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Background: The present study assessed the efficacy of a behavioral intervention to enhance children's sleep and reduce caloric intake and body mass index (BMI) change., Methods: Seventy-eight children 8-11 years old who slept 9.5 h/night or less were randomized to the sleep intervention or to no treatment control. The primary outcome was 2-month change in the actigraph-estimated sleep period; changes in reported caloric intake, percent calories from fat, and BMI/BMI z-score (BMIz) were assessed., Results: Children randomized to intervention enhanced their sleep period by 40 ± 7 min/night relative to control (p < 0.001), and were more likely to increase their sleep period by 30 min/night or more (52% versus 15%, p = 0.003). No differences were observed for reported dietary intake or BMI/BMIz. However, in post-hoc analyses collapsing across groups, those who increased sleep by 30 min/night or more had lower BMI (-0.31 kg/m 2 , p = 0.01) and BMIz (-0.07, p = 0.03) and reported fewer percent calories from fat at 2 months (-2.2%, p = 0.04)., Conclusions: A brief behavioral intervention can enhance children's sleep, but did not result in changes in caloric intake or weight status. Enhancing sleep by 30 min/night or more may be beneficial for weight regulation., Impact: A brief behavioral intervention improved children's nocturnal sleep relative to no treatment control. Given the many benefits of a good night's sleep across domains of functioning, findings have significant implications for children's health and wellbeing. There were no differences between groups on eating behaviors or BMI. However, across groups, children who increased their sleep period by at least 30 min/night, reported reduced intake from fat and evidenced lower BMI at 2 months. Thus, a brief intervention can improve sleep and may have potential benefits for weight regulation., (© 2021. The Author(s), under exclusive licence to the International Pediatric Research Foundation, Inc.)

Short sleep is associated with obesity risk. Experimental studies with adults and observational studies with children demonstrate that changes in eating, including increased caloric intake from energy-dense foods and sugar-sweetened beverages as well as increased caloric intake in the evening, may partially account for this increased risk. We therefore examined whether experimental changes in children's sleep period lead to changes in reported caloric intake from energy-dense snack foods and sugar-sweetened beverages, and in the evening. Thirty-seven children, 8-11 years old, completed a three-week study that used a within-subject randomized cross-over design. Children slept their typical amount for one week and were subsequently randomized to either increase or decrease their typical amount by 1.5 h/night for one week; the alternate schedule was completed during the third week of the study, creating a 3-h time in bed difference between the increase and decrease conditions. Sleep was monitored with actigraphy, and dietary intake was assessed with 24-hour dietary recalls. Participants reported consuming 35 kcal per day more from sugar-sweetened beverages during the decrease sleep than the increase sleep condition, p = .033. There were no reported differences between conditions from energy-dense snack foods. Although no differences in reported intake were observed earlier in the day, from 2000 h (8:00 PM) and later, children reported consuming 132 kcal more during the decrease sleep condition than the increase condition, p < 0.001. Shortened sleep achieved by delaying bedtimes led to increased caloric intake in the evening and from sugar-sweetened beverages. Clinical Trials Registration: clinicaltrials.gov Identifier: NCT01030107., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Background: Stimuli that promote eating in the absence of the physiological need for food are pervasive and can facilitate excessive energy intake. The practices of mindful eating (ME) and intuitive eating (IE) have been developed to minimize external drivers of energy intake by helping individuals emphasize the sensory properties of foods and internal indicators of hunger and fullness., Objective: To enhance understanding about the effect of ME and IE interventions on dietary intake, this systematic review included randomized trials of ME and IE interventions that examined dietary intake, defined as energy intake or diet quality, in adults of varying weight status without a diagnosis of an eating disorder., Methods: The selection of literature followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses systematic review process, in which PubMed, CINAHL (Cumulative Index to Nursing and Allied Health Literature), and PsycINFO databases were searched for studies published between January 1980 and November 2019. Studies were included if they met the following criteria: randomized trial design in which 1 arm was an intervention with an ME or IE component and there was at least 1 control or active comparison arm; enrolled participants were of a healthy weight or with overweight or obesity and reported not having an eating disorder (ie, anorexia, bulimia nervosa, or binge eating disorder) or other health conditions in which dietary restrictions were applied; were at least 18 years of age; and outcomes of energy intake or diet quality were reported at baseline and post intervention. The modified Downs and Black checklist was used to assess risk of bias for each study that met inclusion criteria., Results: A total of 13 studies, including 8 investigating ME interventions and 5 investigating IE interventions, represented in 14 articles, were included in the review. Seven of the 9 articles reporting on energy intake did not find significant group differences. Eight of the 12 articles reporting on diet quality did not find significant group differences. The mean bias assessment score was 13.6 out of 28, indicating poor quality., Conclusions: Little evidence suggests that ME and IE interventions influence energy intake or diet quality. To draw strong conclusions about the effect of ME and IE on dietary intake, future research using study designs of high rigor are needed., (Copyright © 2021 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.)

