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Effect of glucocorticoid therapy on energy intake in children treated for acute lymphoblastic leukemia.

Despite a widespread belief that glucocorticoid therapy is associated with positive energy balance and excess weight gain there is a dearth of quantitative evidence about its effects and the underlying mechanisms of any effects. The primary aim of the present study was to quantify the effect of dexamethasone and prednisone treatment on energy intake in children treated for childhood acute lymphoblastic leukemia. A secondary aim was to test for differences in excess weight gain between patients treated using the 2 glucocorticoids. We measured energy intake in 26 patients (mean +/- SD age, 6.3 +/- 2.3 yr) during a 5-d period "on" steroids and again in the week before steroid treatment. Changes in body mass index from diagnosis to 1 and 2 yr postdiagnosis were expressed as SD scores. Steroid treatment was associated with a significant increase in energy intake of approximately 20% (mean paired difference, 1.7 MJ/d; SD, 2.8; 95% confidence interval, 0.7-2.8 MJ/d), with no significant difference between the 2 steroids. The mean change in body mass index SD score was +0.38 (SD, 1.10; P < 0.05) to 1 yr and +0.68 (SD, 1.38; P < 0.05) to 2 yr, with no significant difference between the 2 groups of patients. Glucocorticoid treatment in childhood acute lymphoblastic leukemia increases energy intake markedly, and this effect contributes to the excess weight gain and obesity characteristic of patients being treated for acute lymphoblastic leukemia.

Body Mass Index↗

Increasing the portion size of a packaged snack increases energy intake in men and women.

The objective of this study was to determine how the portion size of a packaged snack affects energy intake of the snack and of the subsequent meal. On five separate days, 60 subjects (34 women and 26 men) ate an afternoon snack and dinner in individual cubicles. For each snack, subjects were served one of five packages of potato chips (28, 42, 85, 128, or 170 g), which they consumed ad libitum directly from the unlabelled, opaque package. Subjects returned to the lab three hours later for a standard dinner, which was also consumed ad libitum. Results showed that snack intake increased significantly as the package size increased for both males and females (p < 0.001). The combined energy intake from snack and dinner also increased as the package size increased. On average, when served the largest snack package compared to the smallest, subjects consumed an additional 596 kJ (143 kcal) at snack and dinner combined. Results from this study demonstrate that short-term energy intake increases with increasing package size of a snack. These data suggest that the availability of large packages of energy-dense snacks may be one of the environmental influences associated with excess energy intake.

Adult↗

How much should we eat? The association between energy intake and mortality in a 36-year follow-up study of Japanese-American men.

Energy restriction extends life span and lowers mortality from age-related diseases in many species, but the effects in humans are unknown. We prospectively examined this relationship in a large epidemiological study of Japanese-American men. We followed 1915 healthy nonsmokers, aged 45-68 years at study onset, for 36 years. Twenty-four-hour recall of diet was recorded at baseline, and follow-up was for all-cause mortality. After adjustment for age and other confounders, there was a trend toward lower mortality in the second quintile of energy intake, suggesting that men who consumed 15% below the group mean were at the lowest risk for all-cause mortality. Increased mortality was seen with intakes below 50% of group mean. Thus, we observed trends between low energy intake and reduced risk for all-cause mortality in humans until energy intake fell to less than half the group mean, consistent with previous findings in other species.

Aged↗

Energy-dense meals improve energy intake in elderly residents in a nursing home.

BACKGROUND: Several studies have shown that malnutrition is common among nursing home residents. AIM: We hypothesized that addition of natural energy-dense ingredients to a standard diet would improve voluntary energy intake and ability to perform activities of daily living (ADL) and decrease infections in elderly residents under nursing home care. METHODS: Thirty-five residents in a municipality nursing home (median age 83 years) were served either a standard diet (1600 kcal/day) (control group, n=18) or the same meals fortified with natural energy-dense ingredients (2100 kcal/day) (experimental group, n=17). Energy intake and ADL function were measured before and after the intervention. All episodes of infection were registered. Non-parametric statistics were used. RESULTS: Energy intake increased in the experimental group from 23.5 (21.3-28.5) kcal/kg/body weight before, to 31.9 (29.7-33.7) kcal/kg/body weight during the intervention (P<0.001). There was no change in energy intake in the control group. ADL function in the experimental group was unchanged, while it decreased significantly in the control group (P<0.001). The number of infections tended to be lower in the experimental group than in the control group (5 vs 13). The cost for the energy-dense ingredients was approx. 0.11 EUR per resident and day. CONCLUSIONS: Addition of natural energy-dense ingredients to regular meals is an inexpensive way to improve voluntary energy intake in elderly nursing home residents, a treatment that was accompanied by maintained ADL function.

