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PubMed2005

Appetite sensations as a marker of overall intake.

The aim of this study was to evaluate the clinical utility of appetite sensations to characterize individual overall energy intake. A group of men (n 28) and women (n 23) was recruited to record their 'desire to eat', 'hunger', 'fullness' and 'prospective food consumption' (PFC) on visual analogue scales before a standardized meal test, immediately after and every 10 min for a period of 1 h after the meal. The 1 h post-meal area under the curve (1 h AUC) and the satiety quotient (SQ) were calculated for all appetite sensations. In a second visit, all participants were invited to eat three meals in order to measure total energy intake (TEI) and food preferences. Metabolic rate (MR) was also assessed to derive daily relative energy intake (REI) by subtracting this variable from TEI (TEI-MR=REI). The Three-Factor Eating Questionnaire scores were also calculated for all participants. One h AUC for fullness was the appetite sensation most strongly associated with TEI and REI (r-0.42, P< or =0.003 and r-0.32, P< or =0.05, respectively). SQ for fullness was the only predictor of TEI and REI (r-0.42, P< or =0.0003 and r-0.30, P< or =0.05, respectively). Restraint, disinhibition and hunger scores were not associated with appetite sensation variables. These results suggest that the fullness dimension seems to be a useful appetite sensation to predict long-term TEI and REI. Thus, assessment of appetite sensation such as fullness in response to a fixed load may be useful to evaluate individual overall energy intake.

Adult↗

PubMed2006

Food insecurity, malnutrition and mortality in Maewo and Ambae Islands, Vanuatu.

CONTEXT: This paper reports on findings from the ex-post evaluation of the Maewo Capacity Building project in Maewo Island, Vanuatu, which was funded by World Vision Australia. OBJECTIVES: To examine the extent to which the infrastructure and systems left behind by the project contributed to the improvement of household food security and health and nutritional outcomes in Maewo Island, using Ambae Island as a comparator. SETTING: Two-stage cluster survey conducted from 6 to 20 July 2004, which included anthropometric measures and 4.5-year retrospective mortality data collection. PARTICIPANTS: A total of 406 households in Maewo comprising 1623 people and 411 households in Ambae comprising 1799 people. MAIN OUTCOME MEASURES: Household food insecurity, crude mortality rate (CMR), under-five mortality rate (U5MR) and malnutrition prevalence among children. RESULTS: The prevalence of food insecurity without hunger was estimated at 15.3% (95% confidence interval (CI): 12.1, 19.2%) in Maewo versus 38.2% (95% CI: 33.6, 43.0%) in Ambae, while food insecurity with hunger in children did not vary by location. After controlling for the child's age and gender, children in Maewo had higher weight-for-age and height-for-age Z-scores than children of the same age in Ambae. The CMR was lower in Maewo (CMR = 0.47/10 000 per day, 95% CI: 0.39, 0.55) than in Ambae (CMR=0.59/10 000 per day, 95% CI: 0.51, 0.67) but no difference existed in U5MR. The major causes of death were similar in both locations, with frequently reported causes being malaria, acute respiratory infection and diarrhoeal disease. CONCLUSIONS: Project initiatives in Maewo Island have reduced the risks of mortality and malnutrition. Using a cross-sectional 'external control group' design, this paper demonstrates that it is possible to draw conclusions about project effectiveness where baseline data are incomplete or absent. Shifting from donor-driven evaluations to impact evaluations has greater learning value for the organisation, and greater value when reporting back to the beneficiaries about project impact and transformational development in their community. Public health nutritionists working in the field are well versed in the collection and interpretation of anthropometric data for evaluation of nutritional interventions such as emergency feeding programmes. These same skills can be used to conduct impact evaluations, even some time after project completion, and elucidate lessons to be learned and shared. These skills can also be applied more widely to projects which impact on the longer-term nutritional status of communities and their food security.

Anthropometry↗

PubMed2002

Ready-to-eat cereal used as a meal replacement promotes weight loss in humans.