Objective: To determine associations among objectively-measured nocturnal sleep time, bedtime and obesogenic behaviors, including dietary intake, timing of intake, and physical activity, in a diverse sample of school-aged children who presented for behavioral treatment to enhance sleep duration., Methods: Eighty-seven children (8-11 y, 66.7% female, zBMI: 0.86 ± 1.0) who self-reported sleeping <9.5 h/night were studied for one week using wrist actigraphy to estimate sleep; hip-worn accelerometers to measure physical activity; and 24 h dietary recalls to capture dietary intake and meal timing. Pearson and Spearman's rho correlations and linear regressions controlling for age, gender and race were used for statistical analyses., Results and Conclusion: Mean bedtime was 10:31 PM (±58.2 min) and mean nocturnal sleep time was 7.7 h (±37.5 min). Although later bedtime was associated with shorter sleep time (r = -0.61, p < 0.001), the two variables were differentially related to obesity risk factors. Later bedtime, but not sleep time, correlated with greater daily fat intake, later first meal of the day, and greater after-dinner intake (all p < 0.05). Nocturnal sleep time, but not bedtime, correlated with zBMI (p = 0.04). Both sleep time and later bedtime were associated with a later last meal of the day (all p < 0.05). Findings remained consistent after controlling for demographic factors. In short-sleeping school-aged children, bedtime may be more predictive of dietary obesity risk factors whereas sleep duration may be more predictive of zBMI. Results suggest that health providers should consider both bedtime and sleep duration for reducing obesity risk in children., Clinical Trial: Enhancing Sleep Duration: Effects on Children's Eating and Activity Behaviors, NCT03186508, https://clinicaltrials.gov/ct2/show/NCT03186508., (Copyright © 2019. Published by Elsevier B.V.)

Timing of energy intake, a temporal dietary pattern, may enhance health. Eating a greater amount of energy earlier and a smaller amount of energy later in the day, a behavioral circadian rhythm, may assist with chronoenhancement. Chronoenhancement seeks to enhance entrainment (synchronization) of biological and behavioral circadian rhythms. In humans, research reports that eating a greater amount of energy early and a smaller amount of energy later in the day increases dietary induced thermogenesis, improves cardiometabolic outcomes, and enhances weight loss. However, little human research has examined if this eating pattern enhances regularity of biological circadian rhythm. In a randomized controlled 8-week pilot study, the influence of energy distribution timing on weight loss and regularity of sleep onset and wake times (marker for biological circadian rhythm) was examined. Within an hypocaloric, three-meal prescription, participants (n = 8) were assigned to either: 1) Morning: 50%, 30%, and 20% of kcal at breakfast, lunch, and dinner, respectively; or 2) Evening: 20%, 30%, and 50% of kcal at breakfast, lunch, and dinner, respectively. Percent weight loss and regularity of sleep onset and wake times were significantly (p < 0.05) greater for Morning than Evening. To enhance understanding of the influence of energy distribution timing on health, longer studies conducted in free-living participants, with dietary intake assessed using time-stamped methods, that include measures of the circadian timing system are needed. This small review is based upon a symposium presentation at the Society of the Study of Ingestive Behavior in 2017., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Purpose of Review: In accordance with US dietary guidance, incorporating variety into the diet can align with energy balance, though greater food variety in some categories may make energy balance more challenging. Thus, experimental and epidemiologic evidence is summarized on the relationship between food variety, food and energy intake, and energy balance., Recent Findings: Lab-based, experimental research consistently demonstrates that greater variety within foods or sensory characteristics of food increases food and energy intake within an eating occasion. Epidemiologic evidence is less consistent, potentially driven by differing methodologies, particularly in defining and measuring food variety. Moreover, the effect of variety on energy balance appears to be moderated by food energy density. Integrating insights from experimental and epidemiologic research are essential for strengthening food variety guidance including developing evidence-based definitions of food variety, understanding moderators of the relationship, and developing practical guidance interpretable to consumers.

The purpose of this study was to explore relations between food craving, caloric intake, and body mass index (BMI) changes over the course of an 18-month weight loss trial. Two-hundred two obese adults (mean BMI = 34.9 kg/m 2 ; mean age = 51.30 years, 92.2% White; 57.8% female) who participated in a behavioral weight loss trial completed measures of food craving, caloric intake, and BMI at baseline, 6 and 18 months. From baseline to 6 months, higher initial food cravings were associated with more gradual and less steep reductions in BMI. Additionally, the relation between changes in food craving and BMI changes varied by levels of change in caloric intake, such that BMI change and change in food cravings were positively associated at low levels of change in caloric intake, but were unrelated at average and high levels of change in caloric intake. Similarly, from baseline to 6 months and from 6 to 18 months, the relation between changes in food craving and BMI changes also varied by initial levels of caloric intake. Explicit clinical targeting of food craving management may be beneficial for individuals beginning weight loss programs, especially for those who report higher levels of food craving at baseline. Baseline caloric intake and change in calorie intake over time may serve as moderators of the relation between food cravings and BMI.

Background: When a hypocaloric, low-fat diet is prescribed, intake of currently consumed foods can decrease, foods naturally low in fat and/or added sugar may increase, or fat- or sugar-modified foods may increase., Objective: To examine food group intake change and its relation to reductions in energy and fat intake and weight during a lifestyle intervention., Design: Secondary cohort analysis., Participants: One hundred sixty-nine participants (aged 52.0±8.6 years, body mass index 34.9±4.5, 92% white, 97.6% non-Hispanic, and 56.8% women) with complete data at 0 and 6 months collected in a research setting., Main Outcome Measures: From three 24-hour telephone dietary recalls, 165 food groups from Nutrition Data System for Research software were coded into 25 larger food groups assessing intake of higher-fat and/or added-sugar food groups vs naturally lower-fat and/or added-sugar food groups and into 17 larger food groups assessing intake of nonmodified vs fat- and/or sugar-modified food groups., Statistical Analyses Performed: Repeated measures analyses of covariance (intervention group: covariate) assessed changes from 0 to 6 months. Hierarchical regressions examined changes in food group intake and changes in energy intake, percent energy from fat intake, and weight from 0 to 6 months., Results: Significant reductions (P<0.05) in intake of high-fat and/or high-added-sugar food groups (Higher-Fat Dairy; Higher-Fat Eggs; Higher-Fat Fats; Higher-Fat Fruit; Higher-Fat Meat; Nonmodified Higher-Fat Fats, Oils, and Sweets; Nonmodified Higher-Fat Sugar-Sweetened Fats, Oils, and Sweets; Nonmodified Regular-Fat Dairy; and Nonmodified Regular-Fat Sugar-Sweetened Dairy) occurred. Decreases in the Higher-Fat Meat group were significantly (P<0.05) related to decreases in energy intake, percent energy from fat intake, and weight., Conclusions: When a hypocaloric, low-fat diet is prescribed, reductions in high-fat and/or high-added-sugar food groups occur. Targeting reductions in high-fat meats may improve outcomes., (Copyright © 2016 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.)

