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Food structure affects the breakdown kinetics of food. This has been extensively studied via in vitro digestion models. However, these in vitro findings need to be verified in vivo. Previously, we found that MRI parameters (T1 and T2 relaxation times) can serve as markers of protein digestion. Here, we assessed the effect of food hardness and protein content on gastric emptying as well as the application of these MRI parameters to monitor in vivo gastric digestion of solid foods. In a randomized cross-over trial, 18 healthy males (age: 27 ± 5 y; BMI 23 ± 1 kg/m2) ingested three gels: a soft gel with low protein content (Soft-LP), a hard gel with low protein content (Hard-LP), and a hard gel with high protein content (Hard-HP). Before and every 10 min after ingestion till 85 min, abdominal MRI scans were obtained to determine the gastric content volume and T1 and T2 of the gastric content. The decrease in gastric content volume differed among gels: Hard-HP < Hard-LP < Soft-LP. For all gels, mean T1 and T2 of the measured stomach content decreased directly after ingestion and then after 15 min gradually increased with Hard-HP < Hard-LP < Soft-LP. In conclusion, high protein content and high hardness slowed gastric emptying down. In addition, we show that T1 and T2 measurements provide extra information on the dilution and digestion of solid foods in the stomach. This underpins the potential of MRI to provide insights into in vivo protein digestion and link in vitro and in vivo digestion research.

Background: Conventional dietary assessment methods are affected by measurement errors. We developed a smartphone-based 2-h recall (2hR) methodology to reduce participant burden and memory-related bias. Objective: Assessing the validity of the 2hR method against traditional 24-h recalls (24hRs) and objective biomarkers. Methods: Dietary intake was assessed in 215 Dutch adults on 6 randomly selected nonconsecutive days (i.e., 3 2hR-days and 3 24hRs) during a 4-wk period. Sixty-three participants provided 4 24-h urine samples, to assess urinary nitrogen and potassium concentrations. Results: Intake estimates of energy (2052±503 kcal vs. 1976±483 kcal) and nutrients (e.g., protein: 78±23 g vs. 71±19 g; fat: 84±30 g vs. 79±26 g; carbohydrates: 220±60 g vs. 216±60 g) were slightly higher with 2hR-days than with 24hRs. Comparing self-reported protein and potassium intake to urinary nitrogen and potassium concentrations indicated a slightly higher accuracy of 2hR-days than 24hRs (protein: −14% vs. −18%; potassium: −11% vs. −16%). Correlation coefficients between methods ranged from 0.41 to 0.75 for energy and macronutrients and from 0.41 to 0.62 for micronutrients. Generally, regularly consumed food groups showed small differences in intake (0.60). Intake of energy, nutrients, and food groups showed similar reproducibility (intraclass correlation coefficient) for 2hR-days and 24hRs. Conclusions: Comparing 2hR-days with 24hRs showed a relatively similar group-level bias for energy, most nutrients, and food groups. Differences were mostly due to higher intake estimates by 2hR-days. Biomarker comparisons showed less underestimation by 2hR-days as compared with 24hRs, suggesting that 2hR-days are a valid approach to assess the intake of energy, nutrients, and food groups. This trial was registered at the Dutch Central Committee on Research Involving Human Subjects (CCMO) registry as ABR. No. NL69065.081.19.

Background Childhood obesity is influenced by myriad individual, societal and environmental factors that are not typically reflected in current interventions. Socio-ecological conditions evolve and require ongoing monitoring in terms of assessing their influence on child health. The aim of this study was to identify and prioritise indicators deemed relevant by public health authorities for monitoring and evaluating childhood obesity interventions. Method A three-round Delphi Panel composed of experts from regions across Europe, with a remit in childhood obesity intervention, were asked to identify indicators that were a priority in their efforts to address childhood obesity in their respective jurisdictions. In Round 1, 16 panellists answered a series of open-ended questions to identify the most relevant indicators concerning the evaluation and subsequent monitoring of interventions addressing childhood obesity, focusing on three main domains: built environments, dietary environments, and health inequalities. In Rounds 2 and 3, panellists rated the importance of each of the identified indicators within these domains, and the responses were then analysed quantitatively. Results Twenty-seven expert panellists were invited to participate in the study. Of these, 16/27 completed round 1 (5 9% response rate), 14/16 completed round 2 (87.5% response rate), and 8/14 completed the third and final round (57% response rate). Consensus (defined as > 70% agreement) was reached on a total of 45 of the 87 indicators (49%) across three primary domains (built and dietary environments and health inequalities), with 100% consensus reached for 5 of these indicators (6%). Conclusion Forty-five potential indicators were identified, pertaining primarily to the dietary environment, built environment and health inequalities. These results have important implications more widely for evaluating interventions aimed at childhood obesity reduction and prevention.