OBJECTIVES: The primary aim was to determine whether ready-to-eat cereal used as a portion-controlled, meal replacement promotes weight loss. Additional aims were to determine whether weight loss differed if the cereal was provided as a single brand or variety of brands and whether this use of ready-to-eat cereal promotes continued weight loss following transition to a high-fiber, high-volume (Volumetric) diet. METHODS: Body composition was measured and diet records, appetite questionnaires and activity logs were completed during baseline and end of intervention weeks 2 and 6. Participants were assigned to one of four treatment groups. Group 1 (6 M, 22 F, mean age 43.0 +/- 1.9 years, mean initial BMI 28.9 +/- 0.4 kg/m(2)) consumed a serving of a single brand of ready-to-eat cereal with 2/3 C skim milk and a 100 Kcal portion of fruit for breakfast and as a replacement for either lunch or dinner for weeks 1 and 2. No restrictions were placed on the non-cereal meal. They then followed the Volumetric diet for weeks 3 to 6 with a target energy restriction of 500 kcal/day. Group 2 (3 M, 25 F, mean age 40.9 +/- 2.3 years, mean initial BMI 29.39 +/- 0.6 kg/m(2)) followed the same protocol, but was permitted to select from a variety of ready-to-eat cereals during weeks 1 and 2. Group 3 (7 M, 19 F, mean age 41.6 +/- 2.4 years, mean initial BMI 29.3 +/- 0.6 kg/m(2)) received no dietary instruction during the six-week study and Group 4 (9 M, 18 F, mean age 38.2 +/- 2.8 years, mean initial BMI 29.3 +/- 0.6 kg/m(2)) received no intervention prior to adoption of the Volumetric diet for weeks 3 to 6. RESULTS: The cereal interventions resulted in 640 +/- 109 and 617 +/- 105 kcal/day reductions of energy intake in Groups 1 and 2, respectively, during the two-week cereal intervention. This led to comparable mean weight losses (1.91 +/- 0.19 kg-Group 1, 1.37 +/- 0.15 kg-Group 2) that were significantly greater than that observed in Group 3 (0.08 +/- 0.15 kg). The losses were primarily of fat mass. No significant changes of total body water were observed. Weight loss continued during the Volumetric diet in Groups 1 and 2. The changes were comparable to those observed in Group 4, and all were significantly greater than that of Group 3. Self-reported hunger was slightly, but significantly higher than baseline in Groups 1 and 2 during the cereal intervention, but similar to baseline in Groups 1, 2 and 3 during the Volumetric diet. Based on predicted weight loss, compliance with the Volumetric diet was similar and limited in all three intervention groups. CONCLUSIONS: Ready-to-eat cereals may be used to promote weight loss when consumed as a portion-controlled, meal replacement. Provision of a variety of brands does not compromise efficacy. Weight losses may be maintained or increased after transition to the Volumetric diet. The later regimen effectively controls hunger and may lead to weight loss, but compliance is limited.

Adipose Tissue↗

PubMed2000

The effects of sugar-free vs sugar-rich beverages on feelings of fullness and subsequent food intake.

This study compared the effects of equal volumes of sugar-rich and sugar-free beverages on feelings of hunger and fullness and the ad libitum consumption of a palatable, fat-rich snack. Eleven healthy males consumed equal volumes (375 mL) of three drinks (sugar-rich cola, sugar-free cola, mineral water) in random order on separate mornings. After 20 min, the subjects were able to snack freely on potato crisps during the next 90 min. Each subject's individual bowl of potato crisps was covertly replenished at 15 min intervals while the subjects were completing appetite and mood ratings. After the 110 min experimental period, the subjects' ad libitum food intake from a buffet-style lunch was covertly recorded. On leaving the laboratory, the subjects filled in a weighed food dairy for the rest of the day. The equal-volume preloads initially decreased hunger to a similar degree and potato crisp intake during the first 15 min interval was not significantly different among the three preloads. On average, total energy intakes from the crisps and lunch were not significantly different among the preloads, and by the end of the day, total energy intakes were similar for the three test conditions. Therefore, the low-calorie/low-sugar drinks did not facilitate a reduced energy intake by the lean, non-dieting male subjects.

Adult↗

PubMed1976

Ineffectiveness of human chorionic gonadotropin in weight reduction: a double-blind study.

