Food essentialism: Implications for expectations and perceptions of the properties of processed foods

Despite the impact of processed foods on health, sustainability, and food security, consumers vary greatly in expectations about and preferences for processed foods. Essentialism is the lay belief that items in a category share a fundamental and immutable essence that generates the category's defining characteristics. Although essentialism may be an important determinant of consumers' cognitions about processed foods, there has been limited investigation of essentialism's role in food-related perceptions. Across two studies (n=598 total), we used a novel measure of food essentialism to examine whether individual differences in beliefs about foods as having essences (food essentialism) are related to perceptions of foods retaining more of their natural characteristics (sensory and nutritive properties) despite their level of processing. Across diverse food categories (meats, vegetables, fruits, legumes, dairy), higher levels of perceived food processing were associated with lower perceived retention of naturalness, nutritiousness, natural taste, functional post-ingestive benefits, and acceptability (liking). However, participants endorsing greater (vs. lower) food essentialism beliefs exhibited weaker relationships between perceived processing and these characteristics. We also observed variations across food categories in relationships between perceived level of processing and food properties, suggesting that some foods (i.e., milk-based products) are perceived to possess essences that are more robust despite undergoing higher levels of processing. These findings demonstrate that food-specific essentialism beliefs may be a fundamental determinant of consumers' expectations of how human intervention, such as processing, affects natural properties of foods. These beliefs may be a promising target for future research to shift consumer acceptance of processed foods.

Unit size influences ad libitum intake in a snacking context via eating rate

Geometric and textural properties of food, like unit size, have previously been shown to influence energy intake. While mechanism(s) driving this effect are unclear, unit size may relate to intake by affecting eating microstructure (e.g., eating rate, bite size). In a randomized crossover study, we investigated relationships between unit size, eating microstructure, and intake. Adults (n = 75, 75% women) consumed an ad libitum snack three times in our laboratory. This snack was a 70-g portion (∼2.5 servings) of one of three sizes of pretzel (small, medium, large). Intake was measured in grams by difference in weight before and after the snack. Each session was video recorded to measure eating microstructure; snack duration (min) and number of bites were annotated and used to calculate mean eating rate (g/min) and mean bite size (g/bite). Results revealed unit size influenced intake (grams and kcal; both p's ≤ 0.001), such that participants consumed 31% and 22% more of the large pretzels (16.9 ± 2.3 g) compared to the small (12.9 ± 2.3 g) and medium sizes (13.8 ± 2.3 g), respectively. Unit size also influenced eating rate and bite size (both p's < 0.001); the largest pretzel size yielded the fastest eating rate and largest mean bite size. Further analysis revealed that after accounting for eating microstructure, the effects of unit size on intake were no longer significant, suggesting eating microstructure was driving these effects. Together, these findings indicate that unit size influences intake by affecting eating microstructure and that food properties like unit size can be leveraged to moderate snack intake.

Sweet and sour sips: No effect of repeated exposure to sweet or sour-tasting sugary drinks on children's sweetness preference and liking

Health agencies advocate reducing children's sweetness exposure to lower sweetness preference or liking to ultimately lower sugar intake. However, the relationship between sweetness exposure, preference, and liking remains unclear. This work investigated the influence of exposure to a sucrose-containing sweet or sour-tasting drink on sweetness preference and liking for sweet and sour products in 4-7-year-old children (n = 65). The children were randomized into three groups with one daily exposure to either the sweet drink, sour drink, or water (control group) for 14 days. Sweetness preference was assessed at baseline (t1), day 15 (t2), and two months after the intervention (t3), using a forced-choice, paired comparison test with five beverages varying in sweetness intensity. Hedonic liking for the intervention drinks, a sweet and sour yogurt, and a sweet and sour candy was evaluated using a 5-point pictorial scale. Linear mixed models revealed a significant increase in sweetness preference from t1 to t3 (F(2) = 7.46, p < 0.001). However, ANCOVA analysis indicated that this effect was not caused by the intervention. Based on linear mixed models, we observed that children's hedonic liking for sweet and sour products remained stable from t1 to t3 and was not influenced by the intervention. These findings suggest that 14 exposures to a sucrose-containing sweet or sour-tasting drink did not affect sweetness preference or liking in 4-7-year-old children.

Comparison of differences in sensory, volatile odour-activity and volatile profile of commercial plant-based meats

Descriptive sensory analysis was paired with temporal check-all-that-apply gas-chromatography olfactometry (TCATA GC-O) to compare differences in perceived flavour and volatile odour activity across a series of commercial plant-based meat analogues (PBMAs) versus conventional beef products. Multiple factor analysis separated PBMAs in two clusters along the first principal axis. The first cluster, rated higher in meaty flavour and odour, also showed higher citation proportions of sulfurous odourants. In contrast, the second cluster, higher in off odour and flavour, had higher citation proportions for fatty / legume odourants. Key odourants correlated with meaty flavour and odour were putatively identified as 2-methyl-3-furanthiol, dimethyl trisulfide, and furfuryl mercaptan while compounds correlated to off flavour and odour were putatively identified as (E,E)-3,5-octadien-2-one, 2-undecanol, and (E,E)-2,4-decadienal. No correspondence was found between PBMA odour-activity and source protein, suggesting that volatile flavour production in PBMAs is derived primarily from exogeneous flavouring materials or precursors rather than the base protein material. Contributions of lipid-protein interactions to overall flavour differences is further suggested by the putative discovery of 5,6-dihydro-2,4,6-trimethyl-4H-1,3,5-dithiazine odour activity in several meat samples profiled.

Perspective: A Research Roadmap about Ultra-Processed Foods and Human Health for the United States Food System: Proceedings from an Interdisciplinary, Multi-Stakeholder Workshop

Our objective was to convene interdisciplinary experts from government, academia, and industry to develop a Research Roadmap to identify research priorities about processed food intake and risk for obesity and cardiometabolic diseases (CMD) among United States populations. We convened attendees at various career stages with diverse viewpoints in the field. We held a "Food Processing Primer" to build foundational knowledge of how and why foods are processed, followed by presentations about how processed foods may affect energy intake, obesity, and CMD risk. Breakout groups discussed potential mechanistic and confounding explanations for associations between processed foods and obesity and CMD risk. Facilitators created research questions (RQs) based on key themes from discussions. Different breakout groups convened to discuss what is known and unknown for each RQ and to develop sub-RQs to address gaps. Workshop attendees focused on ultra-processed foods (UPFs; Nova Group 4) because the preponderance of evidence is based on this classification system. Yet, heterogeneity and subjectivity in UPF classification was a challenge for RQ development. The 6 RQs were: 1) What objective methods or measures could further categorize UPFs, considering food processing, formulation, and the interaction of the two? 2) How can exposure assessment of UPF intake be improved? 3) Does UPF intake influence risk for obesity or CMDs, independent of diet quality? 4) What, if any, attributes of UPFs influence ingestive behavior and contribute to excess energy intake? 5) What, if any, attributes of UPFs contribute to clinically meaningful metabolic responses? 6) What, if any, external environmental factors lead people to consume high amounts of UPFs? Uncertainty and complexity around UPF intake warrant further complementary and interdisciplinary causal, mechanistic, and methodological research related to obesity and CMD risk to understand the utility of applying classification by degree of processing to foods in the United States.

Observations of feeding practices of US parents of young children with Down syndrome

Parental behaviours influence food acceptance in young children, but few studies have measured these behaviours using observational methods, especially among children with Down syndrome (CWDS). The overall goal of this study was to understand parent feeding practices used during snack time with young CWDS (N = 111, aged 11-58 months). A coding scheme was developed to focus on feeding practices used by parents of CWDS from a structured home-use test involving tasting variously textured snack products. Behavioural coding was used to categorise parental feeding practices and quantify their frequencies (N = 212 video feeding sessions). A feeding prompt was coded as successful if the child ate the target food product or completed the prompt within 20 s of the prompt being given without a refusal behaviour. CWDS more frequently consumed the test foods and completed tasks in response to Autonomy-Supportive Prompts to Eat (49.3%), than to Coercive-Controlling Prompts to Eat (24.2%). By exploring the parent-CWDS relationship during feeding, we can identify potentially desirable parent practices to encourage successful feeding for CWDS. Future research should build upon the knowledge gained from this study to confirm longitudinal associations of parent practices with child behaviours during feeding.