Recent studies suggest that circulating fibroblast growth factor 21 (FGF21) may be a marker of metabolic health status. We performed a secondary analysis of a 12-week randomized controlled trial to investigate the effects of two energy restriction (ER) diets on fasting and postprandial plasma FGF21 levels, as well as to explore correlations of plasma FGF21 with metabolic health markers, (macro)nutrient intake and sweet-taste preference. Abdominally obese subjects aged 40–70 years (n = 110) were randomized to one of two 25% ER diets (high-nutrient-quality diet or low-nutrient-quality diet) or a control group. Plasma FGF21 was measured in the fasting state and 120 min after a mixed meal. Both ER diets did not affect fasting or postprandial plasma FGF21 levels despite weight loss and accompanying health improvements. At baseline, the postprandial FGF21 response was inversely correlated to fasting plasma glucose (ρ = −0.24, p = 0.020) and insulin (ρ = −0.32, p = 0.001), HOMA-IR (ρ = −0.34, p = 0.001), visceral adipose tissue (ρ = −0.24, p = 0.046), and the liver enzyme aspartate aminotransferase (ρ = −0.23, p = 0.021). Diet-induced changes in these markers did not correlate to changes in plasma FGF21 levels upon intervention. Baseline higher habitual polysaccharide intake, but not mono- and disaccharide intake or sweet-taste preference, was related to lower fasting plasma FGF21 (p = 0.022). In conclusion, we found no clear evidence that fasting plasma FGF21 is a marker for metabolic health status. Circulating FGF21 dynamics in response to an acute nutritional challenge may reflect metabolic health status better than fasting levels.

L-arabinose is a bio-active compound derived from the side-streams of plant food processing. L-arabinose lowers glycemic and insulinemic responses when added to simple water-based sugary liquids. However, the effect in more complex foods, including fat and starch, is inconsistent. This study assessed the effect of fat or starch in a sugary drink on the efficacy of L-arabinose. Twenty-three healthy volunteers (12 female/11 male; aged 24 ± 3 years; BMI 23 ± 3 kg/m2) participated in a randomised cross-over trial with six drinks: control: 50 g sucrose in water; fat: control + 22 g oil; starch: control + 50 g starch; and all three with and without the addition of 5 g L-arabinose. The addition of L-arabinose to the control drink lowered glucose and insulin peaks by 15% and 52%; for the fat drink by 8% and 45%; and for the starch drink by 7% and 29%. For all three drinks, adding L-arabinose increased glucagon-like peptide 1 (GLP-1) responses and lowered Glucose-dependent insulinotropic polypeptide (GIP) responses. Despite adding large quantities of starch and fat to sugary drinks, L-arabinose significantly lowered postprandial glycemic and insulinemic responses in healthy subjects. These findings suggest that L-arabinose can be functional in more complex foods; however, the factors affecting its efficacy in solid food matrices need to be studied in more detail.

Worldwide initiatives currently aim to reduce free sugar intakes, but success will depend on consumer attitudes towards sugar and the alternatives. This work aimed to explore attitudes towards sugar, sweeteners and sweet-tasting foods in the general public of the UK, including attitudes towards personal consumption and related policies. Focus groups and interviews were conducted with 34 adults (7 males, ages: 18-65 years). Thematic analysis identified six themes: ‘Value’ (e.g. pleasure, emotions), ‘Angle’ (e.g. disinterest), ‘Personal Relevance’ (to be concerned and/or change one’s own behaviour), ‘Personal Responsibility’ (one has an active relationship with these food items), ‘Understanding’ (the acquisition, comprehension and application of information surrounding these food items) and ‘It’s Not Up to Me’ (a passive approach towards these food items, because intake is subjected to other factors). Both positive and negative attitudes towards sugar, sweeteners and sweet-tasting foods were expressed in all themes, largely dependent on the individual. Potential strategies for reducing free sugar intakes were also reported, but differences in likely value were suggested by different individuals. Future work should assess associations between attitudes and intakes. For greatest population benefit, evidence of the dominant attitudes in those in greatest need of reduced free sugar intakes would be of value.

The vast majority of dietary and eating behavior assessment methods are based on self-reports. They are burdensome and also prone to measurement errors. Recent technological innovations allow for the development of more accurate and precise dietary and eating behavior assessment tools that require less effort for both the user and the researcher. Therefore, a new sensor-based device to assess food intake and eating behavior was developed. The device is a regular dining tray equipped with a video camera and three separate built-in weighing stations. The weighing stations measure the weight of the bowl, plate, and drinking cup continuously over the course of a meal. The video camera positioned to the face records eating behavior characteristics (chews, bites), which are analyzed using artificial intelligence (AI)-based automatic facial expression software. The tray weight and the video data are transported at real-time to a personal computer (PC) using a wireless receiver. The outcomes of interest, such as the amount eaten, eating rate and bite size, can be calculated by subtracting the data of these measures at the timepoints of interest. The information obtained by the current version of the tray can be used for research purposes, an upgraded version of the device would also facilitate the provision of more personalized advice on dietary intake and eating behavior. Contrary to the conventional dietary assessment methods, this dietary assessment device measures food intake directly within a meal and is not dependent on memory or the portion size estimation. Ultimately, this device is therefore suited for daily main meal food intake and eating behavior measures. In the future, this technology based dietary assessment method can be linked to health applications or smart watches to obtain a complete overview of exercise, energy intake, and eating behavior.