Our investigation was designed to retest the hypothesis of the efficacy of human chorionic gonadotropin (HCG) on weight reduction in obese women in a clinic setting. We sought to duplicate the Asher-Harper study (1973) which had found that the combination of 500 cal diet and HCG had a statistically significant benefit over the diet and placebo combination as evidenced by greater weight loss and decrease in hunger. Fifty-one women between the ages of 18 and 60 participated in our 32-day prospective, randomized, double-blind comparison of HCG versus placebo. Each patient was given the same diet (the one prescribed in the Asher-Harper study), was weighed daily Monday through Saturday and was counselled by one of the investigators who administered the injections. Laboratory studies were performed at the time of initial physical examinations and at the end of the study. Twenty of 25 in the HCG and 21 of 26 patients in the placebo groups completed 28 injections. There was no statistically significant difference in the means of the two groups in number of injections received, weight loss, percent of weight loss, hip and waist circumference, weight loss per injections, or in hunger ratings. HCG does not appear to enhance the effectiveness of a rigidly imposed regimen for weight reduction.

Adult↗

PubMed1985

Chews and swallows and the microstructure of eating.

The study of eating behavior in animals and humans shows that much is learned if detailed and sensitive measurement of the ingestive process can be made. It is possible to measure all chews and swallows of human subjects during a meal. This proves to be a sensitive way to measure the microstructure of a meal, reflecting hunger, palatability, and satiation. The oral sensor promises to be an unobtrusive and objective method of measuring all meals, snacks, and nibbling throughout the day. The oral sensor should provide a means of evaluating both the palatability and the satiating value of foods and the role of hunger and other manipulations of the internal environment in changing the chewing and swallowing microstructure of eating.

Animals↗

PubMed1995

Age-related impairments in the regulation of food intake.

Low food intake in elderly individuals increases the risk for many nutrition-related acute or chronic illnesses. It is not known whether aging is associated with changes in hunger and satiety, or whether elderly individuals can regulate energy intake in response to manipulations of the energy or nutrient content of foods. Therefore, this study investigated short-term energy regulation in healthy elderly (n = 16; aged 60-84 y) and young (n = 16; aged 18-35 y) men. Participants were given yogurt preloads that varied in energy and macronutrient content (low-fat, low-energy, 962 kJ; high-fat, high-energy, 2134 kJ; high-carbohydrate, high-energy 2134 kJ), or no yogurt, followed by a self-selected lunch (presented 30 min after subjects began to consume the yogurt). Energy intake, the percentage of macronutrients consumed in the meals, and subjective sensations of hunger and satiety were analyzed. The elderly men consumed significantly less energy than the young men in the baseline (no yogurt) condition. Lower intake was concordant with subjective sensations of satiety; visual analog data indicated that the older men were less hungry and more full at the start of lunch. Compensation for energy in the preloads was less precise in the elderly than in the young men, in that elderly men consistently overate at the self-selected lunch. Young men consumed +/- 10% total energy (lunch + yogurt) in the yogurt preload conditions compared with their baseline intake; elderly men overate between 10% and 30% in relation to their baseline intake.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed2002

Eating behavior correlates of adult weight gain and obesity in healthy women aged 55-65 y.

BACKGROUND: The specific underlying causes of adult weight gain remain uncertain. OBJECTIVE: The objective was to determine the association of 3 measures of eating behavior with weight gain and body mass index (BMI; in kg/m(2)) in adults. DESIGN: Current dietary restraint, disinhibition, and hunger were assessed with the use of the Eating Inventory in 638 healthy, nonsmoking women aged 55-65 y. In addition, subjects reported their current weight and height, their weight for 6 age intervals, and changes in voluntary dietary energy restriction over the past 10 y. Current weight and height were validated in 10% of subjects. RESULTS: Current disinhibition strongly predicted weight gain and current BMI (partial r = 0.27 and 0.34, respectively, both P < 0.001). Neither restraint nor hunger was a significant independent predictor of either variable, but the positive associations between disinhibition and both weight gain and BMI were attenuated by restraint (P = 0.016 and 0.010, respectively, after adjustment for confounding variables). In the subpopulation of women who reported a stable level of voluntary dietary energy restriction, disinhibition also strongly predicted weight gain and higher BMI, and restraint was negatively associated with weight gain (partial r = -0.17, P = 0.019). CONCLUSIONS: Higher disinhibition is strongly associated with greater adult weight gain and higher current BMI, and dietary restraint may attenuate this association when disinhibition is high. These findings suggest that eating behavior has an important role in the prevention of adult-onset obesity and that further studies are warranted.

