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PubMed1995

A randomized, blinded trial of uncooked cornstarch to diminish nocturnal hypoglycemia at diabetes camp.

OBJECTIVE: To determine if uncooked cornstarch, as part of the evening snack, can avert nocturnal hypoglycemia in type 1 diabetes. RESEARCH DESIGN AND METHODS: Fifty-one campers and counselors at the American Diabetes Association Camp in San Bernardino, CA were randomly assigned to receive 5 g of uncooked cornstarch as part of the 21:00 evening snack vs. a standard snack of equivalent carbohydrate content. Each snack was given for five nights and the participants and medical personnel were blinded as to assignment. Midnight and 07:00 finger stick blood glucose levels were compared with values <60 mg/dl defined as hypoglycemia and values > 250 mg/dl defined as hyperglycemia. RESULTS: There were 218 midnight and 222 07:00 values for comparison. There were six episodes of hypoglycemia at midnight and nine episodes of hypoglycemia at 07:00 for the cornstarch snack nights vs. 30 hypoglycemia episodes at midnight and 21 at 07:00 for the standard snack nights (P < 0.001 and <0.05, respectively). There was no difference in the number of hyperglycemic events at midnight or 07:00 for the cornstarch vs. standard snack nights. At midnight, 12% of campers had hypoglycemia after the cornstarch snack vs. 46% after the standard snack (P < 0.001), and at 07:00, 16% had hypoglycemia after cornstarch vs. 26% after the standard snack (P = 0.327). CONCLUSIONS: These data suggest that uncooked cornstarch, as part of the evening snack, can diminish the nighttime and morning hypoglycemia associated with type 1 diabetes, without causing hyperglycemia.

Adolescent↗

PubMed1997

Psychological and metabolic responses of carbohydrate craving obese patients to carbohydrate, fat and protein-rich meals.

RATIONALE: A defective central serotonergic neurotransmission has been suggested to result in the concomitant occurrence of an appetite disorder and a disturbed mood. This syndrome was termed carbohydrate carving (CC) obesity. Excessive consumption of carbohydrate-rich snacks would, through a plasma amino acid mediated mechanism, restore serotonergic neurotransmission and thereby relieve the symptoms of atypical depression. OBJECTIVES: To test whether CC obese patients indeed exhibit symptoms of atypical depression, whether these symptoms can be alleviated by carbohydrate-rich snacks and whether they respond differently to the snacks than non-carbohydrate craving (NC) control subjects. Furthermore, we investigated whether differences between CC and NC patients could be related to peripheral metabolic differences. DESIGN: Double blinded, randomized with cross-over. Patients received three types of snacks (100/0/0, 70/29/1 and 35/3/62 energy percent carbohydrate/fat/protein respectively) on three consecutive test days. Before and after snack administration mood and performance were tested and blood samples were obtained. SUBJECTS: 9 CC and 17 NC obese patients, matched for sex, age and body mass index. MEASUREMENTS: Mood states (Profile of Mood States and Visual Analogue Scales) and performance (Bourdon-Wiersma cancellation test), serum glucose and insulin and plasma amino acid concentrations. RESULTS: Before snack consumption, CC patients had slightly higher anger and fatigue scores and tended to have lower mood scores than NC patients. The efficiency of performance increased in both groups after all snacks. No other psychological effects of the snacks were registered. Psychological and metabolic responses of CC and NC patients to the snacks were similar. CONCLUSION: Although they may have a somewhat disturbed mood, CC obese patients do not improve their mood states through ingestion of a carbohydrate-rich snack. It seems, from a therapeutic point of view, useless to maintain the concept of carbohydrate craving.

Adult↗

PubMed1993

Complex carbohydrates in the prevention of nocturnal hypoglycaemia in diabetic children.