The mouth is the first part of the gastrointestinal tract. During mastication sensory signals from the mouth, so-called oro-sensory exposure, elicit physiological signals that affect satiation and food intake. It has been established that a longer duration of oro-sensory exposure leads to earlier satiation. In addition, foods with more intense sweet or salty taste induce earlier satiation compared to foods that are equally palatable, but with lower taste intensity. Oro-sensory exposure to food affects satiation by direct signaling via the brainstem to higher cortical regions involved in taste and reward, including the nucleus accumbens and the insula. There is little evidence that oro-sensory exposure affects satiation indirectly through either hormone responses or gastric signals. Critical brain areas for satiation, such as the brainstem, should be studied more intensively to better understand the neurophysiological mechanisms underlying the process of satiation. Furthermore, it is essential to increase the understanding of how of highly automated eating behaviors, such as oral processing and eating rate, are formed during early childhood. A better understanding of the aforementioned mechanisms provides fundamental insight in relation to strategies to prevent overconsumption and the development of obesity in future generations.

Gastric digestion is crucial for protein breakdown. Magnetic resonance techniques have a great deal of potential but remain underexplored with regard to their application in the study of food digestion via MRI-markers, such as transverse (R2) and longitudinal (R1) relaxation rates. R2 has been used to monitor gastric digestion of whey protein gels, but only in a static in vitro model. It is essential to investigate whether relaxation rates can be valid measures of digestion under dynamic circumstances. We developed a novel MRI-compatible semi-dynamic gastric simulator (MR-GAS) that includes controlled gastric secretion, emptying and mixing at body temperature. PH and protein hydrolysis were measured during protein gel digestion in the MR-GAS. R2 and R1 of the supernatant were measured by time-domain nuclear magnetic resonance (TD-NMR). The stomach chamber of the MR-GAS was also scanned with MRI to measure R2 and R1. For TD-NMR, 99% of the variance in R2 and 96% of variance in R1 could be explained as a function of protein concentration and [H+]. For MRI, the explained variances were 99% for R2 and 60% for R1. From these analysis, the obtained equations enabled the prediction of protein concentration and pH by R2 and R1. The normalised root mean squared deviation of the predictions for protein concentration were 0.15 (NMR) and 0.18 (MRI), and for pH were 0.12 (NMR) and 0.29 (MRI). In conclusion, the MR-GAS model may be used in a clinical MRI to monitor gastric digestion under in vitro dynamic circumstances, by measuring R2 and R1. These results underscore the potential of MRI to monitor nutrients hydrolysis and pH changes in future in vivo studies.

Gastric digestion is crucial for protein breakdown. Although it has been widely studied with in vitro models, verification in vivo remains a big challenge. Magnetic resonance imaging (MRI) has the potential to bridge this gap. Our objective was to use the transverse relaxation time (T2) and rate (R2 = T2−1) to monitor hydrolysis of protein-rich food during in vitro gastric digestion. Whey protein solution and heat-induced hydrogels were digested by means of simulated gastric fluid (SGF). Free amino groups (–NH2 groups) and protein concentration in the supernatant were measured. T2 and R2 of the digestion mixture were determined by time-domain nuclear magnetic resonance (TD-NMR) and MRI. Subsequently, relative amplitudes (TD-NMR) for different T2 values and T2 distribution (MRI) were determined. For the solution, protein concentration and T2 did not change during digestion. For the gels, water in supernatant and gel phase could be discriminated on the basis of their T2 values. During digestion, R2 of supernatant correlated positively with protein (–NH2 groups) concentration in SGF. Also, the decrease in relative amplitude of gel fraction correlated linearly with the increase of supernatant protein concentration. MRI T2-mapping showed similar associations between R2 of supernatant and protein (–NH2 groups) concentration. In conclusion, T2-measurements by TD-NMR and MRI can be used to monitor in vitro gastric digestion of whey protein gels; TD-NMR measurements contributed to interpreting the MRI data. Thus, MRI has high potential for monitoring in vivo gastric digestion and this should be further pursued.

