Energy Density, Portion Size, and Eating Occasions: Contributions to Increased Energy Intake in the United States, 1977–2006

Using data from three surveys, Kiyah Duffey and Barry Popkin found that changes in eating/drinking occasions and portion size consistently account for most of the change in daily total energy intake over a 30-year period

The Effect of Sugar-Free Versus Sugar-Sweetened Beverages on Satiety, Liking and Wanting: An 18 Month Randomized Double-Blind Trial in Children

BACKGROUND: Substituting sugar-free for sugar-sweetened beverages reduces weight gain. A possible explanation is that sugar-containing and sugar-free beverages cause the same degree of satiety. However, this has not been tested in long-term trials. METHODS: We randomized 203 children aged 7-11 years to receive 250 mL per day of an artificially sweetened sugar-free beverage or a similarly looking and tasting sugar-sweetened beverage. We measured satiety on a 5-point scale by questionnaire at 0, 6, 12 and 18 months. We calculated the change in satiety from before intake to 1 minute after intake and 15 minutes after intake. We then calculated the odds ratio that satiety increased by 1 point in the sugar-group versus the sugar-free group. We also investigated how much the children liked and wanted the beverages. RESULTS: 146 children or 72% completed the study. We found no statistically significant difference in satiety between the sugar-free and sugar-sweetened group; the adjusted odds ratio for a 1 point increase in satiety in the sugar group versus the sugar-free group was 0.77 at 1 minute (95% confidence interval, 0.46 to 1.29), and 1.44 at 15 minutes after intake (95% CI, 0.86 to 2.40). The sugar-group liked and wanted their beverage slightly more than the sugar-free group, adjusted odds ratio 1.63 (95% CI 1.05 to 2.54) and 1.65 (95% CI 1.07 to 2.55), respectively. CONCLUSIONS: Sugar-sweetened and sugar-free beverages produced similar satiety. Therefore when children are given sugar-free instead of sugar-containing drinks they might not make up the missing calories from other sources. This may explain our previous observation that children in the sugar-free group accumulated less body fat than those in the sugar group.<br /

Orlistat after initial dietary/behavioural treatment: changes in body weight and dietary maintenance in subjects with sleep related breathing disorders

<p>Abstract</p> <p>Background</p> <p>Sleep related breathing disorders (SRBD) are associated with increased morbidity and mortality and weight loss is recommended to overweight or obese patients with SRBD. However, maintenance of weight loss is difficult to achieve and strategies for weight loss maintenance is needed. Orlistat is a pharmacological agent that reduces the intestinal absorption of fat and may favour long-term weight maintenance.</p> <p>Objective</p> <p>To examine the change in body weight and dietary intake during a 1-year treatment with orlistat after an initial weight loss in obese subjects with SRBD. Furthermore, to explore the dietary determinants of weight maintenance during treatment with orlistat.</p> <p>Methods</p> <p>Men and women with SRBD aged 32-62 years (n = 63) participated in a 3-month dietary intervention to increase intake of vegetables and fruit. After an initial weight loss of 3.4 kg they achieved a mean body mass index of 34.3 ± 4.7 kg/m2. Subsequently they were treated with orlistat for 1 year. During this year, dietary and behavioural interventions to attain weight loss were provided in the course of 14 group sessions. Dietary intake, energy density and food choices were assessed with a food frequency questionnaire before and after orlistat treatment.</p> <p>Results</p> <p>With orlistat, body weight decreased by a mean of 3.5 kg (95% CI 1.5, 5.5). The dietary E% from saturated fat, intake of fatty dairy products and energy density increased after 1 year while intakes of oils, fish and vegetables decreased (all P < 0.05). After multivariate adjustments, weight loss was associated with E% protein (R2_adj= 0.19 [95% CI 0.10, 0.46]), and inversely associated with E% saturated fat (R2_adj= 0.20 [95% CI 0.12, 0.47]) and fatty dairy products (R2_adj= 0.23 [95% CI 0.12, 0.49]).</p> <p>Conclusions</p> <p>Orlistat induced further weight loss, but dietary compliance declined with time. Increasing dietary protein and restricting saturated fat and fatty dairy products may facilitate weight loss with orlistat.</p

Immediate pre-meal water ingestion decreases voluntary food intake in lean young males