In order to prevent nocturnal hypoglycaemia in patients with insulin-dependent diabetes mellitus with complex carbohydrates a pilot-study was designed with nine children with ages of 9-18 years. The children were admitted twice to the hospital (control and test) and remained the evening, night and morning the following day. The standard evening snack, given on the control day, was replaced on the test day by a test snack which contained a solution of uncooked cornstarch as a source of complex carbohydrates. The carbohydrate content of the test snack was maintained but did not contain mono- and disaccharides. Blood samples were collected and when the child had blood glucose concentrations of < or = 3.0 mmol/l or showed clinical symptoms of impending hypoglycaemia, intervention occurred with extra carbohydrates. Six out of nine children needed intervention after the standard snack (blood glucose concentrations were 1.8, 2.7, 3.0, 3.6 and 3.7 mmol/l). After the test snack this was four out of nine (blood glucose concentrations were 2.3, 2.6, 3.2 and 3.2). Three children needed a second intervention after the standard snack versus two after the test snack. One child needed a third intervention after the standard snack. The time of intervention ranged from 11 p.m. to 4 a.m. and from 10 p.m. to 12 a.m., respectively, on the day of the standard and test snack. Raw cornstarch, as a source of complex carbohydrates, did not prevent nocturnal hypoglycaemia in the dose used but blood glucose levels dropped more slowly than those after the standard snack.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMedDate not supplied

Use of uncooked cornstarch to avert nocturnal hypoglycemia in children and adolescents with type I diabetes.

Intensive management of type I diabetes mellitus may lead to a significant increase in hypoglycemia. This study evaluated the use of uncooked cornstarch to avert hypoglycemia in 13 patients, ages 3.0-17.5 years, with diabetes and a history of nighttime hypoglycemia. The usual bedtime snack (Standard Snack Period) was given for 14 days followed by 14 days in which 25%-50% of the carbohydrate content was given as uncooked cornstarch in milk (Test Snack Period). Blood glucose levels were obtained at 0200 and before breakfast during the 28-day study. No difference was found between the mean (+/- SD) before breakfast blood glucose levels during the two periods; however, the mean (+/- SD) number of hypoglycemic episodes (blood glucose < 60 mg/dL or 3.3 mmol/L) was reduced significantly during the Test Snack Period at both 0200 (p < 0.025) and before breakfast (p < 0.01) compared to Standard Snack Period (Standard Snack 2.00 +/- 2.12 versus Test Snack 0.61 +/- 0.87 at 0200, Standard Snack 2.61 +/- 2.25 versus Test Snack 0.69 +/- 1.03 before breakfast). In addition, in four children who were evaluated with every-2-h glucose levels through the night, stable glycemia was achieved after cornstarch ingestion. Our results suggest that uncooked cornstarch may be useful to decrease the frequency of nocturnal hypoglycemia in type I diabetes patients. This low-cost, simple intervention might be considered as an adjunctive therapy to diminish the risk of intensive diabetes management.

Adolescent↗

PubMed1997

Factors affecting nutrition behavior among middle-class adolescents in urban area of Northern region of Brazil.

INTRODUCTION: Brazil has been called a nation in nutrition transitional because of recent increases in the prevalence of obesity and related chronic diseases. With overweight conditions already prevalent among middle-income populations, there exists a need to identify factors that influence nutrition behavior within this group. OBJECTIVE: To address this subject, a research study was implemented among middle-class adolescents attending a large private secondary school in Manaus, Amazonas, Brazil. The study determined the availability and accessibility of snack foods as well as subjects' attitudes and preferences towards, and the influence of family and friends on healthy (high-nutrient density) snack choices. METHODS: The 4-stage process included: (a) a nutrition expert focus group discussion that reported local nutrition problems in general and factors related to adolescent nutrition, (b) an adolescent pilot survey (n = 63) that solicited information about snacking preferences and habits as well as resources for nutrition information and snack money: (c) a survey of various area food market sources to determine the availability and accessibility of high nutrient density snacks; and (d) a follow-up adolescent survey (n = 55) that measured snack food preferences and perceptions about their cost and availability. RESULTS: Results included the finding that, although affordable high nutrient density snacks were available, preferences for low nutrient density snacks prevailed. The adolescents were reportedly more likely to be influenced by and obtain nutrition information from family members than friends. CONCLUSION: From study results it is apparent that a focus on food availability will not automatically result in proper nutritional practices among adolescents. This fact and the parental influence detected are evidence of a need to involve adolescents and their parents in nutrition education campaigns to improve adolescent snack food choices.

Adolescent↗

PubMed2006

Filling yet fattening: stereotypical beliefs about the weight gain potential and satiation of foods.