Activities of Daily Living↗

Food choices at lunch during the third year of life: increase in energy intake but decrease in variety.

AIM: Modelling the evolution between the ages of 2 and 3 y of the energy intake and the variety of free food choices at lunch time in relation to children's and context variables. METHODS: One-year follow-up from 2 to 3 y old. In a nursery canteen, food choices at lunch were recorded by trained assistants who monitored portion size. Energy intake and food variety were estimated. Three hundred and ninety-five children were studied, for 112 meals and over 10 mo on average. Mixed models of analysis of variance were used to take into account the longitudinal character of the data. RESULTS: From 2 to 3 y, energy intake increased. Variety decreased during the first 7 mo and then remained constant. The individual variability in mean values and in evolution was high for both variables. Energy was positively linked to BMI at 2 y. Variety was slightly higher for girls and increased with duration of breastfeeding. Energy was higher in September to November than in December-January. Variety was maximal in December-January and in June-July. CONCLUSION: During the third year of life, while energy intake increases, the restriction of food variety appears to be a normal transition phase. Long duration of breastfeeding is associated with higher food variety.

Age Factors↗

Age-related decline in RMR in physically active men: relation to exercise volume and energy intake.

We tested the hypothesis that resting metabolic rate (RMR) declines with age in physically active men (endurance exercise > or =3 times/wk) and that this decline is related to weekly exercise volume (h/wk) and/or daily energy intake. Accordingly, we studied 137 healthy adult men who had been weight stable for > or =6 mo: 32 young [26 +/- 1 (SE) yr] and 34 older (62 +/- 1 yr) sedentary males (internal controls); and 39 young (27 +/- 1 yr) and 32 older (63 +/- 2 yr) physically active males (regular endurance exercise). RMR was measured by indirect calorimetry (ventilated hood system) after an overnight fast and approximately 24 h after exercise. Because RMR is related to fat-free mass (FFM; r = 0.76, P < 0.001, current study), FFM was covaried to adjust RMR (RMR(adj)). RMR(adj) was lower with age in both the sedentary (72.0 +/- 2.0 vs. 64.0 +/- 1.3 kcal/h, P < 0.01) and the physically active (76.6 +/- 1.1 vs. 67.9 +/- 1.2 kcal/h, P < 0.01) males. In the physically active men, RMR(adj) was related to both exercise volume (no. of h/wk, regardless of intensity; r = 0.56, P < 0.001) and estimated energy intake (r = 0.58, P < 0.001). Consistent with these relations, RMR(adj) was not significantly different in subgroups of young and older physically active men matched either for exercise volume (h/wk; n = 11 each) or estimated energy intake (kcal/day; n = 6 each). These results indicate that 1) RMR, per unit FFM, declines with age in highly physically active men; and 2) this decline is related to age-associated reductions in exercise volume and energy intake and does not occur in men who maintain exercise volume and/or energy intake at a level similar to that of young physically active men.

Adipose Tissue↗

Effect of flavour of liquid Ensure diet supplement on energy intake in male SD rats.

Outbred male Sprague-Dawley rats were provided with one of the four flavours of the liquid diet, Ensure, in addition to chow pellets, to examine whether differences in flavour lead to differences in energy intake i.e. degree of over-consumption. For half the rats, the Ensure supplement was provided for 14 days and then withdrawn for the final 8 days of the study, whereas the remaining animals were allowed to consume Ensure for 22 days. All four flavours of Ensure, chocolate, vanilla, coffee and asparagus, induced a sustained increase in daily energy intake of approximately 15%. There was an effect of flavour on initial consumption of the Ensure diet, with coffee and asparagus flavours being consumed less avidly than vanilla or chocolate. However, this effect was short-lived. Overall, there was no effect of flavour on body weight gain, energy intake from Ensure, total energy intake, body composition, or measured blood hormones and metabolites. Withdrawal of Ensure resulted in reductions in body weight gain, total energy intake, fat but not lean tissue mass, and concentrations of blood leptin, non-esterified fatty acids and triglycerides, but there was no effect of the flavour of Ensure previously supplied on any of these parameters. The ability of the liquid diet, Ensure, to stimulate long-term caloric over-consumption is not due to its flavouring. Rather, other attributes of Ensure must be more important, such as its intrinsic flavour, liquid formulation, macronutrient composition, and ease of ingestion, digestion and absorption.