It has been recommended that beverages other than 100% fruit juice, such as water, be served at meals and snacks for preschool-aged children to reduce excessive energy intake. Using a 2 × 2 × 2 design (between-subjects factor of order and within-subjects factors of beverage type and size), 26 children (3.9 ± 0.6 years of age, 50% female, 73% white, and 88.5% non-Hispanic or Latino) completed four, 20-min snack sessions consisting of 200 g of applesauce, 60 g of graham crackers, and either 6 oz. (approximately 180 g) or 12 oz. (approximately 360 g) of 100% berry fruit juice or water, to examine the influence of 100% fruit juice and the portion size of the provided fruit juice, on beverage, food, and overall snack intake. Mixed-factor analyses of covariance revealed a significant (p < 0.05) beverage type and size interaction for amount of beverage consumed, with the 12 oz. juice condition consuming the greatest amount of beverage (226.6 ± 116.4 g), and for energy consumed from food, with the 12 oz. water condition consuming more than the 12 oz. juice condition (117.7 ± 69.1 kcal vs. 88.5 ± 64.1 kcal). A main effect of beverage type was found on overall snack energy intake, with more overall energy consumed when juice was provided (175.4 ± 50.0 kcal vs. 104.8 ± 62.8 kcal, p < 0.001). Providing preschool-aged children with a larger size of beverage at a snack increased beverage and/or food intake, and serving 100% juice led to greater overall snack energy intake. Future research should examine the role of 100% fruit juice, and beverage portion size, in contributing to excessive daily energy intake in preschool-aged children., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Single-serving packages (SSPs) may assist people in reducing consumption. Because overweight/obese individuals and individuals practicing dietary restraint may be more responsive to external food cues regarding an amount of food to consume, we examined whether weight and restraint status influence the relationship between package size and consumption. It was hypothesized that SSPs would reduce intake in overweight/obese individuals and individuals practicing dietary restraint compared with standard packages (STPs). Using a 2×2×2 (unrestrained/restrained×normal weight/overweight×SSP/STP) between-subjects design, 64 participants (aged 23.7±3.3 years; 81.3% white; 46.9% female), from June to October 2011, were randomly assigned to receive 20 oz pretzels packaged in SSPs or STPs, and were instructed to eat the pretzels ad libitum for 4 days. Each condition in the design contained eight participants. Total grams consumed was determined by subtracting postconsumption from preconsumption weight of packages provided. Using an analysis of variance for total grams of pretzels consumed, there was a significant interaction (P=0.01) between package size and weight status. Overweight/obese participants in the SSP condition ate fewer grams of pretzels than overweight/obese participants in the STP condition (107.0±101.9 g vs 204.4±144.9; P<0.05). No effect of restraint was found on consumption. For overweight/obese individuals, fewer pretzels were consumed when packaged in SSPs compared with STPs. Thus, replacing STPs with SSPs may assist with reducing consumption in some overweight/obese individuals., (Copyright © 2014 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.)

Objective: To examine the effect of experimental changes in children's sleep duration on self-reported food intake, food reinforcement, appetite-regulating hormones, and measured weight., Methods: Using a within-subjects, counterbalanced, crossover design, 37 children, 8 to 11 years of age (27% overweight/obese) completed a 3-week study. Children slept their typical amount at home for 1 week and were then randomized to either increase or decrease their time in bed by 1.5 hours per night for 1 week, completing the alternate schedule on the third week. Primary outcomes were dietary intake as assessed by 24-hour dietary recalls, food reinforcement (ie, points earned for a food reward), and fasting leptin and ghrelin. The secondary outcome was child weight., Results: Participants achieved a 2 hour, 21 minute difference in the actigraph defined sleep period time between the increase and decrease sleep conditions (P < .001). Compared with the decrease sleep condition, during the increase condition, children reported consuming an average of 134 kcal/day less (P < .05), and exhibited lower fasting morning leptin values (P < .05). Measured weights were 0.22 kg lower during the increase sleep than the decrease sleep condition (P < .001). There were no differences in food reinforcement or in fasting ghrelin., Conclusions: Compared with decreased sleep, increased sleep duration in school-age children resulted in lower reported food intake, lower fasting leptin levels, and lower weight. The potential role of sleep duration in pediatric obesity prevention and treatment warrants further study.

