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Microfibrillated cellulose (MFC) has potential to be used as clean label texture modifier in foods due to its structural and mechanical properties. These properties deteriorate upon drying of MFC dispersions due to aggregation of the microfibrils. In this study dried MFC particles were prepared by spray-drying MFC dispersions in a surplus of maltodextrin to prevent hornification. The aim of this study was to evaluate the effect of MFC particle concentration and MFC:maltodextrin ratio of dried MFC powders on rheological, tribological and sensory texture properties of liquid foods. Scanning Electron Microscopy demonstrated that after spray-drying, MFC powders with polydisperse particle size distribution were obtained (1–30 μm). Upon suspension of spray-dried MFC powder in water, maltodextrin dissolved in the aqueous continuous phase whereas spherical MFC networks retained their shape and co-existed in a mixture with individual fibrils. Spray-dried MFC powders were added to skimmed milk and tomato soup at different concentrations. With increasing concentration of dried MFC particles, shear viscosity, consistency index K, storage and loss modulus of skimmed milks and tomato soups increased whereas flow index n decreased. Addition of spray-dried MFC particles to milks and soups significantly (p < 0.05) increased sensory thickness and creaminess. Milks displayed similar tribological properties irrespective of MFC particle concentration, which was presumably caused by exclusion of the MFC network from the tribological gap. Rheological properties, thickness and creaminess increased more effectively upon addition of low MFC:maltodextrin particles compared to particles with high MFC:maltodextrin ratio. We conclude that spray-dried microfibrillated cellulose particles can be used as thickener or fat replacer in liquid foods. Microfibrillated cellulose (MFC) has potential to be used as clean label texture modifier in foods due to its structural and mechanical properties. These properties deteriorate upon drying of MFC dispersions due to aggregation of the microfibrils. In this study dried MFC particles were prepared by spray-drying MFC dispersions in a surplus of maltodextrin to prevent hornification. The aim of this study was to evaluate the effect of MFC particle concentration and MFC:maltodextrin ratio of dried MFC powders on rheological, tribological and sensory texture properties of liquid foods. Scanning Electron Microscopy demonstrated that after spray-drying, MFC powders with polydisperse particle size distribution were obtained (1–30 μm). Upon suspension of spray-dried MFC powder in water, maltodextrin dissolved in the aqueous continuous phase whereas spherical MFC networks retained their shape and co-existed in a mixture with individual fibrils. Spray-dried MFC powders were added to skimmed milk and tomato soup at different concentrations. With increasing concentration of dried MFC particles, shear viscosity, consistency index K, storage and loss modulus of skimmed milks and tomato soups increased whereas flow index n decreased. Addition of spray-dried MFC particles to milks and soups significantly (p < 0.05) increased sensory thickness and creaminess. Milks displayed similar tribological properties irrespective of MFC particle concentration, which was presumably caused by exclusion of the MFC network from the tribological gap. Rheological properties, thickness and creaminess increased more effectively upon addition of low MFC:maltodextrin particles compared to particles with high MFC:maltodextrin ratio. We conclude that spray-dried microfibrillated cellulose particles can be used as thickener or fat replacer in liquid foods.

Background Longitudinal assessment of the determinants of obesogenic growth trajectories in childhood can suggest appropriate developmental windows for intervention. Methods Latent class growth mixture modelling was used to identify body mass index (BMI) z-score trajectories from birth to age 6 years in 994 children from a prospective mother–offspring cohort (Chinese, Indian and Malay ethnicities) based in Singapore. We evaluated the early-life determinants of the trajectories as well as their associations with cardiometabolic risk markers at age 6 years. Results Five BMI z-score trajectory patterns were identified, three within the healthy weight range, alongside early-acceleration and late-acceleration obesogenic trajectories. The early-acceleration pattern was characterized by elevated fetal abdominal circumference growth velocity, BMI acceleration immediately after birth and crossing of the obesity threshold by age 2 years. The late-acceleration pattern had normal fetal growth and BMI acceleration after infancy, and approached the obesity threshold by age 6 years. Abdominal fat, liver fat, insulin resistance and odds of pre-hypertension/hypertension were elevated in both groups. Indian ethnicity, high pre-pregnancy BMI, high polygenic risk scores for obesity and shorter breastfeeding duration were common risk factors for both groups. Malay ethnicity and low maternal educational attainment were uniquely associated with early BMI acceleration, whereas nulliparity and obesogenic eating behaviours in early childhood were uniquely associated with late BMI acceleration. Conclusion BMI acceleration starting immediately after birth or after infancy were both linked to early cardiometabolic alterations. The determinants of these trajectories may be useful for developing early risk stratification and intervention approaches to counteract metabolic adversities linked to childhood obesity.

Ultra-processed food consumption has increased worldwide, yet little is known about the potential links with taste preference and sensitivity. This exploratory study aimed to (i) compare sweet and salty taste detection thresholds and preferences following consumption of ultra-processed and unprocessed diets, (ii) investigate whether sweet and salty taste sensitivity and preference were associated with taste substrates (i.e. sodium and sugar) and ad libitum nutrient intake, and (iii) examine associations of taste detection thresholds and preferences with blood pressure (BP) and anthropometric measures following consumption of ultra-processed and unprocessed diets. In a randomized crossover study, participants (N = 20) received ultra-processed or unprocessed foods for 2 weeks, followed by the alternate diet. Baseline food intake data were collected prior to admission. Taste detection thresholds and preferences were measured at the end of each diet arm. Taste-substrate/nutrient intake, body mass index (BMI), and body weight (BW) were measured daily. No significant differences were observed in participant salt and sweet detection thresholds or preferences after 2 weeks on ultra-processed or unprocessed diets. There was no significant association between salt and sweet taste detection thresholds, preferences, and nutrient intakes on either diet arm. A positive correlation was observed between salt taste preference and systolic BP (r = 0.59; P = 0.01), BW (r = 0.47, P = 0.04), and BMI (r = 0.50; P = 0.03) following consumption of the ultra-processed diet. Thus, a 2-week consumption of an ultra-processed diet does not appear to acutely impact sweet or salty taste sensitivity or preference. Trial Registration: ClinicalTrials.gov Identifier NCT03407053.

Portion size manipulation is well known to be effective in increasing vegetable intake in adults, whereas less is known about the effects of portion size manipulation on reducing meat intake. This online study investigated the effects of recommended and regularly consumed portion sizes of vegetables and meat in five familiar Dutch meals. Participants evaluated 60 food pictures of five meals and used a 100 mm VAS to measure expected liking, satiety, food-evoked emotions, and the perceived normal portion size. The results show that both regular and recommended portions scored above 55 on the 100 mm VAS on expected liking and satiety. Similarly, both portion sizes scored high (55–70 on the 100 mm VAS) in positive emotions (i.e., happy, relaxed, and satisfied). Regarding the perceived amount of meat, men consistently preferred larger portions of meat than women. However, the optimal portion sizes of vegetables were similar for men and women. Furthermore, the recommended portion sizes led to positive food-evoked emotions, implying that the effective implementation of portion size strategies for increasing vegetable and limiting meat intake requires a careful, holistic approach focusing on the sensory characteristics of food products as well as the emotions evoked by the total food experience.

