Racial Variations in Appetite-Related Hormones, Appetite, and Laboratory-Based Energy Intake from the E-MECHANIC Randomized Clinical Trial.

African Americans (AAs) have a higher obesity risk than Whites; however, it is unclear if appetite-related hormones and food intake are implicated. We examined differences in appetite-related hormones, appetite, and food intake between AAs (n = 53) and Whites (n = 111) with overweight or obesity. Participants were randomized into a control group or into supervised, controlled exercise groups at 8 kcal/kg of body weight/week (KKW) or 20 KKW. Participants consumed lunch and dinner at baseline and follow-up, with appetite and hormones measured before and after meals (except leptin). At baseline, AAs had lower peptide YY (PYY; p < 0.01) and a blunted elevation in PYY after lunch (p = 0.01), as well as lower ghrelin (p = 0.02) and higher leptin (p < 0.01) compared to Whites. Despite desire to eat being lower and satisfaction being higher in AAs relative to Whites (p ≤ 0.03), no racial differences in food intake were observed. Compared to Whites, leptin increased in the 8 KKW group in AAs (p = 0.01), yet no other race-by-group interactions were evident. Differences in appetite-related hormones between AAs and Whites exist; however, their influence on racial disparities in appetite, food intake, and obesity within this trial was limited.

"Those who care much, understand much." Maternal perceptions of children's appetite: Perspectives from urban and rural caregivers of diverse parenting experience in Bangladesh.

Appetite in children is an important determinant of nutritional intake and growth. The information used by caregivers to understand children's appetite can help inform infant and young child feeding promotion and appetite assessment. We conducted a qualitative study to (a) explore maternal perceptions and responses to children's appetite and (b) to identify how these factors differ by type of caregiver, level of maternal experience, and urban versus rural context. We used purposive sampling to recruit mothers and alternate caregivers into 14 total focus group discussions (six to eight participants in each group; N = 95) in both urban and rural settings in Bangladesh. To understand children's appetite, caregivers monitor children's dietary patterns, emotional signs, and physical and verbal cues. Healthy appetite was observed by willingness to eat diverse foods, finish offered portions, and by acceptance of foods without excessive prompting. Child illness was cited for a cause of low appetite, which was manifested through fussiness, and avoiding commonly consumed foods. Mothers described a limited set of feeding practices (offering diverse foods, playing, and cheering children with videos) to encourage consumption when children lacked appetite. Mothers' stress related to work was noted as a barrier to identifying appetite cues. Urban mothers described a lower access to instrumental social support for child feeding but informational support than mothers in the rural setting. Understanding caregivers' perceptions of children's appetite may inform strategies to improve responsive feeding and tool development to assess changes in appetite as early indicators of change in health or nutrition status among high-risk children.

See food diet? Cultural differences in estimating fullness and intake as a function of plate size.

Previous research has suggested that manipulations of plate size can have a direct impact on perception of food intake, measured by estimated fullness and intake. The present study, involving 570 individuals across Canada, China, Korea, and New Zealand, is the first empirical study to investigate cultural influences on perception of food portion as a function of plate size. The respondents viewed photographs of ten culturally diverse dishes presented on large (27 cm) and small (23 cm) plates, and then rated their estimated usual intake and expected fullness after consuming the dish, using 100-point visual analog scales. The data were analysed with a mixed-model ANCOVA controlling for individual BMI, liking and familiarity of the presented food. The results showed clear cultural differences: (1) manipulations of the plate size had no effect on the expected fullness or the estimated intake of the Chinese and Korean respondents, as opposed to significant effects in Canadians and New Zealanders (p < 0.05); (2) Canadian (88.91 ± 0.42) and New Zealanders (90.37 ± 0.41) reported significantly higher estimated intake ratings than Chinese (80.80 ± 0.38) or Korean (81.69 ± 0.44; p < 0.05), notwithstanding the estimated fullness ratings from the Western respondents were comparable or even higher than those from the Asian respondents. Overall, these findings, from a cultural perspective, support the notion that estimation of fullness and intake are learned through dining experiences, and highlight the importance of considering eating environments and contexts when assessing individual behaviours relating to food intake.