Background Taste preference is an important determinant of dietary intake and is influenced by taste exposure in early life. However, data on dietary taste patterns in early childhood are scarce. Objectives We aimed to evaluate dietary taste patterns in early childhood, to examine their tracking between the ages of 1 and 2 y, and to examine their associations with socioeconomic and lifestyle factors. Methods Dietary intake of children participating in a population-based cohort was assessed with a 211-item age-specific FFQ at the ages of 1 y ( n = 3629) and 2 y (n = 844) (2003–2007). Taste intensity values of FFQ food items were calculated based on a food taste database that had been previously constructed and evaluated using a trained adult sensory panel. Cluster analysis based on taste values identified 5 taste clusters that we named: “neutral,” “sweet and sour,” “sweet and fat,” “fat,” and “salt, umami and fat.” Linear regression models were used to examine associations of percentage energy (E%) intake from these taste clusters with socioeconomic and lifestyle factors. Results At the age of 1 y, 64% ± 13% (mean ± SD) of energy intake was obtained from the “neutral” cluster, whereas at age 2 y, this was 42% ± 8%. At age 2 y, children had higher energy intakes from the “sweet and fat” (18% ± 7%), “fat” (11% ± 4%), and “salt, umami, and fat” (18% ± 6%) clusters than at age 1 y (7% ± 6%, 6% ± 4%, and 11% ± 6%, respectively). In multivariable models, older maternal age, longer breastfeeding duration, and later introduction of complementary feeding were associated with more energy from the “neutral” cluster (e.g., β: 0.31 E%; 95% CI: 0.19, 0.43 E% per 1 mo longer breastfeeding). Higher child BMI was associated with more energy from the “salt, umami, and fat” cluster (β: 0.22 E%; 95% CI: 0.06, 0.38 E% per BMI standard deviation score). Conclusions Dietary taste patterns in this Dutch cohort were more varied and intense in taste at age 2 y than at 1 y, reaching a level similar to that previously observed in Dutch adults. Important factors related to dietary taste patterns of young children are maternal sociodemographic factors and feeding practices. This trial was registered at trialregister.nl as NL6484.

Glycaemic control is important in metabolic diseases such as diabetes and impaired glucose tolerance. L-arabinose inhibits the hydrolysis of sucrose into glucose and fructose. So far little is known about its functionality in different food matrices. We assessed the effect of replacing sucrose with L-arabinose in drinks and in cereal foods on blood glucose and insulin in healthy adults. Glucose and insulin responses were reduced when sucrose was replaced by L-arabinose in drinks. Replacement of sucrose in cereal foods did not affect glucose responses, however it reduced the insulin peak. L-arabinose without sucrose in a drink did not affect glucose responses. Therefore, replacing sucrose with L-arabinose is potentially a good strategy to lower glycaemic and insulin responses. However, the effects depend on the food matrix and the nutritional composition of the food. Moreresearch is warranted on the functionality of L-arabinose in different food matrices and in other populations.

Background In the current obesogenic environment we often eat while electronic devices, such as smart phones, computers, or the television, distract us. Such “distracted eating” is associated with increased food intake and overweight. However, the underlying neurocognitive mechanisms of this phenomenon are unknown. Objective Our aim was to elucidate these mechanisms by investigating whether distraction attenuates processing in the primary and secondary taste cortices, located in the insula and orbitofrontal cortex (OFC), respectively. Methods Forty-one healthy, normal-weight participants received fixed amounts of higher- and lower-sweetness isocaloric chocolate milk while performing a high- or low-distracting detection task during fMRI in 2 test sessions. Subsequently, we measured ad libitum food intake. Results As expected, a primary taste cortex region in the right insula responded more to the sweeter drink (P < 0.001, uncorrected). Distraction did not affect this insular sweetness response across the group, but did weaken sweetness-related connectivity of this region to a secondary taste region in the right OFC (P–family-wise error, cluster, small-volume corrected = 0.020). Moreover, individual differences in distraction-related attenuation of taste activation in the insula predicted increased subsequent ad libitum food intake after distraction (r = 0.36). Conclusions These results reveal a mechanism explaining how distraction during consumption attenuates neural taste processing. Moreover, our study shows that such distraction-induced decreases in neural taste processing contribute to individual differences in the susceptibility for overeating. Thus, being mindful about the taste of food during consumption could perhaps be part of successful prevention and treatment of overweight and obesity, which should be further tested in these target groups. This study was preregistered at the Open Science Framework as https://bit.ly/31RtDHZ.

Background Longer oral processing decreases food intake. This can be attributed to greater oro-sensory exposure (OSE) and a lower eating rate (ER). How these factors contribute to food intake, and the underlying physiological mechanisms, remain unclear. Objectives We aimed to determine the independent and simultaneous effects of OSE and ER on satiation and associated endocrine responses. Methods Forty participants in study 1 [mean ± SD age: 24 ± 4 y; BMI (in kg/m2): 22 ± 2] and 20 in study 2 (mean ± SD age: 23 ± 3 y; BMI: 23 ± 2) participated in a 2 × 2 randomized trial. In both studies, participants ate chocolate custard with added caramel sauce (low OSE) or caramel fudge (high OSE) and with short (fast ER) or long breaks (slow ER) in between bites, until fullness. In study 2, endocrine responses were measured during the meal. Results In study 1, participants ate (mean ± SEM) 42 ± 15 g less in the slow- than in the fast-ER condition, only within the high-OSE condition (P = 0.04). In study 2, participants ate 66 ± 21 g less in the high- than in the low-OSE condition and there were no intake differences between slow and fast ER (P = 0.35). Eight minutes after starting to eat, insulin concentrations increased by 42%–65% in all treatments compared with the control. At the end of the meal, insulin concentrations were 81% higher in the high-OSE, slow-ER than in the low-OSE, fast-ER condition (P = 0.049). Pancreatic polypeptide (PP) increased by 62%, 5 min after meal onset in the low-OSE, fast-ER condition (P = 0.005). Ghrelin concentrations did not change. Conclusions Greater OSE increases insulin responsiveness. In contrast, PP responses are stronger when OSE is reduced and ER is fast. Insulin and PP responses may mediate the independent effects of OSE and ER on food intake. These may be beneficial eating strategies, particularly for type 2 diabetic patients, to control food intake and maintain glucose homeostasis. This trial was registered at trialregister.nl as NL6544.