Little is known as to how 6-n-propylthiouracil (PROP) taster status may influence changes in dietary intake in adults participating in a lifestyle intervention to assist with reducing weight. This secondary data analysis examined changes in energy, percent energy from macronutrients, and food group intake; physical activity; and body mass index (BMI) in super-tasters and non-tasters participating in two randomized controlled trials implementing a lifestyle obesity intervention. One trial focused on lowering energy density of the diet and the other trial focused on changing eating frequency. Overweight and obese participants (n = 57) who completed measures of dietary intake, physical activity, and anthropometrics at 0 and 3 months were included in the analyses. Taster status was determined at baseline: 46 non-tasters and 11 super-tasters. After controlling for condition assignment and baseline values, results indicated that a significantly greater reduction in energy intake occurred for super-tasters as compared to non-tasters (-1149 ± 561 kcal/day vs. -902 ± 660 kcal/day, p < 0.05). No other significant differences in changes in dietary intake, physical activity, or BMI were found. These results suggest that in situations of reducing energy intake, overweight and obese super-tasters may be more successful than overweight and obese non-tasters. More research is needed to understand the influence of taster-status on dietary change during a lifestyle intervention and how this may impact weight loss., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

Greater variety of energy-dense foods increases intake in meals composed of several courses. Little research has examined the effect of variety in low-energy-dense foods (i.e., fruits and vegetables). This study examined the effect of fruit variety on fruit intake during a four-course snack. Twenty unrestrained eaters (50% female, 100% White and Non-Hispanic, aged 26.5±8.1years, with a body mass index [BMI] of 22.9±3.0kg/m) completed two, counter-balanced sessions, VARIETY and NON-VARIETY. In VARIETY, participants received four highly-liked fruits over 4, 7-min courses, while in NON-VARIETY participants received their most highly-liked fruit (fruit 1) for each of the four courses, to consume ad libitum. Intake, grams and energy, in each course was measured. Changes in pleasantness for each of the four fruits, with measures taken prior to course 1 and at the completion of course 4, were calculated. Greater intake (grams and energy) occurred in course 4 in VARIETY as compared to NON-VARIETY. Changes in pleasantness for fruit 1 were significantly different between the sessions, with NON-VARIETY decreasing more so than VARIETY. These results indicate that greater fruit variety increased fruit consumption in the last course, which may be due to differential changes in fruit pleasantness., (Copyright © 2012 Elsevier Ltd. All rights reserved.)

Dietary goals specific for lowering energy density (ED) may promote a nutrient-dense diet and weight loss. This pilot study examined the effects of ED-based diet prescriptions on diet quality and weight loss during a 3-month behavior-based obesity intervention conducted in a research setting. Forty-four adults with overweight/obesity (age 52.1±7.6 years, body mass index [BMI; calculated as kg/m(2)] 34.8±4.8, 81.8% women, and 93.2% white) were recruited between December 2009 and March 2010 and randomly assigned to: Low ED (consume ≥10 foods ≤1.0 kcal/g dietary ED and ≤2 foods ≥3.0 kcal/g dietary ED per day (n=15); Low-Energy, Low-Fat (1,200 to 1,500 kcal/day, ≤30% energy from fat (n=15); or Low-ED, Low-Energy, Low-Fat (n=14). Participants received 12 weekly group sessions led by a research interventionist. Dietary intake (measured by 3-day food records), self-reported physical activity, and weight were measured at baseline and 3 months. Intent-to-treat analyses showed all conditions reduced dietary ED and energy intake (P<0.001). Low-ED and Low-ED, Low-Energy, Low-Fat interventions increased fruit consumption (P<0.05). All conditions increased self-reported physical activity (P<0.001), with no difference between conditions. Although participants in all conditions lost weight (P<0.001), those in the Low-ED condition lost more (P<0.05) than those in the Low-ED, Low-Energy, Low-Fat condition (Low-ED -20.5±7.0 lb, Low-Energy, Low-Fat -16.9±10.1 lb, and Low-ED, Low-Energy, Low-Fat -12.5± 6.5 lb). A diet prescription that lowered ED increased fruit intake and enhanced weight loss compared with other weight loss prescriptions., (Copyright © 2012 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.)

Due to the high prevalence of overweight and obesity, developing strategies to improve weight loss and weight loss maintenance is imperative. One dietary environmental variable that has received little attention in being targeted in an intervention to assist with obesity treatment is dietary variety. Experimental research has consistently shown that greater dietary variety increases consumption, with the effect of variety on consumption hypothesized to be a consequence of the differential experience of the more varied sensory properties of food under those conditions with greater dietary variety. As reduced energy intake is required for weight loss, limiting variety, particularly in food groups that are high in energy-density and low in nutrient-density, may assist with reducing energy intake and improving weight loss. A series of investigations, both observational and experimental, were conducted to examine if limiting variety in an energy-dense, non-nutrient-dense food group, snack foods (i.e., cookies, chips), assisted with reducing energy intake of the food group and improving weight loss. Results of the investigations suggest that a prescription for limiting variety in a food group can be implemented during obesity treatment, limiting variety is associated with the occurrence of monotony, and that reducing food group variety is related to decreased consumption of that food group. Future research is needed to ascertain the long-term effect of prescriptions targeting dietary variety on weight loss and weight loss maintenance., (Copyright © 2012 Elsevier Inc. All rights reserved.)

Background: Genome-wide association studies (GWAS) have identified consistent associations with obesity. However, the mechanisms remain unclear., Objective: The objective was to determine the association between obesity susceptibility loci and dietary intake., Design: The association of GWAS-identified obesity risk alleles (FTO, MC4R, SH2B1, BDNF, INSIG2, TNNI3K, NISCH-STAB1, MTIF3, MAP2K5, QPCTL/GIPR, and PPARG) with dietary intake, measured through food-frequency questionnaires, was investigated in 2075 participants from the Look AHEAD (Action for Health in Diabetes) clinical trial. We adjusted for age, sex, population stratification, and study site., Results: Obesity risk alleles at FTO rs1421085 significantly predicted more eating episodes per day (P = 0.001)-an effect that persisted after adjustment for body weight (P = 0.004). Risk variants within BDNF were significantly associated with more servings from the dairy product and the meat, eggs, nuts, and beans food groups (P ≤ 0.004). The risk allele at SH2B1 rs4788099 was significantly associated with more servings of dairy products (P = 0.001), whereas the risk allele at TNNI3K rs1514176 was significantly associated with a lower percentage of energy from protein (P = 0.002)., Conclusion: These findings suggest that obesity risk loci may affect the pattern and content of food consumption among overweight or obese individuals with type 2 diabetes. The Look AHEAD Genetic Ancillary Study was registered at clinicaltrials.gov as NCT01270763 and the Look AHEAD study as NCT00017953.