The heat is on: Consumers modify their oral processing behavior when eating spicy foods

Food texture properties and consumer characteristics influence oral processing behaviors. Little is known about oral processing behavior of pungent spicy foods. In two experiments, we investigated how adding ground dried chilies to tomato soup or beef patties and curried rice altered oral processing behaviors. In Experiment One, tomato soups differing in concentration of added ground dried chilies (0.01, 0.03, 0.20 or 0.40% w/w) were consumed (n = 23). In Experiment Two, lunch meals that differed in added ground dried chilies consisting of beef patties (0.0, 0.6 or 1.2% w/w) and curried rice (0.0, 0.4 or 1.0% w/w) were consumed (n = 49). Sip/bite sizes were determined using hidden balances. Oral processing behavior was quantified using video recordings followed by post hoc annotations of specific behaviors. When eating tomato soup, increasing oral burn was associated with increasing number of water sips, water intake and total time between sips. For the solid meals (beef patties and curried rice), increasing oral burn was associated with increased time between bites and total sips of water; conversely, total oral exposure time, total number of chews and number of chews per bite all decreased with greater burn. Saliva content and rate of saliva incorporation into the solid food bolus increased with added ground dried chilies while oral exposure time decreased. We conclude consumers adapt their oral processing behaviors to oral burn of solid foods by reducing oro-sensory exposure time, chewing bites less, increasing time between bites, and consuming more water, potentially to mitigate the discomfort associated with the burn imparted by ground dried chilies.

Beyond ultra-processed: considering the future role of food processing in human health

Food-based dietary guidelines have been the basis of public health recommendations for over half a century, but more recently, there has been a trend to classify the health properties of food not by its nutrient composition, but by the degree to which it has been processed. This concept has been supported by many association studies, narrative reviews and the findings from one randomised controlled feeding trial, which demonstrated the sustained effect of ultra-processed diets on increasing both energy intake and body weight. This has led to widespread speculation as to specific features of ultra-processed foods that promote increased energy intakes. Rising interest in the ultra-processed topic has led to proposals to include guidance and restrictions on the consumption of processed foods in national dietary guidelines, with some countries encouraging consumers to avoid highly processed foods completely, and only choose minimally processed foods. However, there remains a lack of consensus on the role of processed foods in human health when faced with the challenges of securing the food supply for a growing global population, that is, healthy, affordable and sustainable. There has also been criticism of the subjective nature of definitions used to differentiate foods by their degree of processing, and there is currently a lack of empirical data to support a clear mechanism by which highly processed foods promote greater energy intakes. Recommendations to avoid all highly processed foods are potentially harmful if they remove affordable sources of nutrients and will be impractical for most when an estimated two-thirds of current energy purchased are from processed or ultra-processed foods. The current review highlights some considerations when interpreting the dietary association studies that link processed food intake to health and offers a critique on some of the mechanisms proposed to explain the link between ultra-processed food and poor health. Recent research suggests a combination of higher energy density and faster meal eating rates are likely to influence meal size and energy intakes from processed foods and offers new perspectives on how to manage this in the future. In going beyond the ultra-processed debate, the aim is to summarise some important considerations when interpreting existing data and identify the important gaps for future research on the role of processed food in health.

Combined effect of eating speed instructions and food texture modification on eating rate, appetite and later food intake

Modifying food texture and eating slowly each reduce appetite and energy intake. No study has evaluated the effect of combining these measures to slow eating speed and determine the effect on appetite. The aim of this study was to investigate whether there is a combined effect of manipulating oral processing behaviours (OPBs) in this manner on self-reported satiety and subsequent food intake. A 2 × 2 design was used with four breakfast conditions in total. Twenty-four participants attended four study visits where they were asked to consume one of two isocaloric fixed-portion breakfasts differing in texture: 1) granola with milk and 2) yogurt with muesli and conserve. Participants consumed each breakfast twice, with verbal instructions to chew slowly at one visit and at a normal rate at another. Consumption was video-recorded to behaviourally code OPBs. Participants completed visual analogue scales of self-reported appetite measures at the beginning of the test session, immediately prior to and immediately after breakfast consumption. They also completed a food diary documenting food intake for the remainder of the day. The breakfast designed to be eaten slowest (the harder-textured meal with instructions to eat slowly) was eaten at a slower rate, with a greater number of chews per bite and a slower bite rate (p < 0.001) compared to the other meals. No differences were observed between the breakfast conditions on subjective measures of post-prandial satiety, or subsequent energy or macronutrient consumption. Results of this study highlight that combined effects of texture and instructions are most effective at reducing eating rate, though eating slower was not shown to enhance post-meal satiety. Reduced eating speed has previously been shown to reduce ad-libitum energy intake. Future research should consider combined approaches to reduce eating speed, to mitigate the risk of overconsumption within meals.

No significant salt or sweet taste preference or sensitivity differences following ad libitum consumption of ultra-processed and unprocessed diets: A randomized controlled pilot study

Ultra-processed food consumption has increased world-wide, yet little is known about the potential links with taste preference and sensitivity. This exploratory study aimed to (i) compare sweet and salty taste detection thresholds and preferences following consumption of ultra-processed and unprocessed diets, (ii) investigate whether sweet and salty taste sensitivity and preference were associated with taste-substrates (i.e. sodium and sugar) and ad libitum nutrient intake, and (iii) examine associations of taste detection thresholds and preferences with blood pressure (BP) and anthropometric measures following consumption of ultra-processed and unprocessed diets. In a randomized crossover study, participants (N=20) received ultra-processed or unprocessed foods for 2 weeks, followed by the alternate diet. Baseline food intake data were collected prior to admission. Taste detection thresholds and preferences were measured at the end of each diet arm. Taste-substrate/nutrient intake, body mass index (BMI), and body weight (BW) were measured daily. No significant differences were observed in participant salt and sweet detection thresholds or preferences after two weeks on ultra-processed or unprocessed diets. There was no significant association between salt and sweet taste detection thresholds, preferences, and nutrient intakes on either diet arm. A positive correlation was observed between salt taste preference and systolic BP (r=0.59; p=0.01), BW (r=0.47, p= 0.04), and BMI (r=0.50; p=0.03) following consumption of the ultra-processed diet. Thus, a two-week consumption of an ultra-processed diet does not appear to acutely impact sweet or salty taste sensitivity or preference..

Associations between oral processing, saliva, and bolus properties on daily glucose excursions amongst people at risk of type-2 diabetes

Background: A greater time spent with glucose above the normal range (TAR) has been associated with poorer glycaemic control amongst pre-diabetic individuals. Individual differences in oral processing behaviours and saliva amylase activity have been shown to influence glucose responses. Objective: The current study is a preliminary exploration of the associations of oral processing behaviours, bolus characteristics, and salivary amylase activity with the variability in daily glucose excursions within a free-living setting in populations with an elevated risk of type-2 diabetes. Method: Participant oral processing behaviour was derived from video recordings while they consumed a test meal. Post-meal bolus characteristics and saliva properties were measured. Participants were fitted with a continuous glucose monitor (CGM) which monitored blood glucose fluctuation over 7 consecutive free-living days. Dietary intake was recorded through a smartphone application and physical activity was monitored using a wrist worn accelerometer. Results: Participants varied in daily time spent with glucose above the normal range (>7.8 mmol l^-1) from 0% to 15%. Greater saliva uptake in the bolus was associated with a higher time spent above the normal range for glucose (β = 0.067 [95% CI = 0.015, 0.120]; p < 0.05), which remained significant after adjustment for dietary carbohydrate intake and BMI. Salivary amylase and saliva flow rate were not significantly associated with the time spent above the normal range. Conclusion: In addition to conventional dietary factors, more research is needed to understand how eating behaviours such as oro-sensory exposure, bolus surface area, and saliva uptake contribute to daily variations in postprandial glucose excursions among populations with a higher risk of developing type-2 diabetes.

