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An evaluation of the U.S. Department of Agriculture food security measure with generalized linear mixed models.

Over the last decade, new information has been developed and collected to measure the extent of food insecurity and hunger in the United States. Common measurement of the phenomenon of hunger and food insecurity has become possible through efforts of the U.S. Department of Agriculture (USDA) to develop a set of survey questions that can be used to obtain estimates of the prevalence and severity of food insecurity. We evaluated the measurement of food insecurity and the effect of household variables on measured food insecurity. The effects of demographic and survey-specific variables on the food insecurity/hunger scale were evaluated using a generalized linear model with mixed effects. Data came from the 1995, 1997 and 1999 Food Security Module of the Current Population Survey. The results generally validated the model currently used by the USDA. In addition, our approach made it possible to consider the effect of demographics and several survey design variables on food security among measurably food-insecure households, as well as interactions between these factors and the food security questions. The analysis of the expanded model with the 1995 data found results similar to those reported based on the Rasch model used by the USDA. Even though the sample size was reduced and a number of screening and questionnaire changes were introduced in 1997 and 1999, the results for those years appear mostly unchanged and confirm the robustness of the scale in measuring food insecurity. There is some evidence that interpretation of questions may vary among different demographic groups.

Demography↗

Statewide prevalences of concern about enough food, 1996-1999.

OBJECTIVE: Food insecurity is defined as not having access at all times to enough food for an active and healthy life-style. A Healthy People 2010 objective is to increase food security and reduce the risk of hunger for all households. The objective of this study was to characterize the prevalence of concern about enough food and its association with other sociodemographic and health characteristics at the state level. METHODS: Adult respondents participating in the Behavioral Risk Factor Surveillance System survey provided information on concern about enough food from nine states from 1996 through 1999. RESULTS: Overall, the prevalence of concern about enough food ranged from 3.1% to 11.8% for individual states. Across states, low household income was the strongest predictor of concern about enough food. The odds of being concerned about enough food were generally higher among respondents who were female, younger, and without health care coverage. The odds were generally lower among those reporting excellent or very good general health and among non-Hispanic whites. CONCLUSION: Food security scales could be used at the state level to track progress for the Healthy People 2010 objective of reducing food insecurity and hunger across American households.

Adolescent↗

Stress and food choice: a laboratory study.

OBJECTIVE: This study investigated experimentally whether acute stress alters food choice during a meal. The study was designed to test claims of selective effects of stress on appetite for specific sensory and nutritional categories of food and interactions with eating attitudes. METHODS: Sixty-eight healthy men and women volunteered for a study on "the effects of hunger on physiology, performance, and mood." Eating attitudes and food preferences were measured on entry to the study. The stressed group prepared a 4-minute speech, expecting it to be filmed and assessed after a midday meal, although in fact speeches were not performed. The ad libitum meal included sweet, salty, or bland high- and low-fat foods. The control group listened to a passage of neutral text before eating the meal. Blood pressure, heart rate, mood, and hunger were measured at baseline and after the 10-minute preparatory period, when appetite for 34 foods and food intake were recorded. RESULTS: Increases in blood pressure and changes in mood confirmed the effectiveness of the stressor. Stress did not alter overall intake, nor intake of, or appetite for the six food categories. However, stressed emotional eaters ate more sweet high-fat foods and a more energy-dense meal than unstressed and nonemotional eaters. Dietary restraint did not significantly affect appetitive responses to stress. CONCLUSIONS: Increased eating of sweet fatty foods by emotional eaters during stress, found here in a laboratory setting, may underlie the previously reported finding that dietary restraint or female gender predicts stress-induced eating. Stress may compromise the health of susceptible individuals through deleterious stress-related changes in food choice.

Adolescent↗

Alcohol and the appetizer effect.

