Macronutrient intake and inadequacies of community-dwelling older adults, a systematic review
Borg, S.J. ter; Verlaan, S. ; Mijnarends, D. ; Schols, J.M.G.A. ; Groot, C.P.G.M. de; Luiking, Y.C. - \ 2015
Annals of Nutrition & Metabolism 66 (2015)4. - ISSN 0250-6807 - p. 242 - 255.
dietary-protein intake - dependent elderly population - nutritional-status - cognitive function - physical-activity - food-consumption - body-composition - energy-intake - people - health
Background: Anorexia of ageing may predispose older adults to under-nutrition and protein energy malnutrition. Studies, however, report a large variation in nutrient inadequacies among community-dwelling older adults. Summary: This systematic review provides a comprehensive overview of the energy and macronutrient intakes and possible inadequacies in community-dwelling older adults. PubMed and EMBASE were screened up to December 2013; data from national nutrition surveys were added. Forty-six studies were included, following the PRISMA guideline. Key Messages: Mean daily energy intake was 8.9 MJ in men and 7.3 MJ in women. Mean daily carbohydrate and protein intakes were 46 and 15 En% in men and 47 and 16 En% in women, respectively. Mean daily total fat, saturated fatty acid (SFA), mono-unsaturated fatty acid (MUFA) and poly-unsaturated fatty acid intakes were respectively 34, 13, 13 and 5-6 En%. The carbohydrates and MUFA intakes are below the acceptable macronutrient distribution ranges (AMDR). Fat intake is relatively high, and SFA intake exceeds the upper-AMDR. Based on the estimated average requirement (EAR) cut-point method, 10-12% of older adults do not meet the EAR for protein. To interpret a possible energy imbalance additional information is needed on physical activity, energy expenditure and body weight changes. This systematic review indicates a suboptimal dietary macronutrient distribution and a large variation in nutrient intakes among community-dwelling older adults.
Micronutrient intakes and potential inadequacies of community-dwelling older adults: a systematic review
Borg, S. ter; Verlaan, S. ; Hemsworth, J. ; Mijnarends, D. ; Schols, J.M.G.A. ; Luiking, Y.C. ; Groot, C.P.G.M. de - \ 2015
The British journal of nutrition 113 (2015)8. - ISSN 0007-1145 - p. 1195 - 1206.
vitamin-d status - elderly-people - cognitive function - dietary assessment - nutritional-status - nutrient intake - food-consumption - intake adequacy - united-states - energy-intake
Micronutrient deficiencies and low dietary intakes among community-dwelling older adults are associated with functional decline, frailty and difficulties with independent living. As such, studies that seek to understand the types and magnitude of potential dietary inadequacies might be beneficial for guiding future interventions. We carried out a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Observational cohort and longitudinal studies presenting the habitual dietary intakes of older adults ( = 65 years) were included. Sex-specific mean (and standard deviation) habitual micronutrient intakes were extracted from each article to calculate the percentage of older people who were at risk for inadequate micronutrient intakes using the estimated average requirement (EAR) cut-point method. The percentage at risk for inadequate micronutrient intakes from habitual dietary intakes was calculated for twenty micronutrients. A total of thirty-seven articles were included in the pooled systematic analysis. Of the twenty nutrients analysed, six were considered a possible public health concern: vitamin D, thiamin, riboflavin, Ca, Mg and Se. The extent to which these apparent inadequacies are relevant depends on dynamic factors, including absorption and utilisation, vitamin and mineral supplement use, dietary assessment methods and the selection of the reference value. In light of these considerations, the present review provides insight into the type and magnitude of vitamin and mineral inadequacies.
Ileal brake activation: macronutrient-specific effects on eating behavior?
Avesaat, M. van; Troost, F.J. ; Ripken, D. ; Hendriks, H.F. ; Masclee, A.A.M. - \ 2015
International Journal of Obesity 39 (2015). - ISSN 0307-0565 - p. 235 - 243.