To what extent are stereotypes concerning the weight-gain potential and perceived hunger satisfaction of food names not congruent with views of the nutrient profiles of those same foods? Respondents rated the same 22 food names and descriptions in terms of weight-gain potential and hunger satisfaction. Half of the 22 snacks included foods from the lower two tiers of the USDA Food Guide Pyramid (fruits, vegetables, and grains: FV&G) and the other half from the upper two tiers (meats, dairy, fats, and sweets: MDF&S). FV&G and MDF&S snack names and descriptions were paired for data analyses based on energy content. Name and description ratings for weight-gain potential were not correlated, while these ratings for hunger satisfaction were strongly correlated. For weight-gain potential, fat and fiber content predicted snack-name ratings, while energy and sugar content predicted description ratings. For perceived hunger satisfaction, protein content predicted snack name ratings while energy and fat content predicted description ratings. The MDF&S snack named in each pair was always considered a greater weight gain promoter compared to its corresponding FV&G snack named. However, the description of the FV&G snack in each pair was often judged to promote greater weight-gain than the description of its corresponding MDF&S snack. Also, MDF&S names were generally judged as more filling than FV&G foods named with similar calorie content; however, a trend in the opposite direction was evident when rating the nutrient descriptions of these same foods. Apparently, food names have acquired reputation for promoting obesity and (to a lesser extent) hunger satisfaction that are not based on their nutrient profiles.

Adult↗

PubMed1987

Nutrients that modify the speed of internal clock and memory storage processes.

Two experiments assessed the effects of nutrients on timing behavior by rats. The nutrients were laced with saccharin and given to rats as a snack before training on a 20-s peak-interval procedure. The primary component of the snacks for four groups of 10 rats was lecithin (phosphatidylcholine), protein (casein), carbohydrate (sucrose), or a nonnutrient (saccharin). The primary measure of behavior was the time of the rat's highest response rate during a trial (peak time), which represented the interval during which the rat maximally expected food. With a lecithin snack, peak time was gradually shifted over sessions to a shorter time, remained shifted to the left of the normal function with additional testing, and then remained at the shorter time on two sessions after the snack was discontinued; with the protein snack, peak time was abruptly shifted to a shorter time, returned to normal with additional testing, and then rebounded to a longer time when the snack was discontinued; with a carbohydrate, snack peak time was abruptly shifted to a longer time, returned to normal with additional testing, and then rebounded to a shorter time when the snack was discontinued. The behavioral patterns produced by the nutrients were interpreted in terms of precursor effects on central neurotransmitter synthesis and release, psychological stages of an information-processing model, and mathematical parameters of a scalar timing theory.

Animals↗

PubMed1994

The effects of altered frequency of eating on plasma lipids in free-living healthy males on normal self-selected diets.

OBJECTIVE: To examine the effects of modifying meal consumption frequency on blood lipids in free-living healthy male volunteers on self-selected diets. DESIGN: Cross-over study of snacking to non-snacking and non-snacking to snacking patterns. SETTING: Civic Offices, Dublin. SUBJECTS: 12 men with a mean (SD) eating frequency of 6.0 +/- 0.8 times per day ('snacking') and 11 men with a frequency of 3.1 +/- 0.1 meals per day ('non-snackers'). INTERVENTION: The 'snackers' moved from 6.0 to 3.3 +/- 0.3 meal-eating occasions per day while the 'non-snackers' moved from 3.1 to 5.9 +/- 0.9 times per day. It was intended that these modifications of eating frequency would not be the cause of modified nutrient intake in the cross-over period. MAIN OUTCOME MEASURES: Nutrient intake, plasma total, high density lipoprotein (HDL) and low density lipoprotein (LDL) cholesterol, plasma triglyceride and apoproteins A-I and B. RESULTS: There was a significant treatment (cross-over) effect on plasma total cholesterol (P = 0.038), LDL cholesterol (P = 0.038), HDL/LDL cholesterol ratio (P = 0.013) and apo A-I/B (P = 0.029). There were no significant nutrient changes on moving from meal-eating to snacking but on moving from snacking to meal-eating there were significant changes (P < 0.005) in the % energy from protein, fat, saturated fatty acids and alcohol. These changes accounted for all the changes in blood cholesterol in this group. When the data for meal-eating to snacking were analysed separately, given that nutrient intakes did not change, a significant effect of altered meal-eating frequency was found for total cholesterol (P = 0.027) and HDL/LDL (P = 0.015). CONCLUSION: These data on free-living subjects following normal self-selected diets support the hypothesis and the substantial related literature that more frequent meal consumption has a favourable effect on lowering plasma cholesterol and raising the HDL/LDL cholesterol ratio.