Getting hot: Effect of chili pepper addition on sensory perception of liquid and solid foods

The impact of trigeminal oral burn and pungency on taste, flavor, and mouth-feel perception of commercially available foods is underexplored. This study aimed to determine the effect of oral burn sensations evoked by the addition of chili powder to tomato soup, beef burger patties, and curried rice on taste, flavor, and mouth-feel perception. Chili powder was added to tomato soups, beef burger patties, and curried rice at four concentrations. A consumer panel comprising n = 66 participants (49 women, 25.5 ± 5.8 years, BMI 22.9 ± 2.8 kg/m² ) assessed taste, flavor, trigeminal, and mouth-feel intensity of all samples using Rate-All-That-Apply methodology. Food matrix consistency strongly impacted oral burn sensations with solid food matrices (beef burger patties and curried rice) suppressing oral burn intensity compared to liquid food matrices (tomato soup). With increasing oral burn intensity, perceived intensity of beef flavor decreased significantly for beef burger patties. Tomato flavor, sweetness, and sourness intensity decreased significantly with increasing oral burn intensity for tomato soups. Perceived burn intensity of all food matrices and beef flavor intensity of beef burger patties differed between infrequent and frequent chili pepper consumers. We conclude that increasing oral burn intensity by the addition of chili pepper powder led to only small reductions in taste and flavor intensity of tomato soups and to little or no changes in flavor and mouth-feel perception of beef burger patties and curried rice. We suggest that reductions in taste, flavor, and mouth-feel intensity caused by oral burn might be more pronounced in liquid (tomato soup) than solid foods (beef burger patties and curried rice). PRACTICAL APPLICATION: There is a growing public and scientific interest in the development of strategies to increase the sensory appeal of healthy foods and beverages. Incorporation of trigeminal stimuli, such as chili peppers or capsaicin (pungent component of chili peppers), can be a strategy to increase sensory appeal of foods and beverages. Little is known about how trigeminal oral burn and pungency influence taste, flavor, and mouth-feel perception of commercially available foods, although it has been well established that taste, flavor, mouth-feel, and trigeminal sensations contribute to product acceptance. By investigating the sensory impact of oral burn on flavor and mouth-feel perception of foods, this study may help to better understand how trigeminal stimuli can be applied to moderate flavor and mouth-feel perception of foods to optimize sensory appeal.

Longitudinal characterization of determinants associated with obesogenic growth patterns in early childhood

BACKGROUND

Longitudinal assessment of the determinants of obesogenic growth trajectories in childhood can suggest appropriate developmental windows for intervention.

METHODS

Latent class growth mixture modelling was used to identify body mass index (BMI) z-score trajectories from birth to age 6 years in 994 children from a prospective mother-offspring cohort (Chinese, Indian and Malay ethnicities) based in Singapore. We evaluated the early-life determinants of the trajectories as well as their associations with cardiometabolic risk markers at age 6 years.

RESULTS

Five BMI z-score trajectory patterns were identified, three within the healthy weight range, alongside early-acceleration and late-acceleration obesogenic trajectories. The early-acceleration pattern was characterized by elevated fetal abdominal circumference growth velocity, BMI acceleration immediately after birth and crossing of the obesity threshold by age 2 years. The late-acceleration pattern had normal fetal growth and BMI acceleration after infancy, and approached the obesity threshold by age 6 years. Abdominal fat, liver fat, insulin resistance and odds of pre-hypertension/hypertension were elevated in both groups. Indian ethnicity, high pre-pregnancy BMI, high polygenic risk scores for obesity and shorter breastfeeding duration were common risk factors for both groups. Malay ethnicity and low maternal educational attainment were uniquely associated with early BMI acceleration, whereas nulliparity and obesogenic eating behaviours in early childhood were uniquely associated with late BMI acceleration.

CONCLUSION

BMI acceleration starting immediately after birth or after infancy were both linked to early cardiometabolic alterations. The determinants of these trajectories may be useful for developing early risk stratification and intervention approaches to counteract metabolic adversities linked to childhood obesity.

Independent and combined impact of texture manipulation on oral processing behaviours among faster and slower eaters

Background: Food texture can moderate eating rate and ad libitum energy intake. Many foods are combined with condiments when consumed and the texture and eating properties differ considerably between condiments and carrier foods. Little is known about how combinations of textures impact oral processing or whether these differences are affected by individual eating-styles. Objective: We investigated the impact of texture parameters (unit size, thickness, hardness and lubrication) on oral processing behaviours for carrots and rice-crackers, and tested whether these behaviours differ between 'faster' and 'slower' eaters. Method: Seventy participants (34 males, 26.0 ± 5.4 years, BMI = 21.5 ± 1.7 kg m^-2) consumed 24 weight-matched carrot samples varying in unit size (large/medium/small), thickness (thick/thin), hardness (hard/soft) and lubrication (with/without mayonnaise). In a second step, participants consumed 8 weight-matched cracker samples varying in unit size (large/small), hardness (hard/soft) and lubrication (with/without mayonnaise). Sample consumption was video-recorded for post hoc behavioural annotation to derive specific oral processing behaviours. Participants were divided into 'faster' or 'slower' eater groups using a post hoc median split based on eating rate of raw carrot. Results: Across texture parameters, hardness had the largest influence (p < 0.001) on eating rate for both carrots and crackers. The independent texture differences for carrot ranked from most to least impact on eating rate was hardness > thickness > lubrication > unit size. For crackers, the rank order of eating rate was hardness > lubrication > unit size. Harder carrot samples with decreased unit size and reduced thickness combined had a larger synergistic effect in reducing eating rate (p < 0.001) than manipulation of any single texture parameter alone. Reducing the unit size of crackers while increasing hardness without lubrication combined (p = 0.015) to produce the largest reduction in eating rate. There were no significant differences between fast and slow eaters on their oral processing behaviours across texture manipulations. Conclusions: Combinations of texture manipulations have the largest impact in moderating oral processing behaviours, and this is consistent across 'faster' and 'slower' eaters. Changing food-texture presents an effective strategy to guide reformulation of product sensory properties to better regulate eating rate and energy intake, regardless of an individual's natural eating-style.

Influence of oral processing behaviour and bolus properties of brown rice and chickpeas on in vitro starch digestion and postprandial glycaemic response

PURPOSE

Oral processing behaviour may contribute to individual differences in glycaemic response to foods, especially in plant tissue where chewing behaviour can modulate release of starch from the cellular matrix. The aim of this study was to assess the impact of chewing time of two starch based foods (brown rice and chickpeas) on bolus properties, in vitro starch digestion and postprandial glycaemic excursion in healthy subjects.

METHODS

In a cross-over trial participants (n = 26) consumed two carbohydrates-identical test meals (brown rice: 233 g; chickpeas: 323 g) with either long (brown rice: 41 s/bite; chickpeas: 37 s/bite) or short (brown rice: 23 s/bite; chickpeas: 20 s/bite) chewing time in duplicate while glycaemic responses were monitored using a continuous glucose monitoring device. Expectorated boli were collected, then bolus properties (number, mean area, saliva amylase activity) and in vitro starch digestion were determined.

RESULTS

Longer chewing resulted in significantly (p < 0.05) more and smaller bolus particles, higher bolus saliva uptake and higher in vitro degree of intestinal starch hydrolysis (DH_S_{chewing time}%) than shorter chewing for both foods (brown rice: DH_S%_23 s = 84 ± 4% and DH_%S_41s = 90 ± 6%; chickpeas: DH_S%_20 s = 27 ± 3% and DH_%S_37s = 34 ± 5%, p < 0.001). No significant effect of chewing time on glycaemic response (iAUC) (p > 0.05) was found for both meals. Brown rice showed significantly and considerably higher in vitro degree of intestinal starch hydrolysis and glycaemic response (iAUC) than chickpeas regardless of chewing time. No significant correlations were observed between bolus properties and in vitro starch hydrolysis or glycaemic response (p > 0.05).

CONCLUSION

Differences in the innate structure of starch based foods (brown rice compared to chickpeas) have a larger effect on postprandial glucose response than differences in mastication behaviour although oral processing behaviour showed consistent effects on bolus properties and in vitro starch digestion. Trial registration ClinicalTrials.gov identifier: NCT04648397 (First posted: December 1, 2020).

