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PubMed2003

Effect of conjugated linoleic acid supplementation after weight loss on appetite and food intake in overweight subjects.

OBJECTIVE: To study the effects of 13 weeks conjugated linoleic acid (CLA) supplementation in overweight subjects on body-weight maintenance, parameters of appetite and energy intake (EI) at breakfast after weight loss. DESIGN: This study had a double-blind, placebo-controlled randomized design. SUBJECTS: A total of 26 men and 28 women (age 37.8+/-7.7 y; body mass index 27.8+/-1.5 kg/m(2)). INTERVENTIONS: Subjects were first submitted to a very-low-calorie diet (VLCD; 2.1 MJ/day) for 3 weeks after which they started with the 13-week intervention period. They either received 1.8 g CLA or placebo per day or 3.6 g CLA or placebo per day. Additionally, subjects of the high dosage intervention replaced their habitual lunch by one meal of a protein-rich, low-energy supplement. EI was measured at breakfast and appetite profile after an overnight fast. RESULTS: The mean body weight loss was 6.9+/-1.7% of their original body weight. Multiple regression analysis showed that at the end of the 13-week intervention, CLA did not have an effect on body weight regain. Feelings of fullness and satiety were increased and feelings of hunger were decreased after 13 weeks intervention by CLA compared to placebo, independent of %body weight regain. However, EI measured at breakfast was not affected by CLA. CONCLUSION: Appetite (hunger, satiety and fullness) was favorably, dose-independently affected by a 13-week consumption of 1.8 or 3.6 g CLA/day. This did not result in a lower EI at breakfast or an improved body-weight maintenance after weight loss.

Adult↗

PubMed2005

How to measure dietary intake and food habits in adolescence: the European perspective.

AIM: This paper deals with some methodological aspects of data collection in the context of measuring dietary intake in individuals in their adolescence life stage. METHOD: Experiences from three partners of the HELENA project in dietary intake measurement in children and adolescents are presented in this paper with emphasis on characteristics of under-reporting, long-term diet measurement and food patterns (Dortmund DONALD group), influences of survey duration on under-reporting (Ghent group) and meal habits (Spanish AVENA group). RESULTS: Under-reporters in the DONALD Study, particularly female adolescents, had a significantly higher body mass index (BMI) than non-under-reporters; BMI could not be explained by different long-term dietary patterns during childhood and adolescence clustered according to fat consumption; consumers of fast food had higher BMI values than nonconsumers. In the Ghent experience, the decline in population mean energy intake as calculated over selected clusters of days is 184 kcal (6.5%) in boys and 116 (5.6%) in girls; the cluster of 1 recording day and the cluster of 3 recording days were not significantly different but they were both significantly different from the 7-day cluster; no significant interaction was observed between the effect of time and BMI. In the AVENA Study, the percentage of adolescents skipping breakfast was higher in females (8.6%) than in males (3.5%, P<0.001); higher BMI values were observed in those skipping breakfast than in those notskipping breakfast, but differences were statistically significant in males at 15 y and in females at 14 and 17 y; adolescents avoiding some food groups for breakfast had higher BMI values (carbohydrates, fruits and pastries in males and milk, fruits and pastries in females). CONCLUSION: Dietary and nutrient intake data in the HELENA project will be obtained by means of repeated 24-h dietary recalls. Data from HELENA might be a basis for developing complex approaches like Healthy Eating Indices.

Adolescent↗

PubMed1976

[Glisoxepide treatment in maturity-onset diabetics (author's transl)].

Patterns of blood glucose, serum insulin and non-esterified fatty acids (NEFA) were measured over a period of eight-and-a-half hours in eleven maturity-onset diabetics receiving 8 mg glisoxepide in the morning and 4 mg in the evening (while on a standard diet). The effects of administering the tablets in the morning with breakfast were compared to those on administering the drug half-an-hour (five patients) or one hour (six patients) before breakfast. Although there was a slightly earlier increase in serum insulin when tablets were taken half-an-hour or an hour before breakfast, different times of administration did not significantly affect the blood glucose or NEFA pattern. In particular, the extreme rise in blood glucose levels after the first breakfast could not be avoided.