Analysis of Variance↗

Evaluation of energy intake estimated by a diet history in three free-living 70 year old populations in Gothenburg, Sweden.

OBJECTIVE: To evaluate the credibility of estimates of energy intake from a Diet History (DH) by cut off limits for the multiple of energy intake and basal metabolic rate (EI/BMRest) and by physical activity levels (PAL, total energy expenditure = TEE/BMR). DESIGN: Cohort study. SETTING: Departments of Geriatric Medicine and Clinical Nutrition, Göteborg University, Gothenburg, Sweden. SUBJECTS: 369 males and 440 females from three representative cohorts of free-living individuals from the gerontological and geriatric population studies--H70. RESULTS: Man values for EI/BMR(est) was 1.50 and 1.60 in males and 1.48 and 1.49 in females according to Schofield, Schofield and James (1985) and DHSS 41 (1991), respectively. A significant trend was seen when the sample was stratified at different levels of EI/BMR(est) with higher body weight, lower EI, higher proportion of energy from protein and lower of proportion energy from fat in the group with the lower values of EI/BMR(est). A significant difference was shown regarding food choice expressed as proportion of energy from ten defined food groups with respect to different EI/BMR(est) values. Lean body mass (LBM) by bioelectric impedance (BIA) correlated well with BMR according to DHSS 41 (1991), 0.90 for males and 0.87 for females. CONCLUSION: Energy intake was underreported with the DH method--especially in over-weight individuals. Reported food choice varied with EI/BMR values. EI/BMR(est) limits are useful for detecting underestimation of habitual energy intake.

Aged↗

Elevated energy expenditure and reduced energy intake in obese prepubertal children: paradox of poor dietary reliability in obesity?

The purpose of this study was to assess the validity of two common methods used to assess energy intake. A 3-day weighed dietary record and a dietary history were collected and compared with the total daily energy expenditure (TEE) assessed by the heart rate method in a group of 12 obese and 12 nonobese prepubertal children (mean age 9.3 +/- 1.1 years vs 9.3 +/- 0.4 years). The TEE value was higher in obese than in nonobese children (9.89 +/- 1.08 vs 8.13 +/- 1.39 MJ/day; p < 0.01). Energy intake assessed by the dietary record was significantly lower than TEE in the obese children (7.06 +/- 0.98 MJ/day; p < 0.001) but comparable to TEE in the nonobese children (8.03 +/- 0.99 MJ/day; p = not significant). Energy intake assessed by diet history was lower than TEE in the obese children (8.37 +/- 1.35 MJ/day, p < 0.05) but close to TEE in the nonobese children (8.64 +/- 1.54 MJ/day, p = not significant). These results suggest that obese children underreport food intake and that the dietary record and the diet history are not valid means of assessing energy intake in obese prepubertal children.

Case-Control Studies↗

Energy intake and in-hospital starvation. A clinically relevant relationship.

BACKGROUND: Malnutrition is a common finding in the acute-care hospital. OBJECTIVES: To assess the adequacy of nutritional intake to individual needs and the effects of the hospitalization on nutritional status and to identify the reasons for inadequate energy intake. METHODS: A total of 286 patients with a mean ( +/- SD) age of 79 +/- 6 years (range, 70 to 99 years), consecutively admitted to the geriatrics and internal medicine wards of an acute-care university hospital, underwent multidisciplinary assessment on admission and at discharge and daily dietary data collection. The needed, prescribed, and actual daily energy intake for each individual was measured. Nutritional depletion was diagnosed if midarm circumference decreased by 3.6% or more from admission to discharge. RESULTS: Nutritional depletion occurred in 27% of the patients and correlated with anorexia (86.4% vs 65.5% and 40% in patients whose midarm circumference was unchanged and increased, respectively; P < .001), Mini-Mental State Examination score (21.6 +/- 8.3 vs 23 +/- 6.9 and 26.5 +/- 3.6; P < .05), simplified premorbid Activities of Daily Living score (4.4 +/- 2.2 vs 5.1 +/- 1.8 and 5.0 +/- 1.8; P < .03), lymphocyte count (1.32 +/- 0.63 x 10(9)/L vs 1.62 +/- 0.88 x 10(9)/L and 1.47 +/- 0.50 x 10(9)/L; P < .03), serum albumin level (38 +/- 5g/L vs 40 +/- 4 g/L and 39 +/- 8 g/L; P < .002), ratio of actual to needed energy intake (56.9% +/- 22.1% vs 69.3% +/- 30.4% and 60.0% +/- 14.1%; P < .01), ratio of actual to prescribed energy intake (50.5% +/- 16.9% vs 60.5% +/- 20.%% and 65.5% +/- 15.7%; P < .001). Patients who consumed less than 40% of the prescribed food complained of anorexia and masticatory inefficiency and were unsatisfied with quality and timing of meals compared with other patients. CONCLUSIONS: In-hospital starvation affects mainly patients with baseline nutritional, functional, and cognitive deficits and is strongly related to the inadequate energy intake.