Background Several health organizations recommend lowering the consumption of sweet-tasting foods. The rationale behind this recommendation is that a lower exposure to sweet foods may reduce preferences for sweet tasting foods, thus lowering sugar and energy intake, and in turn aiding in obesity prevention. However, empirical data supporting this narrative are lacking. In fact, relatively little is known about the contribution of long-term sweet taste exposure on one’s sweetness preferences. Methods The primary objective of this randomized controlled trial is to assess the effect of low, regular and high dietary sweetness exposure on preference for sweet foods and beverages, and to compare these effects between intervention groups. One hundred and eighty adults aged 18–65 years with a BMI of 18.5–30.0 kg/m2 will be recruited and randomly allocated to either: low dietary sweetness exposure (LSE) (10–15% daily energy from sweet tasting foods), regular dietary sweetness exposure (RSE) (25–30% daily energy from sweet tasting foods), or high dietary sweetness exposure (HSE) (40–45% daily energy from sweet tasting foods), for 6 months, followed by a 4-month follow up. Intervention foods are provided ad libitum, covering approximately 50% of the daily number of food items, to include sugar-sweetened, low-calorie-sweetener-sweetened and non-sweet foods. The primary outcome measure is the difference in change in sweetness preference from baseline to 6 months between intervention groups. Secondary outcomes include: change in sweet taste preferences at different time-points; taste intensity perception; behavioral outcomes: food choice and intake, sweet-liker type, food cravings, dietary taste preferences and dietary taste patterns; anthropometric outcomes: body composition, waist-hip circumference, body weight; and biochemical outcomes: glucose variability and biomarkers related to CVD and diabetes. Discussion This study will generate important data on the effect of dietary sweetness exposure on sweetness preferences in terms of effect size and change, duration of change and its impact on food intake, body weight status and associated health outcomes. Trial Registration The study protocol has been registered on ClinicalTrials.gov (ID no. NCT04497974, Registered 4 August 2020, https://clinicaltrials.gov/ct2/show/NCT04497974) and approved by Wageningen’s Medical Ethical Committee (ABR no. NL72134).

In vivo aroma release and perception of complex food matrices have been underexplored. The aims of this study were to investigate the effects of (i) fat and sugar content of chocolate-hazelnut spreads on in vivo aroma release and perception and (ii) carrier addition (bread, wafer) on in vivo aroma release and perception of chocolate-hazelnut spread using dynamic nose space analysis (PTR–ToF–MS) and dynamic sensory analysis (TCATA). Carriers were combined with spreads varying in fat and sugar content and were spiked with five volatile organic compounds (benzaldehyde, filbertone, 2-methylpyrazine, delta-dodecalactone, isovaleraldehyde). TCATA profiles from a consumer panel without in vivo nose space analysis (n = 72) and a trained panel performing in vivo nose space analysis (n = 8, triplicate) were compared. TCATA profiles of the spread-carrier combinations obtained by both panels showed similarly that attributes related to the carriers were perceived at the beginning of consumption, whereas attributes related to the spreads were perceived after swallowing. Significant (p < 0.05) and small differences were observed for the attributes cocoa, creamy, milky, sticky and toffee between both panels. In the evaluated reformulation range, fat and sugar content of chocolate-hazelnut spreads had only a limited effect on in vivo aroma release and perception. In contrast, addition of carriers strongly affected in vivo aroma release and perception for all target molecules. The addition of carriers to spreads generally increased aroma release (duration and intensity of aroma release) and decreased aroma perception. The addition of carriers generally reduced the time to reach maximum intensity compared to when spreads were eaten alone for the five volatile organic compounds while perception decreased. We conclude that the strong effect of carrier addition on in vivo aroma release and perception of chocolate-hazelnut spreads highlights the importance of investigating toppings/spreads accompanied with carriers rather than in isolation.

The impact of trigeminal oral burn and pungency on taste, flavor, and mouth-feel perception of commercially available foods is underexplored. This study aimed to determine the effect of oral burn sensations evoked by the addition of chili powder to tomato soup, beef burger patties, and curried rice on taste, flavor, and mouth-feel perception. Chili powder was added to tomato soups, beef burger patties, and curried rice at four concentrations. A consumer panel comprising n = 66 participants (49 women, 25.5 ± 5.8 years, BMI 22.9 ± 2.8 kg/m2) assessed taste, flavor, trigeminal, and mouth-feel intensity of all samples using Rate-All-That-Apply methodology. Food matrix consistency strongly impacted oral burn sensations with solid food matrices (beef burger patties and curried rice) suppressing oral burn intensity compared to liquid food matrices (tomato soup). With increasing oral burn intensity, perceived intensity of beef flavor decreased significantly for beef burger patties. Tomato flavor, sweetness, and sourness intensity decreased significantly with increasing oral burn intensity for tomato soups. Perceived burn intensity of all food matrices and beef flavor intensity of beef burger patties differed between infrequent and frequent chili pepper consumers. We conclude that increasing oral burn intensity by the addition of chili pepper powder led to only small reductions in taste and flavor intensity of tomato soups and to little or no changes in flavor and mouth-feel perception of beef burger patties and curried rice. We suggest that reductions in taste, flavor, and mouth-feel intensity caused by oral burn might be more pronounced in liquid (tomato soup) than solid foods (beef burger patties and curried rice). Practical Application: There is a growing public and scientific interest in the development of strategies to increase the sensory appeal of healthy foods and beverages. Incorporation of trigeminal stimuli, such as chili peppers or capsaicin (pungent component of chili peppers), can be a strategy to increase sensory appeal of foods and beverages. Little is known about how trigeminal oral burn and pungency influence taste, flavor, and mouth-feel perception of commercially available foods, although it has been well established that taste, flavor, mouth-feel, and trigeminal sensations contribute to product acceptance. By investigating the sensory impact of oral burn on flavor and mouth-feel perception of foods, this study may help to better understand how trigeminal stimuli can be applied to moderate flavor and mouth-feel perception of foods to optimize sensory appeal.

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.

Understanding how dietary fat is perceived by the senses is crucial in developing public health strategies aimed at curbing excessive fat intakes. Olfaction is one of several sensory modalities contributing to fat perception in foods, yet the nature and extent of its involvement is relatively unclear. A systematic scoping literature review was conducted to identify and summarise relevant evidence on the contribution of olfaction to dietary fat perception in humans and rodents and highlight relevant knowledge gaps. The review was carried out in accordance with the PRISMA methodology, using combinations of olfaction-, fat- and perception-related search terms. Following searches in Scopus, Web of Science and PubMed databases, 42 articles were ultimately included. Overall, findings are consistent with the notion that olfaction plays a role in the perception of dietary fat in rodents and humans. Rodents can perceive dietary fat via olfactory cues, and this ability may affect their preference for fat-containing feed. Humans can detect, discriminate, and identify fat and its constituents solely by olfaction, even when embedded within a complex food matrix. Food fat content can modulate the perception of various fat- and non-fat olfactory qualities, depending on the food matrix and odorant physio-chemical properties. On the other hand, the presence of fat-related odours can modify the perception of olfactory and non-olfactory sensory qualities (e.g., mouthfeel). Several knowledge gaps were identified, namely, the role of fat-related odours in eating behaviour, the nature of chemical signals underlying olfactory fat perception and factors governing sensitivity to fat-related odours.

Plant-based foods that are designed to mimic and replace animal-based products often do not have the same nutritional composition. Some of these differences cannot be captured in nutritional labels making it even more complicated for consumers to make healthy food choices. This can have implications for the overall dietary quality of diets consisting of modern plant-based foods.

Plant-based foods that are designed to mimic and replace animal-based products often do not have the same nutritional composition. Some of these differences cannot be captured in nutritional labels making it even more complicated for consumers to make healthy food choices. This can have implications for the overall dietary quality of diets consisting of modern plant-based foods.