In order to evaluate the effects of alcohol on appetite, 12 unrestrained and 10 restrained men ate lunch 20 min after consuming preloads consisting of water, an alcoholic fruit juice (alcohol) and a non-alcoholic fruit juice (juice). The unrestrained men ate significantly less after the juice preload, and ate most after alcohol. Intake was not altered significantly in the restrained men. However, both the alcohol and juice preloads reduced rated hunger and increased fullness, relative to the water control, in both restrained and unrestrained men. When the relationship between rated appetite and intake within the test meal was modelled mathematically, it was found that hunger increased more during the initial stages of the test meal in the unrestrained men who had consumed alcohol than in any other condition. No such effects were seen in the restrained subjects. Overall, these results suggest that alcohol has a complex action on appetite, which includes some form of appetite stimulation, and this may explain the excess energy intake reported previously in moderate alcohol consumers.

Adult↗

Hyperglycaemia affects proximal gastric motor and sensory function in normal subjects.

OBJECTIVE: Hyperglycaemia delays gastric emptying in normal subjects and patients with diabetes mellitus by uncertain mechanisms and may affect the perception of somatic sensations. The effects of hyperglycaemia on the motor function of the proximal stomach and the perception of gastric distension were evaluated in normal subjects. DESIGN: Paired studies were performed in randomized order in 10 healthy volunteers on separate days during euglycaemia and hyperglycaemia (blood glucose approximately equal to 15 mmol/l). METHODS: With a barostat and a balloon positioned in the proximal stomach, tasting subjects underwent a stepwise gastric distension. Each 2 mmHg step was maintained at a constant pressure for 2 min. The volume of the barostat balloon was measured and perception of the sensations of fullness, desire to belch, nausea, abdominal discomfort and hunger was scored at each step. RESULTS: Hyperglycaemia was associated with an increase in proximal gastric compliance (P < 0.01) evident from 2 mmHg above basal intragastric pressure. Perception scores for the sensations of nausea and desire to belch were greater during hyperglycaemia than euglycaemia (P < 0.05) in relation to both pressure at each step and volume. Hyperglycaemia did not affect perception of the sensations of abdominal discomfort, fullness or hunger. CONCLUSIONS: Hyperglycaemia increases proximal gastric compliance, reflecting a reduction in gastric tone. This may contribute to the previously observed delay in gastric emptying associated with hyperglycaemia. Hyperglycaemia appears to increase the perception of some of the sensations induced by gastric distension.

Abdominal Pain↗

The appetite-suppressant effect of nicotine is enhanced by caffeine.

AIM: To test whether the anorectic effect of nicotine may be amplified by caffeine. METHODS: Chewing gums with nicotine and caffeine were administered to 12 healthy young men of normal weight. Different combinations of 0, 1 or 2 mg of nicotine and 0, 50 or 100 mg of caffeine were applied during a 2-h period in a randomized, double blind, cross over design. Appetite sensations were measured using visual analogue scales. RESULTS: Hunger and prospective food consumption were negatively associated with the increasing doses of nicotine, whereas satiety and fullness were positively associated with the increasing doses of nicotine (p < 0.05). Caffeine appeared to amplify the effects of nicotine on hunger and fullness as a caffeine x nicotine x time interaction was observed in these scores (p < 0.05). The 2-mg dose of nicotine in combination with the 100-mg dose of caffeine caused nausea in four of the non-smokers. However, the effects of nicotine and the caffeine x nicotine x time interaction persisted after the exclusion of these subjects. CONCLUSION: Caffeine added to nicotine chewing gum appears to amplify its attenuating effects on appetite and the combinations of 1-mg of nicotine with caffeine seem to be well tolerated.

Adolescent↗

Actual versus instructed fasting times and associated discomforts in women having scheduled cesarean birth.