Blood Glucose↗

PubMed2004

Metabolic control in patients with type 2 diabetes using Humalog Mix50 injected three times daily: crossover comparison with human insulin 30/70.

OBJECTIVE: Patients with type 2 diabetes most frequently use injections of premixed insulin formulations twice daily, but intensified insulin therapy may provide better control. This study was designed to compare metabolic control with three daily injections of Humalog Mix50 or premixed human insulin 30/70 (30 % regular/70 % NPH) twice daily in accordance with normal prescription practice. RESEARCH DESIGN AND METHODS: The study cohort of 40 patients with type 2 diabetes used a two-way, crossover design. Patients were randomized to either Mix50 at each main meal or human insulin 30/70 at breakfast and dinner for 3 months, followed by the alternate treatment for 3 months. Blood glucose was measured by the patients at baseline and at the end of each treatment sequence. No significant carryover effects were observed, so treatment sequences were combined and data analyzed by unpaired t-tests. RESULTS: Mean blood glucose level was significantly (p = 0.010) decreased with Mix50 but not with 30/70 (p = 0.237), and there was a significant difference between treatments at the endpoint (p = 0.035). Fasting blood glucose was increased pre-breakfast and decreased at bedtime with Mix50 but was not significantly changed pre-lunch or dinner or at any time with 30/70 insulin. Blood glucose excursions were significantly decreased with Mix50 after breakfast (p = 0.002), lunch (p < 0.001) and dinner (p = 0.037) but not significantly changed from baseline with 30/70 insulin. The decrease from baseline in HbA (1c) was significantly (p = 0.021) greater with Mix50 than with 30/70 insulin. There were no significant differences between treatments regarding incidence of hypoglycemia or adverse events. CONCLUSIONS: In patients with type 2 diabetes, a regimen of Humalog Mix50 administered three times daily before meals maintains glucose control more effectively than premixed human insulin 30/70 administered before breakfast and dinner.

Aged↗

PubMed2002

Acute effects of meal fatty acid composition on insulin sensitivity in healthy post-menopausal women.

Postprandial plasma insulin concentrations after a single high-fat meal may be modified by the presence of specific fatty acids although the effects of sequential meal ingestion are unknown. The aim of the present study was to examine the effects of altering the fatty acid composition in a single mixed fat-carbohydrate meal on glucose metabolism and insulin sensitivity of a second meal eaten 5 h later. Insulin sensitivity was assessed using a minimal model approach. Ten healthy post-menopausal women underwent four two-meal studies in random order. A high-fat breakfast (40 g fat) where the fatty acid composition was predominantly saturated fatty acids (SFA), n-6 polyunsaturated fatty acids (PUFA), long-chain n-3 PUFA or monounsaturated fatty acids (MUFA) was followed 5 h later by a low-fat, high-carbohydrate lunch (5.7 g fat), which was identical in all four studies. The plasma insulin response was significantly higher following the SFA meal than the other meals after both breakfast and lunch (P<0.006) although there was no effect of breakfast fatty acid composition on plasma glucose concentrations. Postprandial insulin sensitivity (SI(Oral)) was assessed for 180 min after each meal. SI(Oral) was significantly lower after lunch than after breakfast for all four test meals (P=0.019) following the same rank order (SFA < n-6 PUFA < n-3 PUFA < MUFA) for each meal. The present study demonstrates that a single meal rich in SFA reduces postprandial insulin sensitivity with 'carry-over' effects for the next meal.

Analysis of Variance↗

PubMed2002

Contribution of meals and snacks to nutrient intake of male and female elite figure skaters during peak competitive season.