Child feeding style is associated with food intake and linear growth in rural Ethiopia.

BACKGROUND: Little is known about mother-child feeding interactions and how this is associated with food intake and linear growth. OBJECTIVE: To characterize mother-child feeding styles and investigate their associations with accepted mouthful and linear growth in west Gojam, rural Ethiopia. SUBJECTS/DESIGN: Two, in-home, meal observations of children aged 12-23 months (n = 100) were video-taped. The number of mouthful accepted was counted and the caregiver/child feeding styles were coded into positive/negative categories of self-feeding, responsive-feeding, active-feeding, social-behavior and distraction. Data on socio-demographic characteristics, child feeding practices, perception about child's overall appetite, and strategies adopted to overcome food refusal were collected through questionnaire-based interviews. Child and mothers' anthropometric measurements were also taken. RESULTS: Stunting was highly prevalent (48%) and the number of mouthful accepted was very low. Offering breastmilk and threatening to harm were the main strategies adopted to overcome food refusal. Although all forms of feeding style were present, active positive feeding style was dominant (90%) and was positively associated with mouthful accepted. Talking with non-feeding partner (64%), and domestic animals (24%) surrounding the feeding place were common distractions of feeding. Feeding was mostly terminated by caregivers (75%), often prematurely. Overall, caregivers of stunted children had poorer complementary- and breast-feeding practices and were less responsive to child's hunger and satiation cues (P < 0.05). Positive responsive feeding behaviors were associated with child's number of mouthful accepted (r = 0.27; P = 0.007) and stunting (r = 0.4; P < 0.001). CONCLUSION: Low complementary food intake in this setting is associated with caregivers' feeding style and stunting. Nutrition interventions that reinforce messages of optimal infant and young child feeding and integrate the promotion of responsive feeding behaviors are needed.

Preschool children's sensitivity to teacher-served portion size is linked to age related differences in leftovers.

A strong predictor of children's food intake at a meal is the amount they are served, and with a high percentage children attending preschool, there is a need to consider the relationship between portion size and intake in this context. In a two-part repeated measures study we investigated whether the portions teachers serve to children i) differ from those children would serve themselves and ii) impact food intake at a local preschool in Singapore. Part 1 (n = 37, 20 boys, 3.0-6.8 years) compared the quantity of food served, consumed and leftover across three serving methods: 'regular' teacher-serving; child self-served portions; and a deliberately large portion served by the teacher (150% of each child's average previous gram intake). Part 2 (n = 44, 23 boys, 2.4-6.2 years old) consisted of three additional observations of school-based servings outside of the experimental manipulation and enhance external validity of the study findings. Results indicated that serving size and intake was similar when the children and teachers served their 'regular' portions, but children consumed most overall when the teacher served the larger 150% portion. This was dependent on the child's age, with the oldest children being most responsive to the large portions while the youngest children tended to serve and consume a similar weight of food, regardless of the serving method. Though the younger children were generally served less than the older children, they consistently had more leftovers across all of the study observations. These data suggest that younger preschool children moderated food intake by leaving food in their bowl, and emphasise the unique influence of caregivers over children's eating behaviours outside of the home environment.

Breakfast Macronutrient Composition Influences Thermic Effect of Feeding and Fat Oxidation in Young Women Who Habitually Skip Breakfast.