glucagon-like peptide-1 - food-intake - hormone-release - energy-intake - antropyloroduodenal motility - gastrointestinal hormones - intestinal motility - duodenal glucose - plasma-levels - healthy-men
Background:Activation of the ileal brake, by infusing lipid directly into the distal part of the small intestine, alters gastrointestinal (GI) motility and inhibits food intake. The ileal brake effect on eating behavior of the other macronutrients is currently unknown.Objective:The objective of this study was to investigate the effects of ileal infusion of sucrose and casein on food intake, release of GI peptides, gastric emptying rate and small-bowel transit time with safflower oil as positive control.Design:This randomized, single-blind, crossover study was performed in 13 healthy subjects (6 male; mean age 26.4±2.9 years; mean body mass index 22.8±0.4¿kg¿m-2) who were intubated with a naso-ileal catheter. Thirty minutes after the intake of a standardized breakfast, participants received an ileal infusion, containing control ((C) saline), safflower oil ((HL) 51.7¿kcal), low-dose casein ((LP) 17.2¿kcal) or high-dose casein ((HP) 51.7¿kcal), low-dose sucrose ((LC) 17.2¿kcal) and high-dose sucrose ((HC) 51.7¿kcal), over a period of 90¿min. Food intake was determined during an ad libitum meal. Visual analogue score questionnaires for hunger and satiety and blood samples were collected at regular intervals.Results:Ileal infusion of lipid, protein and carbohydrate resulted in a significant reduction in food intake compared with control (HL: 464.3±90.7¿kcal, P
How do I look? Focusing attention on the outside body reduces responsiveness to internal signals in food intake
Veer, E. van de; Herpen, E. van; Trijp, J.C.M. van - \ 2015
Journal of Experimental Social Psychology 56 (2015). - ISSN 0022-1031 - p. 207 - 213.
womens self-objectification - thin media images - energy-intake - normal-weight - college-women - portion size - meal intake - awareness - compensation - appearance
The current study investigates the relationship between focusing on body appearance and the ability to adjust food consumption according to feelings of satiety. Based on a resource perspective, we propose that focusing on outward appearance negatively affects people's ability to respond to satiety signals. Specifically, we argue that focusing on appearance takes up attentional resources required for sensing and relying on physiological satiety cues in food consumption. The findings of two experiments support this and show that focusing on appearance through a short mirror exposure (Experiment 1) or by looking at advertisements of models (Experiment 2) interferes with people's ability to compensate for previous consumption (Experiment 1) and leads them to rely less on satiety signals in their eating behavior (Experiment 2). These findings suggest that an emphasis on outer body appearance reduces people's reliance on satiety cues.
PortionControl@HOME: Results of a Randomized Controlled Trial Evaluating the Effect of a Multi-Component Portion Size Intervention on Portion Control Behavior and Body Mass Index
Poelman, M.P. ; Vet, E. de; Velema, E. ; Boer, M.R. de; Seidell, J.C. ; Steenhuis, I.H.M. - \ 2015
Annals of behavioral medicine 49 (2015)1. - ISSN 0883-6612 - p. 18 - 28.
energy-intake - food-intake - consumption volume - relapse prevention - obesity epidemic - college-students - young-adults - impact - maintenance - consumers
Background Food portion sizes influence energy intake. Purpose The purpose of this paper is to determine effectiveness of the “PortionControl@HOME” intervention on body mass index and portion control behavior. Methods A randomized controlled trial among 278 overweight and obese participants was conducted. PortionControl@HOME aimed to increase: portion size awareness, portion control behavior, portion control cooking skills, and to create a home environment favoring portion control. Results Intention-to-treat multi-level regression analysis indicated statistically significant effects of the intervention on portion control behavior at 3, 6, and 12 months follow-up. The effect on body mass index was significant only at 3 months follow-up and when outliers (n¿=¿3) were excluded (B¿=¿-0.45; 95 %CI¿=¿-0.88 to -0.04). The intervention effect on body mass index was mediated by portion control behavior. Conclusions The intervention improves portion control behavior, which in turn influence body mass index. Once the intervention ceased, sustained effects on body mass index were no longer evident. (Current-Controlled-Trials ISRCTN12363482).
Differential effects of proteins and carbohydrates on postprandial blood pressure-related responses
Teunissen-Beekman, K.F.M. ; Dopheide, J. ; Geleijnse, J.M. ; Bakker, S.J.L. ; Brink, E.J. ; Leeuw, P.W. de; Serroyen, J. ; Baak, M.A. van - \ 2014
The British journal of nutrition 112 (2014)4. - ISSN 0007-1145 - p. 600 - 608.
randomized controlled-trials - plasma amino-acids - healthy-subjects - insulin responses - dietary-protein - overweight adults - energy-intake - whey-protein - glucose - fructose
Diet composition may affect blood pressure (BP), but the mechanisms are unclear. The aim of the present study was to compare postprandial BP-related responses to the ingestion of pea protein, milk protein and egg-white protein. In addition, postprandial BP-related responses to the ingestion of maltodextrin were compared with those to the ingestion of sucrose and a protein mix. We hypothesised that lower postprandial total peripheral resistance (TPR) and BP levels would be accompanied by higher plasma concentrations of nitric oxide, insulin, glucagon-like peptide 1 (GLP-1) and glucagon. On separate occasions, six meals were tested in a randomised order in forty-eight overweight or obese adults with untreated elevated BP. Postprandial responses of TPR, BP and plasma concentrations of insulin, glucagon, GLP-1 and nitrite, nitroso compounds (RXNO) and S-nitrosothiols (NOx) were measured for 4 h. No differences were observed in TPR responses. Postprandial BP levels were higher after the ingestion of the egg-white-protein meal than after that of meals containing the other two proteins (P
Taste matters-effects of bypassing oral stimulation on hormone and appetite responses
Spetter, M.S. ; Mars, M. ; Viergever, M.A. ; Graaf, C. de; Smeets, P.A.M. - \ 2014
Physiology and Behavior 137 (2014). - ISSN 0031-9384 - p. 9 - 17.