OBJECTIVE: To examine the contribution of breakfast, lunch, dinner and snack to the macronutrient and micronutrient intake of elite male and female figure skaters during their competitive season. SUBJECTS: Male (n = 46) and female (n = 48) figure skaters who participated in the 1999 U.S. National Figure Skating Championships completed the study. METHODS: Each athlete completed three-day food records, during the athlete's competitive season. Food records were analyzed using Nutritionist V software. Macronutrient and micronutrient contributions from meals were assessed. RESULTS: Lunch and dinner meals were the main contributors to the total calorie intake of these skaters (27% and 32%, respectively). Likewise, lunch and dinner were the main contributors to the total protein (27% and 41%), carbohydrate (26% and 29%), fat (30% and 32%), saturated fat (29% and 32%) and polyunsaturated fat (31% and 32%) intakes. Dinner was the main source of the monounsaturated fat (34%), cholesterol (40%) and dietary fiber (34%). Breakfast was the main source of dietary folate (36%), whereas iron and calcium intakes were mainly contributed by breakfast and dinner (29% and 32%, 27% and 29%, respectively). CONCLUSION: These elite figure skaters appear to be starting their day with low energy reserves and therefore need to be educated about the benefits of consuming breakfast. These athletes also need to be educated about consuming adequate calories throughout the day in order to meet the energy needs of their activity. It is thus important to monitor eating patterns throughout the day to ensure adequate energy intake to sustain the physical and mental aspects of the athletes' training and performance.

Adolescent↗

PubMed1976

The effect of dietary fiber supplementation in man. I. Modification of eating habits.

Six subjects were studied for an 8-week period that consisted of a 3-week control period, followed by a 3-week period during which their daily diets were supplemented with 3 oz of a high fiber breakfast food, All-bran, and a final 2 weeks on their regular diet. Daily diet records of food intake were recorded and analyzed for seven dietary constituents; carbohydrates, proteins, fats, cholesterol, fiber, alcohol, and total calories. The most significant change in eating behavior due to the fiber food supplementation was a decrease in eating eggs, butter, and breakfast meats. These foods were most often replaced because all six subjects chose to eat the major portion of All-bran during breakfast. An increase in milk and fruit also occurred during the supplemented feeding. These particular foods were added to make All-bran more palatable and served to increase carbohydrate and protein intake. Five subjects added the supplement to the between meal-time intake and thus caused an increase in total daily caloric intake. At lunch and dinner few foods were altered with no particular pattern of substitution. Notwithstanding the knowledge that increased fiber content may have beneficial effects, none of the subjects modified his eating behavior to include even 1 oz of a high fiber food daily after the experimental period was concluded. Thus behavior modification by forced diet intake of a high fiber breakfast food resulted in definite diet pattern changes that did not persist following the experimental period.

Adult↗

PubMed1992

Short-term effects of different amounts of protein, fats, and carbohydrates on satiety.

This study investigated the satiating efficiencies of proteins, fats, and carbohydrates (CHOs). Twenty-nine female, normal-weight subjects each received 10 liquid breakfasts, which varied in energy and macronutrient contents. Besides a zero condition [0.3 MJ (8 kcal)], there were three energy levels [0.42, 1.05, and 1.67 MJ (100, 250, and 400 kcal)] combined with three dominant sources of macronutrients (99% of energy from CHO, 92% of energy from fat, and 77% of energy from protein). After breakfast the subjects were not allowed to eat or drink (except water) for 3.5 h. They then recorded their voluntary food intake for the remainder of the day. Subjects also rated their subjective feelings concerning food intake on five different types of appetite. The results showed that neither energy content nor macronutrient composition of the liquid breakfasts had any effect on energy and macronutrient intake during lunch and the remainder of the day. Ratings of different types of appetite showed an increasing satiating effect with increasing energy content of the breakfasts. Proteins, fats, and CHOs had similar effects on appetite.