The Importance of Food Processing and Eating Behavior in Promoting Healthy and Sustainable Diets

Numerous association studies and findings from a controlled feeding trial have led to the suggestion that "processed" foods are bad for health. Processing technologies and food formulation are essential for food preservation and provide access to safe, nutritious, affordable, appealing and sustainable foods for millions globally. However, food processing at any level can also cause negative health consequences that result from thermal destruction of vitamins; formation of toxins such as acrylamide; or excessive intakes of salt, sugar, and fat. Research on ultraprocessed foods centers on food composition and formulation. In addition, many modern food formulations can have poor nutritional quality and higher energy density. We outline the role of processing in the provision of a safe and secure food supply and explore the characteristics of processed foods that promote greater energy intake. Despite the potential for negative health effects, food processing and formulation represent an opportunity to apply the latest developments in technology and ingredient innovation to improve the food supply by creating foods that decrease the risk of overeating. Expected final online publication date for the Annual Review of Nutrition, Volume 42 is August 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

Masticatory function after comprehensive dental treatment in children with severe early childhood caries

BACKGROUND

Parents are frequently concerned that their child's mastication may be compromised after comprehensive dental treatment.

AIM

To evaluate changes in masticatory function and food preferences after dental treatment in children with early childhood caries.

DESIGN

This prospective study assessed masticatory function with the (1) mixing ability test using duo-coloured chewing gum and (2) the number of chews/g and time taken to eat six food items before and 3 months after dental treatment. A dental examination and a food preference questionnaire were also completed.

RESULTS

Twenty-five children (age: 4.9 ± 0.5 years, baseline dmft/child: 11.4 ± 4.9) completed the study. The mean number of restorations/child, total extractions/child, and posterior extractions/child was 5.1 ± 2.9, 6.4 ± 5.2, and 3.6 ± 2.3, respectively. The number of chews/g of cereal (p = .014) and popcorn (p = .003) significantly increased after dental treatment. The number of chews/g and duration taken for cereal (chews/g: r = 0.795, p = .000, duration: r = 0.794, p = .000) and peanuts (chews/g: r = 0.459, p = .032) were significantly associated with more extractions. There was no change in mastication function for the other foods, mixing ability score, and child's food preferences after dental treatment.

CONCLUSIONS

An increased number of chews/g is needed for certain hard foods after dental treatment, which was associated with an increased number of total and posterior extractions.

Interrelations Between Food Form, Texture, and Matrix Influence Energy Intake and Metabolic Responses

Purpose of Review

Nutrition often focuses on food composition, yet differences in food form, texture, and matrix influence energy intake and metabolism. This review outlines how these attributes of food impact oral processing, energy intake, and metabolism.

Recent Findings

Food form has a well-established impact on intake, where liquids are consumed more than solids and semi-solids. For solids, texture properties like thickness, hardness, and lubrication, and geometrical properties like size and shape influence oral processing, eating rate, and intake. Food matrix integrity can influence nutrient and energy absorption and is strongly influenced by food processing.

Summary

Food texture and matrix play important roles in modulating energy intake and absorption. Future research needs to consider the often overlooked role of texture and matrix effects on energy and metabolic responses to composite foods and meals. Research is needed to understand how processing impacts macro- and micro-structure of food and its long-term impact on energy balance and health.

Texture-based differences in eating rate influence energy intake for minimally processed and ultra-processed meals

BACKGROUND

Consumption of ultra-processed foods has been linked with higher energy intakes. Food texture is known to influence eating rate (ER) and energy intake to satiation, yet it remains unclear whether food texture influences energy intakes from minimally processed and ultra-processed meals.

OBJECTIVES

We examined the independent and combined effects of food texture and degree of processing on ad libitum food intake. We also investigated whether differences in energy intake during lunch influenced postmeal feelings of satiety and later food intake.

METHODS

In this crossover study, 50 healthy-weight participants [n = 50 (24 men); mean ± SD age: 24.4 ± 3.1 y; BMI: 21.3 ± 1.9 kg/m2] consumed 4 ad libitum lunch meals consisting of "soft minimally processed," "hard minimally processed," "soft ultra-processed," and "hard ultra-processed" components. Meals were matched for total energy served, with some variation in meal energy density (±0.20 kcal/g). Ad libitum food intake (kcal and g) was measured and ER derived using behavioral coding of videos. Subsequent food intake was self-reported by food diary.

RESULTS

There was a main effect of food texture on intake, whereby "hard minimally processed" and "hard ultra-processed" meals were consumed slower overall, produced a 21% and 26% reduction in food weight (g) and energy (kcal) consumed, respectively. Intakes were higher for "soft ultra-processed" and "soft minimally processed" meals (P < 0.001), after correcting for meal pleasantness. The effect of texture on food weight consumed was not influenced by processing levels (weight of food: texture*processing-effect, P = 0.376), but the effect of food texture on energy intake was (energy consumed: texture*processing-effect, P = 0.015). The least energy was consumed from the "hard minimally processed" meal (482.9 kcal; 95% CI: 431.9, 531.0 kcal) and the most from the "soft ultra-processed" meal (789.4 kcal; 95% CI: 725.9, 852.8 kcal; Δ=↓∼300 kcal). Energy intake was lowest when harder texture was combined with the "minimally processed" meals. Total energy intake across the day varied directly with energy intakes of the test meals (Δ15%, P < 0.001).

CONCLUSIONS

Findings suggest that food texture-based differences in ER and meal energy density contribute to observed differences in energy intake between minimally processed and ultra-processed meals.This trial was registered at clinicaltrials.gov as NCT04589221.

Influence of Sensory Properties in Moderating Eating Behaviors and Food Intake

Sensory properties inform likes and dislikes, but also play an important functional role in guiding food choice and intake behavior. Odors direct food choice and stimulate sensory-specific appetites and taste helps to anticipate calorie and nutrient content of food. Food textures moderate eating rate and the energy consumed to satiation and post-ingestive metabolism. We summarize how sensory cues moderate intake, and highlight opportunities to apply sensory approaches to improve dietary behavior. Salt, sweet and savory taste influence liking, but also influence energy intake to fullness, with higher taste intensity and duration linked to lower intake. Psycho-physical studies show it is relatively easy to rank taste intensities at different concentrations but more challenging to discriminate fat contents, and fat discrimination declines further when combined with high-taste intensity. Fat has low impact on sensory intensity, but makes significant contributions to energy content. Combinations of high taste and fat-content can promote passive energy over-consumption, and adding fat also increases energy intake rate (kcals/min), reducing opportunities to orally meter consumption. Consumers adapt their oral processing behaviors to a foods texture, which can influence the rate and extent of energy intake. Understanding how texture influences eating behaviors and bolus formation, affords new opportunities to impact eating rate, energy intake and metabolic response to food. Food formulation has traditionally focused on composition and sensory appeal. Future research needs to consider the role of sensory properties in moderating consumer interaction with their food environment, and how they influence calorie selection, and shape our eating behaviors and intake.

Nutrition research challenges for processed food and health

Existing highly processed food (HPF) classification systems show large differences in the impact of these foods on biochemical risk factors for disease. If public health nutrition is to consider the degree of food processing as an important element of the link between food and health, certain gaps in research must be acknowledged. Quantifying the food additive exposure derived from HPFs is a task made challenging by the lack of data available on the occurrence and concentration of additives in food and the degree to which the natural occurrence of additives in unprocessed foods confounds exposure estimates. The proposed role of HPFs in health outcomes could also be associated with altered nutrient profiles. Differences exist within and between HPF classification systems in this regard and there are conflicting data on the impact of controlling for nutrient intake. Furthermore, research is needed on how the sensory aspects of HPFs contribute to energy intake. Current data suggest that high energy intake rate may be the mechanism linking HPFs and increased energy intake. A high priority now is to clarify the basis of definitions used to categorize foods as highly processed and, in a constructive sense, to distinguish between the contributions of nutrients, additives and sensory properties to health.

Bioequivalence of long-chain omega-3 polyunsaturated fatty acids from foods enriched with a novel vegetable-based omega-3 delivery system compared to gel capsules: a randomized controlled cross-over acute trial

Purpose

To evaluate bioavailability of omega-3 long-chain polyunsaturated fatty acids (LCPUFA) from foods enriched with novel vegetable-based encapsulated algal oil across Australian and Singaporean populations.