Adult↗

PubMed2002

The effect of etomoxir on 24-h substrate oxidation and satiety in humans.

BACKGROUND: The carnitine O-palmitoyltransferase I (EC 2.3.1.21) inhibitor etomoxir inhibits fatty acid oxidation, and hepatic fatty acid oxidation has been suggested to be a metabolic satiety signal in subjects who consume high-fat diets. OBJECTIVE: We investigated substrate oxidation and satiety after repeated administrations of etomoxir or placebo in subjects who consumed a high-fat diet. DESIGN: In a randomized crossover design consisting of three 5-d treatments, we fed 10 healthy men [mean +/- SE age: 25.6 +/- 1.7 y; mean +/- SE body mass index (in kg/m(2)): 21.8 +/- 0.3] a high-fat diet twice and a low-fat diet once. The subjects consumed each diet at home for 3 consecutive days, after which they spent 36 h in energy balance in a respiration chamber. During the chamber stays with the high-fat treatments, etomoxir or placebo was administered in 5 doses (600 mg etomoxir in total). Blood samples were obtained on the mornings of days 4 and 5 of each treatment, and appetite profiles were assessed. RESULTS: Mean (+/-SE) 24-h respiratory quotients were significantly (P < 0.05) higher with repeated administrations of etomoxir (0.833 +/- 0.004) than with repeated administrations of placebo (0.814 +/- 0.006), and mean (+/-SE) 24-h whole-body fat oxidation tended to be less (13.7%, P = 0.06) with administration of etomoxir (136.0 +/- 5.2 g/d) than with administration of placebo (157.5 +/- 5.6 g/d). With the etomoxir treatment, fat balance was positive (P < 0.0001) and carbohydrate balance was negative (P < 0.001), whereas with the placebo treatment, neither of the balances was significantly different from zero. Hunger and satiety ratings were not affected under these conditions. CONCLUSIONS: Etomoxir decreased whole-body fat oxidation, as indicated by the respiratory quotients in the healthy subjects. With the current protocol, however, hunger and satiety ratings were not affected.

3-Hydroxybutyric Acid↗

PubMed2005

Relation of weight maintenance and dietary restraint to peroxisome proliferator-activated receptor gamma2, glucocorticoid receptor, and ciliary neurotrophic factor polymorphisms.

BACKGROUND: Genetic variation in the peroxisome proliferator-activated receptor gamma2 (PPARgamma2), glucocorticoid receptor (GRL), and ciliary neurotrophic factor (CNTF) genes may play a role in the etiology of obesity. OBJECTIVE: We examined biological, psychological, and genetic determinants associated with weight maintenance (WM) after weight loss. DESIGN: Subjects (n = 120) followed a 6-wk diet and then a 1-y period of WM. Body weight (BW), body composition, leptin concentration, attitude toward eating (measured with the Three-Factor Eating Questionnaire), physical activity, and the polymorphisms of the PPARgamma2, GRL, and CNTF genes were measured. RESULTS: BW loss was 7.0 +/- 3.1 kg. After 1 y, 21 subjects showed successful WM (<10% regain); 99 were unsuccessful (> or =10% regain). Compared with unsuccessful subjects, successful subjects had a higher increase in dietary restraint over time (4.8 +/- 5.0 and 1.8 +/- 3.9, respectively; P < 0.01) but significantly less sensation of general hunger (-4.0 +/- 4.9 and -1.2 +/- 2.7, respectively; P < 0.05). Successful subjects had a significantly different frequency distribution for the PPARgamma2 (P = 0.05) and GRL (P < 0.05) genes than did unsuccessful subjects. The more successful genotypes showed a higher baseline body mass index and waist circumference (PPARgamma2), a greater decrease in disinhibition of dietary restraint (GRL), and less sensation of hunger (GRL). The G/G genotype (GRL) was an independent predictor of successful WM. CONCLUSION: The different genotypes of the PPARgamma2 and GRL genes contribute to WM, either directly (GRL) or indirectly (PPARgamma2 and GRL) via baseline body mass index and waist circumference, and to changes in Three-Factor Eating Questionnaire scores.

Adult↗

PubMed2005

Appetite assessment: simple appetite questionnaire predicts weight loss in community-dwelling adults and nursing home residents.