Adult↗

PubMed1996

Large daily fluctuations in plasma tyrosine in treated patients with phenylketonuria.

In patients with phenylketonuria (PKU), extra tyrosine supplementation is advocated in addition to tyrosine-enriched amino acid mixtures. PKU patients have low fasting plasma tyrosine concentrations, but little is known about tyrosine fluctuations during the day. Plasma tyrosine concentrations were studied in 12 PKU patients in response to a test without breakfast and to three tests with different tyrosine contents in breakfast and lunch: 0%/30%, 25%/30%, 50%/10%, and 75%/10% tests, reflecting the protein consumption at breakfast and lunch, respectively. Prolonged fasting resulted in a small decrease in the already low overnight fasting plasma tyrosine concentrations. Breakfast and lunch with 25% and 30% of the daily tyrosine intake resulted in both lower than normal and higher than normal tyrosine concentrations. The 50%/10% and 75%/10% tests resulted in excessively high plasma tyrosine concentrations in most patients. Therefore, both lower than normal and higher than normal postprandial plasma tyrosine concentrations were found in treated PKU patients, even if the daily tyrosine intake was distributed evenly. When there was a large fractional tyrosine intake from one meal, very high plasma tyrosine concentrations were found. Therefore, strict control of plasma tyrosine is necessary if tyrosine supplementation is considered in addition to the tyrosine-enriched amino acid mixtures.

Adolescent↗

PubMed1998

School feeding in Jamaica: a review of its evaluation.

This paper reviews two studies that evaluated the school feeding program in Jamaica. The first examined 115 children aged 12-13 y who were enrolled in three classes in a poor, rural school. One class was served the standard school meal at 0900 whereas the other two classes served as controls. The outcome variables included school achievement, attendance, and weight gain. After one semester, the class receiving the meal showed improved arithmetic scores and school attendance compared with the control classes; however, they showed no weight gain. The academic improvement remained significant after school attendance was controlled for. It was therefore hypothesized that the gains in arithmetic resulted from the alleviation of hunger in the classroom. The other study, conducted in a metabolic ward, examined the effects of missing breakfast on cognitive function in 90 children aged 9-10 y and of differing nutritional status. Using a crossover design, the investigators tested each child on two mornings 1 wk apart, once after serving them breakfast and second without. Breakfast, consisting of the school program meal, was served at 0800. When severely malnourished, stunted, or wasted children received no breakfast, their performance in various cognitive tests deteriorated. These results indicate that alleviation of hunger was one of the mechanisms by which school feeding improved academic achievement in the previous study. Undernourished children are more likely to benefit from school feeding programs than are adequately nourished children.

Adolescent↗

PubMed2002

Oat bran stimulates bile acid synthesis within 8 h as measured by 7alpha-hydroxy-4-cholesten-3-one.

BACKGROUND: Oat bran contains soluble fibers, such as beta-glucan, that increase bile acid excretion and thus decrease serum cholesterol. Bile acid synthesis correlates with serum concentrations of the metabolite 7alpha-hydroxy-4-cholesten-3-one (alpha-HC). OBJECTIVE: The objective was to investigate whether consumption of beta-glucan from oat bran increases bile acid synthesis, as measured by the serum alpha-HC concentration, within hours after consumption in response to the loss of bile acids from the liver. DESIGN: In a randomized, single-blind, wheat bran-controlled study with crossover design, 8 subjects were served a controlled diet during 2 periods of 3 d each, with an 11-d washout between the periods. Breakfast included either 75 g extruded oat bran, of which 11 g was beta-glucan, or 75 g wheat bran, of which 1 g was beta-glucan. Alpha-HC was measured by HPLC on each day at 0, 12, and 24 h after breakfast and also at 8 h after breakfast on the first day. RESULTS: After 8 and 12 h of the oat bran diet period, the serum alpha-HC concentration was 84% (P = 0.012) and 92% (P = 0.017) higher, respectively, than that before breakfast. Serum concentrations returned to the baseline value after 24 h. Wheat bran did not influence serum alpha-HC concentrations. CONCLUSIONS: Consumption of beta-glucan from oat bran nearly doubled the serum alpha-HC concentration within 8 h, indicating increased bile acid synthesis. alpha-HC in serum could be used as a marker of increased bile acid excretion induced by the diet.