Background Recent observational data and a controlled in-patient crossover feeding trial show that consumption of “ultra-processed foods” (UPFs), as defined by the NOVA classification system, is associated with higher energy intake, adiposity, and at a population level, higher prevalence of obesity. A drawback of the NOVA classification is the lack of evidence supporting a causal mechanism for why UPFs lead to overconsumption of energy. In a recent study by Hall the energy intake rate in the UPF condition (48 kcal/min) was >50% higher than in the unprocessed condition (31 kcal/min). Extensive empirical evidence has shown the impact that higher energy density has on increasing ad libitum energy intake and body weight. A significant body of research has shown that consuming foods at higher eating rates is related to higher energy intake and a higher prevalence of obesity. Energy density can be combined with eating rate to create a measure of energy intake rate (kcal/min), providing an index of a food's potential to promote increased energy intake. Objective The current paper compared the association between measured energy intake rate and level of processing as defined by the NOVA classification. Methods Data were pooled from 5 published studies that measured energy intake rates across a total sample of 327 foods. Results We show that going from unprocessed, to processed, to UPFs that the average energy intake rate increases from 35.5 ± 4.4, to 53.7 ± 4.3, to 69.4 ± 3.1 kcal/min (P

Background/objective: Taste is of key importance in food choice and dietary patterns, but studies on taste profiles are limited. We previously assessed dietary taste patterns by 24 h recalls (24hR), but for epidemiological studies food frequency questionnaires (FFQ) may also be suitable. This study compared dietary taste patterns based on FFQ against 24hR and biomarkers of exposure. Subjects/methods: A taste database including 467 foods’ sweet, sour, bitter, salt, umami and fat sensation values was combined with food intake data to assess dietary taste patterns: the contribution to energy intake of 6 taste clusters. The FFQ’s reliability was assessed against 3-d 24hR and urinary biomarkers for sodium (Na) and protein intake (N) in Dutch men (n = 449) and women (n = 397) from the NQplus validation study (mean age 53 ± 11 y, BMI 26 ± 4 kg/m2). Results: Correlations of dietary taste patterns ranged from 0.39–0.68 between FFQ and 24hR (p < 0.05). Urinary Na levels, but not N levels, were positively associated with % energy intake from ‘salt, umami & fat’ tasting foods (Na; FFQ, r = 0.24, 24hR, r = 0.23, p < 0.001, N; FFQ, r = 0.08, p = 0.1394, 24hR, r = 0.05, p = 0.3427). Conclusions: The FFQ’s reliability against 24hR was acceptable to good for ranking of adults’ dietary taste patterns. Associations between dietary taste patterns and urinary Na and N were similar for FFQ and 24hR. These findings suggests that both FFQ and 24hR can be used in combination with our taste database, to investigate potential relationships between dietary taste patterns and subgroups at risk of obesity and chronic diseases such as cardiovascular disease.

We assessed evidence for changes in efficacy of food-based interventions aimed at reducing appetite or energy intake (EI), and whether this could be used to provide guidance on trial design. A systematic search identified randomized controlled trials testing sustained efficacy of diets, foods, supplements or food ingredients on appetite and/or EI. Trials had to include sufficient exposure duration (≥3 days) with appetite and/or EI measured after both acute and repeated exposures. Twenty-six trials met the inclusion criteria and reported data allowing for assessment of the acute and chronic effects of interventions. Most (21/26) measured appetite outcomes and over half (14/26) had objective measures of EI. A significant acute effect of the intervention was retained in 10 of 12 trials for appetite outcomes, and six of nine studies for EI. Initial effects were most likely retained where these were more robust and studies adequately powered. Where the initial, acute effect was not statistically significant, a significant effect was later observed in only two of nine studies for appetite and none of five studies for EI. Maintenance of intervention effects on appetite or EI needs to be confirmed, but seem likely where acute effects are robust and replicable in adequately powered studies.

