most participants individual t50 time rankings differed significantly between methods. CONCLUSIONS & INFERENCES BT can assess relative emptying differences on group level and collecting breath data for 90 minutes constitutes a lower burden for participants and the research facility. However, BT has severe shortcomings compared to MRI for individual GE assessment. Notably, food matrix effects should be considered when interpreting the results of BT.
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Affiliation(s)
- G Camps
- Division of Human Nutrition, Wageningen University & Research, Wageningen, The Netherlands
| | - M Mars
- Division of Human Nutrition, Wageningen University & Research, Wageningen, The Netherlands
| | - B J M Witteman
- Division of Human Nutrition, Wageningen University & Research, Wageningen, The Netherlands.,Department of Gastroenterology, Gelderse Vallei Hospital, Ede, The Netherlands
| | - C de Graaf
- Division of Human Nutrition, Wageningen University & Research, Wageningen, The Netherlands
| | - P A M Smeets
- Division of Human Nutrition, Wageningen University & Research, Wageningen, The Netherlands.,Image Sciences Institute, University Medical Center Utrecht, Utrecht University, CX Utrecht, The Netherlands
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Lasschuijt MP, Mars M, de Graaf C, Smeets PAM. Exacting Responses: Lack of Endocrine Cephalic Phase Responses Upon Oro-Sensory Exposure. Front Endocrinol (Lausanne) 2018; 9:332. [PMID: 29951037 PMCID: PMC6008312 DOI: 10.3389/fendo.2018.00332] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Accepted: 05/31/2018] [Indexed: 11/22/2022] Open
Abstract
Oro-sensory exposure (OSE) to food plays an important role in the regulation of food intake. One proposed underlying mechanism is the occurrence of cephalic phase responses (CPRs). CPRs include the pre-digestive endocrine responses induced by food-related sensory input. Yet, whether OSE duration or sweetness intensity affects CPRs is unknown. The objective of this study was to determine the independent and interactive effects of oro-sensory duration (chewing) and stimulation intensity (sweetness) on endocrine CPRs and satiation. Eighteen males (22 ± 2 years, BMI 22 ± 2 kg/m2) participated in a 2 × 2 randomized study with a control condition. Each session participants performed modified sham feeding (MSF) with one of the four gel-based model foods. During the control session no MSF was performed. Model foods differed in chewing duration (hard or soft texture) and sweetness (low or high intensity). During each session, eight blood samples were collected up till 25 min after MSF onset. Subsequently, food intake from an ad libitum lunch was measured. No typical CPR was found for insulin, pancreatic polypeptide (PP), and ghrelin. However, the overall PP response was 1.1 times greater for the hard sweet MSF condition compared to control (p = 0.02). Overall ghrelin responses were 1.1 times greater for the hard model food compared to the soft model food conditions (p = 0.003). These differences in endocrine response were not associated with differences in food intake at the subsequent meal. Exploratory sub-analysis of the responsive insulin curves showed that after 2.5 min of MSF the hard texture model foods insulin concentrations were 1.2 greater compared to the soft texture. These findings indicate that texture hardness and sweetness increase the overall PP response and that MSF on hard texture increases the overall ghrelin response compared to soft texture model foods. However, MSF on model foods does not lead to a typical CPR. This study, among others, shows that there are major dissimilarities in the endocrine responses to food stimulation between individuals. This emphasizes the importance of considering cephalic responders and non-responders. More research is needed to understand CPRs in relation to food texture and taste properties.
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Affiliation(s)
- Marlou P. Lasschuijt
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, Netherlands
| | - Monica Mars
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, Netherlands
| | - Cees de Graaf
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, Netherlands
| | - Paul A. M. Smeets
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, Netherlands
- Image Sciences Institute, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, Netherlands
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Camps G, Mars M, de Graaf C, Smeets PA. Empty calories and phantom fullness: a randomized trial studying the relative effects of energy density and viscosity on gastric emptying determined by MRI and satiety. Am J Clin Nutr 2016; 104:73-80. [PMID: 27281305 DOI: 10.3945/ajcn.115.129064] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Accepted: 05/04/2016] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Stomach fullness is a determinant of satiety. Although both the viscosity and energy content have been shown to delay gastric emptying, their relative importance is not well understood. OBJECTIVE We compared the relative effects of and interactions between the viscosity and energy density on gastric emptying and perceived satiety. DESIGN A total of 15 healthy men [mean ± SD age: 22.6 ± 2.4 y; body mass index (in kg/m(2)): 22.6 ± 1.8] participated in an experiment with a randomized 2 × 2 crossover design. Participants received dairy-based shakes (500 mL; 50% carbohydrate, 20% protein, and 30% fat) that differed in viscosity (thin and thick) and energy density [100 kcal (corresponding to 0.2 kcal/mL) compared with 500 kcal (corresponding to 1 kcal/mL)]. After ingestion, participants entered an MRI scanner where abdominal scans and oral appetite ratings on a 100-point scale were obtained every 10 min until 90 min after ingestion. From the scans, gastric content volumes were determined. RESULTS Overall, the gastric emptying half-time (GE t50) was 54.7 ± 3.8 min. The thin 100-kcal shake had the lowest GE t50 of 26.5 ± 3.0 min, followed by the thick 100-kcal shake with a GE t50 of 41 ± 3.9 min and the thin 500-kcal shake with a GE t50 of 69.5 ± 5.9 min, and the thick 500-kcal shake had the highest GE t50 of 81.9 ± 8.3 min. With respect to appetite, the thick 100-kcal shake led to higher fullness (58 points at 40 min) than the thin 500-kcal shake (48 points at 40 min). CONCLUSIONS Our results show that increasing the viscosity is less effective than increasing the energy density in slowing gastric emptying. However, the viscosity is more important to increase the perceived fullness. These results underscore the lack of the satiating efficiency of empty calories in quickly ingested drinks such as sodas. The increase in perceived fullness that is due solely to the increased viscosity, which is a phenomenon that we refer to as phantom fullness, may be useful in lowering energy intake. This trial was registered at www.trialregister.nl as NTR4573.