Background: Dietary variety is a factor that influences consumption but has received little attention in obesity treatment., Objective: This study examined the effect of limiting the variety of different non-nutrient-dense, energy-dense foods (NND-EDFs) (i.e., chips, ice cream, cookies) on dietary intake and weight loss during an 18-mo lifestyle intervention., Design: Two hundred two adults aged 51.3 ± 9.5 y with a BMI (in kg/m2) of 34.9 ± 4.3 (57.8% women, 92.2% white) were randomly assigned to 1 of 2 interventions: Lifestyle (1200-1500 kcal/d, ≤30% of energy as fat; n = 101) or Lifestyle + limited variety (LV) (limit variety of NND-EDFs, i.e., 2 choices; n = 101). Both interventions involved 48 group sessions. Dietary intake, NND-EDF hedonics, NND-EDF variety in the home, and weight were assessed at 0, 6, 12, and 18 mo., Results: Intent-to-treat analyses showed that the Lifestyle+LV group consumed less variety (P < 0.01) and energy daily (P < 0.05) from NND-EDFs than did the Lifestyle group at 6, 12, and 18 mo. The Lifestyle+LV group consumed less total energy daily (P < 0.05) at 6 mo than did the Lifestyle group. The Lifestyle+LV group reported less (P < 0.05) NND-EDF variety in the home at 6 and 18 mo than did the Lifestyle group. The hedonics of one chosen NND-EDF decreased more (P < 0.05) in the Lifestyle+LV group. Despite these effects, no difference in percentage weight loss occurred at 18 mo (Lifestyle+LV: -9.9 ± 7.6%; Lifestyle: -9.6 ± 9.2%)., Conclusions: Limitations in dietary variety decreased intakes in the targeted area but did not affect weight loss. Limiting variety in more areas may be needed to improve weight loss and weight-loss maintenance. This trial was registered at clinicaltrials.gov as NCT01096719.

Eating frequency has been inversely related to BMI but the impact of eating frequency on weight loss is unclear. This randomized controlled trial pilot study examined the effect of eating frequency on hunger, energy intake, and weight loss during a 6-month behavioral weight loss intervention. Participants (age: 51.0 ± 9.9 years, BMI: 35.5 ± 4.8 kg/m(2), 57.8% female, 94.1% white) were randomized to one of two eating frequency prescriptions: Three meal (n = 25): three eating bouts/day; or grazing (n = 26): eat at least 100 kcals every 2-3 h. Both groups attended 20 sessions and had identical dietary (1,200-1,500 kcals/day, <30% kcals from fat) and physical activity goals (200 min/week). Assessments were conducted at 0, 3, and 6 months. Using intent-to-treat analyses, grazing reported a greater eating frequency than three meal at 6 months (5.8 ± 1.1 eating bouts/day vs. 3.2 ± 0.6 eating bouts/day, P < 0.001). Grazing reported a significant reduction in hunger from 0 to 6 months (56.3 ± 15.7 mm vs. 47.9 ± 18.5 mm, P < 0.05). Energy intake and BMI were significantly (P < 0.001) reduced from 0 to 6 months (energy intake: 2,198 ± 692 kcals/day vs. 1,266 ± 353 kcals/day; BMI: 35.5 ± 4.8 kg/m(2) vs. 30.6 ± 4.9 kg/m(2)). There were no significant differences in energy intake or BMI between the groups. While eating more frequently reduced hunger, it may not be related to greater reductions in energy intake or BMI during a behavioral weight loss intervention.

Acute energy and macronutrient intake following an Exercise and Control protocol was compared to determine if active, normal-weight males regulate acute energy intake better, demonstrating more acute accurate energy compensation capabilities, than inactive, normal-weight males after exercise. Males (21.2±1.9 years) of normal percent body fat (10.0-18.0%) and body mass index (23.4±1.7 kg/m(2)), exercising ≥150 min/week (Active: n=10) or ≤60 min/week (Inactive: n=10), completed two protocols, counterbalanced across participants. The exercise protocol (Exercise) was 45-min on a cycle ergometer and the Control protocol consisted of 45-min of reading. Sixty minutes after protocols, an ad libitum meal was provided. Energy and macronutrient intake from the meal was determined. Inactive ate significantly less energy in the ad libitum meal in Exercise as compared to Control, demonstrating acute negative energy compensation (consumed less in the meal while expending more energy in Exercise as compared to Control). Active had no difference in meal energy intake between the protocols, but due to Inactive's reduced acute energy intake in Exercise, Active demonstrated better acute energy compensation than Inactive. No difference in meal macronutrient intake was found. Overall, Active demonstrated better acute energy compensation than Inactive., (Copyright © 2011 Elsevier Ltd. All rights reserved.)

Underreporting in self-reported dietary intake has been linked to dietary restraint (DR) and social desirability (SD), however few investigations have examined the influence of both DR and SD on reporting accuracy and used objective, rather than estimated, measures to determine dietary reporting accuracy. This study investigated accuracy of reporting consumption of a laboratory meal during a 24-hour dietary recall (24HR) in 38 healthy, college-aged, normal-weight women, categorized as high or low in DR and SD. Participants consumed a lunch of four foods (sandwich wrap, chips, fruit, and ice cream) in a laboratory and completed a telephone 24HR the following day. Accuracy of reported energy intake of the meal=((reported energy intake-measured energy intake)/measured energy intake)×100 [positive numbers=overreporting]. Overreporting of energy intake occurred in all groups (overall accuracy rate=43.1±49.9%). SD-high as compared to SD-low more accurately reported energy intake of chips (19.8±56.2% vs. 117.1±141.3%, p<0.05) and ice cream (17.2±78.2% vs. 71.6±82.7%, p<0.05). SD-high as compared to SD-low more accurately reported overall energy intake (29.8±48.2% vs. 58.0±48.8%, p<0.05). To improve accuracy of dietary assessment, future research should investigate factors contributing to inaccuracies in dietary reporting and the best methodology to use to determine dietary reporting accuracy., (Copyright © 2011 Elsevier Ltd. All rights reserved.)