Taste is a key driver of food choice and intake. Taste preferences are widely studied, unlike the diet’s taste profile. This study assessed dietary taste patterns in the Netherlands by sex, BMI, age and education. A taste database, containing 476 foods’ taste values, was combined with 2-d 24-h recalls in two study populations. The percentage of energy intake from six taste clusters was assessed in the Dutch National Food Consumption Survey (DNFCS 2007–2010; n 1351) and in an independent observational study: the Nutrition Questionnaires plus (NQplus) study (2011–2013; n 944). Dietary taste patterns were similar across study populations. Men consumed relatively more energy from ‘salt, umami and fat’ (DNFCS; 24 % energy, NQplus study; 23 %)- and ‘bitter’ (7 %)-tasting foods compared with women (21 %, PP=0·005; 3 %, PPPP=0·001; 10 %, PP=0·037, NQplus 22 %, P=0·001, women; obese 23 %, 24 %, normal weight 20 %, P=0·004, P=0·011, respectively, ‘sweet and fat’, men; obese 11 %, 10 %, normal weight 13 %, PPP=0·12, P=0·99). In conclusion, our taste database can be used to deepen our understanding of the role of taste in dietary intake in the Netherlands by sex, BMI, age and education.

Oro-sensory exposure (OSE) is an important factor in the regulation of food intake with increasing OSE leading to lower food intake. Oral processing time and taste intensity both play an important role in OSE but their individual contribution to satiation is unknown. We aimed to determine the independent and combined effects of oral processing time and taste intensity on satiation.Fifty eight participants (23±9y, BMI 22±2kg/m2) participated in a 2×2 factorial randomized crossover study in which they consumed one of four gel-based model foods until satiation during four sessions. Model foods were offered ad libitum and differed in texture (soft or hard texture, yielding shorter and longer oral processing time) and sweetness (low or high intensity). Model foods were isocaloric and were matched for flavor and palatability. Outcome measures were intake of the model food and the microstructure of eating behavior, such as number of chews and eating rate.There was an overall significant effect of texture (p < 0.001) but not sweetness (p = 0.33) on intake with a 29.2% higher intake of the soft model foods compared to the hard model foods. After correction for palatability the difference in intake between the soft and hard model foods was 21.5% (p < 0.001).The number of chews was significantly lower for the soft (10.1 ± 6.2) than for the hard (26.9 ± 6.2) model foods (p < 0.001), which resulted in a significantly lower eating rate (soft, 26.3 ± 10.2 and hard, 15.3 ± 7.1 g/min, p < 0.001).These results show that increasing texture hardness of gel model foods decreases food intake independent of sweet taste intensity. The higher number of chews and faster eating rate may cause this effect. In conclusion, oro-sensory exposure duration rather than taste intensity appears to be the main determinant of food intake.

Cephalic phase responses (CPRs) are conditioned anticipatory physiological responses to food cues. They occur before nutrient absorption and are hypothesized to be important for satiation and glucose homeostasis. Cephalic phase insulin responses (CPIRs) and pancreatic polypeptide responses (CPPPRs) are found consistently in animals, but human literature is inconclusive. We performed a systematic review of human studies to determine the magnitude and onset time of these CPRs. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used to develop a search strategy. The terms included in the search strategy were cephalic or hormone response or endocrine response combined with insulin and pancreatic polypeptide (PP). The following databases were searched: Scopus (Elsevier), Science Direct, PubMed, Google Scholar, and The Cochrane Library. Initially, 582 original research articles were found, 50 were included for analysis. An insulin increase (≥1μIU/mL) was observed in 41% of the treatments (total n = 119). In 22% of all treatments the increase was significant from baseline. The median (IQR) insulin increase was 2.5 (1.6–4.5) μIU/mL, 30% above baseline at 5± 3 min after food cue onset (based on study treatments that induced ≥1 μIU/mL insulin increase). A PP increase (>10 pg/mL) was found in 48% of the treatments (total n = 42). In 21% of the treatments, the increase was significant from baseline. The median (IQR) PP increase was 99 (26–156) pg/mL, 68% above baseline at 9± 4 min after food cue onset (based on study treatments that induced ≥1 μIU/mL insulin increase). In conclusion, CPIRs are small compared with spontaneous fluctuations. Although CPPPRs are of a larger magnitude, both show substantial variation in magnitude and onset time. We found little evidence for CPIR or CPPPR affecting functional outcomes, that is, satiation and glucose homeostasis. Therefore, CPRs do not seem to be biologically meaningful in daily life.

SummaryDistracted eating is associated with increased food intake and overweight. However, the underlying neurocognitive mechanisms are unknown. To elucidate these mechanisms, 41 healthy normal-weight participants received sips of high- and low-sweet isocaloric chocolate milk, while performing a high- or low-distracting detection task during fMRI on two test days. Subsequently, we measured ad libitum food intake. As expected, a region in the primary taste cortex – located in the insula – responded more to the sweeter drink. Distraction did not affect this right insula sweetness response across the group, but did weaken sweetness-related connectivity of this region to a secondary taste region in the right orbitofrontal cortex. Moreover, distraction-related attenuation of taste processing in the insula predicted increased subsequent ad libitum food intake after distraction between subjects. These results reveal a previously unknown mechanism explaining how distraction during consumption attenuates neural taste processing and increases food intake. The study was preregistered at https://osf.io/vxdhg/register/5771ca429ad5a1020de2872e?view_only=e3207cd6567f41f0a1505e343a64b5aa.