OBJECTIVES: To measure actual and instructed preoperative fasting durations in women undergoing scheduled cesarean birth, to compare these times with national guidelines for healthy patients undergoing elective procedures, and to describe discomforts associated with preoperative fasting. DESIGN: One group, nonexperimental, comparative, descriptive. SETTING: Nonprofit private medical center in Texas with 6,000 births/year. PATIENTS: Convenience sample of 51 hospitalized postpartum women. INTERVENTIONS: Participants were interviewed an average of 44 hours after their cesarean birth, and their medical records were reviewed for fasting information. MAIN OUTCOME MEASURES: Duration of actual and instructed fasting, comparison with national guidelines, and ratings of thirst and hunger. RESULTS: The participants fasted from liquids and solids an average of 11 and 13 hours, respectively. Both actual and instructed fasting durations were significantly longer than national guidelines. Most participants (70%) were instructed to be nulla per os after midnight whether they were to have a.m. or p.m. surgery. Thirst and hunger scores averaged 5 and 4, respectively, on a 0-10 scale. CONCLUSION: Patients having scheduled cesarean birth fast for unnecessarily long periods. Nurses should be knowledgeable about evidence-based preoperative fasting practices and collaborate with physicians to implement them.

Attitude to Health↗

Mechanoreceptors of the proximal stomach and perception of gastric distension.

OBJECTIVES: To assess the role of tension receptors in gastric perception by pharmacologically modifying gastric contractile activity during isovolumetric distensions of the proximal stomach with the hypothesis that relaxation decreased perception and contraction increased it. METHODS: Fourteen healthy subjects underwent two 30-min isovolumetric (75% of the threshold volume for discomfort) distensions using a barostat. During the second distension, either gastric relaxation was induced by intravenous (i.v.) glucagon 4.8 microg/kg bolus plus 9.6 microg/kg per h or contraction by i.v. erythromycin 3 mg/kg. Hunger and fullness were assessed with a 100-mm analog scale before and at 15 and 30 min during each distension. RESULTS: Glucagon decreased baseline intrabag pressure (8.4 +/- 1.0 vs 10.7 +/- 1.3 mmHg; p < 0.05) and abolished the pressure waves (0 vs 16.7 +/- 2.3) when compared with placebo, whereas erythromycin increased baseline pressure (13.2 +/- 1.0 vs 11.9 +/- 0.9 mmHg; p < 0.05) and the rate of pressure waves (31.7 +/- 5.4 vs 20.5 +/- 3.1; p < 0.05). Fullness increased (p < 0.05) during distension, but it was unaffected by either of the drugs: Delta score (i.e., score during distension--baseline score) of 38 +/- 10 mm (glucagon) versus 22 +/- 10 (placebo) and 24 +/- 17 mm (erythromycin) versus 36 +/- 14 (placebo) at 15 min. Similar observation were made at 30 min. Hunger was influenced neither by distension nor by any of the two drugs consistently. CONCLUSIONS: Our data do not support a prominent role of tension receptors of the proximal stomach on perception of fullness, suggesting that stretch, that is, volume, is the more relevant stimulus.

Adult↗

Metabolic rate and feeding behavior.

According to the ischymetric hypothesis, hunger is induced by the decrease of overall metabolic rate. In order to assess such a mechanism, it was necessary to monitor the muscular contraction-free metabolic rate designated "métabolisme de fond" (MF) in rats that were either resting or moving. MF was then examined in relation to either spontaneous or induced feeding patterns. A computerized open-circuit gas analysis system allowed us to monitor MF and behavior and to show that the onset of a spontaneous meal was preceded by a decrease of MF and its termination is preceded by a rebound of MF. Pharmacological blockade of utilization of both glucose and lipids enhanced feeding only to the extent that it reduced MF. These findings apply to pharmacotherapy because the anorexigenic effect of dexfenfluramine results from the enhancement of MF induced by the capacity of this drug to mobilize endogenous fat reserves and to so provide an endogenous meal that inhibits the exogenous meal. The ischymetric mechanism of hunger does not exclude important modulatory input from hormonal, circadian, and environmental factors in the control of feeding.

Animals↗

Dietary energy density and weight regulation.