OBJECTIVES: Strong reward responsiveness to food and insufficient inhibitory control are thought to be implicated in the development and maintenance of obesity. This narrative review addresses the role of inhibitory control in obesity and weight loss, and in how far inhibitory control is a promising target for weight loss interventions. METHODS: PubMed, Web of Science, and Google Scholar were searched for papers up to May 2021. 41 papers were included. RESULTS: Individuals with obesity have poorer food-specific inhibitory control, particularly when hungry, and less concurrent activation of inhibitory brain areas. Moreover, this was strongly predictive of future weight gain. More activation of inhibitory brain areas, on the other hand, was predictive of weight loss: individuals with successful weight loss initially show inhibitory brain activity comparable to that of normal weight individuals. When successful weight maintenance is achieved for at least 1 year, this inhibitory activity is further increased. Interventions targeting inhibitory control in obese individuals have divergent effects. Firstly, food-specific inhibitory control training is particularly effective for people with low inhibitory control and high BMI. Secondly, neuromodulation paradigms are rather heterogeneous: although rTMS to the left dorsolateral prefrontal cortex induced some weight-loss, multiple sessions of tDCS reduced food consumption (desire) and induced weight loss in two thirds of the papers. Thirdly, neurofeedback results in successful upregulation of brain activity and connectivity, but occasionally leads to increased food intake. In conclusion, inhibitory control is implicated in obesity. It can be targeted to promote weight loss although major weight losses have not been achieved.

ObjectivesSensory methods use human senses to evaluate product attributes. This review provides an overview of the types of sensory methods used to evaluate the perception of flavour in tobacco and other nicotine-containing (ToNic) products and to discuss how sensory data could inform flavoured ToNic product policy.Data sourcesPubMed, Embase and Web of Science.Study selectionAll peer-reviewed studies evaluating ToNic products using a sensory method published before 23 May 2020.Data extractionTwo independent coders completed title/abstract and full-text screening to choose articles for inclusion (Cohen’s kappa=0.85, strong agreement). Each coder completed data extraction on half the articles, recording relevant information (eg, sensory methods used, results). The coders categorised sensory methods and generated overarching themes.Data synthesisOf 110 articles identified, we included 29 articles containing 35 studies that used sensory methods to investigate ToNic products. The sensory methods included analytic methods such as discrimination and descriptive tests and hedonic methods such as liking tests. Six themes emerged regarding how sensory methods can be used to understand consumer perception and liking of ToNic products and to inform ToNic product policy.ConclusionsThe identified studies highlight that sensory data can inform ToNic product policy. Analytic and sensory hedonic ratings can be used to assess a ToNic product’s ability to promote addiction in the user (ie, abuse liability). Lastly, hedonic ratings can provide information to assess potential use behaviours.

Microfibrillated cellulose (MFC) is obtained by high-shear treatment of cellulose. MFC is suitable for use as clean-label, low-calorie thickener in semi-solid foods such as mayonnaises due to its high water holding capacity. The aim of this study was to determine the effect of type and concentration of thickener on rheological, tribological and sensory properties of low-fat mayonnaises. Low-fat mayonnaises were prepared with four types of thickeners (MFC, chemically modified starch, native waxy corn starch, xanthan gum) at three concentrations. Higher biopolymer concentrations resulted in increased shear viscosities, G′ and G″, yield stress and enhanced lubrication (i.e. lower friction coefficients). Mayonnaises with modified starch and xanthan gum generally had higher shear viscosity and yield stress compared to mayonnaises with comparable concentrations of MFC and waxy corn starch. MFC-thickened mayonnaises had highest G’, G” and boundary friction coefficients. Sensory properties of mayonnaises were determined using the Rate-All-That-Apply (RATA) method (n = 80). Addition of xanthan gum induced high sliminess and pulpiness, and low melting, creaminess and smoothness. Sensory properties of mayonnaises with MFC were generally similar to those with modified and waxy corn starch, despite differences in appearance (increased yellowness and slightly lower glossiness). Multiple Factor Analysis revealed that more shear-thinning mayonnaises were perceived as slimy. Boundary friction was negatively correlated with stickiness, while friction at the start of the hydrodynamic regime was positively correlated with melting sensations. We conclude that microfibrillated cellulose can be used as a thickener in low-fat mayonnaise as an alternative to commercially used chemically modified starch without considerably affecting its sensory texture properties.

Background: Assessing dietary intake and eating behavior in children is challenging, owing to children's undeveloped food knowledge and perception of portion sizes. Additionally, caregivers cannot always provide complete surrogate information. Consequently, validated dietary behavior assessment methods for children are limited, but technological innovations offer opportunities for the development of new tools. One of the first steps in the developmental process of a newly developed pediatric dietary assessment tool includes an alignment of the needs and preferences of pediatric dieticians (PDs) as potential users. Objectives: To explore opinions of Dutch PDs about traditional dietary behavior assessment methods for children and potential technological innovations to replace or support traditional methods. Methods: Ten PDs participated in semistructured interviews (total of 7.5 h) based on 2 theoretical frameworks, and data saturation was reached after the seventh interview. Interview transcripts were inductively coded in an iterative process, and overarching themes and domains were identified. Interview data were then used as input for an extensive online survey completed by 31 PDs who were not involved in the initial interview rounds. Results: PDs discussed their perspective on dietary behavior assessments in 4 domains: traditional methods, technological methods, future methods, and external influences on these methods. Generally, PDs felt that traditional methods supported them in reaching their desired goals. However, the time needed to obtain a comprehensive overview of dietary intake behavior and the reliability of conventional methods were mentioned as limitations. For future technologies, PDs mention the ease of use and engaging in children as opportunities. Conclusions: PDs have a positive attitude toward the use of technology for dietary behavior assessments. Further development of assessment technologies should be tailored to the needs of children in different care situations and age categories to increase its usability among children, their caregivers, and dietician. Curr Dev Nutr 2023;xx:xx.

To date, little is known regarding if and how healthy eating is discussed, and how the concept of healthy eating is used in everyday interactions of families with a low socioeconomic position (SEP). This is an underrepresented study population in which many health benefits can be gained. By deploying an interactional approach to healthy eating, this study explored how healthy eating is constructed and oriented to during evening mealtimes in families with a low SEP. The data corpus comprised video recordings of 79 mealtimes from ten families with a low SEP. Healthy eating was rarely oriented to explicitly, as shown by the identification of only sixteen cases in which family members referred to (un)healthy eating. Using discursive psychology and conversation analysis, the examination of these cases showed that, how and with what function health claims were produced and designed as either identity-centered health claims or food-centered health assessments. By deploying identity-centered health claims parents constructed a desired prospective identity for their children to manage their eating behavior, whereas by deploying food-centered health assessments speakers accounted for their own behavior, particularly eating or providing food. The findings give a unique insight into how healthy eating is oriented to and constructed in the everyday life of families with a low SEP. In addition, the findings extend the discursive psychological body of literature on healthy eating talk during family mealtimes, and add to the knowledge base on discursive practices deployed to get children to eat.