Background Eating rate is a basic determinant of appetite regulation: people who eat more slowly feel sated earlier and eat less. A high eating rate contributes to overeating and potentially to weight gain. Previous studies showed that an augmented fork that delivers real-time feedback on eating rate is a potentially effective intervention to decrease eating rate in naturalistic settings. This study assessed the impact of using the augmented fork during a 15-week period on eating rate and body weight. Methods In a parallel randomized controlled trial, 141 participants with overweight (age: 49.2 ± 12.3 y; BMI: 31.5 ± 4.48 kg/m2) were randomized to intervention groups (VFC, n = 51 or VFC+, n = 44) or control group (NFC, n = 46). First, we measured bite rate and success ratio on five consecutive days with the augmented fork without feedback (T1). The intervention groups (VFC, VFC+) then used the same fork, but now received vibrotactile feedback when they ate more than one bite per 10 s. Participants in VFC+ had additional access to a web portal with visual feedback. In the control group (NFC), participants ate with the fork without either feedback. The intervention period lasted four weeks, followed by a week of measurements only (T2) and another measurement week after eight weeks (T3). Body weight was assessed at T1, T2, and T3. Results Participants in VFC and VFC+ had a lower bite rate (p p p Conclusions The findings of this study indicate that an augmented fork with vibrotactile feedback is a viable tool to reduce eating rate in naturalistic settings. Further investigation may confirm that the augmented fork could support long-term weight loss strategies. Trial registration The research reported in this manuscript was registered on 4 November 2015 in the Netherlands Trial Register with number NL5432 (https://www.trialregister.nl/trial/5432).

Background: Stomach fullness is a determinant of satiety. Although both the viscosity and energy content have been shown to delay gastric emptying, their relative importance is not well understood. Objective: We compared the relative effects of and interactions between the viscosity and energy density on gastric emptying and perceived satiety. Design: A total of 15 healthy men [mean ± SD age: 22.6 ± 2.4 y; body mass index (in kg/m2): 22.6 ± 1.8] participated in an experiment with a randomized 2 x 2 crossover design. Participants received dairy-based shakes (500 mL; 50% carbohydrate, 20% protein, and 30% fat) that differed in viscosity (thin and thick) and energy density [100 kcal (corresponding to 0.2 kcal/mL) compared with 500 kcal (corresponding to 1 kcal/mL)]. After ingestion, participants entered an MRI scanner where abdominal scans and oral appetite ratings on a 100-point scale were obtained every 10 min until 90 min after ingestion. From the scans, gastric content volumes were determined. Results: Overall, the gastric emptying half-time (GE t50) was 54.7 ± 3.8 min. The thin 100-kcal shake had the lowest GE t50 of 26.5 ± 3.0 min, followed by the thick 100-kcal shake with a GE t50 of 41 ± 3.9 min and the thin 500-kcal shake with a GE t50 of 69.5 ± 5.9 min, and the thick 500-kcal shake had the highest GE t50 of 81.9 ± 8.3 min. With respect to appetite, the thick 100-kcal shake led to higher fullness (58 points at 40 min) than the thin 500-kcal shake (48 points at 40 min). Conclusions: Our results show that increasing the viscosity is less effective than increasing the energy density in slowing gastric emptying. However, the viscosity is more important to increase the perceived fullness. These results underscore the lack of the satiating efficiency of empty calories in quickly ingested drinks such as sodas. The increase in perceived fullness that is due solely to the increased viscosity, which is a phenomenon that we refer to as phantom fullness, may be useful in lowering energy intake. This trial was registered at www.trialregister.nl as NTR4573.

Introduction:In the broad literature on the effects of ingredients, foods and diets on appetite and energy intake (EI), most trials involve a single acute intervention. It is unclear whether these acute results are generally sustained over longer periods. Researchers and regulators therefore lack an objective basis to judge the appropriate duration of efficacy trials in appetite control, to have confidence that acute effects are likely to be maintained. This gap creates uncertainty in requirements and study designs for the substantiation of satiety-enhancing approaches to help in controlling eating behaviour.Materials and Methods:A systematic search of literature (Prospero registration number CRD42015023686) identified studies testing both the acute and chronic effects of food-based interventions aimed at reducing appetite or EI. From 9680 unique records identified from titles and abstracts, 178 papers were selected for full screening. Twenty-six trials met the inclusion criteria and provided data sufficient for use in this analysis, and were also scored for risk of bias (RoB) indicators.Results:Most of these trials (21/26) measured appetite outcomes and over half (14/26) had objective measures of EI. A significant acute effect of the intervention was retained in 10 of 12 trials for appetite outcomes, and six of nine studies for EI. Initial effects were most likely retained where these were more robust and studies adequately powered. Where the initial, acute effect was not statistically significant, a significant effect was later observed in only two of nine studies for appetite and none of five studies for EI. The main sources of RoB were lack of a priori power calculations and failure to report analyses based on intention-to-treat. Furthermore, 12/26 studies were not adequately powered to detect a meaningful reduction in appetite (~10%).Discussion:Maintenance of acute intervention effects on appetite or EI need to be confirmed, but seems likely where the initially observed effects are robust and replicable in adequately powered studies.