Dietary energy density (ED) has been suggested as an important determinant of energy intake and, therefore, energy regulation. This review summarizes published studies on the effects of dietary ED on hunger, satiety, energy intake, and body weight in healthy individuals, and compares the relative effects of ED manipulated by dietary fat only, fat and fiber, water, and type of sweetener. In short-term studies, consumption of low-ED foods promotes satiety, reduces hunger, and decreases energy intake with no marked differences between different dietary manipulations used to change ED. In addition, low-ED diets promote moderate weight loss in long-term studies. In studies lasting longer than 6 months, weight loss was more than three times as great in individuals consuming diets both low in fat and high in fiber compared with diets only low in fat (-3.4 kg versus -1.0 kg). Combined, these studies suggest that diets low in fat and high in fiber may be the most effective low-ED diets for promoting weight loss. Further research is needed on the effects of dietary ED by changing water or sweetener content.

Body Composition↗

Dietary fiber and weight regulation.

The influence of dietary fiber on energy regulation remains controversial. This review summarizes published studies on the effects of dietary fiber on hunger, satiety, energy intake, and body composition in healthy individuals. Under conditions of fixed energy intake, the majority of studies indicate that an increase in either soluble or insoluble fiber intake increases postmeal satiety and decreases subsequent hunger. When energy intake is ad libitum, mean values for published studies indicate that consumption of an additional 14 g/day fiber for >2 days is associated with a 10% decrease in energy intake and body weight loss of 1.9 kg over 3.8 months. Furthermore, obese individuals may exhibit a greater suppression of energy intake and body weight loss (mean energy intake in all studies was reduced to 82% by higher fiber intake in overweight/obese people versus 94% in lean people; body weight loss was 2.4 kg versus 0.8 kg). These amounts are very similar to the mean changes in energy intake and body weight changes observed when dietary fat content is lowered from 38% to 24% of energy intake in controlled studies of nonobese and obese subjects. The observed changes in energy intake and body weight occur both when the fiber is from naturally high-fiber foods and when it is from a fiber supplement. In view of the fact that mean dietary fiber intake in the United States is currently only 15 g/day (i.e., approximately half the American Heart Association recommendation of 25-30 g/day), efforts to increase dietary fiber in individuals consuming <25 g/day may help to decrease the currently high national prevalence of obesity.

Body Composition↗

Lateral hypothalamus: learning of food-seeking response motivated by electrical stimulation.

Stimulation of the lateral hypothalamus, which induces eating, resembles hunger in that it motivates rats to learn, for food reward, a response of pressing a bar. The response is discriminatively confined to only a bar that delivers food on either a 100-percent or a partial schedule of reinforceinent. This discriminative responding can be transferred to hunger that is normally induced by deprivation of food.

Animals↗

World food and nutrition: the scientific and technological base.

Alleviation of world hunger and poverty will require the accelerated development and application in each low-income country of a broad spectrum of technologies based on advances in the biological, social, and physical sciences. They will range from improved cropping systems for farmers or small labor-intensive enterprises (small and beautiful) to nationwide transportation and communications systems, power grids, and other distribution and marketing capabilities (big and beautiful). Concerted action through a combination of commodity production campaigns, area development efforts, and overhaul of outdated national agencies offers the best prospect for overcoming both hunger and poverty.

Agriculture↗

What is distinct about infants' "colic" cries?

AIMS: To investigate (1) whether colic cries are acoustically distinct from pre-feed "hunger" cries; (2) the role of the acoustic properties of these cries versus their other properties in accounting for parents' concerns about colic. DESIGN: From a community sample, infants were selected who met Wessel colic criteria for amounts of crying and whose mothers identified colic bouts. Using acoustic analyses, the most intense segments of nine colic bouts were compared with matched segments from pre-feed cries presumed to reflect hunger. RESULTS: The colic cries did not have a higher pitch or proportion of dysphonation than the pre-feed cries. They did contain more frequent shorter utterances, but these resembled normal cries investigated in other studies. There is no evidence that colic cries have distinct acoustic features that are reproducible across samples and studies, which identify a discrete clinical condition, and which are identified accurately by parents. CONCLUSIONS: The most reliable finding is that colic cries convey diffuse acoustic and audible information that a baby is highly aroused or distressed. Non-acoustic features, including the prolonged, hard to soothe, and unexplained nature of the cries may be specific to colic cries and more important for parents. These properties might reflect temperament-like dispositions.