The original article [1] contained the following errors with their respective amendments: 1) Abstract, lines 48 and 49: “Median TDI score on SST was 26.8 (IQR 23.6-29.3) in the placebo group and 28.8 (IQR 24.0-30.9) in the prednisolone group, with a median difference of 2.0 (95% CI 0.75 to 1.5).” to “Median TDI score on SST was 26.8 (IQR 23.6-29.3) in the placebo group and 28.8 (IQR 24.0-30.9) in the prednisolone group, with a median difference of - 1.5 (-3.0 to 0.25).” 2) Outcome, line 233-235: “Median TDI score was 26.8 (IQR 23.6- 29.3) in the placebo group and 28.8 (IQR 24.0- 30.9) in the prednisolone group, with a median difference of 2.0 (95% CI 0.75 to 1.5, p = 0.10).” to “Median TDI score was 26.8 (IQR 23.6- 29.3) in the placebo group and 28.8 (IQR 24.0- 30.9) in the prednisolone group, with a median difference of - 1.5 (-3.0 to 0.25).” 3) Line 237-238: "Self-reported smell function on VAS-score was 3.2 (IQR 1.8- 6.5) in the placebo group and 3.6 (IQR 1.0- 5.8) in the prednisolone group with a median difference of 0.45 (95% CI 1.1 to -1.2, p = 0.53)." to "Self-reported smell function on VAS-score was 3.2 (IQR 1.8- 6.5) in the placebo group and 3.6 (IQR 1.0- 5.8) in the prednisolone group with a median difference of 0.3 (95% CI -0.9 to -1.3, p = 0.53)." 4) Line 240-242: “Self-reported taste function on VAS-score was 5.6 (IQR 2.3- 7.6) in the placebo group and 5.0 (IQR 2.0- 7.8) in the prednisolone group with a median difference of 0.25 (95% CI 0.1 to -0.2, p = 0.80).” to “Self-reported taste function on VAS-score was 5.6 (IQR 2.3- 7.6) in the placebo group and 5.0 (IQR 2.0- 7.8) in the prednisolone group with a median difference of 0.1 (95% CI -1.0 to 1.3, p = 0.80)”.

Background: Parenting interventions during the first years of life on what and/or how to feed infants during complementary feeding can promote healthy eating habits. Objectives: An intervention promoting repeated exposure to a variety of vegetables [repeated vegetable exposure (RVE); what] and an intervention promoting responding sensitively to child signals during mealtime [video-feedback intervention to promote positive parenting-feeding infants (VIPP-FI); how] were compared, separately and combined (COMBI), with an attention control condition (AC). Primary outcomes were vegetable consumption and self-regulation of energy intake; secondary outcomes were child anthropometrics and maternal feeding practices (sensitive feeding, pressure to eat). Methods: Our 4-arm randomized controlled trial included 246 first-time Dutch mothers and their infants. Interventions started when infants were 4-6 mo old and ended at age 16 mo. The present study evaluated effects at 18 (t18) and 24 (t24) mo of age. Vegetable acceptance was assessed using three 24-h dietary recalls, self-regulation of energy intake by an eating-in-the-absence-of-hunger experiment and mother-report, and maternal feeding behavior by observation and mother-report. Results: Linear mixed model and ANOVA analyses revealed no follow-up group differences regarding child vegetable intake or self-regulatory behavior. The proportion of children with overweight was significantly lower in the COMBI group, compared with the VIPP-FI group at t18 (2% compared with 16%), and with the AC group at t24 (7% compared with 20%), although this finding needs to be interpreted cautiously due to the small number of infants with overweight and nonsignificant effects on the continuous BMI z-score measure (P values: 0.29-0.82). Finally, more sensitive feeding behavior and less pressure to eat was found in the VIPP-FI and COMBI groups, compared with the RVE and AC groups, mostly at t18 (significant effect sizes: D = 0.23-0.64). Conclusions: Interventions were not effective in increasing vegetable intake or self-regulation of energy intake. Future research might usefully focus on risk groups such as families who already experience problems around feeding. This trial is registered at clinicaltrials.gov as NCT03348176.

Background: Food texture can moderate eating rate and ad libitum energy intake. Many foods are combined with condiments when consumed and the texture and eating properties differ considerably between condiments and carrier foods. Little is known about how combinations of textures impact oral processing or whether these differences are affected by individual eating-styles. Objective: We investigated the impact of texture parameters (unit size, thickness, hardness and lubrication) on oral processing behaviours for carrots and rice-crackers, and tested whether these behaviours differ between 'faster' and 'slower' eaters. Method: Seventy participants (34 males, 26.0 ± 5.4 years, BMI = 21.5 ± 1.7 kg m-2) consumed 24 weight-matched carrot samples varying in unit size (large/medium/small), thickness (thick/thin), hardness (hard/soft) and lubrication (with/without mayonnaise). In a second step, participants consumed 8 weight-matched cracker samples varying in unit size (large/small), hardness (hard/soft) and lubrication (with/without mayonnaise). Sample consumption was video-recorded for post hoc behavioural annotation to derive specific oral processing behaviours. Participants were divided into 'faster' or 'slower' eater groups using a post hoc median split based on eating rate of raw carrot. Results: Across texture parameters, hardness had the largest influence (p < 0.001) on eating rate for both carrots and crackers. The independent texture differences for carrot ranked from most to least impact on eating rate was hardness > thickness > lubrication > unit size. For crackers, the rank order of eating rate was hardness > lubrication > unit size. Harder carrot samples with decreased unit size and reduced thickness combined had a larger synergistic effect in reducing eating rate (p < 0.001) than manipulation of any single texture parameter alone. Reducing the unit size of crackers while increasing hardness without lubrication combined (p = 0.015) to produce the largest reduction in eating rate. There were no significant differences between fast and slow eaters on their oral processing behaviours across texture manipulations. Conclusions: Combinations of texture manipulations have the largest impact in moderating oral processing behaviours, and this is consistent across 'faster' and 'slower' eaters. Changing food-texture presents an effective strategy to guide reformulation of product sensory properties to better regulate eating rate and energy intake, regardless of an individual's natural eating-style.

Contains fulltext : 230060.pdf (Publisher’s version ) (Closed access) Many American and Dutch adolescents use marijuana regularly. There is concern that such use may impair cognitive function more in adolescents than adults. We examined effects of regular marijuana use on long-term memory and perseveration among American and Dutch adolescents. We administered Buschke's Selective Reminding Test (BSRT) to assess long-term memory and the Wisconsin Card Sorting Test (WCST) to assess perseveration in male teenagers. Usable test data were obtained for 12 American marijuana users, 13 American controls, 9 Dutch marijuana users, and 12 Dutch controls. In BSRT, users showed lower overall long-term storage than controls (adjusted means ± SE's for numbers of words per trial of 9.4 ± 0.2, 13.4 ± 0.3, 11.7 ± 0.2, and 12.4 ± 0.2 for American users, Dutch users, American controls, and Dutch controls, respectively). Marijuana was associated with memory effects only in American, not Dutch, users. Bivariate Pearson correlations for American and Dutch users combined showed associations of lower total recall with more uses in the previous year and lifetime (r = -0.61 and r = -0.53, respectively); and more perseverative errors with more uses in the previous year (r = 0.55). Some findings were consistent with the possibility that regular adolescent marijuana use causes deficits in cognition, especially memory. However, a causal interpretation cannot be inferred from our findings and is challenging to reconcile with the observation of memory deficits only in American users. Our study was novel in examining the influence of nationality on marijuana's cognitive effects. More studies of this topic should compare effects across nationalities or cultures. 23 p.