cephalic phase responses - placebo-controlled trial - sensory-specific satiety - plasma ghrelin levels - food-intake - eating behavior - short-term - circulating ghrelin - energy-intake - c-peptide
The interaction between oral and gastric signals is an important part of food intake regulation. Previous studies suggest that bypassing oral stimulation diminishes the suppression of hunger and increases gastric emptying rate. However, the role of appetite hormones, like cholecystokinin-8 and ghrelin, in this process is still unclear. Our objective was to determine the contributions of gastric and oral stimulation to subsequent appetite and hormone responses and their effect on ad libitum intake. Fourteen healthy male subjects (age 24.6 ± 3.8y, BMI 22.3 ± 1.6 kg/m2) completed a randomized, single-blinded, cross-over experiment with 3 treatment-sessions: 1) Stomach distention: naso-gastric infusion of 500 mL/0 kJ water, 2) Stomach distention with caloric content: naso-gastric infusion of 500 mL/1770 kJ chocolate milk, and 3) Stomach distention with caloric content and oral exposure: oral administration of 500 mL/1770 kJ chocolate milk. Changes in appetite ratings and plasma glucose, insulin, cholecystokinin-8, and active and total ghrelin concentrations were measured at fixed time-points up to 30 min after infusion or oral administration. Subsequently, subjects consumed an ad libitum buffet meal. Oral administration reduced appetite ratings more than both naso-gastric infusions (P <0.0001). Gastric infusion of a caloric load increased insulin and cholecystokinin-8 and decreased total ghrelin concentrations more than ingestion (all P <0.0001). No differences in active ghrelin response were observed between conditions. Ad libitum intake did not differ between oral and gastric administration of chocolate milk (P > 0.05). Thus, gastric infusion of nutrients induces greater appetite hormone responses than ingestion does. These data provide novel and additional evidence that bypassing oral stimulation not only affects the appetite profile but also increases anorexigenic hormone responses, probably driven in part by faster gastric emptying. This confirms the idea that learned associations between sensory characteristics and associated metabolic consequences serve to adapt hormone responses to nutrient content. These findings underscore the importance of oral stimulation in the regulation of food intake.
Human protein status modulates brain reward responses to food cues1–3
Griffioen-Roose, S. ; Smeets, P.A.M. ; Heuvel, E.M. van den; Boesveldt, S. ; Finlayson, G. ; Graaf, C. de - \ 2014
American Journal of Clinical Nutrition 100 (2014)1. - ISSN 0002-9165 - p. 113 - 122.
leverage hypothesis - energy-intake - taste - breakfast - appetite - satiety - carbohydrate - mechanisms - receptors - choice
Background: Protein is indispensable in the human diet, and its intake appears tightly regulated. The role of sensory attributes of foods in protein intake regulation is far from clear. Objective: We investigated the effect of human protein status on neural responses to different food cues with the use of functional magnetic resonance imaging (fMRI). The food cues varied by taste category (sweet compared with savory) and protein content (low compared with high). In addition, food preferences and intakes were measured. Design: We used a randomized crossover design whereby 23 healthy women [mean SD age: 22 +/- 2 y; mean +/- SD body mass index (in kg/m(2)): 22.5 +/- 1.8] followed two 16-d fully controlled dietary interventions involving consumption of either a low-protein diet (0.6 g protein center dot kg body weight(-1) center dot d(-1), similar to 7% of energy derived from protein, approximately half the normal protein intake) or a high-protein diet (2.2 g protein center dot kg body weight(-1) center dot d(-1), similar to 25% of energy, approximately twice the normal intake). On the last day of the interventions, blood oxygen level-dependent (BOLD) responses to odor and visual food cues were measured by using fMRI. The 2 interventions were followed by a 1 -d ad libitum phase, during which a large array of food items was available and preference and intake were measured. Results: When exposed to food cues (relative to the control condition), the BOLD response was higher in reward-related areas (orbitofrontal cortex, striatum) in a low-protein state than in a high-protein state. Specifically, BOLD was higher in the inferior orbitofrontal cortex in response to savory food cues. In contrast, the protein content of the food cues did not modulate the BOLD response. A low protein state also increased preferences for savory food cues and increased protein intake in the ad libitum phase as compared with a high-protein state. Conclusions: Protein status modulates brain responses in reward regions to savory food cues. These novel findings suggest that dietary protein status affects taste category preferences, which could play an important role in the regulation of protein intake in humans. This trial was registered at www.trialregister.nl/trialreg/admin/rctview.asp?TC=3288 as NTR3288.