Adult↗

PubMed2006

Influence of high-carbohydrate mixed meals with different glycemic indexes on substrate utilization during subsequent exercise in women.

BACKGROUND: Few data exist on the metabolic responses to mixed meals with different glycemic indexes and their effects on substrate metabolism during exercise in women. OBJECTIVE: We examined the effects of preexercise mixed meals providing carbohydrates with high (HGI) or low glycemic index (LGI) on substrate utilization during rest and exercise in women. DESIGN: Eight healthy, active, eumenorrheic women [aged 18.6 +/- 0.9 y; body mass: 59.9 +/- 7.1 kg; maximal oxygen uptake (VO(2)max): 48.7 +/- 1.1 mL . kg(-1) . min(-1)] completed 2 trials. On each occasion, subjects were provided with a test breakfast 3 h before performing a 60-min run at 65% VO(2)max on a motorized treadmill. Both breakfasts provided 2 g carbohydrate/kg body mass and were isoenergetic. The calculated GIs of the meals were 78 (HGI) and 44 (LGI). RESULTS: Peak plasma glucose and serum insulin concentrations were greater after the HGI breakfast than after the LGI breakfast (P < 0.05). No significant differences in substrate oxidation were reported throughout the postprandial period. During exercise, the estimated rate of fat oxidation was greater in the LGI trial than in the HGI trial (P < 0.05). Similarly, plasma free fatty acid and glycerol concentrations were higher throughout exercise in the LGI trial (P < 0.05). No significant differences in plasma glucose or serum insulin were observed during exercise. CONCLUSION: Altering the GI of the carbohydrate within a meal significantly changes the postprandial hyperglycemic and hyperinsulinemic responses in women. A LGI preexercise meal resulted in a higher rate of fat oxidation during exercise than did an HGI meal.

Adipose Tissue↗

PubMed2006

Glycemic and insulinemic responses as determinants of appetite in humans.

BACKGROUND: The importance of the postprandial glycemic and insulinemic responses for appetite and energy intake (EI) is controversial. OBJECTIVE: The aim of the study was to test the hypothesis that postprandial appetite sensations and subsequent EI are determined by postprandial glycemic and insulinemic responses after the intake of a range of breakfast meals. DESIGN: The study was a randomized, crossover meal test including 28 healthy young men, each of whom tested 10 of 14 breakfast meals. Each meal contained 50 g carbohydrate with various glycemic index and energy and macronutrient contents. Blood samples were taken, and appetite sensations were measured 3 h after the meals. Subsequently, EI at lunch (EI(lunch)) was recorded. RESULTS: The glycemic response was unrelated to appetite sensations, whereas the insulinemic response was positively associated with postprandial fullness (R2 = 0.33, P < 0.05). In contrast, the insulinemic response was unrelated to the subsequent EI(lunch), whereas the glycemic response was positively associated with EI(lunch) (R2 = 0.33, P < 0.05). Although no significant difference in EI(lunch) was observed between different breakfast conditions, a low breakfast EI was associated with a high EI(lunch) (R2 = 0.60, P < 0.001). CONCLUSIONS: The current study does not support the contention that the postprandial glycemic response has an important effect on short-term appetite sensations, but a low-glycemic index meal may reduce subsequent EI. In contrast, postprandial insulin seems to affect short-term appetite sensations.

Adult↗

PubMed2000

Ambulatory blood pressure monitoring and postprandial hypotension in elderly persons with falls or syncopes.