Methods

27 men (n = 12 Australian European; n = 15 Singaporean Chinese), 21–50 yr; 18–27.5 kg/m², with low habitual intake of omega-3 LCPUFA completed a multicentre randomised controlled acute 3-way cross-over single-blind trial. They consumed, in random order 1-week apart after an overnight fast, standard breakfast meals including 400 mg docosahexanoic acid (DHA) from either extruded rice snacks or soup both containing cauliflower-encapsulated HiDHA^® algal oil or gel capsules containing HiDHA^® algal oil. Blood samples for analysis of plasma DHA and eicosapentaenoic acid (EPA) were taken pre-meal and after 2, 4, 6, 8 and 24 h. Primary analyses comparing 24-h incremental area under the plasma DHA, EPA and DHA + EPA concentration (µg/ml) curves (iAUC_0-24 h) between test foods were performed using linear mixed models by including ethnicity as an interaction term.

Results

Plasma iAUC_0-24 h did not differ significantly between test foods (adjusted mean [95% CI] plasma DHA + EPA: extruded rice snack, 8391 [5550, 11233] µg/mL*hour; soup, 8862 [6021, 11704] µg/mL*hour; capsules, 11,068 [8226, 13910] µg/mL*hour, P = 0.31) and did not differ significantly between Australian European and Singaporean Chinese (treatment*ethnicity interaction, P = 0.43).

Conclusion

The vegetable-based omega-3 LCPUFA delivery system did not affect bioavailability of omega-3 LCPUFA in healthy young Australian and Singaporean men as assessed after a single meal over 24 h, nor was bioavailability affected by ethnicity. This novel delivery system may be an effective way to fortify foods/beverages with omega-3 LCPUFA.

Trial registration

The trial was registered with clinicaltrials.gov (NCT04610983), date of registration, 22 November 2020.

Supplementary Information

The online version contains supplementary material available at 10.1007/s00394-021-02795-7.

The COVOSMIA-19 trial: Preliminary application of the Singapore smell and taste test to objectively measure smell and taste function with COVID-19

Sudden loss of smell and/or taste has been identified as an early symptom of SARS-CoV-2 2019 (COVID-19) infection, and presents an effective target for prompt self-isolation and reducing community spread. The current study sought to develop and test a novel, rapid, self-administered test to objectively measure smell and taste losses associated with COVID-19, and administered self-report questionnaires to characterise symptoms associated with COVID-19 in Singapore. Participants (N = 99) completed questionnaires to record recent changes in smell and taste ability. This was followed by the ‘Singapore Smell and Taste Test’ (SSTT), a personal, objective testing kit for daily self-assessment of smell and taste function at their place of residence. Seventy-two recruited participants were confirmed as COVID-19 positive at baseline, of which 58 completed the SSTT at home. Of these, 36.2% had objectively measured smell and/or taste loss. The SSTT measures of smell and taste function were positively associated with participants’ self-reported smell and taste acuity, and rated smell intensity of 6 common household items. This study presents the first application of the SSTT as a rapid, cost-effective, objective tool to self-monitor smell and taste function in a residential setting, and ensures comparability across individuals through the use of standardised stimuli. The SSTT has potential for future application in populations with limited access to formal COVID-19 testing as a self-administered objective method to monitor sudden changes in smell and taste, and to prompt early self-isolation, in order to reduce community transmission of COVID-19.

Taste of Modern Diets: The Impact of Food Processing on Nutrient Sensing and Dietary Energy Intake

BACKGROUND

Both fresh and processed foods are available in the modern food environment where taste can signal presence of nutrients. However, whether these taste-nutrient relationships are maintained across different degrees of food processing is not well understood, and less is known about the relative contribution of different taste qualities to population energy intakes.

OBJECTIVES

To investigate the association between perceived intensity of 6 taste modalities and a food's nutrient content in the context of food processing and to further examine the relative contribution of different taste clusters to total energy intakes, stratified by weight status.

METHODS

Diet and lifestyle data from the Singapore Multi-Ethnic Cohort Phase 2 (N = 7011; aged 21-75 y) were collected through interviewer-administrated questionnaires. Taste and nutrient profiles for each of the 269 Singaporean foods were derived using a published taste database and food composition table. Each food was then categorized into the NOVA food-processing classification (unprocessed, processed, ultra-processed) to compare the strength of taste-nutrient relationships. Multivariable-adjusted models were used to examine associations between relative consumption of foods from different taste clusters and processing categories, energy intake, and BMI (in kg/m2) within a population cohort.

RESULTS

Sweet taste and mono- and disaccharide content of foods were significantly associated across all processing categories, although this association was weaker among ultra-processed foods (UPFs) (r = 0.42) than among unprocessed foods (r = 0.72). In contrast, associations between fat sensation and fat content (r = 0.74), as well as salt taste and sodium content (r = 0.84), were stronger for UPFs. Individuals who had higher energy intakes or were overweight (BMI >23) derived significantly greater percentage of energy from processed foods rather than UPFs, and this energy was higher from "savory-fatty" and lower from "neutral" tasting foods than those with lower energy intakes and normal weight (all P < 0.001). Eighty percent of individuals' dietary energy was from both "savory-fatty" and "neutral" foods, independent of differences in total energy intake and weight status.

CONCLUSIONS

Taste-nutrient relationships are maintained across different degrees of food processing. Greater consumption of foods that have a high "savory-fatty" taste was associated with increased energy intakes and overweight in the Asian population.

Unintended Consequences: Nutritional Impact and Potential Pitfalls of Switching from Animal- to Plant-Based Foods

Consumers are shifting towards plant-based diets, driven by both environmental and health reasons. This has led to the development of new plant-based meat alternatives (PBMAs) that are marketed as being sustainable and good for health. However, it remains unclear whether these novel PBMAs to replace animal foods carry the same established nutritional benefits as traditional plant-based diets based on pulses, legumes and vegetables. We modelled a reference omnivore diet using NHANES 2017–2018 data and compared it to diets that substituted animal products in the reference diet with either traditional or novel plant-based foods to create flexitarian, vegetarian and vegan diets matched for calories and macronutrients. With the exception of the traditional vegan diet, all diets with traditional plant-based substitutes met daily requirements for calcium, potassium, magnesium, phosphorus, zinc, iron and Vitamin B12 and were lower in saturated fat, sodium and sugar than the reference diet. Diets based on novel plant-based substitutes were below daily requirements for calcium, potassium, magnesium, zinc and Vitamin B12 and exceeded the reference diet for saturated fat, sodium and sugar. Much of the recent focus has been on protein quality and quantity, but our case study highlights the risk of unintentionally increasing undesirable nutrients while reducing the overall nutrient density of the diet when less healthy plant-based substitutes are selected. Opportunities exist for PBMA producers to enhance the nutrient profile and diversify the format of future plant-based foods that are marketed as healthy, sustainable alternatives to animal-based products.

Evaluation of a child food reward task and its association with maternal feeding practices

Food reward is defined as the momentary value of a food to the individual at the time of ingestion and is characterised by two psychological processes-"liking" and "wanting". We aimed to validate an age-appropriate food reward task to quantify implicit wanting of children from the GUSTO cohort (n = 430). At age 5 years, child appetitive traits and maternal feeding practices were reported by mothers via questionnaires. At age 6, a write-for-food task based on the child's preference for food or toy rewards was undertaken in laboratory conditions. Child BMI and skinfold measurements were taken at age 7. Convergent validity of the food reward task was assessed by associating with child appetitive traits, where enjoyment of food/food responsiveness (OR: 1.51; 95% CI: 1.06, 2.15) and emotional overeating (OR: 1.64; 95% CI: 1.09, 2.48) were positively associated with high food reward in children. Criterion validity was tested by associating with child BMI, however no significant relationships were observed. Multivariable logistic regression analysis with maternal feeding practices revealed that children whose mother tend to restrict unhealthy food (OR: 1.37; 95% CI: 1.03, 1.82) and girls whose mothers taught them about nutrition (OR: 2.09; 95% CI: 1.19, 3.67) were more likely to have high food reward. No further significant associations were observed between food reward, other appetitive traits and feeding practices. Despite the lack of association with child weight status, this study demonstrated the value of the write-for-food task to assess food reward in children and presented sex-specific associations with maternal feeding practices.

Consumption of Foods With Higher Energy Intake Rates is Associated With Greater Energy Intake, Adiposity, and Cardiovascular Risk Factors in Adults

BACKGROUND

Both high energy density and fast eating rates contribute to excess energy intakes. The energy intake rate (EIR; kcal/min) combines both the energy density (kcal/g) and eating rate (g/min) of a food to quantify the typical rate at which calories of different foods are ingested.