The unit size effect of indulgent food: How eating smaller sized items signals impulsivity and makes consumers eat less
Kleef, E. van; Kavvouris, C. ; Trijp, J.C.M. van - \ 2014
Psychology and Health 29 (2014)9. - ISSN 0887-0446 - p. 1081 - 1103.
portion size - energy-intake - self-control - item sizes - consumption - children - decrease - obesity - cues - behavior
In deciding how much to eat, people are influenced by environmental cues. The unit size of food (i.e. the number of units in which a given amount of food is divided) provides such a cue. Previous research showed that given equal caloric and volumetric content, smaller units of food tend to reduce food consumption. We propose that the unit size of food impacts intake as it influences perceptions of impulsiveness and appropriateness. Our analysis is based on three experimental studies, all employing between subject designs. When consuming similar amounts of chocolates in studies 1 (n¿=¿118) and 2 (n¿=¿124), both studies show that consumption of five small units of chocolates is considered to be more impulsive, excessive and less appropriate than consuming one large unit of chocolate. Results of a third study (n¿=¿165) indicate that about 23% less chocolate is eaten when it is presented in small unit size vs. a large unit size and this effect is mediated by perceptions of impulsivity. All three studies suggest that perceptions of impulsivity and excess eating while eating several smaller units of food compared to one large unit might be a key factor explaining consumption effects in earlier studies on this bias.
Both a higher number of sips and a longer oral transit time reduce ad libitum intake
Bolhuis, D.P. ; Lakemond, C.M.M. ; Wijk, R.A. de; Luning, P.A. ; Graaf, C. de - \ 2014
Food Quality and Preference 32 (2014)Part C. - ISSN 0950-3293 - p. 234 - 240.
food-intake - energy-intake - young-adults - eating rate - bite size - body-weight - appetite - consumption - satiety - meal
Background - A higher eating rate leads to a higher food intake, possibly through shorter orosensory exposure to food. The transit time in the oral cavity and the number of bites or sips per gram (inversely related to bite or sip size) are main contributors that affect eating rate. The separate role of these two aspects on satiation and on orosensory exposure needs further clarification. Objective - The objective of the first study was to investigate contributions of the number of sips per gram (sips/g) and oral transit time per gram (s/g) on ad libitum intake. The objective of the second study was to investigate both aspects on the total magnitude of orosensory exposure per gram food. Methods - In study 1, 56 healthy male subjects consumed soup where the number of sips and oral transit time differed by a factor three respectively: 6.7 vs. 20 sips/100 g, and 20 vs. 60 s/100 g (2 × 2 cross-over design). Eating rate of 60 g/min was kept constant. In study 2, the effects of number of sips and oral transit time (equal as in study 1) on the total magnitude of orosensory exposure per gram soup were measured by time intensity functions by 22 different healthy subjects. Results - Higher number of sips and longer oral transit time reduced ad libitum intake by respectively ~22% (F(1, 157) = 55.9, P <0.001) and ~8% (F(1, 157) = 7.4, P = 0.007). Higher number of sips led to faster increase in fullness per gram food (F(1, 157) = 24.1, P <0.001) (study 1). Higher number of sips and longer oral transit time both increased the orosensory exposure per gram food (F(1, 63) = 23.8, P <0.001) and (F(1, 63) = 19.0, P <0.001), respectively (study 2). Conclusion - Higher number of sips and longer oral transit time reduced food intake, possibly through the increased the orosensory exposure per gram food. Designing foods that will be consumed with small sips or bites and long oral transit time may be effective in reducing energy intake.
Behavioural strategies to control the amount of food selected and consumed
Poelman, M.P. ; Vet, E.W.M.L. de; Velema, E. ; Seidell, J.C. ; Steenhuis, I.H.M. - \ 2014
Appetite 72 (2014). - ISSN 0195-6663 - p. 156 - 165.
weight-control behaviors - portion size - energy-intake - obesity epidemic - healthy women - young-adults - older-adults - meal intake - consumption - television
Several factors within the food environment may stimulate overconsumption. The present study aimed to (1) identify behavioural strategies to cope with this environment to control the amount of food consumed, (2) examine the feasibility and usefulness of the strategies, and (3) evaluate the association between the strategies and body mass index (BMI). After the literature was screened for evidence of factors that contribute to the consumption of large amounts of food, 32 behavioural strategies were identified to overcome these influences (study 1). Subjectively reported feasibility and usefulness of the 32 behavioural strategies in weight management were explored using a pretest post-test study (study 2: n = 52). Additionally, two cross-sectional questionnaire studies (study 3a: n = 120 and study 3b: n = 278) were conducted to evaluate the association between the 32 behavioural strategies and BMI. The strategies were subjectively reported as feasible and useful in weight management. Frequent use of strategies discriminated non-overweight from overweight individuals, but did not discriminate overweight from obese individuals. In conclusion, the findings provided preliminary evidence for the acceptability and validity of the strategies. The effectiveness of the strategies for controlling the amount consumed should be further investigated, especially in overweight and obese participants.