Activities of Daily Living↗

Energy intake, ghrelin, and cholecystokinin after different carbohydrate and protein preloads in overweight men.

CONTEXT: Dietary proteins appear to be more satiating than carbohydrate. The mechanism and effect of protein and carbohydrate type are unclear. OBJECTIVE: The objective of the study is to compare the acute effect of different proteins and carbohydrates on indicators of appetite and appetite regulatory hormones. DESIGN: This is a randomized cross-over study of four orally consumed preloads followed by blood sampling (+15, 30, 45, 60, 90, 120, 180 min), then a buffet meal. SETTING: The study was carried out in an outpatient clinic. PATIENTS AND OTHER PARTICIPANTS: Nineteen overweight (body mass index 32.1 +/- 0.9 kg/m(2)) men participated. INTERVENTIONS: Liquid preloads (1 MJ) contained whey (55 g), casein (55 g), lactose (56 g), or glucose (56 g). MAIN OUTCOME MEASURES: Plasma ghrelin, cholecystokinin (CCK), insulin, glucose and amino acids, gastric emptying rate (plasma paracetamol), appetite rating (visual analog scale), and ad libitum energy intake were the main outcome measures. RESULTS: Energy intake was 10 +/- 3% higher after the glucose preload compared with lactose and protein preloads (P < 0.05), which were predicted by ghrelin at 120 min (P < 0.05). CCK was 71 +/- 6% higher 90 min after the protein preloads compared with glucose and lactose (P < 0.05), which predicted appetite at 180 min (P < 0.05). There was a small increase in branched chain amino acids after the whey preload compared with casein (P < 0.01), but this was independent of appetite and energy intake. CONCLUSION: Acute appetite and energy intake are equally reduced after consumption of lactose, casein, or whey compared with glucose, which was consistent with differences in plasma ghrelin. Higher CCK responses after proteins correlated with satiety but did not affect energy intake.

Acetaminophen↗

Factors influencing energy intake of rats fed either a high-fat or a fat mimetic diet.

The aim of this study was to compare the effects of chronic feeding of a high-fat diet and a diet containing a fat mimetic on energy intake, body composition and tissue metabolism of mature female Sprague Dawley rats. Rats were fed a control, 25% kJ fat, diet for 10 days. Preference for this diet compared with a high-fat, 45% kJ fat, or fat mimetic, 25% kJ fat, diet was determined by offering rats two diets, in random order, for a period of 13.5 hours on three different occasions at two day intervals. Animals were then divided into three groups, receiving one of the three diets for 42 days. Dietary preference was tested again. Hepatic and muscle glucose and fatty acid utilization were measured in vitro and body composition was determined. Most of the rats preferred the mimetic diet over either control or high-fat diet, but there was no correlation between preference for a diet and intake of that diet during the experimental period. Animals fed either the high-fat or mimetic diet had greater energy intakes and body fat contents than control rats. Stepwise multiple regression determined which combination of variables correlated with energy intake of animals in each group. In rats fed high-fat diet, energy intake = 7.2 hepatic fatty acid oxidation (FAO) -0.2 hepatic glycogen - 131 muscle glycogen -0.9 hepatic fatty acid esterification (FAE) + 1.3 hepatic fatty acid synthesis (FAS) (R2 = 0.67). In rats fed mimetic diet, energy intake = 77.3 initial weight + 4.5 hepatic FAS -2.4 serum free fatty acids + 68.4 serum insulin (R2 = 0.67). These data suggest that obesity can be induced by changing the orosensory properties of a diet without changing macronutrient composition.