Objectives Dementia can lead to decreased appetite and nutritional intake. Food odor exposure has been shown to increase appetite and nutritional intake in young healthy adults. This study investigates the effect of food odor exposure on appetite, nutritional intake and body weight of Dutch nursing home residents with dementia. Design This was a one-armed, non-randomized, non-blinded intervention study consisting of a four-week control period followed by a twelve-week intervention period. Setting Four nursing homes in the Netherlands. Participants Forty-five nursing home residents with dementia. Intervention During the intervention period, odors were dispersed prior to the main meals. Measurements General and specific appetite for sweet and savory foods was measured weekly. Nutritional intake was measured once during the control period and three times during the intervention period through a 3-day food record. Body weight was assessed at the start and end of the control period and at the start, end and halfway the intervention period. Data were analyzed with linear mixed models. Results Small changes in general and specific appetite were observed after odor exposure. Overall energy intake did not change during the first four intervention weeks, but increased during the second and third (+118kcal/d, p=0.003 and +122kcal/d, p=0.004). Protein intake and body weight did not significantly change during the study. Conclusion In this study, no clinically relevant changes in appetite, nutritional intake and body weight were observed after food odor exposure. Future studies should assess the effect of natural food odors and/or meal-tailored odors on nutritional intake of older adults with dementia.

Introduction The characteristics and impact of mouthfeel, temperature, smell, and taste alterations in patients with COVID-19 at a long term are yet not well known. In this study, these characteristics and their impact on daily life and quality of life (QoL) were assessed, six to ten months after infection, in patients with COVID-19 searching for peer support on Facebook. Methods Between December 2020 and January 2021, members of two COVID-19 Facebook groups were invited to complete a questionnaire. Participants were asked to report their perception of mouthfeel, temperature, smell, and taste alterations and their impact. Results The questionnaire was completed by 157/216 respondents (73%), with 92% being women. Alterations in mouthfeel, temperature, smell, and taste were reported by respectively 66, 40, 148, and 133 participants. The most frequently reported mouthfeel alterations were “a different feeling” and “dry mouth” in 38 and 30 participants, respectively. Preferences for food temperature were equally changed to “freezing”, “cool”, “room temperature”, “a bit warmer”, and “warmer”. An impact on daily life and QoL was reported by most patients with alterations in mouthfeel (91% and 79%), temperature (78% and 60%), smell (98% and 93%), and taste (93% and 88%), respectively. Conclusions Patients with COVID-19 searching for peer support on Facebook experienced, next to smell and taste alterations, mouthfeel and temperature disturbances, six to ten months after infection. These alterations have an impact on daily life and QoL. Implications Health professionals should, next to smell and taste alterations, be aware of mouthfeel and temperature alterations in patients with COVID-19.

The relation among the various causal factors of obesity is not well understood, and there remains a lack of viable data to advance integrated, systems models of its etiology. The collection of big data has begun to allow the exploration of causal associations between behavior, built environment, and obesity-relevant health outcomes. Here, the traditional epidemiologic and emerging big data approaches used in obesity research are compared, describing the research questions, needs, and outcomes of 3 broad research domains: eating behavior, social food environments, and the built environment. Taking tangible steps at the intersection of these domains, the recent European Union project "BigO: Big data against childhood obesity" used a mobile health tool to link objective measurements of health, physical activity, and the built environment. BigO provided learning on the limitations of big data, such as privacy concerns, study sampling, and the balancing of epidemiologic domain expertise with the required technical expertise. Adopting big data approaches will facilitate the exploitation of data concerning obesity-relevant behaviors of a greater variety, which are also processed at speed, facilitated by mobile-based data collection and monitoring systems, citizen science, and artificial intelligence. These approaches will allow the field to expand from causal inference to more complex, systems-level predictive models, stimulating ambitious and effective policy interventions.

The Nutri-Score front-of-pack label, which classifies the nutritional quality of products in one of 5 classes (A to E), is one of the main candidates for standardized front-of-pack labeling in the EU. The algorithm underpinning the Nutri-Score label is derived from the Food Standard Agency (FSA) nutrient profile model, originally a binary model developed to regulate the marketing of foods to children in the UK. This review describes the development and validation process of the Nutri-Score algorithm. While the Nutri-Score label is one of the most studied front-of-pack labels in the EU, its validity and applicability in the European context is still undetermined. For several European countries, content validity (i.e., ability to rank foods according to healthfulness) has been evaluated. Studies showed Nutri-Score's ability to classify foods across the board of the total food supply, but did not show the actual healthfulness of products within different classes. Convergent validity (i.e., ability to categorize products in a similar way as other systems such as dietary guidelines) was assessed with the French dietary guidelines; further adaptations of the Nutri-Score algorithm seem needed to ensure alignment with food-based dietary guidelines across the EU. Predictive validity (i.e., ability to predict disease risk when applied to population dietary data) could be re-assessed after adaptations are made to the algorithm. Currently, seven countries have implemented or aim to implement Nutri-Score. These countries appointed an international scientific committee to evaluate Nutri-Score, its underlying algorithm and its applicability in a European context. With this review, we hope to contribute to the scientific and political discussions with respect to nutrition labeling in the EU.

Infants become increasingly exposed to sweet-tasting foods in their first year of life. However, it is still unclear whether repeated exposure to sweet taste is linked to infants’ sweetness liking during this period. Making use of data from the OPALINE cohort, this study aimed to examine the link between sweetness exposure and sweetness liking during two important periods in early infant feeding: at the start of complementary feeding (3–6 months) and the transition to the family table (10–12 months). Infants’ sweetness exposure was assessed using 7-d food records which were completed by mothers every month (n 312), reporting daily consumption rates of formula/breast milk or complementary food and the type of formula milk and/or complementary foods for each feeding occasion. Infants’ sweetness liking was studied in the laboratory at 3, 6 and 12 months of age by assessing their response to a lactose–water solution and the amount drunk of this solution compared with plain water. Linear regressions and structural equation model assessed associations between exposure to and liking for sweetness at 6 and 12 months. Neither at 6 (n 182) nor at 12 months (n 197) was sweetness exposure associated with sweetness liking. While sweetness liking at 3 months was unrelated to liking at 6 months, the latter predicted sweetness liking at 12 months. These findings demonstrate no association between sweetness exposure at 3 to 12 months and liking at 6 and 12 months despite a sharp increase in sweetness exposure in that period. However, sweetness liking at 6 and 12 months was positively associated.

Eating rate (ER) is now recognised as an important driver of food and energy intake, and is strongly influenced by a food's texture. However, little is known about how the textures of multiple food components combined affect the ER of a composite dish. In a full cross-over study, 54 healthy participants (age: 25 ± 7 years, BMI: 22 ± 3 kg/m2) consumed 12 different pasta dishes. The dishes comprised single penne or carrot (hard and soft; 4 samples), single penne or carrot (hard and soft) with tomato sauce (4 samples), and combined penne (hard and soft) with carrots (hard and soft) and tomato sauce (4 samples). Behavioural coding analysis was used to quantify participant ER and oral processing behaviours for each dish. Soft penne was consumed 42% faster than hard penne (P < 0.001) and soft carrots were consumed 94% faster than hard carrots(P < 0.001) when presented as single foods without sauce. The addition of sauce increased ER for both penne and carrots by approximately 30% (both P < 0.001). For the composite dishes, the ER of the dish with soft carrot, soft penne and sauce was consumed 45% faster than the same dish with hard components (P < 0.001). The ER of the composite dishes could be predicted from the ER of its single components. The ER of individual components cumulatively determined the ER of the composite dish, rather than ER being driven only by the slowest dish component. These insights provide guidance on how to compose texture modified meals that moderate both ER and energy intake.