Texture and savoury taste influences on food intake in a realistic hot lunch time meal
Forde, C.G. ; Kuijk, N.L. van; Thaler, T. ; Graaf, C. de; Martin, N. - \ 2013
Appetite 60 (2013). - ISSN 0195-6663 - p. 180 - 186.
bite size - energy-intake - portion size - questionnaire - satiation - weight - young - consumption - intensity - healthy
Background: Previous studies with model foods have shown that softer textures lead to higher eating rates and higher ad libitum food intake and higher intensity of salt taste has been shown to result in a lower ad libitum food intake. These observations have yet to be replicated in the context of realistic solid hot meal components. Aim: The objective of the present study was to assess the effect of texture and taste on the ad libitum intake of a realistic hot lunchtime meal. Methods: The meals consisted of potatoes, carrots, steak and gravy varied according to a 2 (texture: mashed vs. whole) x 2 (taste: standard taste vs. strong taste) design. The texture dimension referred to mashed potatoes, mashed carrots and pieces of steak vs. whole boiled potatoes, whole boiled carrots and whole steak. The taste was varied by manipulating the taste intensity of the gravy to be either standard or high intensity savoury taste. The current study used a between groups, single course ad libitum design whereby subjects were recruited for a one off meal study, during which their food intake was measured. The four groups consisted of about 40 subjects (mashed, standard, n = 37; mashed, savoury n = 39; whole, standard n = 40; and whole, savoury n = 41) matched for age (average age = 44.8 +/- 5.3), gender (on average 19 males and 20 females), normal BMI (average 22.6 +/- 1.7) and dietary restraint score (DEBQ score = 1.74 +/- 0.6). Results: The results showed that the estimated means of the intake of the two mashed conditions was 563.2 +/- 20.3 g and intake of whole meal was 527.5 +/- 20.0 g (p = 0.23). The texture effect was significant in the higher savoury condition with an average of 91 g less food consumed in the solid-savoury meal than in the mashed savoury meal. This effect was not replicated in the standard gravy condition, with no significant difference between solid and mashed textures. This was reflected in an interaction effect that was approaching significance (p = 0.051). The estimated mean eating rate in the two mashed conditions was 57.0 +/- 2.5 g and was significantly higher than the whole meal condition (47.2 +/- 2.5 g (p <0.05), with no difference in eating rate between the standard and savoury gravy conditions. Discussion: Although interpretation was made difficult by the between groups design and the interaction between taste * texture, the results nonetheless confirm the effect of texture on eating rate and ad libitum intake for solid savoury meal components. The impact of taste on ad libitum intake of a solid meal remains unclear. We conclude that people consumed more of the meal when the food was simultaneously mashed and savoury. Food texture may be used to produce slower eating rates that result in a reduced overall energy intake within a realistic hot lunchtime meal. (C) 2012 Elsevier Ltd. All rights reserved.
Evaluation of food and nutrient intake assessment using concentration biomarkers in European adolescents from the Healthy Lifestyle in Europe by Nutrition in Adolescence study
Vandevijvere, S. ; Geelen, A. ; Gonzalez-Gross, M. ; Veer, P. van 't; Dallongeville, J. ; Mouratidu, T. ; Dekkers, A. ; Börnhorst, C. ; Breidenassel, C. - \ 2013
The British journal of nutrition 109 (2013)4. - ISSN 0007-1145 - p. 736 - 747.
serum cholesteryl esters - n-3 fatty-acids - dietary-intake - energy-intake - additional measurements - micronutrient intake - biochemical markers - adipose-tissue - vitamin-c - validation
Accurate food and nutrient intake assessment is essential for investigating diet–disease relationships. In the present study, food and nutrient intake assessment among European adolescents using 24 h recalls (mean of two recalls) and a FFQ (separately and the combination of both) were evaluated using concentration biomarkers. Biomarkers included were vitamin C, ß-carotene, DHA+EPA, vitamin B12 (cobalamin and holo-transcobalamin) and folate (erythrocyte folate and plasma folate). For the evaluation of the food intake assessment 390 adolescents were included, while 697 were included for the nutrient intake assessment evaluation. Spearman rank and Pearson correlations, and validity coefficients, which are correlations between intake estimated and habitual true intake, were calculated. Correlations were higher between frequency of food consumption (from the FFQ) and concentration biomarkers than between mean food intake (from the recalls) and concentration biomarkers, especially for DHA+EPA (r 0·35 v. r 0·27). Most correlations were higher among girls than boys. For boys, the highest validity coefficients were found for frequency of fruit consumption (0·88) and for DHA+EPA biomarker (0·71). In girls, the highest validity coefficients were found for fruit consumption frequency (0·76), vegetable consumption frequency (0·74), mean fruit intake (0·90) and DHA+EPA biomarker (0·69). After exclusion of underreporters, correlations slightly improved. Correlations between usual food intakes, adjusted for food consumption frequency, and concentration biomarkers were higher than correlations between mean food intakes and concentration biomarkers. In conclusion, two non-consecutive 24 h recalls in combination with a FFQ seem to be appropriate to rank subjects according to their usual food intake
The Development and Evaluation of an Internet-Based Intervention to Increase Awareness about Food Portion Sizes: A Randomized Controlled Trial
Poelman, M.P. ; Steenhuis, I.H.M. ; Vet, E.W.M.L. de; Seidell, J.C. - \ 2013
Journal of Nutrition Education and Behavior 45 (2013)6. - ISSN 1499-4046 - p. 701 - 707.