Adipose Tissue↗

Comparison of energy intakes determined by food records and doubly labeled water in women participating in a dietary-intervention trial.

The accuracy of estimates of usual energy intake derived from food records in participants of a long-term dietary-intervention trial was studied in a subset of 29 women aged 48.7+/-5.0 y and weighing 61.9+/-6.5 kg. This sample was similar to the population in the whole trial (n=715), from which it was selected in terms of age, weight, body mass index (BMI), and reported energy and fat intakes. During the validation study, reported energy intake was derived from 7 consecutive days of food records, and total energy expenditure was measured by the doubly labeled water method over 13 d. Reported energy intake (6.98+/-1.58 MJ/d) was significantly lower than energy expenditure (9.00+/-2.08MJ/d) and represented 79.8+/-17.6% of expenditure. The correlation between reported energy intake and expenditure was 0.46 (P=0.01, 95% CI: 0.15, 0.71). Body weight, BMI, height, length of time in the dietary trial, and percentage of energy from fat and carbohydrate were not significantly associated with the accuracy of reporting. These results indicate that energy intake derived from food records is an imprecise measure that substantially underestimates energy intake in middle-aged women participating in a long-term dietary-intervention trial.

Adult↗

Dose-related effects of lauric acid on antropyloroduodenal motility, gastrointestinal hormone release, appetite, and energy intake in healthy men.

We recently reported that intraduodenal infusion of lauric acid (C12) (0.375 kcal/min, 106 mM) stimulates isolated pyloric pressure waves (IPPWs), inhibits antral and duodenal pressure waves (PWs), stimulates release of cholecystokinin (CCK) and glucagon-like peptide-1 (GLP-1), and suppresses energy intake and that these effects are much greater than those seen in response to isocaloric decanoic acid (C10) infusion. Administration of C12 was, however, associated with nausea, confounding interpretation of the results. The aim of this study was to evaluate the effects of different intraduodenal doses of C12 on antropyloroduodenal (APD) motility, plasma CCK and GLP-1 concentrations, appetite, and energy intake. Thirteen healthy males were studied on 4 days in double-blind, randomized fashion. APD pressures, plasma CCK and GLP-1 concentrations, and appetite perceptions were measured during 90-min ID infusion of C12 at 0.1 (14 mM), 0.2 (28 mM), or 0.4 (56 mM) kcal/min or saline (control; rate 4 ml/min). Energy intake was determined at a buffet meal immediately following infusion. C12 dose-dependently stimulated IPPWs, decreased antral and duodenal motility, and stimulated secretion of CCK and GLP-1 (r > 0.4, P < 0.05 for all). C12 (0.4 kcal/min) suppressed energy intake compared with control, C12 (0.1 kcal/min), and C12 (0.2 kcal/min) (P < 0.05). These effects were observed in the absence of nausea. In conclusion, intraduodenal C12 dose-dependently modulated APD motility and gastrointestinal hormone release in healthy male subjects, whereas effects on energy intake were only apparent with the highest dose infused (0.4 kcal/min), possibly because only at this dose was modulation of APD motility and gastrointestinal hormone secretion sufficient for a suppressant effect on energy intake.

Adult↗

Regulation of energy intake in relation to metabolic state and nutritional status.

Inadequate energy intake can be an important contributor to weight loss in older individuals. This review highlights recent studies on possible causes of negative energy balance in older individuals. Studies of the regulation of food intake suggest that aging is associated with a significant impairment in the regulation of food intake that inhibits appropriate short-term and long-term compensation for imposed alterations in energy intake. The combination of a reduced ability to regulate energy intake, decreased sensory-specific satiety, and disadvantageous social factors such as functional limitations, social isolation and depression, increases the risk of negative energy balance leading to weight loss in older individuals.

Aged↗

The effect of breakfast type on total daily energy intake and body mass index: results from the Third National Health and Nutrition Examination Survey (NHANES III).