Research shows a positive relationship between dietary energy density (ED) and body mass index (BMI), but dietary ED of weight loss maintainers is unknown. This preliminary investigation was a secondary data analysis that compared self-reported dietary ED and food group servings consumed in overweight adults (OW: BMI=27-45kg/m(2)), normal weight adults (NW: BMI=19-24.9 kg/m(2)), and weight loss maintainers (WLM: current BMI=19-24.9kg/m(2) [lost≥10% of maximum body weight and maintained loss for ≥5years]) participating in 2 studies, with data collected from July 2006 to March 2007. Three 24-h phone dietary recalls from 287 participants (OW=97, NW=85, WLM=105) assessed self-reported dietary intake. ED (kcal/g) was calculated by three methods (food+all beverages except water [F+AB], food+caloric beverages [F+CB], and food only [FO]). Differences in self-reported consumption of dietary ED, food group servings, energy, grams of food/beverages, fat, and fiber were assessed using one-way MANCOVA, adjusting for age, sex, and weekly energy expenditure from self-reported physical activity. ED, calculated by all three methods, was significantly lower in WLM than in NW or OW (FO: WLM=1.39±0.45kcal/g; NW=1.60±0.43 kcal/g; OW=1.83±0.42 kcal/g). Self-reported daily servings of vegetables and whole grains consumed were significantly higher in WLM compared to NW and OW (vegetables: WLM=4.9±3.1 servings/day; NW=3.9±2.0 servings/day; OW=3.4±1.7 servings/day; whole grains: WLM=2.2±1.8 servings/day; NW=1.4±1.2 servings/day; OW=1.3±1.3 servings/day). WLM self-reported consuming significantly less energy from fat and more fiber than the other two groups. Self-reported energy intake per day was significantly lower in WLM than OW, and WLM self-reported consuming significantly more grams of food/beverages per day than OW. These preliminary findings suggest that consuming a diet lower in ED, characterized by greater intake of vegetables and whole grains, may aid with weight loss maintenance and should be further tested in prospective randomized controlled trials., (Copyright © 2011 Elsevier Ltd. All rights reserved.)

The influence of dietary environmental factors on child weight status may be important in the battle against childhood obesity. Portion size and energy density are factors shown to impact entrée energy intake in children. However, the influence of these factors on child snack energy intake has not been studied. Thus, the aim of this study was to investigate the impact of portion size on intake of a lower energy-dense and higher energy-dense snack in preschool-aged children. A 2×2 crossover design (within-subject factors of portion size and energy density) was conducted on Wednesdays in a preschool setting on the University of Tennessee campus from October 2008 to November 2008. Seventeen children had complete data (age 3.8±0.6 years; 10 of 17 were female; 14 of 17 were white). Foods were applesauce (lower energy dense=0.43 kcal/g) and chocolate pudding (higher energy dense=1.19 kcal/g), and portion sizes were 150 g (small) and 300 g (large). Measures included anthropometrics, hunger, liking of foods, and caretakers' child-feeding practices using validated instruments. Mixed factorial analyses of covariance, with order controlled, analyzed gram and energy snack intake across conditions. There was no significant main effect of energy density on snack intake, but the main effect of portion size on snack intake (small portion size 84.2±30.8 kcal, large portion size 99.0±52.5 kcal; P<0.05) was significant. Results indicate increased energy intake when snacks are offered in larger portion size, regardless of energy density. Snack portion size may be an environmental strategy that can reduce excessive energy intake in children., (Copyright © 2011 American Dietetic Association. Published by Elsevier Inc. All rights reserved.)

Larger portion sizes increase energy intake, yet it is unclear whether single-serving packages can reduce intake. This study examined the effects of providing breakfast foods in single-serving packages and nonportioned packages on energy intake of these foods during an 8-week behavioral weight-loss program. In fall 2005, 19 adults (mean body mass index [calculated as kg/m(2)]=31.8+/-4.0) were randomized to conditions that provided foods in single-serving packages (Single-Serving) or in nonportioned packages (Standard). Overall amounts and types of foods provided were consistent across conditions: cereal and peaches (weeks 1, 3, 5, and 7) and applesauce and cheese (weeks 2, 4, 6, and 8). Participants were instructed to eat one serving of each food for breakfast and not to consume the provided foods at other times. Mean daily energy intake of the provided foods was the primary dependent variable. The Single-Serving group ate less energy from the combined pairs of foods provided together as compared to Standard (cereal and peaches, 117.0+/-3.2 kcal/day vs 143.5+/-39.3 kcal/day; P<0.05 and applesauce and cheese, 174.2+/-13.5 kcal/day vs 199.0+/-29.4 kcal/day; P<0.05). This effect was a result of less energy consumed from cereal and applesauce in Single-Serving compared to Standard conditions (cereal, 80.2+/-2.9 kcal/day vs 106.3+/-22.9 kcal/day; P<0.01 and applesauce, 44.5+/-0.6 kcal/day vs 59.3+/-5.0 kcal/day; P<0.01), with no differences in energy consumption for peaches and cheese (P>0.10). This suggests that single-serving packages may help reduce energy intake at breakfast within the context of a behavioral weight-control program.