Adult↗

PubMed1999

Restricting access to foods and children's eating.

This study evaluated maternal restriction of children's access to snack foods as a predictor of children's intake of those foods when they were made freely available. In addition, child and parent eating-related "risk" factors were used to predict maternal reports of restricting access. Participants were 71, 3-to-5-year-old children (36 boys, 35 girls) and their parents. Children's snack food intake was measured immediately following a meal, in a setting offering free access to palatable snack foods. Child and maternal reports of restricting children's access to those snack foods were obtained. In addition, information on child and parent adiposity as well as parents' restrained and disinhibited eating was used to examine "risk" factors for restricting access. For girls only, child and maternal reports of restricting access predicted girls' snack food intake, with higher levels of restriction predicting higher levels of snack food intake. Maternal restriction, in turn, was predicted by children's adiposity. Additionally, parents' own restrained eating style predicted maternal restriction of girls' access to snack foods.

Child Behavior↗

PubMed2007

Daily hassles and eating behaviour: the role of cortisol reactivity status.

Previous research has shown high cortisol reactors to consume a greater amount of snack foods than low reactors following a laboratory stressor. The current study tested whether high cortisol reactors also consume more snacks than low reactors in response to field stressors. Fifty pre-menopausal women completed a laboratory stressor, provided saliva samples to assess cortisol reactor status and then completed daily hassles and snack intake diaries over the next fourteen days. Hierarchical multivariate linear modelling showed a significant association between daily hassles and snack intake within the overall sample, where an increased number of hassles was associated with increased snack intake. This significant positive association between number of hassles and snack intake was only observed within the high cortisol reactors and not within the low cortisol reactors. These findings suggest that high cortisol reactivity to stress promotes food intake. Furthermore, the eating style variables of restraint, emotional eating, external eating and disinhibition were more strongly associated with snack intake in high reactors than in low reactors. This suggests that cortisol reactivity may in part account for the moderating role of eating style on stress-induced eating. The results are discussed within the context of future health risk.

Adult↗

PubMed1997

Eating frequency: methodological and dietary aspects.

It is commonly stated that 'snack' foods provide 'empty calories' and, therefore elevate energy intake whilst providing insignificant quantities of other nutrients. The data presented in the present review suggest that foods which contribute to the pattern of 'snacking' contribute significantly to the nutrient quality of the diet. Those who 'snack' frequently tend to eat more food in general. Part of the difficulty in identifying the nutritional implications of 'snacking' is related to the definitions of 'meals' and 'snacks' and subsequent categorization of individual patterns. The physiological definitions typically relating to energy content or the time of eating do not necessarily coincide with colloquial, cultural or individual perceptions of what constitutes a 'meal' or 'snack'. Clearly, a more consistent approach would facilitate interpretation of the literature and enable more effective health education messages about 'snacking' to be delivered.

Age Factors↗

PubMed1997

Alanine and terbutaline in the prevention of nocturnal hypoglycemia in IDDM.