energy-intake - young-adults - meal intake - accuracy - program - women
Objective To develop a Web-based tool (PortionSize@warenessTool) and to evaluate its effectiveness in increasing awareness of reference serving sizes and factors that may contribute to overeating in response to large portion sizes. Methods A randomized, controlled trial (intervention, n = 167; control, n = 143) was conducted. The authors measured awareness of reference serving size and overeating triggers from larger portions by an online questionnaire, assessed at baseline and 1 week later. Exposure dose reflected online activity (eg, number of Web pages viewed). Process evaluation data were collected within the intervention group. Results The intervention group demonstrated significantly higher awareness of reference serving sizes (¿2 = .062; P <.001) and overeating triggers from larger portions (¿2 = .061; P <.001) at posttest. Also, the authors observed a dose-dependent effect that led to improved awareness. Conclusions and Implications The PortionSize@warenessTool constitutes a promising tool to improve portion size awareness. Results The intervention group demonstrated significantly higher awareness of reference serving sizes (¿2 = .062; P <.001) and overeating triggers from larger portions (¿2 = .061; P <.001) at posttest. Also, the authors observed a dose-dependent effect that led to improved awareness. Conclusions and Implications The PortionSize@warenessTool constitutes a promising tool to improve portion size awareness.
Relative validity of the food frequency questionnaire used to assess dietary intake in the Leiden Longevity Study
Streppel, M.T. ; Vries, J.H.M. de; Meyboom, S. ; Beekman, M. ; Craen, A.J.M. ; Slagboom, P.E. ; Feskens, E.J.M. - \ 2013
Nutrition Journal 12 (2013). - ISSN 1475-2891 - 8 p.
basal metabolic-rate - energy-intake - goldberg cutoff - limitations - validation - markers - design
Background - Invalid information on dietary intake may lead to false diet-disease associations. This study was conducted to examine the relative validity of the food frequency questionnaire (FFQ) used to assess dietary intake in the Leiden Longevity Study. Methods - A total of 128 men and women participating in the Leiden Longevity Study were included in the present validation study. The performance of the FFQ was evaluated using the mean of three 24-hour recalls as the reference method. Evaluation in estimating dietary intake at the group level was done by paired t-tests. The relative validity of the individual energy adjusted level of intake was assessed with correlation analyses (Pearson’s), with correction for measurement error. Results - On group level, the FFQ overestimated as well as underestimated absolute intake of various nutrients and foods. The Bland and Altman plot for total energy intake showed that the agreement between the FFQ and the 24-hour recalls was dependent of intake level. Pearson correlation coefficients ranged from 0.21 (alpha linolenic acid) to 0.78 (ethanol) for nutrients and from -0.02 (legumes, non-significant) to 0.78 (alcoholic beverages) for foods. Adjustment for energy intake slightly lowered the correlation coefficients for nutrients (mean coefficient: 0.48 versus 0.50), while adjustment for within-subject variation in the 24-h recalls resulted in higher correlation coefficients for both nutrients and foods (mean coefficient: 0.69 for nutrients and 0.65 for foods). Conclusions - For most nutrients and foods, the ability of the FFQ to rank subjects was acceptable to good.