Purpose: Consuming 375-500 ml of water 30 min before a meal has been shown to reduce energy intake in older, but not younger adults. This study investigated the effects of ingesting a water preload immediately pre-meal (<1 min before eating) on within-meal ad-libitum energy intake in non-obese young males. Methods: Fourteen healthy males (mean (SD) age 27 (3) y, Height 1.83 (0.05) m, body weight 80.47 (9.89) kg, body fat 17.5 (4.0) %, body mass index 24.0 (2.5) kg/m2) completed a familiarisation trial and two experimental trials in randomised counterbalanced order. Subjects arrived at the laboratory overnight fasted and consumed an ad-libitum porridge breakfast. Immediately prior to the meal, subjects consumed either a 568 ml (1 pint) water preload (preload trial) or no preload (control trial). Visual analogue scale questionnaires to assess hunger, fullness and satisfaction were completed before and after the meal in both trials, as well as after the water preload. Results: Ad-libitum energy intake was greater (P<0.001) during control (2551 (562) kJ) than preload (1967 (454) kJ). Ad-libitum water intake was also greater (P<0.001) during control (318 (226-975) ml) than preload (116 (0-581) ml). The water preload increased fullness and satisfaction and decreased hunger compared to pre-trial (P<0.001) and the control trial (P<0.001). Conclusion: This study demonstrates that consumption of a 568 ml water preload immediately before a meal reduces energy intake in non-obese young males. This might therefore be an effective strategy to suppress energy intake in this population and possibly assist with weight management

Energy density of foods and beverages in the Australian food supply: influence of macronutrients and comparison to dietary intake

Objectives: The energy density (ED) of the diet is considered an important determinant of total energy intake and thus energy balance and weight change. We aimed to compare relationships between ED and macronutrient content in individual food and beverage items as well as population diet in a typical Western country. Design: Nutrient data for 3673 food items and 247 beverage items came from the Australian Food and Nutrient database (AusNut). Food and beverage intake data came from the 1995 Australian National Nutrition Survey (a 24-h dietary recall survey in 13 858 people over the age of 2). Relationships between ED and macronutrient and water content were analysed by linear regression with 95% prediction bands. Results: For both individual food items and population food intake, there was a positive relationship between ED and percent energy as fat and negative relationships between ED and percent energy as carbohydrate and percent water by weight. In all cases, there was close agreement between the slopes of the regression lines between food items and dietary intake. There were no clear relationships between ED and macronutrient content for beverage items. Carbohydrate (mostly sucrose) contributed 91, 47, and 25% of total energy for sugar-based, fat-based, and alcohol-based beverages respectively. Conclusions: The relationship between ED and fat content of foods holds true across both population diets and individual food items available in the food supply in a typical Western country such as Australia. As high-fat diets are associated with a high BMI, population measures with an overall aim of reducing the ED of diets may be effective in mediating the growing problem of overweight and obesity

Can Reduced Intake Associated with Downsizing a High Energy Dense Meal Item be Offset by Increased Vegetable Variety in 3–5-year-old Children?

Large portions of energy dense foods promote overconsumption but offering small portions might lead to compensatory intake of other foods. Offering a variety of vegetables could help promote vegetable intake and offset the effect of reducing the portion size (PS) of a high energy dense (HED) food. Therefore, we tested the effect on intake of reducing the PS of a HED unit lunch item while varying the variety of the accompanying low energy dense (LED) vegetables. In a within-subjects design, 43 3–5-year-old pre-schoolers were served a lunch meal in their nursery on 8 occasions. Children were served a standard (100%) or downsized (60%) portion of a HED sandwich with a side of LED vegetables offered as a single (carrot, cherry tomato, cucumber) or variety (all 3 types) item. Reducing the PS of a HED sandwich reduced sandwich (g) (p < 0.001) and total meal intake (kcal) consumption (p = 0.001) without an increased intake of other foods in the meal (LED vegetables (p = 0.169); dessert (p = 0.835)). Offering a variety of vegetables, compared with a single vegetable, increased vegetable intake (g) (p = 0.003) across PS conditions. Downsizing and variety were effective strategies individually for altering pre-schoolers’ intakes of HED and LED meal items, however, using variety to offset HED downsizing was not supported in the present study

Validation of the Diet Satisfaction Questionnaire: a new measure of satisfaction with diets for weight management