Acoustics↗

Glucagon-like peptide-1: a potent regulator of food intake in humans.

BACKGROUND/AIMS: Studies in animals suggest a physiological role for glucagon-like peptide-1-(7-36)-amide (GLP-1) in regulating satiety. The role of GLP-1 in regulating food intake in man has, however, not been investigated. Subjects-Sixteen healthy male subjects were examined in a double blind placebo controlled fashion. METHODS: The effect of graded intravenous doses (0, 0.375, 0.75, and 1.5 pmol/kg/min) of synthetic human GLP-1 on food intake and feelings of hunger and satiety was tested in healthy volunteers. RESULTS: Graded GLP-1 infusions resulted in a dose dependent reduction in food intake (maximal inhibition 35%, p<0.001 v control) and a similar reduction in calorie intake (32%; p<0.001). Fluid ingestion was also reduced by GLP-1 (18% reduction, p<0.01). No overt side effects were produced by GLP-1, but subjects experienced less hunger and early fullness in the period before a meal during GLP-1 infusion at the highest dose (p<0.05). CONCLUSIONS: Intravenous infusions of GLP-1 decrease spontaneous food intake even at physiological plasma concentrations, implying an important role for GLP-1 in the regulation of the early satiety response in humans.

Adult↗

Leptin response to carbohydrate or fat meal and association with subsequent satiety and energy intake.

To assess the impact of the macronutrient content of a meal on the postprandial leptin response and its relationship with postprandial satiety, 22 young healthy subjects (11 men and 11 women) were given, in a randomized order, an isoenergetic meal [carbohydrate (81%) or fat (79%)] or remained fasting. Blood sampling and hunger and satiety scores were collected hourly during 9 h after the meal. Spontaneous intake was measured at a buffet meal at 9 h postprandially. In both genders, leptin response was higher after the carbohydrate meal than after the fat meal and while fasting. In women, leptin levels were higher after the fat meal than while fasting. Leptin response was significantly correlated to insulin response (r = 0.51, P < 0.0001). Hunger and satiety ratings and subsequent energy intake were not different after carbohydrate or fat intake. In conclusion, a carbohydrate meal induces higher postprandial leptin levels than an isoenergetic fat meal. Short-term regulation of postprandial satiety and food intake is not influenced by circulating leptin.

Adult↗

High-fat diet effects on gut motility, hormone, and appetite responses to duodenal lipid in healthy men.

There is evidence that gastrointestinal function adapts in response to a high-fat (HF) diet. This study investigated the hypothesis that an HF diet modifies the acute effects of duodenal lipid on appetite, antropyloroduodenal pressures, plasma CCK and plasma glucagon-like peptide-1 (GLP-1) levels in humans. Twelve healthy men were studied twice in randomized, crossover fashion. The effects of a 90-min duodenal lipid infusion (6.3 kJ/min) on the above parameters were assessed immediately following 14-day periods on either an HF or a low-fat (LF) diet. After the HF diet, pyloric tonic and phasic pressures were attenuated, and the number of antropyloroduodenal pressure-wave sequences was increased when compared with the LF diet. Plasma CCK and GLP-1 levels did not differ between the two diets. Hunger was greater during the lipid infusion following the HF diet, but there was no difference in food intake. Therefore, exposure to an HF diet for 14 days attenuates the effects of duodenal lipid on antropyloroduodenal pressures and hunger without affecting food intake or plasma hormone levels.

Adult↗