OBJECTIVE: The objective of this study was to investigate the relationship between breakfast type, energy intake and body mass index (BMI). We hypothesized not only that breakfast consumption itself is associated with BMI, but that the type of food eaten at breakfast also affects BMI. METHODS: Data from the Third National Health and Nutrition Examination Survey (NHANES III), a large, population-based study conducted in the United States from 1988 to 1994, were analyzed for breakfast type, total daily energy intake, and BMI. The analyzed breakfast categories were "Skippers," "Meat/eggs," "Ready-to-eat cereal (RTEC)," "Cooked cereal," "Breads," "Quick Breads," "Fruits/vegetables," "Dairy," "Fats/sweets," and "Beverages." Analysis of covariance was used to estimate adjusted mean body mass index (BMI) and energy intake (kcal) as dependent variables. Covariates included age, gender, race, smoking, alcohol intake, physical activity and poverty index ratio. RESULTS: Subjects who ate RTEC, Cooked cereal, or Quick Breads for breakfast had significantly lower BMI compared to Skippers and Meat and Egg eaters (p < or = 0.01). Breakfast skippers and fruit/vegetable eaters had the lowest daily energy intake. The Meat and Eggs eaters had the highest daily energy intake and one of the highest BMIs. CONCLUSIONS: This analysis provides evidence that skipping breakfast is not an effective way to manage weight. Eating cereal (ready-to-eat or cooked cereal) or quick breads for breakfast is associated with significantly lower body mass index compared to skipping breakfast or eating meats and/or eggs for breakfast.

Adolescent↗

Effects of recombinant human leptin treatment as an adjunct of moderate energy restriction on body weight, resting energy expenditure and energy intake in obese humans.

We explored the effects of recombinant human leptin (rL) as an adjunct of mild energy restriction (2092 kJ/day less than needed) in the treatment of obese humans as part of a larger multicentre trial. In a double blind, randomised, placebo (P)-controlled design, the effects of 10 mg of rL once daily vs twice daily (rL OD/BID, by s.c. injection) upon body weight, resting energy expenditure (REE) and energy intake were compared. The study groups comprised 9 (P), 15 (rL OD) and 6 (rL BID) healthy subjects (body mass index 27.5-35 kg/m2). We observed in both groups treated with rL a decline of body weight. [2.8+/-1.1 kg (P), 5.2+/-0.9 kg (rL OD), 7.9+/-1.4 kg (rL BID), p < 0.035]. No significant effects of rL treatment upon energy intake or REE were observed. However, rL tended to reduce the decline of energy expenditure associated with energy restriction, whereas the tendency of energy intake to increase back to baseline levels in placebo-treated subjects was largely prevented in subjects treated with rL. Thus, rL appears to enhance the loss of body weight in obese humans in a dose-dependent fashion if prescribed as an adjunct of energy restriction. This effect might be mediated by rL ability to counteract the behavioural and metabolic adaptations that accompany weight loss attempts.

Adaptation, Physiological↗

Energy intake and appetite are related to antral area in healthy young and older subjects.

BACKGROUND: Gastric distension reduces food intake, and antral, rather than proximal, gastric distension may be the dominant mechanism in the induction of appetite-related sensations. Healthy aging is associated with reduced appetite. OBJECTIVE: We examined the effects of different energy preloads on appetite, plasma cholecystokinin, antral area, and subsequent energy intake in healthy older and young subjects. DESIGN: On 3 separate days, 12 young and 12 older subjects consumed 400 mL of a drink containing either 0 kcal (water), 250 kcal, or 750 kcal 70 min before a buffet-style meal. RESULTS: Hunger was less in the older than in the young subjects (P < 0.001). Both nutrient preloads reduced hunger and increased fullness more than did water (P < 0.02), and older subjects were more full than were the young (P < 0.05). Antral area was greater after the nutrient preloads than after water (P = 0.001) and greater in the older than in the young subjects (P = 0.005). In both groups, food intake was suppressed in an energy-dependent manner (P = 0.008). Plasma cholecystokinin was greater in the older than in the young subjects (P = 0.003). Immediately before the meal, hunger (r = -0.59) and energy intake (r = -0.90) were inversely related and fullness (r = 0.66) was directly related to antral area (all: P < 0.001). Antral area, but not plasma cholecystokinin, was a predictor of subsequent energy intake. CONCLUSION: In healthy young and older subjects, the suppression of subsequent energy intake by a liquid preload is nutrient dependent and comparable, and both satiation and satiety are related to antral area and (presumably) antral distension.

Adolescent↗