Modifying food texture and eating slowly each reduce appetite and energy intake. No study has evaluated the effect of combining these measures to slow eating speed and determine the effect on appetite. The aim of this study was to investigate whether there is a combined effect of manipulating oral processing behaviours (OPBs) in this manner on self-reported satiety and subsequent food intake. A 2 × 2 design was used with four breakfast conditions in total. Twenty-four participants attended four study visits where they were asked to consume one of two isocaloric fixed-portion breakfasts differing in texture: 1) granola with milk and 2) yogurt with muesli and conserve. Participants consumed each breakfast twice, with verbal instructions to chew slowly at one visit and at a normal rate at another. Consumption was video-recorded to behaviourally code OPBs. Participants completed visual analogue scales of self-reported appetite measures at the beginning of the test session, immediately prior to and immediately after breakfast consumption. They also completed a food diary documenting food intake for the remainder of the day. The breakfast designed to be eaten slowest (the harder-textured meal with instructions to eat slowly) was eaten at a slower rate, with a greater number of chews per bite and a slower bite rate (p

Profound understanding of healthy eating beliefs in populations with a low socioeconomic position (SEP) can benefit attempts to improve diet quality in this population, but literature on this subject is fragmented. The purpose of this scoping review was to systematically map healthy eating beliefs and the meaning of food and eating in populations with a low SEP. Systematic search of electronic databases yielded 35 relevant publications that were included in a qualitative synthesis. Populations with a low SEP perceived healthy eating as important, although they expressed various meanings of ‘healthy’ and ‘good’ eating. Lack of time and money posed perceived barriers to healthy eating, as well as social influences, and desired identities that can be expressed by specific foods. Traditions were important influences on food and eating practices. Eating behavior was perceived as one's own responsibility and desirably within one's own control. Parents expressed the role of food to regulate children's (eating) behavior. In conclusion, perceived limited control over what is eaten due to various barriers as described by populations with a low SEP, may also be viewed as competing values. Deeper understanding of reasons and thoughts underlying healthy eating beliefs and what it means to eat ‘well’ is largely lacking in this domain. The findings call for an in-depth exploration of the origin and construction of beliefs regarding ‘healthy’ and ‘good’ eating in populations with a low SEP.

Numerous association studies and findings from a controlled feeding trial have led to the suggestion that “processed” foods are bad for health. Processing technologies and food formulation are essential for food preservation and provide access to safe, nutritious, affordable, appealing and sustainable foods for millions globally. However, food processing at any level can also cause negative health consequences that result from thermal destruction of vitamins; formation of toxins such as acrylamide; or excessive intakes of salt, sugar, and fat. Research on ultraprocessed foods centers on food composition and formulation. In addition, many modern food formulations can have poor nutritional quality and higher energy density. We outline the role of processing in the provision of a safe and secure food supply and explore the characteristics of processed foods that promote greater energy intake. Despite the potential for negative health effects, food processing and formulation represent an opportunity to apply the latest developments in technology and ingredient innovation to improve the food supply by creating foods that decrease the risk of overeating.

Several studies have demonstrated food texture manipulation on oral processing behaviour (OPB). We explored the effect of texture-differences of equivalent carbohydrate load on OPB, bolus properties and postprandial glycaemic responses (PPG). In a randomised cross-over, within-subjects, non-blinded design, healthy male participants (N = 39) consumed fixed portions of white rice (WR) and rice cake (RC) while being video recorded to measure microstructural eating behaviours. PPG was compared between test foods over a period of 120-min, and the bolus properties and saliva uptake at swallow were measured for both test foods. RC displayed higher instrumental hardness, chewiness and Young's modulus than WR (p = 0.01), and participants perceived RC as more springy and sticky than WR (p, Graphical abstract Natural adjustments of oral processing behaviours were observed in response to food texture modification, producing large differences in eating microstructure, bolus properties and subsequent temporal postprandial glucose responses.Image 1, Highlights • Food texture differences influences oral processing, bolus particle size and saliva uptake. • Increased bolus surface area, saliva uptake and oro-sensory exposure time increases glycaemic excursions. • Salivary α-amylase concentration does not influence postprandial glycaemic response.

This study determined the gluten content of foods and meals consumed by coeliac disease (CD) patients who adhere to a gluten-free diet, and to estimate the total daily intake of gluten of these patients. CD patients fulfilling defined inclusion criteria were preselected and approached for participation in the study. Duplicate portions (DP) of foods and mixed dishes were collected from the CD patients for evaluating complete daily food intake during two individual days. Also, for these days, written food records were completed by the participants. From each DP, a laboratory sample was prepared and analysed for its gluten concentration and total daily gluten intake was calculated. Each individual’s total daily intakes of energy and macronutrients were calculated using the Dutch food composition database. In total, twenty-seven CD patients participated, seven males and twenty females, aged between 21 and 64 years. In thirty-two (6 %) of 499 food samples collected in total, more than 3 mg/kg gluten was present. In four of these thirty-two samples, the gluten concentration was above the European legal limit of 20 mg/kg and three of the four samples had a gluten-free label. The maximal gluten intake was 3·3 mg gluten/d. The gluten tolerance for sensitive CD patients (>0·75 mg/d) was exceeded on at least six out of fifty-four study days. To also protect these sensitive CD patients, legal thresholds should be re-evaluated and the detection limit of analytical methods for gluten analysis lowered.

When undergoing compression during oral processing, stacked gels display different mechanical properties that shape perceptions of texture contrasts (Santagiuliana et al., 2018). However, to date, characterizing the mechanical responses of individual gel layers has been impossible. In this study, an ultrasound (US) technique was developed, that allowed such deformation dynamics to be visualized in real time. Stacked gels were created using layers (height: 5 mm) of brittle agar and elastic gelatin in different combinations. In a series of experimental tests, different stacked gel combinations were placed on a rough, deformable artificial tongue model (ATM) made of polyvinyl alcohol; a texture analyzer was used to apply uniaxial force, and deformation was monitored by an US transducer (5 MHz) located under the ATM. From the obtained results, it was observed that the deformation of ATM surface during compression was in accordance with the force recorded by the texture analyzer, suggesting a collaborative response of different layers under compression. Moreover, US imaging revealed that differences in Young's modulus values between layers led to heterogeneous strain distributions, which were more pronounced for the agar layers. Biopolymer elasticity was also a key factor. Regardless of combination type, the gelatin layers never fractured; such was not the case for the agar layers, especially those with lower Young's modulus values. The results of this US study have thus paved the way for a better understanding of the mechanical deformation that occurs in heterogeneous foods, a phenomenon that has been difficult to examine because of the limitations of conventional techniques.

Oral processing behaviour can affect the bioavailability of macronutrients. The aim of the present study was to determine the influence of oral processing behaviour on bolus properties and in vitro protein digestion of chicken and soya-based vegetarian chicken. Natural chewing time and chewing frequency of both foods were determined in healthy adults (n 96). While natural chewing time differed considerably between consumers (chicken: 7·7–39·4 s; soya-based vegetarian chicken: 7·8–46·2 s), chewing frequency (1·4 chews/s) did not differ considerably between consumers and was independent of product type. Natural chewing times of 11 and 24 s were found for clusters of consumers showing shortest and longest chewing time for both products. Chicken and soya-based vegetarian chicken were chewed for 11 and 24 s and boli expectorated by n 16 consumers to determine in vitro gastric digestion and by n 7 to determine in vitro intestinal digestion. For both foods, longer chewing time resulted in the formation of significantly (P in vitro degree of protein hydrolysis (DH%) than shorter chewing time (chicken: DH%11s = 7 ± 23 % and DH%24s = 89 ± 26 %; soya-based vegetarian chicken: DH%11s = 57 ± 18 % and DH%24s = 70 ± 21 %, P In vitro degree of protein hydrolysis was higher for chicken than that for soya-based vegetarian chicken regardless of chewing time. We conclude that naturally occurring longer chewing time leads to more and smaller bolus particles of chicken and soya-based vegetarian chicken and thereby increases in vitro protein hydrolysis compared with shorter chewing time.