BACKGROUND: Postprandial hypotension (PPH) is increasingly recognized as a common cause of falls and syncope in elderly persons. Noninvasive ambulatory blood pressure monitoring (ABPM) has been recommended for detecting PPH. This study investigates postprandial blood pressure (BP) changes by means of ABPM in elderly patients experiencing falls or syncopes. METHODS: Twenty-four-hour ABPM was performed in 156 inpatients (111 women, mean age 80.4 +/- 8.1 years). Among them, 45 had been admitted for falls and 75 for syncope; 36 with no history of falls or syncope served as controls. Postprandial change in systolic blood pressure (deltaSBP) was calculated by subtracting the mean SBP within the 2 hours following the meal from the mean SBP within the 2 hours preceding the meal. PPH was defined by a deltaSBP > or = 20 mm Hg. RESULTS: For the entire group, mean SBP decreased after the three meals. On average, the decline in SBP was greater after breakfast than after lunch or dinner, and the number of patients experiencing PPH was greater after breakfast. Average maximal deltaSBP was significantly larger in the syncope group than in the other groups ( p < .05). Moreover, the number of patients experiencing PPH was significantly higher in the syncope/fall group than in the control group (23% vs 9%; p = .03). Compared with patients without PPH, patients with PPH were more likely to have a history of diabetes mellitus (p < .01) or to use more than three different drugs daily ( p = .04), and they showed greater daytime SBP variability (p < .0001). Furthermore, there was a strong positive correlation between preprandial SBP and deltaSBP after breakfast. CONCLUSIONS: About one out of four elderly patients with falls or syncope experiences PPH, usually after breakfast. Postprandial decline in BP contributes to BP variability. deltaSBP and preprandial SBP are positively correlated.

Accidental Falls↗

PubMed2003

The effect of meals at different mealtimes on blood pressure and symptoms in geriatric patients with postprandial hypotension.

BACKGROUND: The variability of postprandial hypotension (PPH) during the day in elderly patients is unknown. We examined the effect of meals administered at different mealtimes on postprandial blood pressure (BP) responses in geriatric patients. METHODS: In 14 geriatric patients (6 men and 8 women, aged 66-97) previously diagnosed with PPH, standardized liquid test meals were given in random order at breakfast, lunchtime, or dinnertime on 3 separate days. Systolic BP (SBP), diastolic BP (DBP), and heart rate (HR) were measured with an ambulatory BP device every 10 minutes from 20 minutes before until 90 minutes after each meal. Postprandial symptoms were observed continuously. RESULTS: Significant decreases in SBP and DBP were present after each meal (p <.050). The maximum SBP decrease was significantly smaller at dinnertime (-18 +/- 3 mmHg) than at breakfast (-29 +/- 2 mmHg) or lunchtime (-34 +/- 4 mmHg) (p <.005 between groups). Eight patients showed no PPH in the evening, whereas all patients had PPH after breakfast and lunch. The duration of PPH was significantly shorter (p <.001), and postprandial symptoms were less frequent and less severe after dinner compared to breakfast and lunch. CONCLUSIONS: In geriatric patients, postprandial BP responses show a variation during the day, with significantly less PPH and fewer symptoms in the evening. Clinical implication is that, in the diagnostic process and management of PPH, the variation of the occurrence of PPH during the day should be taken into account. Through adjustment of BP decreasing activities to the time PPH is least prevalent, the risk of developing symptomatic PPH can be reduced.

Aged↗

PubMed2006

Socio-cognitive and nutritional factors associated with body mass index in children and adolescents: possibilities for childhood obesity prevention.