OBJECTIVES

We describe the EIRs of diets in a multi-ethnic Asian population, and examine relationships between the consumption of high-EIR foods and total energy intake, body composition, and cardio-metabolic risk factors.

METHODS

Diet and lifestyle data from the Singapore Multi-Ethnic Cohort 2 (n = 7011; 21-75 y), were collected through interviewer-administrated questionnaires. The EIR for each of the 269 foods was calculated as the product of its eating rate and energy density. Multivariable models were used to examine associations between the relative consumption of foods with higher and lower EIRs and energy intake, body composition, and cardio-metabolic risks, after adjusting for age, sex, ethnicity, education level, physical activity, smoking status, and alcohol drinking status.

RESULTS

Individuals with higher daily energy intakes and with obesity consumed a significantly larger percentage of their energy from high-EIR foods, with a smaller relative intake of lower-EIR foods. Individuals with raised serum cholesterol also consumed a significantly higher proportion of high-EIR foods, whereas those without hypertension consumed a larger percentage of energy intake from low-EIR foods. Individuals classified as having a "very high" dietary EIR had a significantly 1.3 kg higher body weight (95% CI, 0.2-1.5; P = 0.013), 0.4 kg/m2 higher BMI (95% CI, 0.03-0.8; P = 0.037), and 1.2 cm larger waist circumference (95% CI, 0.2-2.2; P = 0.010), and were more likely to have abdominal overweight (OR, 1.3; 95% CI, 1.1-1.5; P < 0.001) than those with a "low" dietary EIR.

CONCLUSIONS

Comparing foods by their EIRs summarizes the combined impact of energy density and eating rate, and may identify foods and dietary patterns that are associated with obesogenic eating styles and higher diet-related cardiovascular disease risk in an Asian population.

Children's Eating Behaviors and Energy Intake: Overlapping Influences and Opportunities for Intervention

The transition from risk factors in the first 1,000 days to childhood obesity occurs largely through the development of maladaptive eating behaviors that emerge early, remain stable, and support greater energy intake over time. We have examined the association between eating behaviors, energy intake, and body composition at 4.5 and 6 years of age among children from the GUSTO (Growing Up in Singapore towards Healthy Outcomes) cohort. Our findings demonstrate that when children select larger portions, eat at a faster rate, and continue to eat when sated, they consume more energy than children who do not exhibit these behaviors. We have shown that these behaviors are stable over time and independently predict higher adiposity and BMIz scores at the later time point. We observed that faster eating and greater intakes were associated with parent report measures of appetitive traits, such as the child's satiety responsiveness, food fussiness, and enjoyment of food. Importantly, faster eating rates mediated the link between these appetitive traits and child energy intakes. In addition, within-meal parental feeding practices were linked to a faster eating rate, higher energy intakes, and higher BMIz scores in some children, suggesting that parents are aware of these eating behaviors and likely adapt their feeding practices to influence their child's energy intake. These findings emphasize the need to consider the interaction and cumulative impact of these eating behaviors and parental feeding practices on children's energy intake, and, consequently, the need to develop holistic intervention approaches that target the behaviors that contribute most to a child's risk of developing overweight and obesity.

A Critical Appraisal of the Evidence Supporting Consumer Motivations for Alternative Proteins

Alternative proteins are receiving increased global attention. This burgeoning interest in plants (especially plant-based meat alternatives), insects, algae, and cultured meat has been attributed to their reported health benefits, lower environmental impact and improved animal welfare compared to conventional animal-based meat. Food producers and the media are promoting acceptance of these products, claiming superior nutritional, environmental and ethical credentials and a desirable novel sensory experience. However, the evidence supporting these claims remains unclear. In this review, we summarise the main evidence underlying the nutritional, sensorial, economical, ethical, and environmental reasons reported for the rise in consumer demand for alternative proteins. We found many of these reasons to lack a strong evidence base. For instance, evidence is emerging for the nutritional benefits of plant-based meat alternatives, but present claims are largely based on established evidence for plant-based diets. Significant research gaps remain, especially longitudinal evidence on the sustained effects of replacing conventional animal-based proteins with alternative sources. For many alternative proteins, challenges exist in achieving desirable sensory properties akin to animal-based meat to promote their acceptance by consumers. Overall, fundamental shifts in the food system are required to create a culture in which healthful and sustainable food choices are the norm.

Combined Impact of a Faster Self-Reported Eating Rate and Higher Dietary Energy Intake Rate on Energy Intake and Adiposity

Eating more quickly and consuming foods with a higher energy-intake-rate (EIR: kcal/min) is associated with greater energy intake and adiposity. However, it remains unclear whether individuals who eat more quickly are more likely to consume foods with higher EIR. We investigated the overlap between self-reported eating rate (SRER) and the consumption of higher EIR foods, and their combined impact on daily energy intake and adiposity in a population-based Asian cohort (n = 7011; 21-75y). Food consumption was assessed using a validated Food Frequency Questionnaire. Moderated regression with simple slope analysis was conducted to evaluate whether SRER modified the association between dietary EIR and total dietary energy intakes. Faster eaters consumed a significantly higher proportion of energy from higher EIR foods among overweight individuals, but not among normal-weight individuals. Associations between dietary EIR and total energy intake were stronger among medium (β = 15.04, 95%CI: 13.00-17.08) and fast (β = 15.69, 95%CI: 12.61-18.78) eaters, compared with slower eaters (β = 9.89, 95%CI: 5.11-14.67; p-interaction = 0.032). Higher dietary EIR also tended to be more strongly associated with BMI in fast eaters (β = 0.025, 95%CI: 0.011-0.038) than in slow eaters (β = 0.017, 95%CI: -0.007-0.040). These findings suggest that the combination of eating more quickly and selecting a greater proportion of energy from higher EIR foods (i.e., softly textured, energy dense), promoted higher dietary energy intakes and adiposity.

Associations between Psycho-Hedonic Responses to Sweet and Savoury Tastes with Diet and Body Composition in a Sample of Asian Females

Taste preferences guide food choices and dietary behaviours, yet few studies have shown a relationship between sweet and savoury taste preference and differences in dietary intakes or energy consumed from different "taste clusters". We investigated differences in psycho-hedonic responses to sweet and savoury tastes and their association with energy intake, proportion of energy from macronutrients and energy intake from different "taste clusters". In addition, we evaluated correspondence between two methods to classify "sweet-liker" status and the overlap between sweet and savoury taste preferences. Psycho-hedonic responses to sweet and savoury tastes of female participants (n = 66) were captured via staircase paired preference and the "sweet-liker phenotype" classification method. Quantitative dietary energy and macronutrient intakes were measured using three-day food diary, and the relative contributions of specific taste clusters to energy intake were derived for each participant. All participants completed anthropometric assessments measuring body mass index (BMI) and adiposity. Results showed no association between sweet and savoury preferences with dietary energy or macronutrient intakes, though there was a trend towards higher sweet food consumption among "sweet-likers". A higher preference for savouriness was not associated with differences in daily energy intake, energy intake from protein, BMI or adiposity levels. There was little overlap in sweet and savoury preferences, suggesting a bi-modal split in taste preferences. "Sweet-likers" preferred a higher mean sucrose concentration than sweet "dislikers" (p < 0.001) indicating agreement between the two approaches. Future studies should consider comparing taste-liker differences using food choice tasks to address the current gap between taste preference measures and actual dietary behaviours.