OBJECTIVE: To test the hypothesis that because of sustained glycemic actions, bedtime administration of the glucagon-releasing amino acid alanine or the epinephrine-simulating beta2-adrenergic agonist terbutaline more effectively prevents nocturnal hypoglycemia than a conventional bedtime snack, we studied 15 patients with IDDM. RESEARCH DESIGN AND METHODS: On each of four occasions, the same individualized dose of NPH insulin (0.1-0.2 U/kg) was administered with either no treatment (control) or, in random sequence, oral treatment with a snack (240 ml of 2% milk plus one slice of toast, approximately 200 kcal), alanine (40 g, plus 10 g of glucose, approximately 200 kcal), or terbutaline (5.0 mg) at 2200. RESULTS: During the first half of the night (2315-0300), mean plasma glucose concentrations were higher after the snack (P < 0.02), alanine plus glucose (P < 0.01), or terbutaline (P < 0.001), compared with no treatment. During the second half of the night, mean plasma glucose levels were no different from control values (73 +/- 5 mg/dl, 4.1 +/- 0.3 mmol/l) after the snack (73 +/- 7 mg/dl, 4.1 +/- 0.4 mmol/l), tended to be higher after alanine plus glucose (96 +/- 16 mg/dl, 5.3 +/- 0.9 mmol/l), and were significantly higher after terbutaline (124 +/- 15 mg/dl, 6.9 +/- 0.8 mmol/l, P < 0.01). Nocturnal plasma glucose levels of 40 mg/dl (2.2 mmol/l) or less (which were treated with intravenous glucose) occurred on 13 occasions in seven patients in the control arm and 10 occasions in six patients in the snack arm (not significantly different from the control arm), but on only 1 occasion in the alanine-plus-glucose arm (P < 0.02) and the terbutaline arm (P < 0.02). CONCLUSIONS: In patients with IDDM given an evening dose of NPH insulin, a conventional bedtime snack exerts an inconsistent glycemic effect only during the first half of the night, and bedtime administration of the glucagon-releasing amino acid alanine or the epinephrine-simulating beta2-adrenergic agonist terbutaline more effectively prevents nocturnal hypoglycemia than a conventional bedtime snack.

Adrenergic beta-Agonists↗

PubMed1989

Postprandial alterations in arterial pressure control during hemodialysis in uremic patients.

To test the hypothesis that eating may adversely affect the hemodynamic response to ultrafiltration-dialysis, we studied the effect of a standard snack (about 400 Kcal) in 13 patients on RDT. Each patient was studied in random order during two standard hemodialysis sessions (snack-HD and control-HD) performed at identical UF rate. Arterial pressure fell significantly (p less than 0.01) during both the Control-HD (from 135 +/- 8/76 +/- 3 to 121 +/- 10/68 +/- 5 mmHg) and the Snack-HD (from 137 +/- 7/77 +/- 3 to 105 +/- 8/59 +/- 4 mmHg). The rate of fall, however, was significantly higher (p less than 0.01) after the snack than during the corresponding period in the control HD. Consequently, there were more hypotensive episodes requiring saline infusion during Snack-HD (23 in 10 patients) than during Control-HD (12 in 6 patients) (p less than 0.025). In spite of the greater number of interventions, the average fall in arterial pressure after a snack (-22 +/- 3/-13 +/- 2 mmHg) was more marked than during the corresponding period in the control-HD (-13 +/- 3/-9 +/- 2 mmHg). The hypotensive effect of snack was more pronounced in the presence of advanced autonomic neuropathy. Food ingestion impairs the arterial pressure response to UF in patients on RDT. Fasting during hemodialysis may in part prevent hypotension.

Autonomic Nervous System↗

PubMed1989

Learned caloric adjustment of human intake.

The time course of caloric compensation of food intake was studied in human subjects presented with a new calorically dilute snack food under naturalistic conditions. In a preliminary test, two versions of the snack food, normal in calories (NC) or low in calories (LC), were found equally palatable by the subjects (15 to 17-year-old boys). In the first part of the experiment two groups were presented with a 125g serving of either NC or LC version as an afternoon snack. Intakes during the subsequent dinner (1 h later) were measured. In the second part of the experiment, the same subjects were allowed to habituate to NC or LC, i.e. on five consecutive days, subjects were served NC or LC food ad libitum at afternoon snack-time; servings and left-overs were weighed. On the sixth day, the snack was a 125 g serving of the habitual food and dinner intakes were measured. It was shown that in these adolescent males a 200 kcal difference in the afternoon snack was not immediately compensated for by dinner intake. However, precise caloric adjustment occurred after habituation. This casts in question the value for weight control of such a use of food products having lower caloric content than conventional products.

Adolescent↗

PubMed2006

Predictors of disinhibited eating in children with and without overweight.