A large national study of schoolchildren aged 6-18 years was conducted to assess nutritional and socio-cognitive factors associated with body mass index (BMI). A questionnaire was used to assess nutritional quality of breakfast, importance of physical activity and food variety score, among 4441 students from randomly selected schools in all states and territories of Australia between September and December 2000. Height and weight were measured. Nutritional knowledge, dietary self-efficacy and dietary locus of control were also assessed among adolescents. School socio-economic status (SES) was derived from parental income. The factors were modelled using multiple linear regression to determine significant predictors of BMI. Dietary self-efficacy, nutritional quality of breakfast and SES were found to be the principal predictors of BMI in addition to the expected biological factors of age, gender and height. Furthermore, low SES was found to contribute to high BMI, mediated by the low nutritional quality of breakfast. Food variety was positively associated with high BMI and this was mediated by dietary self-efficacy. Nutrition knowledge and dietary locus of control were not associated with BMI. These results suggest that breakfast programmes for low-income children may be an effective measure in the prevention of childhood obesity.

Adolescent↗

PubMed1996

Dietary intake pattern relates to plasma folate and homocysteine concentrations in the Framingham Heart Study.

We examined the relationship between intake of food group (and supplement) sources of folate and plasma folate and homocysteine concentrations among 885 elderly subjects in the Framingham Heart Study. Dietary data were collected by food-frequency questionnaire, and blood samples analyzed for folate and homocysteine concentrations. Top contributors to total folate intake were ranked. Mean folate intake, plasma folate and homocysteine concentrations were estimated for users vs. non-users of supplements, and key foods--those which both contribute to total folate intake and are known to be good sources of folate--and examined statistically with adjustment for age, gender and total energy intake. Plasma folate and homocysteine concentrations were also determined by quintile of intake frequency for breakfast cereals and for fruits and vegetables. Plasma folate was significantly greater and homocysteine lower in women than in men. Despite somewhat greater plasma folate concentrations with age, homocysteine was significantly higher in those over 80 y of age than in younger subjects. Major contributors to folate intake were cold breakfast cereals (13.3%), multivitamins (12.8%) and orange juice (12.4%). Users of supplements, breakfast cereals, or green leafy vegetables had significantly greater plasma folate and lower homocysteine levels than non-users. Plasma folate concentration was also greater in those who drank orange juice. We identified clear dose-response relationships for both plasma folate and homocysteine with increased quintile of breakfast cereal and of fruit and vegetable use. Frequent consumption of these foods is associated with higher folate and lower homocysteine concentrations.

Aged↗

PubMed2000

Toast and tea before elective surgery? A national survey on current practice.

UNLABELLED: A more tolerant approach to preoperative fasting guidelines for healthy adults undergoing elective surgery was recently recommended by a task force appointed by the American Society of Anesthesiologists. This recommendation liberalizes the intake of clear liquids and specifically allows a light breakfast (e.g., toast and tea or coffee) up to 6 h before elective surgery. We conducted a national survey to determine whether anesthesiologists giving anesthesia in an outpatient setting in the United States were currently following these recommendations, and whether institutional policy reflects these new guidelines. The population consisted of the entire active membership of the Society for Ambulatory Anesthesia, providing an initial sample size of 623 subjects. Most conservatively calculated, we had a response rate of 59.6%. A total of 62% of the respondents said they have an institutional policy in place to allow clear liquids orally 2-3 h before the induction of anesthesia. However, only 35% of the respondents said their institutions had a policy in place allowing a light breakfast 6 h before elective surgery. Nevertheless, only 3% of the responders said they would cancel the operation if a patient actually arrived at the facility after consuming a light breakfast, such as toast and tea 6 h before elective surgery, 32% would delay surgery to later that day, and 65% would proceed without delay. We concluded that most anesthesiologists practicing outpatient anesthesia in the United States have already changed their practice pattern to conform to the recent recommendations of the American Society of Anesthesiologists task force on preoperative fasting time. IMPLICATIONS: Findings of this national survey conducted among active members of the Society for Ambulatory Anesthesia may encourage anesthesiologists throughout the world to take a more liberal attitude toward allowing clear liquids 2-3 h and a light breakfast 6 h before an elective surgery in healthy patients.

Adult↗