Low subjective socioeconomic status alters taste-based perceptual sensitivity to the energy density of beverages

Lower socioeconomic status (SES) is associated with increased consumption of energy-dense foods and sugar-sweetened beverages. Recent findings suggest that the mere perception of having lower subjective SES (SSES) compared to others was sufficient to elicit heightened preferences and consumption of higher energy foods and meals. This increased drive for energy intake associated with low SSES may be accompanied by heightened perceptual sensitivity to the presence of energy in foods, which may aid discrimination and selection of energy-dense foods. The present study tested this prediction by investigating whether acute experiences of low SSES may produce subsequent shifts in perceptual sensitivity to the energy density of beverages. Participants performed two taste tests on 6 iced tea beverages that varied in energy density prior to (at baseline) and after an experimental SSES manipulation. There were no differences in general frequency of ice tea consumption across the SSES conditions. Results revealed that participants were better at perceiving beverages that were higher in energy to be more energy dense following the low SSES manipulation (compared to baseline evaluations). By contrast, participants in the high SSES and neutral control conditions exhibited no overall consistent change in sensitivity to perceived energy density across the beverages following the manipulation. Additionally, no effects of SSES manipulation were observed for rated palatability of the beverages. These findings demonstrate that subjective experiences of having inadequate socioeconomic resources may produce taste-based perceptual shifts that increase sensitivity to the presence of energy in foods, potentially through heightened attentiveness to or expectations of sensory characteristics that signal energy (i.e., sweetness, texture). Such perceptual shifts may have been adaptive for facilitating the discrimination and selection of energy-dense foods in the face of resource insecurity. Importantly, this study suggests that merely perceiving a socioeconomic disadvantage may enhance identification and consumption of energy-dense foods and beverages, which may represent a psychosocial process that contributes to socioeconomic disparities in consumption of energy dense foods, and may be operational via heightened perceptual sensitivity to sensory cues associated with the presence of energy in the consumed food.

Eating behaviors moderate the associations between risk factors in the first 1000 days and adiposity outcomes at 6 years of age

BACKGROUND

Several risk factors in the first 1000 d are linked with increased obesity risk in later childhood. The role of potentially modifiable eating behaviors in this association is unclear.

OBJECTIVES

This study examined whether the association between cumulated risk factors in the first 1000 d and adiposity at 6 y is moderated by eating behaviors.

METHODS

Participants were 302 children from the GUSTO (Growing Up in Singapore Towards healthy Outcomes) cohort. Risk factors included maternal prepregnancy and paternal overweight, excessive gestational weight gain, raised fasting plasma glucose during pregnancy, short breastfeeding duration, and early introduction of solid foods. Composite risk scores reflecting the prevalence and the importance of the risk factors present were computed. Adiposity outcomes were child BMI and sum of skinfolds (SSF), and candidate eating behavior moderators were portion size, eating rate, and energy intake during lunch and in an eating in the absence of hunger task.

RESULTS

Higher composite risk score predicted higher BMI z scores (B = 0.08; 95% CI: 0.04, 0.13) and larger SSF (0.70 mm; 0.23, 1.18 mm), and was associated with larger self-served food portions (5.03 kcal; 0.47, 9.60 kcal), faster eating rates (0.40 g/min; 0.21, 0.59 g/min), and larger lunch intakes (7.05 kcal; 3.37, 10.74 kcal). Importantly, the association between composite risk score and adiposity was moderated by eating behaviors. The composite risk score was unrelated to SSF in children who selected smaller food portions, ate slower, and consumed less energy, but was positively associated with SSF among children who selected larger food portions, ate faster, and consumed more energy (eating behavior × risk score interactions: P < 0.05).

CONCLUSIONS

The association between risk factors in the first 1000 d and adiposity at 6 y varies by eating behaviors, highlighting modifiable behavioral targets for interventions.This trial was registered at clinicaltrials.gov as NCT01174875.

Ultra-Processing or Oral Processing? A Role for Energy Density and Eating Rate in Moderating Energy Intake from Processed Foods

BACKGROUND

Recent observational data and a controlled in-patient crossover feeding trial show that consumption of "ultra-processed foods" (UPFs), as defined by the NOVA classification system, is associated with higher energy intake, adiposity, and at a population level, higher prevalence of obesity. A drawback of the NOVA classification is the lack of evidence supporting a causal mechanism for why UPFs lead to overconsumption of energy. In a recent study by Hall the energy intake rate in the UPF condition (48 kcal/min) was >50% higher than in the unprocessed condition (31 kcal/min). Extensive empirical evidence has shown the impact that higher energy density has on increasing ad libitum energy intake and body weight. A significant body of research has shown that consuming foods at higher eating rates is related to higher energy intake and a higher prevalence of obesity. Energy density can be combined with eating rate to create a measure of energy intake rate (kcal/min), providing an index of a food's potential to promote increased energy intake.

OBJECTIVE

The current paper compared the association between measured energy intake rate and level of processing as defined by the NOVA classification.

METHODS

Data were pooled from 5 published studies that measured energy intake rates across a total sample of 327 foods.

RESULTS

We show that going from unprocessed, to processed, to UPFs that the average energy intake rate increases from 35.5 ± 4.4, to 53.7 ± 4.3, to 69.4 ± 3.1 kcal/min (P < 0.05). However, within each processing category there is wide variability in the energy intake rate.

CONCLUSIONS

We conclude that reported relations between UPF consumption and obesity should account for differences in energy intake rates when comparing unprocessed and ultra-processed diets. Future research requires well-controlled human feeding trials to establish the causal mechanisms for why certain UPFs can promote higher energy intake.

Rate-All-That-Apply (RATA) comparison of taste profiles for different sweeteners in black tea, chocolate milk, and natural yogurt

Growing health concerns have increased interest in reducing the consumption of added sugars, which can be achieved by substituting or replacing sugar with sweeteners to maintain sensory intensity and quality. The growing availability of sweeteners has increased the complexity of the perceptual landscape as sweeteners differ in the qualitative, intensity, and temporal properties. A sweetener that can match the perceptual properties of sucrose in different food matrices is likely to have broad applications. In complex foods, sweetness is influenced by the taste interactions with the existing tastants and possible matrix effects that influence release and perception of sweetness. The current study compared the taste properties of three food matrices (black tea, chocolate milk, and natural yogurt) sweetened by sucrose to those sweetened using eight different sweeteners (acesulfame-K, aspartame, erythritol, luo han guo (Mogroside), palatinose (iso-maltulose), stevia (Reb-A), sucralose, and sucrose-allulose mixture) using Rate-All-That-Apply. The sensory properties of each sweetener differed across matrices, with sucrose-allulose mixture, aspartame, erythritol, palatinose, and sucralose having the most similar taste to sucrose across all foods. By contrast, acesulfame-K, stevia, and luo han guo had taste profiles that most varied from sucrose, characterized by side tastes such as bitterness, chemical taste, and a low sweetness. Sweeteners differed most from sucrose when presented in natural yogurt compared to tea and chocolate milk. A food's taste properties can suppress sweetness intensity and promote undesirable side tastes. Taken together, these findings highlight the importance of testing sweeteners in complex foods and help identify sweeteners and sweetener combinations that can replicate the sweetness of sucrose and support sugar reduction. PRACTICAL APPLICATION: Food manufacturers and researchers can refer to the results of the sensory profiles to identify suitable sweeteners substitutes for sucrose in foods with similar taste profiles to those tested. The current article highlights important changes to sweetener sensory properties when presented in different complex foods, and provides an indication of the potential for calorie reduction by substituting sucrose with a range of low or no calorie sweeteners.

The contribution of texture contrasts and combinations to food acceptance across cultures

Texture has long been considered an important attribute for food acceptance. However, which specific textural characteristics contribute to overall acceptance of a food is not well understood. It has been suggested that texture contrasts and combinations are a universal feature in giving foods a desirable texture, yet this notion is largely based upon anecdotal data. This study uses multiple survey research methods to assess the importance of texture contrast and combinations across cultures (Poland, U.S.A., and Singapore). Participants (N = 288) completed a survey that included overt measures of food texture contrast importance as well as free response questions regarding texture. The overall importance of texture for food liking was not different across the populations. However, the participants from Singapore and Poland gave more importance to a desirable food having multiple textures than the U.S.A. cohort. When looking at free responses, participants were twice as likely to mention combinations (multiple textures) with a texture contrast when describing foods they liked, in comparison to foods they disliked. This was observed across all three cultures. However, the type and quantity of texture terms used within combinations were different among cultures. For instance, Singaporeans enjoyed more texturally diverse food combinations than the other two cultures. These findings highlight the importance of texture contrasts and combinations in three distinct cultures.