Potential benefits of satiety to the consumer: scientific considerations
Hetherington, M.M. ; Cunningham, K. ; Dye, L. ; Gibson, E.L. ; Gregersen, N.T. ; Halford, J.C.G. ; Lawton, C.L. ; Lluch, A. ; Mela, D.J. ; Trijp, J.C.M. van - \ 2013
Nutrition Research Reviews 26 (2013). - ISSN 0954-4224 - p. 22 - 38.
low-calorie diet - high-protein-diet - body-weight loss - disentangling food reward - sensory-specific satiety - glucagon-like peptide-1 - cognitive performance - energy-intake - appetite sensations - eating behavior
Foods and dietary patterns that enhance satiety may provide benefit to consumers. The aim of the present review was to describe, consider and evaluate research on potential benefits of enhanced satiety. The proposal that enhanced satiety could only benefit consumers by a direct effect on food intake should be rejected. Instead, it is proposed that there is a variety of routes through which enhanced satiety could (indirectly) benefit dietary control or weight-management goals. The review highlights specific potential benefits of satiety, including: providing appetite control strategies for consumers generally and for those who are highly responsive to food cues; offering pleasure and satisfaction associated with low-energy/healthier versions of foods without feeling ‘deprived’; reducing dysphoric mood associated with hunger especially during energy restriction; and improved compliance with healthy eating or weight-management efforts. There is convincing evidence of short-term satiety benefits, but only probable evidence for longer-term benefits to hunger management, possible evidence of benefits to mood and cognition, inadequate evidence that satiety enhancement can promote weight loss, and no evidence on which consumers would benefit most from satiety enhancement. The appetite-reducing effects of specific foods or diets will be much more subtle than those of pharmaceutical compounds in managing hunger; nevertheless, the experience of pharmacology in producing weight loss via effects on appetite suggests that there is potential benefit of satiety enhancement from foods incorporated into the diet to the consumer.
Consumption with Large Sip Sizes Increases Food Intake and Leads to Underestimation of the Amount Consumed
Bolhuis, D.P. ; Lakemond, C.M.M. ; Wijk, R.A. de; Luning, P.A. ; Graaf, C. de - \ 2013
PLoS ONE 8 (2013)1. - ISSN 1932-6203
increased meal intake - energy-intake - portion size - bite size - cognitive-factors - healthy women - satiety - fat - satiation - appetite
Background A number of studies have shown that bite and sip sizes influence the amount of food intake. Consuming with small sips instead of large sips means relatively more sips for the same amount of food to be consumed; people may believe that intake is higher which leads to faster satiation. This effect may be disturbed when people are distracted. Objective The objective of the study is to assess the effects of sip size in a focused state and a distracted state on ad libitum intake and on the estimated amount consumed. Design In this 3×2 cross-over design, 53 healthy subjects consumed ad libitum soup with small sips (5 g, 60 g/min), large sips (15 g, 60 g/min), and free sips (where sip size was determined by subjects themselves), in both a distracted and focused state. Sips were administered via a pump. There were no visual cues toward consumption. Subjects then estimated how much they had consumed by filling soup in soup bowls. Results Intake in the small-sip condition was ~30% lower than in both the large-sip and free-sip conditions (P
Dietary glycemic index, glycemic load, and digestible carbohydrate intake are not associated with risk op type 2 diabetes in eight European countries
Sluijs, I. van der; Beulens, J.W.J. ; Schouw, Y.T. van der; Buckland, G. ; Kuijsten, A. ; Schulze, M.B. ; Amiano, P. ; Ardanaz, E. ; Balkau, B. ; Boeing, H. ; Gavrila, D. ; Feskens, E.J.M. - \ 2013
The Journal of Nutrition 143 (2013)1. - ISSN 0022-3166 - p. 93 - 99.
fiber intake - energy-intake - life-style - nutrition - cancer - women - mellitus - cohort - prevention - disease
The association of glycemic index (GI) and glycemic load (GL) with the risk of type 2 diabetes remains unclear. We investigated associations of dietary GI, GL, and digestible carbohydrate with incident type 2 diabetes. We performed a case-cohort study nested within the European Prospective Investigation into Cancer and Nutrition Study, including a random subcohort (n = 16,835) and incident type 2 diabetes cases (n = 12,403). The median follow-up time was 12 y. Baseline dietary intakes were assessed using country-specific dietary questionnaires. Country-specific HR were calculated and pooled using random effects meta-analysis. Dietary GI, GL, and digestible carbohydrate in the subcohort were (mean +/- SD) 56 +/- 4, 127 +/- 23, and 226 +/- 36 g/d, respectively. After adjustment for confounders, GI and GL were not associated with incident diabetes [HR highest vs. lowest quartile (HRQ4) for GI: 1.05 (95% CI = 0.96, 1.16); HRQ4 for GL: 1.07 (95% CI = 0.95, 1.20)]. Digestible carbohydrate intake was not associated with incident diabetes [HRQ4: 0.98(95% CI = 0.86, 1.10)]. In additional analyses, we found that discrepancies in the GI value assignment to foods possibly explain differences in GI associations with diabetes within the same study population. In conclusion, an expansion of the GI tables and systematic GI value assignment to foods may be needed to improve the validity of GI values derived in such studies, after which GI associations may need reevaluation. Our study shows that digestible carbohydrate intake is not associated with diabetes risk and suggests that diabetes risk with high-GI and -GL diets may be more modest than initial studies suggested. J. Nutr. 143: 93-99, 2013.
