Optimising foods for satiety

Foods that generate strong satiety sensations have obvious ben- efits for weight management. This review builds on the under- standing that a food’s satiating power is dependent on the amount of protein, carbohydrate, fat and fibre it contains by examining evidence that the consumer’s sensory and cognitive appraisal of the food is also important. It is concluded that numerous features of a food product can be manipulated to enhance the consumer’s experience of satiety but the combi- nation of these features will ultimately determine its effect on appetite control. Taking this integrated approach to satiety will optimise the development of high satiety foods

Fluid or fuel? The context of consuming a beverage is important for satiety

Energy-containing beverages have a weak effect on satiety, limited by their fluid characteristics and perhaps because they are not considered ‘food’. This study investigated whether the context of consuming a beverage can influence the satiating power of its nutrients. Eighty participants consumed a lower- (LE, 75 kcal) and higher-energy (HE, 272 kcal) version of a beverage (covertly manipulated within-groups) on two test days, in one of four beverage contexts (between-groups): thin versions of the test-drinks were consumed as a thirst-quenching drink (n = 20), a filling snack (n = 20), or without additional information (n = 20). A fourth group consumed subtly thicker versions of the beverages without additional information (n = 20). Lunch intake 60 minutes later depended on the beverage context and energy content (p = 0.030): participants who consumed the thin beverages without additional information ate a similar amount of lunch after the LE and HE versions (LE = 475 kcal, HE = 464 kcal; p = 0.690) as did those participants who believed the beverages were designed to quench-thirst (LE = 442 kcal, HE = 402 kcal; p = 0.213), despite consuming an additional 197 kcal in the HE beverage. Consuming the beverage as a filling snack led participants to consume less at lunch after the HE beverage compared to the LE version (LE = 506 kcal, HE = 437 kcal; p = 0.025). This effect was also seen when the beverages were subtly thicker, with participants in this group displaying the largest response to the beverage’s energy content, consuming less at lunch after the HE version (LE = 552 kcal, HE = 415 kcal; p<0.001). These data indicate that beliefs about the consequences of consuming a beverage can affect the impact of its nutrients on appetite regulation and provide further evidence that a beverage’s sensory characteristics can limit its satiating power

Effects of repeated consumption on sensory-enhanced satiety

Previous research suggests that sensory characteristics of a drink modify the acute satiating effects of its nutrients, with enhanced satiety evident when a high energy drink was thicker and tasted creamier. The present study tested whether this modulation of satiety by sensory context was altered by repeated consumption. Participants (n=48) consumed one of four drinks mid-morning on seven non-consecutive days with satiety responses measured pre-exposure (day 1), post-exposure (day 6) and at a one month follow-up. Drinks combined two levels of energy (lower energy, LE, 326 KJ: higher energy, HE, 1163KJ) with two levels of satiety-predictive sensory characteristics (low-sensory, LS, or enhanced sensory, ES). Test lunch intake 90 minutes after drink consumption depended on both the energy content and sensory characteristics of the drink before exposure, but on energy content alone at post-exposure and the follow-up. The largest change was an increase in test meal intake over time in the LE/LS condition. Effects on intake were reflected in appetite ratings, with rated hunger and expected filling affected by sensory characteristics and energy content pre-exposure, but were largely determined by energy content post exposure and at follow up. In contrast, a measure of expected satiety reflected sensory characteristics regardless of energy content on all three test days. Overall these data suggest that some aspects of the sensory-modulation of satiety are changed by repeated consumption, with covert energy becoming more effective in suppressing appetite over time, but also suggest that these behavioural changes are not readily translated into expectations of satiety

Expectations about satiety and thirst are modified by acute motivational state

Prior research has shown that consumers have clear and measurable expectations about the likely effects of food and drink items on their appetite and thirst, which are acquired with experience and influenced by a product’s taste and texture. What is unclear is whether expression of these expectations also varies with current appetitive state. It is possible that current appetite could increase or decrease the relevance of these expectations for future food choice and magnify a product’s expected impact on appetite. To test this, we contrasted expectations about satiety and thirst for four products consumed two hours after an appetite manipulation at breakfast, achieved through ad libitum access to low-energy drinks only (hunger condition), cereal only but no drinks (thirst condition) or both foods and drinks (sated condition). The test products were two soups and two drinks, with a thicker and thinner version of each product type to act as positive control to ensure sensitivity in detecting differences in expectations. For satiety, the predicted differences between products were seen: soups and thicker products were expected to be more filling and to suppress subsequent hunger more than drinks and thinner products, but these differences were more pronounced in the hunger than thirsty or sated conditions. Being thirsty also enhanced expectations of how much drinks would appease immediate thirst. Overall the data show that expectations were adjusted subtly by a person’s current appetitive state, suggesting that we have mechanisms that highlight the most important features of a product at the time when it may be most beneficial to the consumer

Additive effects of sensory-enhanced satiety and memory for recent eating on appetite