OBJECTIVE: This study examined how 7-13-year-old children with and without overweight respond to free access to snack food in the absence of hunger and whether this eating behaviour could be predicted by parental feeding strategies and child's characteristics. METHODS: A total of 52 children (26 normal weight and 26 overweight children) were exposed to snack food after consuming a typical meal. Parental feeding practices and child's variables were assessed via self-report. RESULTS: Two-third of the sample ate of the presented snacks and consumed an average of 68 g. Overweight boys consumed twice as much than the normal weight boys. Parental feeding strategies did not contribute to the prediction of this eating behaviour. Regardless of the children's weight status, the child's eating style strongly predicted snack intake. CONCLUSIONS: This study provides evidence that overweight boys show difficulties in regulating their eating behaviour. Inconsistent with previous work, no evidence for parental contribution of snack intake was found. The present findings suggest that in older children especially children's own eating style account for the variance in snack eating behaviour.

Adolescent↗

PubMed1990

Effect of food on H2-receptor blockade in normal subjects and duodenal ulcer patients.

Two separate studies of 24 hour intragastric acidity were carried out in normal volunteers and duodenal ulcer patients to define the interaction of food and the antisecretory effects of H2-receptor blockers. Both investigations were double blind randomised comparisons using ranitidine 300 mg with either different meal times or ad libitum snacks after an evening meal. Meals taken after drug administration nearly abolished measurable antisectory effects. Median 24 hour pH was 1.3 on placebo, 2.6 when ranitidine was administered after the evening meal and 1.9 when administered before the evening meal. Snacks taken after evening dosing with ranitidine also significantly decreased pharmacodynamic efficacy. During placebo, median night-time pH was 1.3 without snacks and 1.4 with snacks. pH rose to 5.9 during ranitidine treatment when snacks were forbidden but was only 3.1 when snacks were allowed. These findings could be of therapeutic importance and should rationalise dietary advise to patients receiving H2 blockers. The timing of drug administration can be adjusted according to individual life styles.

Adult↗

PubMed2006

Trends in eating behaviours among Chinese children (1991 -1997).

This study examined the trends in snacking behaviours and eating food-prepared-outside-the-home (FPOH) by Chinese children and adolescents using data from the China Health and Nutrition Survey. The sample consisted of 3223 subjects aged 6-18 in 1991 and 2836 in 1997. Three days of 24hr recall dietary data and per capita income (deflated to 1989) was used. The percentage of Chinese children having snacking behaviours was significantly differentiated according to the income level while percentage of eating FPOH increased in middle and high income groups. Snacking contributed about 8% of the energy intake (EI) for snackers, compared with over 15% from FPOH for those who ate FPOH. Fruit was a major component of snacking: snacks based on fruit intake almost doubled over the study period as did snacks based on soft drink consumption. Animal source food consumption was a key component of FPOH and its intake also increased.

Adolescent↗

PubMed1997

Factors influencing marijuana self-administration by humans.

The self-administration of marijuana cigarettes varying in tetrahydrocannabinol (THC) content was measured by having participants choose between marijuana and an alternative reinforcer, i.e., snack food. Twelve marijuana users (eight men, four women), in groups of four, participated in a 16-day residential study. Each day, participants had the opportunity to choose repeatedly between a marijuana cigarette and a snack. The THC concentration of the cigarette changed each day (0.0, 2.2 or 3.9% delta 9-THC w/w), as did the number of snack items (one or two); each THC concentration was compared to each snack condition twice. Days were divided into a work period (09.15-16.45 h), comprising performance and subjective-effects tasks, and a recreation period (17.15-23.30 h). Each day at 10.00 h, participants "sampled" a marijuana cigarette containing the delta 9-THC concentration available that day, and selected the number of snack items available that day. Six "choice" trials occurred from 14.00-19.00 h, when participants responded under a modified progressive ratio schedule for either marijuana or snacks. At 18.15 h, participants could participate in a 10-min math task, in which each correct answer earned $1.00. Cigarettes containing 2.2 or 3.9% delta 9-THC were self-administered more often than placebo. The only other factor influencing marijuana choice was the opportunity to earn additional money, with participants choosing not to smoke immediately before the math task. By the end of the study, active marijuana had smaller effects on ratings of "high", "stimulated," and "good drug effect." These data demonstrate that: (a) delta 9-THC is an essential reinforcing component of marijuana; (b) marijuana use may be manipulated by monetary contingencies; and (c) tolerance may develop more readily to marijuana's subjective effects than its reinforcing effects.

Adult↗