BACKGROUND: Anorexia-related weight loss can have devastating consequences on quality-of-life, morbidity, and mortality. Without a simple tool to evaluate appetite, health care providers often use inaccurate surrogates, such as measurement of energy consumption and nutritional risk, to reflect appetite. OBJECTIVE: We aimed to validate a simple tool for assessing appetite and predicting weight loss. DESIGN: This was a cross-sectional measurement study conducted on long-term care residents and community-dwelling adults. Construct validity of the 8-item Council on Nutrition appetite questionnaire (CNAQ) and its 4-item derivative, the simplified nutritional appetite questionnaire (SNAQ), were examined through correlation with a previously validated research tool: the appetite hunger and sensory perception questionnaire (AHSP). The length and complexity of the AHSP render it inefficient for clinical use. The sensitivity and specificity of the CNAQ and SNAQ to predict significant weight loss were calculated. RESULTS: Cronbach's alpha coefficients for the CNAQ were 0.47 (long-term care group) and 0.72 (community-dwelling group). In the long-term care group, the CNAQ correlated with the AHSP (r = 0.60, P < 0.001) and with the AHSP domains of taste (r = 0.47, P < 0.0001), hunger (r = 0.51, P < 0.0001), and smell (r = 0.53, P < 0.0001). The CNAQ showed sensitivities and specificities for 5% and 10% weight losses of 80.2 and 80.3 and 82.4 and 81.9, respectively. The SNAQ had sensitivities and specificities for 5% and 10% weight losses of 81.3 and 76.4 and 88.2 and 83.5, respectively. CONCLUSIONS: The SNAQ and CNAQ are short, simple appetite assessment tools that predict weight loss in community-dwelling adults and long-term care residents. The SNAQ is a 4-item derivative of the CNAQ and thus is clinically more efficient.

Adult↗

PubMed1986

Effects of preoperative fasting on morbidity and gastric contents in patients undergoing day-stay surgery.

The effects of overnight fasting on gastric contents and on the symptoms associated with fasting were studied prospectively in female outpatients. Group A (n = 66) were patients scheduled for first trimester therapeutic abortion; group B (n = 66) were scheduled for minor gynaecological surgery. It was demonstrated that overnight fasting (15 +/- 3 h) did not guarantee an empty stomach (volume 22 +/- 13 ml) and that gastric acidity was high (pH 1.6 +/- 0.5). Gastric volumes and pH were the same in both groups. Group A patients had a higher incidence of preoperative nausea and vomiting (P less than 0.001). Before anaesthesia, 50% of all patients had symptoms of moderate to severe hunger, while 44% of patients had symptoms of moderate to severe thirst. Neither the severity of symptoms of fasting nor the duration of fast correlated with gastric volume or pH. Patients in group A had significantly greater symptoms of hunger; however, they also had fasted for significantly longer (P less than 0.002).

Adult↗

PubMed2006

Motivation modulates the activity of the human mirror-neuron system.

It is not known whether the mirror-neuron system is modulated by motivation, such as hunger. In this study, 2 groups of healthy participants underwent 2 functional magnetic resonance imaging scanning sessions separated by 1.5 h interval. During each session, participants were presented with video clips of another person grasping objects or grasping food. The first session was conducted after participants from group 1 had fasted. Then these participants were allowed to eat and were scanned again. Participants from group 2 had a meal before the first session. Food-related stimuli elicited specific hemodynamic response in the parahippocampal gyrus, orbitofrontal cortex, and amygdala, when participants were in a hungry state as compared with a satiated state. In addition, regions that belong to the mirror-neuron system, including the inferior frontal gyrus, and the posterior parietal cortex showed greater response when participants were hungry. Increased activity was also detected in the extrastriate body area. A positive correlation was observed between the self-report ratings of hunger and the hemodynamic activity in the inferior frontal gyrus as well as in the amygdala. Our results suggest that motivation to eat modulates the neural activity in the mirror-neuron system, facilitating the preparation or the intention to act.

Adult↗

PubMed2004

Incidental learning and memory for three basic tastes in food.