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Affiliation(s)
- Guido Camps
- Division of Human Nutrition, Wageningen University and Research Centre, Wageningen, Netherlands; and
| | - Monica Mars
- Division of Human Nutrition, Wageningen University and Research Centre, Wageningen, Netherlands; and
| | - Cees de Graaf
- Division of Human Nutrition, Wageningen University and Research Centre, Wageningen, Netherlands; and
| | - Paul Am Smeets
- Division of Human Nutrition, Wageningen University and Research Centre, Wageningen, Netherlands; and Image Sciences Institute, University Medical Center Utrecht, Utrecht, Netherlands
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Sustained satiety induced by food foams is independent of energy content, in healthy adults. Appetite 2016; 97:64-71. [DOI: 10.1016/j.appet.2015.11.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Revised: 10/29/2015] [Accepted: 11/20/2015] [Indexed: 11/23/2022]
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Effects of Oral Exposure Duration and Gastric Energy Content on Appetite Ratings and Energy Intake in Lean Men. Nutrients 2016; 8:64. [PMID: 26821045 PMCID: PMC4772028 DOI: 10.3390/nu8020064] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Revised: 01/19/2016] [Accepted: 01/20/2016] [Indexed: 11/16/2022] Open
Abstract
Studies show that longer oral exposure to food leads to earlier satiation and lowers energy intake. Moreover, higher energy content of food has been shown to lead to higher satiety. Up to now, it has not been studied systematically how oral exposure duration and gastric energy content interact in satiety regulation. Thirty-seven men (22 ± 4 years, 22 ± 2 kg/m²) participated in a randomized cross-over trial, in which we independently manipulated: (1) oral exposure duration by modified sham feeding (MSF) for 1 or 8 min; and (2) energy content of gastric load (GL) by a nasogastric tube: 100 kcal/500 mL or 700 kcal/500 mL. Outcome measures were appetite ratings and subsequent energy intake from an ad libitum meal. Energy intake was 35% lower after the GLs with 700 kcal than with 100 kcal (p < 0.0001). All appetite ratings were lower in the 700 kcal than in the 100 kcal treatments (area under the curve (AUC); p-values ≤ 0.002); fullness was higher and prospective consumption was lower in the 8 min than in the 1 min MSF treatments (AUC; p-values ≤ 0.02). In conclusion, the current showed that a GL of 700 kcal/500 mL vs. 100 kcal/500 mL increased satiety and lowered energy intake. No additional effects of oral exposure duration could be observed, presumably due to the high contrast in energy between the manipulations. Future research should also focus on the role of oral exposure as such and not only the duration.
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Ferriday D, Bosworth ML, Lai S, Godinot N, Martin N, Martin AA, Rogers PJ, Brunstrom JM. Effects of eating rate on satiety: A role for episodic memory? Physiol Behav 2015; 152:389-96. [PMID: 26143189 PMCID: PMC4664113 DOI: 10.1016/j.physbeh.2015.06.038] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2015] [Revised: 06/22/2015] [Accepted: 06/28/2015] [Indexed: 11/03/2022]
Abstract
Eating slowly is associated with a lower body mass index. However, the underlying mechanism is poorly understood. Here, our objective was to determine whether eating a meal at a slow rate improves episodic memory for the meal and promotes satiety. Participants (N=40) consumed a 400ml portion of tomato soup at either a fast (1.97ml/s) or a slow (0.50ml/s) rate. Appetite ratings were elicited at baseline and at the end of the meal (satiation). Satiety was assessed using; i) an ad libitum biscuit 'taste test' (3h after the meal) and ii) appetite ratings (collected 2h after the meal and after the ad libitum snack). Finally, to evaluate episodic memory for the meal, participants self-served the volume of soup that they believed they had consumed earlier (portion size memory) and completed a rating of memory 'vividness'. Participants who consumed the soup slowly reported a greater increase in fullness, both at the end of the meal and during the inter-meal interval. However, we found little effect of eating rate on subsequent ad libitum snack intake. Importantly, after 3h, participants who ate the soup slowly remembered eating a larger portion. These findings show that eating slowly promotes self-reported satiation and satiety. For the first time, they also suggest that eating rate influences portion size memory. However, eating slowly did not affect ratings of memory vividness and we found little evidence for a relationship between episodic memory and satiety. Therefore, we are unable to conclude that episodic memory mediates effects of eating rate on satiety.
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Affiliation(s)
- Danielle Ferriday
- Nutrition and Behaviour Unit, School of Experimental Psychology, University of Bristol, UK.
| | - Matthew L Bosworth
- Nutrition and Behaviour Unit, School of Experimental Psychology, University of Bristol, UK
| | - Samantha Lai
- Nutrition and Behaviour Unit, School of Experimental Psychology, University of Bristol, UK
| | - Nicolas Godinot
- Behavior and Perception Group, Nestlé Research Centre, Switzerland
| | - Nathalie Martin
- Behavior and Perception Group, Nestlé Research Centre, Switzerland
| | - Ashley A Martin
- Nutrition and Behaviour Unit, School of Experimental Psychology, University of Bristol, UK
| | - Peter J Rogers
- Nutrition and Behaviour Unit, School of Experimental Psychology, University of Bristol, UK
| | - Jeffrey M Brunstrom
- Nutrition and Behaviour Unit, School of Experimental Psychology, University of Bristol, UK
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