There is growing interest in the adoption of a more sustainable diet, and this has led to the development of plant-derived alternative products that are used as a substitute for products of animal origin. This is a promising way to improve the sustainability of the agricultural food industry; however, there are increasing concerns regarding the nutritional profile of plant-based products, with emerging evidence that many are not nutritionally equivalent to conventional animal products. In this study, we provide a narrative review focusing on the nutritional quality of plant-based alternative products. First, we summarize the available literature examining consumers’ and healthcare professionals’ perceived healthfulness and nutritional concerns regarding plant-based foods. Then, we compare the nutritional composition (macro- and micronutrients) of plant-based alternatives to their conventional animal counterparts. Moreover, we outline the potential impact of these nutritional differences on overall diet quality and provide a summary of the differences in the digestibility and bioavailability of nutrients from plant and animal sources. We highlight the role of product development and innovations in food processing to support the nutritional composition of plant-based products and outline the priorities for more comprehensive research on the nutrient density of these products and the sustained effect of modern plant-derived diets on long-term health.

Various global public health agencies recommend minimizing exposure to sweet-tasting foods or beverages. The underlying rationale is that reducing exposure to the perception of sweet tastes, without regard to the source of sweetness, may reduce preferences for sweetness, added sugar intake, caloric intake, and body weight. However, the veracity of this sequence of outcomes has yet to be documented, as revealed by findings from recent systematic reviews on the topic. Efforts to examine and document the effects of sweetness exposure are needed to support evidence-based recommendations. They require a generally agreed-upon methodology for measuring sweetness in foods, beverages, and the overall diet. Although well-established sensory evaluation techniques exist for individual foods in laboratory settings, they are expensive and time-consuming, and agreement on the optimal approach for measuring the sweetness of the total diet is lacking. If such a measure could be developed, it would permit researchers to combine data from different studies and populations and facilitate the design and conduct of new studies to address unresolved research questions about dietary sweetness. This narrative review includes an overview of available sensory techniques, their strengths and limitations, recent efforts to measure the sweetness of foods and diets across countries and cultures, and a proposed future direction for improving methods for measuring sweetness toward developing the data required to support evidence-based recommendations around dietary sweetness.

In this study, we propose a fast and accurate method to automatically localize anatomical landmarks in medical images. We employ a global-to-local localization approach using fully convolutional neural networks (FCNNs). First, a global FCNN localizes multiple landmarks through the analysis of image patches, performing regression and classification simultaneously. In regression, displacement vectors pointing from the center of image patches towards landmark locations are determined. In classification, presence of landmarks of interest in the patch is established. Global landmark locations are obtained by averaging the predicted displacement vectors, where the contribution of each displacement vector is weighted by the posterior classification probability of the patch that it is pointing from. Subsequently, for each landmark localized with global localization, local analysis is performed. Specialized FCNNs refine the global landmark locations by analyzing local sub-images in a similar manner, i.e. by performing regression and classification simultaneously and combining the results. Evaluation was performed through localization of 8 anatomical landmarks in CCTA scans, 2 landmarks in olfactory MR scans, and 19 landmarks in cephalometric X-rays. We demonstrate that the method performs similarly to a second observer and is able to localize landmarks in a diverse set of medical images, differing in image modality, image dimensionality, and anatomical coverage., Comment: 12 pages, accepted at IEEE transactions in Medical Imaging

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.

Nudges have been proposed as an effective tool to stimulate influenza vaccination uptake in healthcare workers. However, the success of such nudges in practice is heavily reliant on their acceptance by the intended healthcare worker population, which has not been thoroughly examined to date. This study investigated healthcare workers’ acceptability of diverse influenza vaccination nudges implemented in a real-world vaccination campaign and explored the relationship between nudge acceptability and vaccination uptake. A cross-sectional study was conducted among 244 Dutch hospital employees, following a hospital-wide influenza vaccination nudging intervention. A survey assessed healthcare workers’ perceived acceptability of ten distinct influenza vaccination nudges, along with their vaccination status and relevant covariates (e.g., general perceptions regarding influenza vaccination of healthcare workers). Influenza vaccination nudges in general were deemed acceptable, with reward-based nudges being the least accepted, while digital vaccination forms, a mobile vaccination post, peer vaccination, and digital vaccination reminders were most appreciated. A higher overall acceptance of these nudges was associated with a greater likelihood of being vaccinated, particularly in healthcare workers with favorable perceptions of influenza vaccination usefulness. Our findings suggest that influenza vaccination nudges are an accepted means to systematically promote immunization of healthcare workers, and thus present a viable strategy for public health policies aimed at this group.

Objective: Health goal priming has been shown to stimulate healthy food choices by activating an individual's weight-control goal. The present study combined fMRI with a novel virtual reality food choice task to elucidate the underlying neural mechanisms of health goal priming. Previous research has suggested that the ventromedial prefrontal cortex (vmPFC) and dorsolateral prefrontal cortex (dlPFC) play a role in the incorporation of health considerations into the food choice process. Responses may be more representative for those found in real life when assessed in an environment similar to the actual choice environment. Therefore, the first aim of the study was to explore if a novel virtual reality food choice task is sufficiently sensitive to detect basic valuation processes in food choice. The second aim was to examine whether increased activation in the dlPFC drives the effects of health goal priming. Methods: Fifty-six female participants performed an fMRI food choice task embedded in a virtual supermarket environment. They chose between perceived healthy and unhealthy products in a health prime, hedonic prime, and non-food control condition, while activation in brain areas involved in self-control and valuation (vmPFC, dlPFC) was assessed. Results: There were no differences in relative preference for perceived healthy products over unhealthy products between the conditions. There were also no main effects of prime condition on brain activation in the vmPFC and dPFC during food choice. Across conditions, activation in the vmPFC correlated with the tastiness of the chosen product during food choice. Conclusions: Although the study does not provide support for health goal priming triggering neural self-control mechanisms, results did show that virtual reality has potential for a more realistic fMRI food choice paradigm.

Background Human memory appears to prioritise locations of high-calorie foods, likely as an adaptation for foraging within fluctuating ancestral food environments. Importantly, this “high-calorie bias” in human spatial memory seems to yield consequences for individual eating behaviour in modern food-abundant settings. However, as studies have mainly been conducted in European (Dutch) populations to date, we investigated whether the existence of the cognitive bias can be reasonably generalised across countries that vary on culturally-relevant domains, such as that of the USA and Japan. Furthermore, we investigated whether sociodemographic factors moderate the expression of the high-calorie spatial memory bias in different populations. Methods In a cross-cultural online experiment, we measured the food location memory of diverse participants from the USA (N = 72; 44.4% Male; 54 ± 15.99 years) and Japan (N = 74; 56.8% Male; 50.85 ± 17.32 years), using a validated computer-based spatial memory task with standardised images of high-calorie and low-calorie foods. To directly compare the magnitude of the high-calorie spatial memory bias in a broader cultural scope, we also included data from a previous online experiment that identically tested the food spatial memory of a Dutch sample (N = 405; 56.7% Male; 47.57 ± 17.48 years). Results In the US sample, individuals more accurately recalled (i.e. had lower pointing errors for) locations of high-calorie foods versus that of low-calorie alternatives (Mean difference = -99.23 pixels, 95% CI = [-197.19, -1.28]) – regardless of one’s hedonic preferences, familiarity with foods, and encoding times. Likewise, individuals in the Japanese sample displayed an enhanced memory for locations of high-calorie (savoury-tasting) foods (Mean difference = -40.41 pixels, 95% CI = [-76.14, -4.68]), while controlling for the same set of potential confounders. The magnitude of the high-calorie bias in spatial memory was similar across populations (i.e. the USA, Japan, and the Netherlands), as well as across diverse sociodemographic groups within a population. Conclusions Our results demonstrate that the high-calorie bias in spatial memory transcends sociocultural boundaries. Since the cognitive bias may negatively impact on our dietary decisions, it would be wise to invest in strategies that intervene on our seemingly universal ability to efficiently locate calorie-rich foods.