Objective: Compare parent-reported preschool- and school-aged children's eating and leisure-time activity patterns that are proposed to influence energy balance., Design: Cross-sectional investigation of children, 2 to 12 years, attending a well visit., Setting: Pediatric private practice/ambulatory pediatric clinic., Participants: One hundred seventy-four children: 49% preschool-aged, 54% female, 28% Hispanic, and 34% overweight or at risk for overweight., Variables Measured: Parent-reported eating/leisure-time behaviors. Height/weight from medical records., Analysis: Analyses of covariance/chi-square tests; significance at P

Purpose: To investigate whether fast food consumption and breakfast skipping are associated with weight gain during the transition from adolescence to adulthood., Methods: A prospective study of 9919 adolescents participating in Waves II (age range 11-21 years) and III (age range 18-27 years) of the National Longitudinal Study of Adolescent Health. BMI z scores (zBMI) were computed using the 2000 Centers for Disease Control and Prevention growth charts. Multivariate regression models assessed the relationship between Wave II fast food and breakfast consumption and change in fast food and breakfast consumption between Waves II and III and weight gain during the transition to adulthood., Results: Marked increases in fast food consumption and decreases in breakfast consumption occurred over the 5-year interval. Greater days of fast food consumption at Wave II predicted increased zBMI at Wave III. Fewer days of breakfast consumption at Wave II and decreases in breakfast consumption between Waves II and III predicted increased zBMI at Wave III., Conclusions: Fast food consumption and breakfast skipping increased during the transition to adulthood, and both dietary behaviors are associated with increased weight gain from adolescence to adulthood. These behaviors may be appropriate targets for intervention during this important transition.

Decreased variety within a meal reduces intake, which is hypothesized to be due to sensory-specific satiety. This study examined whether reduced variety across days also influences food hedonics and intake. Twenty-one, non-obese, college-aged, dietarily unrestrained males were randomized to one of two conditions: a Same Snack condition in which they were given the same sweet snack food (crumb cake) to eat in four laboratory sessions and to take home and eat between sessions, or a Variety condition in which they were given different snack foods (both sweet and salty) to eat in four sessions and to take home and eat between sessions. Dependent measures were caloric intake from crumb cake and hedonic ratings of snack foods in sessions 1 and 4. Mixed repeated measures analysis of variance found no effect of snack food variety on consumption. However, the Same Snack condition had a lower hedonic rating of the crumb cake on Day 4 than the Variety condition and the change from day 1 to 4 in hedonics of the crumb cake was greater than that of the salty snack foods in the Same Snack condition. These findings indicate that limiting variety across several days reduces hedonics of the limited food.

Background: Changes in sedentary behavior may be related to changes in energy intake., Objective: The purpose of this study was to investigate how experimental changes in the amount of sedentary behaviors influence energy intake., Design: Sixteen nonoverweight 12-16-y-old youth were studied in a within-subject crossover design with three 3-wk phases: baseline, increasing targeted sedentary behaviors by 25-50% (increase phase), and decreasing targeted sedentary behaviors by 25-50% (decrease phase). Repeated 24-h recalls were used to assess energy and macronutrient intakes during targeted sedentary behaviors. Accelerometers were used to assess activity levels., Results: Targeted sedentary behaviors increased by 81.5 min/d (45.8%) and decreased by 109.8 min/d (-61.2%) from baseline (both: P<0.01). Girls increased sedentary behaviors significantly more than did boys (107.3 and 55.8 min/d, respectively; P<0.01) in the increase phase. Energy intake decreased (-463.0 kcal/d; P<0.01) when sedentary behaviors decreased: the decrease in fat intake was -295.2 kcal/d (P<0.01). No significant changes in energy intake were observed when sedentary behaviors were increased. Youth also increased their activity by 102.4 activity counts min-1d-1 (estimated at 113.1 kcal) when sedentary behaviors were decreased (P<0.05)., Conclusions: Decreasing sedentary behaviors can decrease energy intake in nonoverweight adolescent youth and should be considered an important component of interventions to prevent obesity and to regulate body weight.

Watching television while eating and eating from larger portion sizes of food are factors that have been found to independently increase food intake. When combined, these factors may further enhance consumption. This investigation, using a 4 × 2 × 2 mixed factorial design, with a between-subjects factor of order of conditions and within-subjects factors of television watching (NO TV and TV) and portion size (SMALL and LARGE), tested the independent effects and interaction of these factors in seventeen women and three men (21.6 ± 2.3 kg/m 2 , 22.3 ± 3.7 years, 80% white and 95% non-Hispanic). In each condition, participants had 30 min to eat a meal containing macaroni and cheese and salad with dressing. For NO TV, participants sat for 30 min while eating, while for TV, participants viewed a 30-min show containing no food cues while eating. In SMALL the meal provided 1083 kcal, while in LARGE the meal provided 200% of SMALL. Mixed factorial analysis of variance revealed a significant main effect of portion size on grams and energy consumed of the total meal. Participants consumed more grams (577.9 ± 150.5 g vs. 453.1 ± 96.6 g; p < 0.001) and energy (903.9 ± 270.4 kcal vs. 734.6 ± 187.1 kcal; p < 0.001) in LARGE as compared to SMALL. No significant effect of television watching or interaction of television watching and portion size was found. Results of this study suggest that to assist with reducing intake, smaller portion sizes should be implemented in all types of eating situations. [ABSTRACT FROM AUTHOR]