Objective: The Diet Satisfaction Questionnaire was developed to fill the need for a validated measure to evaluate satisfaction with weight‐management diets. This paper further develops the questionnaire, examining the factor structure of the original questionnaire, cross‐validating a revised version in a second sample and relating diet satisfaction to weight loss during a 1‐year trial. Methods: The 45‐item Diet Satisfaction Questionnaire (DSat‐45) uses seven scales to assess characteristics that influence diet satisfaction: Healthy Lifestyle, Convenience, Cost, Family Dynamics, Preoccupation with Food, Negative Aspects, and Planning and Preparation. It was administered five times during a 1‐year weight‐loss trial (n = 186 women) and once as an online survey in a separate sample (n = 510 adults). Confirmatory factor analysis was used to assess and refine the DSat‐45 structure, and reliability and validity data were examined in both samples for the revised questionnaire, the DSat‐28. Associations were examined between both DSat questionnaires and weight loss in the trial. Results: Internal consistency (reliability) was moderate for the DSat‐45. Confirmatory factor analysis showed improved fit for a five‐factor structure, resulting in the DSat‐28 that retained four of the original scales and a shortened fifth scale. This revised questionnaire was reliable in both samples. Weight loss across the year‐long trial was positively related to satisfaction with Healthy Lifestyle, Preoccupation with Food, and Planning and Preparation in both versions of the questionnaire. Conclusions: Measures of reliability and validity were improved in the more concise DSat‐28 compared to the DSat‐45. This shorter measure should be used in future work to evaluate satisfaction with weight‐management diets

Applications of nutrient profiling : potential role in diet-related chronic disease prevention and the feasibility of a core nutrient-profiling system

Background/objectives: A number of different nutrient-profiling models have been proposed and several applications of nutrient profiling have been identified. This paper outlines the potential role of nutrient-profiling applications in the prevention of diet-related chronic disease (DRCD), and considers the feasibility of a core nutrient-profiling system, which could be modified for purpose, to underpin the multiple potential applications in a particular country.Methods: The &lsquo;Four &lsquo;P&rsquo;s of Marketing&rsquo; (Product, Promotion, Place and Price) are used as a framework for identifying and for classifying potential applications of nutrient profiling. A logic pathway is then presented that can be used to gauge the potential impact of nutrient-profiling interventions on changes in behaviour, changes in diet and, ultimately, changes in DRCD outcomes. The feasibility of a core nutrient-profiling system is assessed by examining the implications of different model design decisions and their suitability to different purposes.Results and conclusions: There is substantial scope to use nutrient profiling as part of the policies for the prevention of DRCD. A core nutrient-profiling system underpinning the various applications is likely to reduce discrepancies and minimise the confusion for regulators, manufacturers and consumers. It seems feasible that common elements, such as a standard scoring method, a core set of nutrients and food components, and defined food categories, could be incorporated as part of a core system, with additional application-specific criteria applying. However, in developing and in implementing such a system, several country-specific contextual and technical factors would need to be balanced.<br /

Comparison of three nudge interventions (priming, default option, and perceived variety) to promote vegetable consumption in a self-service buffet setting.

BACKGROUND: Dietary choices in out-of-home eating are key for individual as well as for public health. These dietary choices are caused by a wide array of determinants, one of which is automatic decision-making. Nudging is attracting considerable interest due to its understanding and application of heuristic biases among consumers. The aim of this study is to test and compare three nudges in promoting vegetable consumption among test persons in a food lab-based experiment. METHODS: The initial sample consisted of 88 participants recruited in Copenhagen, Denmark. Each study participant was randomly assigned to one of the three experiments: priming, default and perceived variety. The priming arm of the experiment consisted of creating a leafy environment with green plants and an odour of herbs. In the default arm of the experiment, the salad was pre-portioned into a bowl containing 200g of vegetables. The third experiment divided the pre-mixed salad into each of its components, to increase the visual variety of vegetables, yet not providing an actual increase in items. Each individual was partaking twice thus serving as her/his own control, randomly assigned to start with control or experimental setting. RESULTS: The default experiment successfully increased the energy intake from vegetables among the study participants (124 kcal vs. 90 kcal in control, p<0.01). Both the priming condition and perceived variety reduced the total energy intake among the study participants (169 kcal, p<0.01 and 124 kcal, p<0.01, respectively), mainly through a decrease in the meat-based meal component. CONCLUSIONS: Considerable progress has been made with regard to understanding the use of nudging in promoting a healthier meal composition, including increasing vegetable intake. This study suggests that the nature of a nudge-based intervention can have different effects, whether it is increasing intake of healthy components, or limiting intake of unhealthy meal components. This work has demonstrated that consumer behaviour can be influenced without restricting or providing incentives for behaviour change. The present findings have promising application to the foodservice sector