Background Indirect methods to assess gastric emptying (GE), such as 13 C breath tests (BT), are commonly used. However, BT usually use a sampling time of 4+ hours. The current study aims to assess the validity of BT for four liquid meals differing in physicochemical properties. To this aim, we compared them to MRI GE-measurements. Methods Fifteen healthy males (age 22.6 ± 2.4 years, BMI 22.6 ± 1.8 kg/m2 ) participated in a randomized 2 × 2 crossover experiment. Test foods were liquid meals, which were either thin/thick and 100/500 kcal, labeled with 100 mg of 13 C-octanoate. GE was measured with MRI and assessed by 13 C recovery from breath. Participants were scanned every 10 minutes and at six time points breath samples were collected up to t = 90 minutes. Two curves were fitted to the data to estimate emptying halftime (t50 Ghoos and t50 Bluck ). T50 times were ranked per participant and compared between methods. Key results On average, MRI and BT showed similar t50 rankings for the four liquid meals. In comparison to MRI, t50 Ghoos overestimated, while t50 Bluck underestimated GE time. Moreover, more viscous foods were overestimated. In most participants individual t50 time rankings differed significantly between methods. Conclusions & inferences BT can assess relative emptying differences on group level and collecting breath data for 90 minutes constitutes a lower burden for participants and the research facility. However, BT has severe shortcomings compared to MRI for individual GE assessment. Notably, food matrix effects should be considered when interpreting the results of BT.

BACKGROUND The available methods for monitoring food intake—which for a great part rely on self-report—often provide biased and incomplete data. Currently, no good technological solutions are available. Hence, the SPLENDID eating detection sensor (an ear-worn device with an air microphone and a photoplethysmogram [PPG] sensor) was developed to enable complete and objective measurements of eating events. The technical performance of this device has been described before. To date, literature is lacking a description of how such a device is perceived and experienced by potential users. OBJECTIVE The objective of our study was to explore how potential users perceive and experience the SPLENDID eating detection sensor. METHODS Potential users evaluated the eating detection sensor at different stages of its development: (1) At the start, 12 health professionals (eg, dieticians, personal trainers) were interviewed and a focus group was held with 5 potential end users to find out their thoughts on the concept of the eating detection sensor. (2) Then, preliminary prototypes of the eating detection sensor were tested in a laboratory setting where 23 young adults reported their experiences. (3) Next, the first wearable version of the eating detection sensor was tested in a semicontrolled study where 22 young, overweight adults used the sensor on 2 separate days (from lunch till dinner) and reported their experiences. (4) The final version of the sensor was tested in a 4-week feasibility study by 20 young, overweight adults who reported their experiences. RESULTS Throughout all the development stages, most individuals were enthusiastic about the eating detection sensor. However, it was stressed multiple times that it was critical that the device be discreet and comfortable to wear for a longer period. In the final study, the eating detection sensor received an average grade of 3.7 for wearer comfort on a scale of 1 to 10. Moreover, experienced discomfort was the main reason for wearing the eating detection sensor CONCLUSIONS The SPLENDID eating detection sensor, which uses an air microphone and a PPG sensor, is a promising new device that can facilitate the collection of reliable food intake data, as shown by its technical potential. Potential users are enthusiastic, but to be successful wearer comfort and discreetness of the device need to be improved.

BackgroundThe available methods for monitoring food intake—which for a great part rely on self-report—often provide biased and incomplete data. Currently, no good technological solutions are available. Hence, the SPLENDID eating detection sensor (an ear-worn device with an air microphone and a photoplethysmogram [PPG] sensor) was developed to enable complete and objective measurements of eating events. The technical performance of this device has been described before. To date, literature is lacking a description of how such a device is perceived and experienced by potential users. ObjectiveThe objective of our study was to explore how potential users perceive and experience the SPLENDID eating detection sensor. MethodsPotential users evaluated the eating detection sensor at different stages of its development: (1) At the start, 12 health professionals (eg, dieticians, personal trainers) were interviewed and a focus group was held with 5 potential end users to find out their thoughts on the concept of the eating detection sensor. (2) Then, preliminary prototypes of the eating detection sensor were tested in a laboratory setting where 23 young adults reported their experiences. (3) Next, the first wearable version of the eating detection sensor was tested in a semicontrolled study where 22 young, overweight adults used the sensor on 2 separate days (from lunch till dinner) and reported their experiences. (4) The final version of the sensor was tested in a 4-week feasibility study by 20 young, overweight adults who reported their experiences. ResultsThroughout all the development stages, most individuals were enthusiastic about the eating detection sensor. However, it was stressed multiple times that it was critical that the device be discreet and comfortable to wear for a longer period. In the final study, the eating detection sensor received an average grade of 3.7 for wearer comfort on a scale of 1 to 10. Moreover, experienced discomfort was the main reason for wearing the eating detection sensor