Basal Metabolic Rate and Body Composition Predict Habitual Food and Macronutrient Intakes: Gender Differences

The underlying mechanisms that regulate energy homeostasis and food intake are not fully understood. Moreover, little research has been performed on the relation of body composition with habitual macronutrient intake among free-living populations. Since body composition and energy metabolism differ between males and females, we aimed to determine whether the relationship between body composition and habitual macronutrient intakes is gender-dependent. In this cross-sectional study, 261 participants (99 males) were recruited from Singapore. Macronutrient intake was evaluated from a three-day self-reported dietary record. Body composition and basal metabolic rate (BMR) were determined by using dual-energy X-ray absorptiometry (DEXA) and indirect calorimetry, respectively. Our results show that both BMR (p < 0.001) and lean body mass (LBM, p < 0.001) predicted daily energy intake (EI). LBM was positively associated with intakes of protein (PRO) and fat (FAT) in females, but not in males. This relationship persisted even after adjustment for fat mass (FM). On the other hand, no significant associations between FM and macronutrient intake were observed in both males and females. Therefore, the relationship between habitual macronutrient intake, LBM, and BMR is gender-dependent. Elucidating the gender differences in energy metabolism is important for understanding the factors that regulate energy homeostasis and can subsequently help better manage energy balance.

Taste sensitivities and diet of Chinese and Indians in Singapore

BACKGROUND AND OBJECTIVES

Taste perception plays a key role in consumer acceptance and food choice, which has an important impact on human health. Our aim was to examine the relationship between recognition thresholds for five basic tastes (sweet, salty, sour, bitter, and umami) in Chinese and Indians in relation to their dietary intake.

METHODS AND STUDY DESIGN

This cross-sectional study included 114 subjects (60 Chinese, 54 Indians). Taste thresholds were determined using a forced choice method and dietary intakes were assessed using an estimated three-day food diary.

RESULTS

Indians had significantly higher recognition thresholds for sweet, salty, sour, umami and bitter tastes compared to Chinese (all p0.047). Overall energy intake was not significantly different between the Chinese and Indians. Correlations between taste and diet between the Chinese and Indians were not significant (p>0.05).

CONCLUSION

Future work is needed to further understand how differences in taste perception may influence dietary intakes between ethnic groups.

Taste perception and diet in people of Chinese ancestry

BACKGROUND AND OBJECTIVES

Taste perception plays a key role in consumer acceptance and food choice, which has an important impact on human health. Our aim was to examine the relationship between taste intensities and preferences of sweet (sucrose), salty (sodium chloride and potassium chloride), sour (citric acid), and bitter (quinine and phenylthiocarbamide) in relation to dietary intake and dietary patterns in people of Chinese ancestry.

METHODS AND STUDY DESIGN

This cross-sectional study included 100 adult Singaporean Chinese (50 women). A validated taste methodology was used with taste solutions provided by Monell Chemical Senses Center. Dietary intake and patterns were assessed by dietary recalls.

RESULTS

There was little relationship between taste intensity and tastant preference in regard to background dietary intake or pattern. Tastant differentiation was reliable, but there was some confusion in regard to the rating of saltiness as sourness.

CONCLUSIONS

There was a salty-sour confusion among Singaporean Chinese unlike the bitter-sour confusion reported for Caucasians. Most sodium came from sauces and was added during food preparation. In programs to address sodium: potassium ratio excess among Chinese prone to hypertension and stroke, sour as well as salty taste may need to be considered.

Correlation of instrumental texture properties from textural profile analysis (TPA) with eating behaviours and macronutrient composition for a wide range of solid foods

Faster eating rates have previously been associated with higher ad libitum energy intakes, and several studies have manipulated eating rates and intake by changing food textures. Food texture based changes to slow eating rates can produce reductions in energy intake without affecting post-meal satisfaction or re-bound hunger. However, an understanding of how specific food textures and instrumental texture properties influence oral processing behaviour remains limited. The current study sought to establish relationships between objective measures of oral processing behaviour (i.e. number of bites, average bite size, total chews, chews per bite, oro-sensory exposure time and eating rate) and instrumental measures of a food texture including hardness, adhesiveness, springiness, cohesiveness, chewiness, resilience and modulus. Across two studies, behavioural coding analysis was completed on video-recordings of participants consuming fixed portions of a wide range of different solid foods (n = 59) to derive objective measures of oral processing behaviours. These measures were correlated with instrumental Textural Profile Analysis (TPA) for the same set of foods. Significant correlations (p < 0.05) were found between oral processing parameters and texture properties (i.e. springiness, cohesiveness, chewiness and resilience). No significant correlations were found between hardness and modulus and oral processing parameters. Protein content of the food was associated with springiness and chewiness, which may help to further reduce eating rates. In terms of the 'breakdown path model', hardness and modulus might represent degree of initial food structure while springiness, cohesiveness, chewiness and resilience seem to determine how fast the degree of structure is reduced to the swallowing plane. Water content and adhesiveness were associated with level of lubrication that is required before reaching the swallowing plane. The current study highlights opportunities to understand eating rate (g min-1) through the breakdown path model and the potential for specific features of a foods texture to influence rate and extent of energy intake. The correlation between instrumental texture properties and oral processing patterns provides guidance on the parameters that are likely to produce 'faster' and 'slower' versions of foods, and suggests how texture modifications could be applied to moderate eating rate and energy intake within meals.

Eating in the absence of hunger: Stability over time and associations with eating behaviours and body composition in children

BACKGROUND/OBJECTIVES

Eating in the absence of hunger (EAH) has been linked to obesity in adults and children. This study examined the stability of EAH in children between 4.5 and 6 years old, and associations with energy intake and portion selection, as well as cross-sectional and prospective associations with body composition.

METHODS

The participants were 158 boys and girls from the Growing Up in Singapore Towards healthy Outcomes cohort. At ages 4.5 and 6 years old children were provided lunch ad libitum, and immediately afterwards were exposed to palatable snacks to measure energy intake in the absence of hunger. At age 6 children completed an additional computer-based task to measure ideal portion size, where they selected pictures of the portions they would like to eat across eight foods. Measures of anthropometry (height/weight/skinfolds) were collected at both ages.

RESULTS

Children who consumed energy during the EAH task at age 4.5 years were 3 times more likely to also do so at age 6 years. Children with high EAH intakes at age 4.5 years had high EAH intakes at age 6, highlighting stability of this behaviour over time. Energy consumed at lunch was unrelated to energy consumed during the EAH task, but children who ate in the absence of hunger cumulatively consumed more energy over lunch and the EAH task. Children who showed EAH tended to select larger ideal portions of foods during the computer task. EAH was not associated with measures of body composition.

CONCLUSIONS

EAH is a stable behavioural risk factor for increased energy intake, but was not associated with body composition in this cohort. The majority of children ate in the absence of hunger, suggesting that interventions aimed at reducing responsiveness to external food cues could help to reduce energy intakes. Trial Registry Number: NCT01174875; https://clinicaltrials.gov/.

Prospective associations between parental feeding practices and children's oral processing behaviours

Previous research demonstrated that faster eating rates are linked with increased intake of energy during a meal. Here, we examined whether within-meal parental feeding practices show cross-sectional and prospective associations with children's oral processing behaviours and whether the previously demonstrated association between faster eating rates and higher energy intakes varies by parental feeding practices. A subset (n = 155) of children and their mothers from the Growing Up in Singapore Towards healthy Outcomes cohort participated in an ad libitum meal at age 4.5 years. Children's oral processing behaviours (eating rate, bite size, chews per gram, oral exposure time, and meal duration) and parental feeding practices (autonomy-supporting and coercive prompts, restrictions, hurrying, and slowing) were recorded during the meal. Subsequently, 94 of the children participated in a follow-up meal without their mothers at age 6 years. Parental feeding practices were not consistently associated with child oral processing behaviours overall. However, exploratory post hoc analyses revealed some sex differences. The mothers of girls with faster eating rates, larger bite sizes, and fewer chews were more likely to use hurrying, slowing, and restrictions, but similar associations were not observed among boys. Children who had the most problematic eating style and were eating fast and for long experienced more restrictions, instructions to slow down, and prompts. Faster eating rates were linked with the highest energy intakes if children were additionally prompted to eat. Prospective analyses showed that children who were more often prompted using coercive techniques and less frequently hurried at age 4.5 years had faster eating rates at 6 years and a larger increase in eating rates between ages 4.5 and 6 years but did not consume more energy. Although the direction of these associations cannot be assumed, these exploratory analyses suggest sex differences in the associations between feeding practices and oral processing behaviours and highlight the potential role of parents in the development of children's oral processing behaviours.