Forty three subjects were invited under the pretence that they would take part in an experiment on hunger feelings. They came without having eaten anything that morning and received a standard breakfast containing orange juice, cream cheese on crackers and yoghurt. These products were later (when subjects returned after scoring hunger feelings during the day) used as targets amidst a set of distractors varied by adding or subtracting different amounts of two basic tastes. Orange juice was varied in sweetness and bitterness, cream cheese in sourness and bitterness and yoghurt in sweetness and sourness. The changes were made comparable by using just noticeable differences, determined in preliminary experiments with other subjects, as units of change. Two measurements of memory were compared, an absolute (indicating which were the targets) and a relative one (indicating whether the targets and distractors were more, less or equally pleasant, sweet, sour, bitter or salty as the item eaten at breakfast). Both methods showed incidental learning, but relative memory was superior. Memory differed between tastes and was partly product dependent. These experiments suggest that taste memory is tuned to detect novel and potentially dangerous stimuli rather than to remember features of earlier experienced stimuli with great precision.

Adult↗

PubMed1990

Functional indicators and outcomes of undernutrition.

The advantages and limitations of using functional methods are discussed in the context of identifying undernutrition and hunger in children in the United States. At this time many of these methods have been used only in developing countries where undernutrition is more serious. However, there is great need to investigate whether, when and how undernutrition in the United States affects children's development. Functional measures can detect undernutrition and hunger in some situations where biochemical or clinical measures cannot.

Child↗

PubMed1991

Food insecurity: a nutritional outcome or a predictor variable?

The phenomenon loosely labeled hunger in the 1980s is now being discussed as food security or insecurity. Food security is defined as access by all people at all times to enough food for an active, healthy life, and at a minimum includes the following: 1) the ready availability of nutritionally adequate and safe foods and 2) the assured ability to acquire personally acceptable foods in a socially acceptable way. Food insecurity exists whenever food security is limited or uncertain. The measurement of food insecurity at the household or individual level involves the measurement of those quantitative, qualitative, psychological and social or normative constructs that are central to the experience of food insecurity, qualified by their involuntariness and periodicity. Risk factors for food insecurity include any factors that affect household resources and the proportion of those resources available for food acquisition. Potential consequences of food insecurity include hunger, malnutrition and (either directly or indirectly) negative effects on health and quality of life. The precise relationships between food insecurity and its risk factors and potential consequences need much more research now that there is an emerging consensus on the definition and measurement of food insecurity. Indicators of food security or insecurity are proposed as a necessary component of the core measures of the nutritional state of individuals, communities or nations.

Anxiety↗

PubMed1994

Effect of level and source of dietary fiber on food intake in the dog.

The effects of dietary fiber on challenge meal intake and on the perception of hunger in dogs were evaluated. A program of testing variants of a standard low energy diet, to which one of five fiber containing raw materials was added, was undertaken. Diets were fed to a group of six dogs for 12-d periods in a latin square design and in amounts that corresponded to the food allowance for weight reduction. Behavioral characteristics of dogs were recorded on videotape for 30-min periods after introduction of test diets. On two occasions during each 12-d feeding period dogs were presented with a challenge meal. At the end of each 12-d feeding period all dogs entered a 6-d washout period. There was no significant effect of diet on the intake of the challenge meal or on intake of food during the subsequent washout period. In addition, diet had no apparent effect on the perception of hunger, as represented by behavioral characteristics during the 30-min period after presentation of test diets. It was concluded that inclusion of moderate levels of raw materials, composed primarily of insoluble fiber, in a commercial low energy diet had no apparent beneficial effects on satiety, when fed to dogs on an energy intake corresponding to allowances for weight reduction.

Animal Feed↗

PubMed1999

Women's dietary intakes in the context of household food insecurity.

A study of food insecurity and nutritional adequacy was conducted with a sample of 153 women in families receiving emergency food assistance in Toronto, Canada. Contemporaneous data on dietary intake and household food security over the past 30 d were available for 145 of the women. Analyses of these data revealed that women who reported hunger in their households during the past 30 d also reported systematically lower intakes of energy and a number of nutrients. The effect of household-level hunger on intake persisted even when other economic, socio-cultural, and behavioral influences on reported dietary intake were considered. Estimated prevalences of inadequacy in excess of 15% were noted for Vitamin A, folate, iron, and magnesium in this sample, suggesting that the low levels of intake associated with severe household food insecurity are in a range that could put women at risk of nutrient deficiencies.

Diet↗