Do European people with Type 1 diabetes consume a high atherogenic diet? 7-year follow-up of the EURODIAB Prospective Complications Study
Soedamah-Muthu, S.S. ; Chaturveldi, N. ; Fuller, J. ; Toeller, M. - \ 2013
European Journal of Nutrition 52 (2013)7. - ISSN 1436-6207 - p. 1701 - 1710.
density lipoprotein cholesterol - cardiovascular-disease - iddm complications - body-weight - nutritional intake - metabolic-control - heart-disease - energy-intake - risk-factors - lipid-levels
Background/objectives - Individuals with type 1 diabetes have a high risk of developing cardiovascular diseases, and it has been reported that they consume a high atherogenic diet. We examined how nutrient intake and adherence to current European nutritional recommendations evolved in a large cohort of European individuals with type 1 diabetes over a period of 7 years. Subjects/methods - We analysed data from the EURODIAB Prospective Complications Study, a European multicentre prospective cohort study. Standardized 3-day dietary records were employed in individuals with type 1 diabetes. One thousand one hundred and two patients (553 men, 549 women, baseline age 33 ± 10 years, duration 15 ± 9 years) had complete nutritional data available at baseline and after 7 years. We calculated mean differences in reported nutrients over time and adjusted these for age, gender, HbA1c and BMI with ANOVA models. Results - Compared to baseline, there were minor changes in nutrients. Reported protein (-0.35 % energy (en), fat (-1.07 % en), saturated fat (-0.25 % en) and cholesterol (-7.42 mg/1000 kcal) intakes were lower, whereas carbohydrate (+1.23 % en) and fibre (+0.46 g/1000 kcal) intakes were higher at the 7-year follow-up. European recommendations for adequate nutrient intakes were followed in individuals with type 1 diabetes for protein (76 % at baseline and 78 % at follow-up), moderately for fat (34, 40 %), carbohydrate (34, 41 %) and cholesterol (39, 47 %), but poorly for fibre (1.4, 2.4 %) and saturated fat (11, 13 %). Conclusion - European individuals with type 1 diabetes consume a high atherogenic diet as few patients met recommendations for dietary fibre and saturated fat. This study showed minor changes in dietary nutrients and energy intakes over a period of 7 years. Nutrition education needs particular focus on strategies to increase dietary fibre and reduce saturated fat to exploit their potential benefit.
Oral processing characteristics of solid meal components and relationship with foord composition, sensory attributes and expected satiation.
Forde, R.M. ; Kuijk, N. van; Thaler, T. ; Graaf, C. de; Martin, N.A. - \ 2013
Appetite 60 (2013). - ISSN 0195-6663 - p. 208 - 219.
sugar-sweetened beverages - energy-intake - bite size - portion size - eating rate - dietary fiber - body-weight - satiety - women - humans
Background: The modern food supply is often dominated by a large variety of energy dense, softly textured foods that can be eaten quickly. Previous studies suggest that particular oral processing characteristics such as large bite size and lack of chewing activity contribute to the low satiating efficiency of these foods. To better design meals that promote greater feelings of satiation, we need an accurate picture of the oral processing characteristics of a range of solid food items that could be used to replace softer textures during a normal hot meal. Aim: The primary aim of this study was to establish an accurate picture of the oral processing characteristics of a set of solid savoury meal components. The secondary aim was to determine the associations between oral processing characteristics, food composition, sensory properties, and expected satiation. Methods: In a within subjects design, 15 subjects consumed 50 g of 35 different savoury food items over 5 sessions. The 35 foods represented various staples, vegetables and protein rich foods such a meat and fish. Subjects were video-recorded during consumption and measures included observed number of bites, number of chews, number of swallows and derived measures such as chewing rate, eating rate, bite size, and oral exposure time. Subjects rated expected satiation for a standard 200 g portion of each food using a 100 mm and the sensory differences between foods were quantified using descriptive analysis with a trained sensory panel. Statistical analysis focussed on the oral processing characteristics and associations between nutritional, sensory and expected satiation parameters of each food. Results: Average number of chews for 50 g of food varied from 27 for mashed potatoes to 488 for tortilla chips. Oral exposure time was highly correlated with the total number of chews, and varied from 27 s for canned tomatoes to 350 s for tortilla chips. Chewing rate was relatively constant with an overall average chewing rate of approximately 1 chew/s. Differences in oral processing were not correlated with any macronutrients specifically. Expected satiation was positively related to protein and the sensory attributes chewiness and saltiness. Foods that consumed in smaller bites, were chewed more and for longer and expected to impart a higher satiation. Discussion: This study shows a large and reliable variation in oral exposure time, number of required chews before swallowing and expected satiation across a wide variety of foods. We conclude that bite size and oral-sensory exposure time could contribute to higher satiation within a meal for equal calories.