The sensory characteristics of a product have been shown to interact with actual nutrient content to generate satiety. Separately, cued recall of recent eating has also been shown to reduce food intake. Here we explore for the first time how these two effects interact, with the hypothesis that sensory enhancement of satiety might be mediated by more vivid memory of the earlier consumed item. On each of two test sessions, 119 women volunteers consumed a control drink (lemonade) on one morning and then one of two test drinks on the next day 30 min before an ad libitum lunch. The test drinks were equicaloric but one was noticeably thicker and creamier, and expected to generate stronger satiety. Just prior to the test lunch, participants were asked to recall either the test drink (test recall) or the drink from the previous day (control recall). Overall, lunch intake was significantly lower after the thicker and creamier (enhanced sensory ES) than thinner (low sensory: LS) test drink (p < 0.001, η2 = 0.11) regardless of recall condition (p = 0.65, η2 < 0.01), but was significantly lower after the test than control recall condition (p < 0.001, η2 = 0.14). Rated hunger was lower after consuming the ES than LS drink both immediately after consumption (p < 0.001, η2 = 0.11) and prior to the test lunch (p = 0.007, η2 = 0.06), while rated hunger just before lunch tended to be lower after recalling the test than control drink (p = 0.052, η2 = 0.03) regardless of the sensory characteristics (p = 0.27, η2 = 0.01). Overall these data further demonstrate the power of ‘sensory-enhanced satiety’ and cued recall of earlier eating as methods to reduce acute food intake, but suggest these effects operate independently

Wound infection following Hepatopancreatobiliary (HPB) surgery – a measure of predictive surgical and transmission factors and patient outcomes

Incidence of surgical site infections (SSIs) following hepatopancreatobiliary (HPB) surgery can be as high as 20 – 40 %. SSIs, particularly those caused by antimicrobial resistant (AMR) organisms, are a significant burden for both patients and the NHS. The aim of this study was to determine risk factors, incidence and the source of these infections and to measure how bacteria that can cause SSIs can form biofilms. Patients’ surgical sites were swabbed before and after surgery as well as different surfaces on the HPB ward. The bacteria were identified and their AMR was determined. Patient demographics, comorbidities and full blood counts were analysed to determine risk factors associated with SSIs. Biofilm assays (crystal violet, XTT and bacterial percentage coverage), using three of the isolates found on patients (Enterobacter cloacae, Enterococcus faecium and Staphylococcus haemolyticus) were conducted. The incidence of SSIs was 23.1 % and risk factors identified included bile leak, use of drains, pancreatic surgery, open surgery, long surgery and long hospital stay. Statistical analysis showed poor post-operative nutrition, post- operative pneumonia and return to the operating theatre as being significant risk factors for SSI. The bacteria found to cause SSIs were all gut commensals that were isolated from the drain fluid and not from the wound swabs, suggesting transmission occurred during surgery. High levels of multi-drug resistant (MDR) and extensively drug resistant (XDR) species were isolated, particularly XDR coagulase negative staphylococci. The surfaces with the most MDR and XDR species included most of the bathroom surfaces, the nurses’ phone and computer keyboard, bedside cabinet and the soap dispenser. In vitro biofilm assays showed that AMR could develop among bacteria in a polymicrobial biofilm and this could therefore occur within a polymicrobial SSI and hospital setting, making treatment more difficult. It is clear that more needs to be done to prevent SSIs following HPB surgery and that the hospital can still act as a reservoir for MDR and XDR bacteria

Lateral habenula regulates temporal pattern organization of rat exploratory behavior and acute nicotine-induced anxiety in hole board

Nicotine is one of the most addictive drugs of abuse. Tobacco smoking is a major cause of many health problems worldwide, and is the first preventable cause of death. Several findings show that nicotine exerts significant aversive as well as the well-known rewarding motivational effects. Less certain is the anatomical substrate that mediates or enables nicotine aversion. Here we have focused on nicotine-induced anxiety-like behavior in unlesioned and lesioned lateral habenula (LHb) rats. Firstly, we showed that acute nicotine induces anxiogenic effects in rats at the doses investigated (0.1, 0.5, and 1.0 mg/kg, i.p.) as measured by the hole-board apparatus, and manifested in behaviors such as decreased rearing and head-dipping and increased grooming. No changes in locomotor behavior were observed at any of the nicotine doses given. T-pattern analysis of the behavioral outcomes revealed a drastic reduction and disruption of complex behavioral patterns induced by all three nicotine doses, with the maximum effect for 1 mg/kg. Lesion of the LHb induced a significant anxiogenic effect, reduced the mean occurrences of T-patterns detected, and strikingly reverted the nicotine-induced anxiety to an anxiolytic effect. We suggest that LHb is critically involved in emotional behavior states and in nicotine-induced anxiety, most likely through modulating serotonergic/dopaminergic nuclei.peer-reviewe

Perceptions of Low Income by Canadian Student Occupational Therapists

Low income negatively impacts health, access to health services, and overall quality of life. Living with low income is complex, strongly correlated with disability, age, gender, race, and mental illness, and can present barriers to participation in employment, self-care, and leisure occupations. Occupational therapists are well-positioned to reduce these socioeconomic, environmental, and personal barriers. Research on student occupational therapists’ learning and perceptions in working with individuals living with low income is unexplored. This study aimed to understand student occupational therapists’ perceptions and experiences related to low income and their knowledge of their professional roles in working with low income populations. Fourteen Canadian occupational therapy programs were asked to invite final year students to complete an online survey. Resulting data was analyzed for student perceptions of their professional roles, personal experiences, and learning experiences related to working with low income populations. Eighty-eight respondents completed the survey. Ninety-one percent (n=81) agreed with the occupational therapy role as a change agent with marginalized and low income populations. Fifty-seven percent of respondents (n=53) disagreed that they learned enough about low income in their programs. Students reported gaps in their learning about working with low income populations, with six percent (n=5) having learned to screen for low income. Respondent comments resulted in 21 unique codes that built three themes; ‘academic experiences’, ‘perception of role’, and ‘individual experiences’. Occupational therapy programs need to address gaps in student learning to prepare student occupational therapists to advocate for individuals living with low income and address socioeconomic inequities of occupational engagement