Objective: Large portions increase intake and are hypothesized to contribute to the obesity epidemic. However, it is unclear if portion size affects intake through changes in the unit size of available food or the overall amount of food available for consumption. Thus, this study examined the independent effects of package unit size and amount of food on intake. It was hypothesized that both variables would influence intake.Research Methods and Procedures: Non-obese (BMI <30 kg/m(2)), non-smoking, unrestrained, college-aged men (n = 12) and women (n = 16) who regularly consumed (>or=3 times/wk) snack foods were randomly assigned to one of four groups crossing package unit size (small vs. large) and amount of food (small vs. large). Participants were given a box with 4 snack foods (potato chips, cheese crackers, cookies, and candy) packaged according to their assigned group to take home and eat over 3 days. Dependent variables were energy and gram intake of provided snack foods.Results: An effect of amount of food was found (p < 0.01). A 100% increase in the amount of food provided produced an 81% increase in energy consumed from the snack foods [small amount, 21,037.6 +/- 10,852 kJ (5,028 +/- 2,596 kcal) vs. large amount, 11,640.7 +/- 4,914.1 kJ (2,782 +/- 1,174 kcal)]. No effect of package unit size was found.Discussion: These results suggest that the amount of food available to eat strongly influences intake. [ABSTRACT FROM AUTHOR]

Concerns remain about dietary changes during pediatric obesity treatment and eating pathology, which have not been investigated. This secondary data analysis from a randomized clinical trial examined associations between adolescents' changes in energy intake and diet quality during obesity treatment with post-treatment eating pathology. Adolescents (N = 82: 13.7 ± 1.2 y, 34.9 ± 7.0 kg/m2, 63.4% female, 46.3% black) received TEENS+, a 4-month multicomponent intervention. TEENS+ provided individualized dietary goals (1200–1800 kcal/day; number of "Go" foods/day (low-energy, high-nutrient-dense foods)). At 0 and 4 months, 3-day food records assessed energy intake and diet quality (Healthy Eating Index 2015 (HEI-2015)). Two HEI-2015 subscores were created: components to increase (increase), and components to limit (decrease). The Eating Disorder Examination Questionnaire measured eating pathology (total score and subscales: restraint; and eating, weight, and shape concern). Corrected p-values are reported as q-values. Energy intake decreased (−292 ± 418 kcal/day; q < 0.001), while diet quality improved during treatment (total HEI-2015 (4.5 ± 15.1; q = 0.034) and increase (3.3 ± 9.4; q = 0.011)). Restraint increased (+0.6 ± 1.4; q < 0.001), whereas shape (−0.5 ± 1.3; q = 0.004) and weight (−0.5 ± 1.4; q = 0.015) concerns decreased. Greater decreases in energy intake were associated with greater restraint post-treatment (F = 17.69; q < 0.001). No other significant associations were observed. Changes in adolescents' dietary intake during obesity treatment were unrelated to increased shape, weight, or eating concerns post-treatment. [ABSTRACT FROM AUTHOR]

Understanding and intervening on eating behavior often necessitates measurement of energy intake (EI); however, commonly utilized and widely accepted methods vary in accuracy and place significant burden on users (e.g., food diaries), or are costly to implement (e.g., doubly labeled water). Thus, researchers have sought to leverage inexpensive and low-burden technologies such as wearable sensors for EI estimation. Paradoxically, one such methodology that estimates EI via smartwatch-based bite counting has demonstrated high accuracy in laboratory and free-living studies, despite only measuring the amount, not the composition, of food consumed. This secondary analysis sought to further explore this phenomenon by evaluating the degree to which EI can be explained by a sensor-based estimate of the amount consumed versus the energy density (ED) of the food consumed. Data were collected from 82 adults in free-living conditions (51.2% female, 31.7% racial and/or ethnic minority; M age = 33.5, SD = 14.7) who wore a bite counter device on their wrist and used smartphone app to implement the Remote Food Photography Method (RFPM) to assess EI and ED for two weeks. Bite-based estimates of EI were generated via a previously validated algorithm. At a per-meal level, linear mixed effect models indicated that bite-based EI estimates accounted for 23.4% of the variance in RFPM-measured EI, while ED and presence of a beverage accounted for only 0.2% and 0.1% of the variance, respectively. For full days of intake, bite-based EI estimates and ED accounted for 41.5% and 0.2% of the variance, respectively. These results help to explain the viability of sensor-based EI estimation even in the absence of information about dietary composition. [ABSTRACT FROM AUTHOR]

Abstract: Greater food variety is related to increased energy intake, and one approach to reduce food intake is to reduce food variety. The effects of varying the variety of foods at the dinner meal to reduce energy intake was assessed in laboratory and field experiments. Experiment 1 randomly assigned 31 overweight children to one of three conditions that provided one laboratory meal per day over a week. Conditions were the SAME macaroni and cheese, SIMILAR types of macaroni and cheese, or a VARIETY of high-energy-dense foods. On days 1 and 5 all children consumed the same macaroni and cheese meal. Results showed significant differences in energy consumed between SAME and SIMILAR versus VARIETY from day 1 to 5, with SAME and SIMILAR decreasing and VARIETY increasing energy intake. Trials to habituation, a potential mechanism for the variety effect, showed the same pattern of between group differences as energy intake. Experiment 2 randomly assigned 30 overweight children to conditions that provided the SAME, SIMILAR or VARIETY of high-energy-dense entrees along with a variety of low-energy-dense dinner entrees to eat in their homes for 4weeks. Results showed significant between group differences in energy intake across weeks, with significant decreases over weeks for the SAME and SIMILAR versus VARIETY groups. The pattern of results across the experiments shows the same pattern of reduction in energy intake if children eat the same or similar characteristics of foods (types of macaroni and cheese), which may provide ideas about how to develop dietary variety prescriptions that can reduce intake and be tested in clinical trials. [Copyright &y& Elsevier]