The mechanisms underlying the ability of humans to olfactorily discriminate fat content in milks remain unknown. In this study, we found that fat contents (0.5, 1.5 and 3.5% fat) can be discriminated by olfaction in commercially available pasteurized milks (p < 0.05) but not in ultra-high temperature processed (UHT) milks. The composition of volatile compounds of pasteurized milks differed with fat content, whereas that of UHT milks differing in fat content was similar. Principal component analysis revealed that differences in volatile compound composition of pasteurized milks differing in fat content contribute to olfactory discrimination. In UHT milks, acetoin and 2-heptanone may mask odor differences leading to indistinguishable odors. No differences were observed regarding perceived odor intensity of pasteurized milks or UHT milks differing in fat content. We conclude that the olfactory discrimination of fat content in pasteurized milks is facilitated by differences in volatile compound composition rather than odor intensity.

Sudden loss of smell and/or taste has been identified as an early symptom of SARS-CoV-2 2019 (COVID-19) infection, and presents an effective target for prompt self-isolation and reducing community spread. The current study sought to develop and test a novel, rapid, self-administered test to objectively measure smell and taste losses associated with COVID-19, and administered self-report questionnaires to characterise symptoms associated with COVID-19 in Singapore. Participants (N = 99) completed questionnaires to record recent changes in smell and taste ability. This was followed by the ‘Singapore Smell and Taste Test’ (SSTT), a personal, objective testing kit for daily self-assessment of smell and taste function at their place of residence. Seventy-two recruited participants were confirmed as COVID-19 positive at baseline, of which 58 completed the SSTT at home. Of these, 36.2% had objectively measured smell and/or taste loss. The SSTT measures of smell and taste function were positively associated with participants’ self-reported smell and taste acuity, and rated smell intensity of 6 common household items. This study presents the first application of the SSTT as a rapid, cost-effective, objective tool to self-monitor smell and taste function in a residential setting, and ensures comparability across individuals through the use of standardised stimuli. The SSTT has potential for future application in populations with limited access to formal COVID-19 testing as a self-administered objective method to monitor sudden changes in smell and taste, and to prompt early self-isolation, in order to reduce community transmission of COVID-19.

The metabolic impact of oral processing is often overlooked in food design and when considering diet and lifestyle interventions to improve health and post-prandial metabolism. Food oral processing is the first step in the digestion and absorption of nutrients and informs a cascade of neuroendocrine and metabolic responses that occur post-ingestion. A food's physical, mechanical and lubricant properties inform how we adapt the duration and extent of oral processing during mastication, which, in turn, influences the incorporation of saliva and the surface area of the bolus. The properties of a food bolus at swallow can alter digestive kinetics and the rate and extent of post-prandial changes in the plasma concentrations of nutrients, in addition to the endocrine signals linked to feelings of satiety during the post-meal period. This chapter summarizes our current understanding of the metabolic impact of oral processing from acute feeding trials, long-term interventions and population-based studies. We focus on the impact of oral processing on post-prandial glucose and insulin responses, and energy intake and satiety, as they relate to body weight and metabolic health. We describe the impact of oral processing on gastric emptying and diet-induced thermogenesis. We provide an overview of the potential applications of these findings to food design and eating interventions that can be used to promote healthier diets and food intake behaviour. A better understanding of the metabolic impact of oral processing behaviour for specific consumer groups could assist in steering sensory perception, food choice and eating behaviour to promote healthier metabolic responses.

Understanding how genomes, particularly genetic variants, instruct animals to develop and function is crucial for animal breeders. Copy number variants (CNVs), the gain or loss of DNA segments, can affect gene expression and alter phenotypes. However, most large-scale genetic analyses in animal breeding use single nucleotide polymorphism (SNP) genotypes from genotyping arrays, and efforts to incorporate CNVs are limited. In theory, variation from CNVs can be captured by SNPs, if they are in high linkage disequilibrium (LD). We evaluated the LD of CNV-SNP pairs in whole genome sequencing and genotyping array data. Our whole genome sequencing data showed that most CNVs have tagging SNPs. However, CNV-SNP pairs from genotyping array data were mostly in low LD, because most CNV-SNP pairs had unmatching allele frequencies. We conclude that most rare CNVs may not be fully captured by genotyping arrays.

Consumer interest in Grass-Fed dairy products is increasing with some consumer groups willing to pay a premium for dairy labelled as Grass-Fed. The aim of this study was to examine the effect of the term Grass-Fed on a label in combination with claims on fat content, on consumer perceptions of Cheddar cheese in Irish and US participants. Consumers from Ireland (n = 345) and the United States (n = 432) completed an anonymous online survey and were presented with one of two sets of cheese label images, either Regular-Fat and Regular-Fat-Grass-Fed or Lighter-Fat and Lighter-Fat-Grass-Fed. Participants were asked to rate expected sensory characteristics and perceived healthiness and naturalness, based on each label. Participants then selected a portion of each cheese that they would be likely to consume on a slice of toast for lunch, from 100 portion size images ranging from 1.2 g to 120 g. Inclusion of a Grass-Fed claim on a cheese label did not influence sensory expectations of cheese, but perceived healthiness and naturalness were higher, in both cohorts. The Lighter-Fat claim had a negative influence on sensory expectations, with consumers in both cohorts reporting a lower expected liking and flavour intensity. In the Irish cohort, a Lighter-Fat claim enhanced perceived healthiness. The front-of-pack claim had no impact on portion selection in US consumers. Irish consumers, however, chose a larger portion for the Lighter-Fat cheese compared to the Regular-Fat-Grass-Fed cheese. Inclusion of Grass-Fed on the label alongside information on Regular-Fat or Lighter-Fat may enhance consumers’ perceptions of healthiness and naturalness, without compromising sensory expectations. Products with Lighter labels may be chosen in larger portions, with potential implications for consumers who choose them as part of a weight-control strategy.

The present study explored how primary school-aged children from families with a low socioeconomic position produce ‘likes’ and ‘dislikes’ of foods during everyday family meals, and how these (dis)likes are understood and treated by their parents. It is crucial to understand how food preferences develop in the course of everyday life, as it is known that there are socioeconomic disparities in food preference and consumption, and that children from families with a low socioeconomic position have relatively poorer diets. Deploying an interactional approach to food preference, video recordings of 79 evening meals in families with a low socioeconomic position were analyzed using discursive psychology and conversation analysis. The analysis highlighted that children's food likes and dislikes were treated differently by their parents. While likes were routinely not responded to, agreed with or further elaborated, dislikes were predominantly oriented to as food refusals or treated as inappropriate, or non-genuine claims. Children's food assessments, i.e., likes and dislikes, were often disattended by parents when they appeared to be food preference displays. By contrast, assessments that accomplished social actions like refusals and complaints were more often responded to. The analysis also revealed the importance of distinguishing between assessments about food items in general, that were not currently being eaten, and assessments of food eaten here-and-now. All in all, the study evidences that and how assessment sequences open up interactional spaces where children and parents orient to and negotiate relative rights and responsibilities to know, to assess and to accomplish specific actions. Implications for food preference research are discussed.