The purpose of this study was to determine if breakfast macronutrient composition improved thermic effect of feeding (TEF) and appetite after a one-week adaptation in young women who habitually skip breakfast. A randomized, controlled study was conducted in females (24.1 ± 2 years), who skip breakfast (≥5 times/week). Participants were placed into one of three groups for eight days (n = 8 per group): breakfast skipping (SKP; no breakfast), carbohydrate (CHO; 351 kcal; 59 g CHO, 10 g PRO, 8 g fat) or protein (PRO; 350 kcal; 39 g CHO, 30 g PRO, 8 g fat). On days 1 (D1) and 8 (D8), TEF, substrate oxidation, appetite and blood glucose were measured. PRO had higher (p < 0.05) TEF compared to SKP and CHO on D1 and D8, with PRO having 29% higher TEF than CHO on D8. On D1, PRO had 30.6% higher fat oxidation than CHO and on D8, PRO had 40.6% higher fat oxidation than CHO. SKP had higher (p < 0.05) fat oxidation on D1 and D8 compared to PRO and CHO. There was an interaction (p < 0.0001) of time and breakfast on appetite response. In addition, CHO had a significant increase (p < 0.05) in PP hunger response on D8 vs. D1. CHO and PRO had similar PP (postprandial) glucose responses on D1 and D8. Consumption of PRO breakfast for 8 days increased TEF compared to CHO and SKP, while consumption of CHO for one week increased PP hunger response.

Variation in the Oral Processing of Everyday Meals Is Associated with Fullness and Meal Size; A Potential Nudge to Reduce Energy Intake?

Laboratory studies have demonstrated that experimental manipulations of oral processing can have a marked effect on energy intake. Here, we explored whether variations in oral processing across a range of unmodified everyday meals could affect post-meal fullness and meal size. In Study 1, female participants (N = 12) attended the laboratory over 20 lunchtime sessions to consume a 400-kcal portion of a different commercially available pre-packaged meal. Prior to consumption, expected satiation was assessed. During each meal, oral processing was characterised using: (i) video-recordings of the mouth and (ii) real-time measures of plate weight. Hunger and fullness ratings were elicited pre- and post-consumption, and for a further three hours. Foods that were eaten slowly had higher expected satiation and delivered more satiation and satiety. Building on these findings, in Study 2 we selected two meals (identical energy density) from Study 1 that were equally liked but maximised differences in oral processing. On separate days, male and female participants (N = 24) consumed a 400-kcal portion of either the "fast" or "slow" meal followed by an ad libitum meal (either the same food or a dessert). When continuing with the same food, participants consumed less of the slow meal. Further, differences in food intake during the ad libitum meal were not compensated at a subsequent snacking opportunity an hour later. Together, these findings suggest that variations in oral processing across a range of unmodified everyday meals can affect fullness after consuming a fixed portion and can also impact meal size. Modifying food form to encourage increased oral processing (albeit to a lesser extent than in experimental manipulations) might represent a viable target for food manufacturers to help to nudge consumers to manage their weight.

Complexity of nutritional behavior: Capturing and depicting its interrelated factors in a cause-effect model.

The aim of this article is to demonstrate the complexity of nutritional behavior and to increase understanding of this complex phenomenon. We developed a cause-effect model based on current literature, expert consultation, and instruments dealing with complexity. It presents factors from all dimensions of nutrition and their direct causal relationships with specification of direction, strength, and type. Including the interplay of all relationships, the model reveals cause-effect chains, feedback loops, multicausalities, and side effects. Analyses based on the model can further enhance understanding of nutritional behavior and help identify starting points for measures to modify food consumption.

Eating behaviors and overweight among adolescents: a population-based survey in Japan.

OBJECTIVES: The aim of the present study was to investigate the relationship between eating behaviors and overweight among population-based adolescents in Japan. METHODS: Study subjects comprised adolescents in the seventh grade (age range, 12-13 years) from Ina, a town in Saitama Prefecture, Japan, between 1999 and 2008. The height and weight of the subjects were measured, and information concerning eating behaviors (eating speed and eating until full) was obtained using a self-administered questionnaire. RESULTS: Among boys (n = 1586), fast eating speed significantly increased the odds ratio (OR) for overweight when compared with medium eating speed, regardless of eating until full or not; moreover, a more marked increase in the OR was observed among boys eating until full (OR: 2.78, 95% confidence interval: 1.76-4.38) than among those not eating until full (2.43, 1.41-4.20). Among girls (n = 1542), fast eating speed led to a significant increase in the OR in those eating until full; however, no significant increases were observed in the OR in those eating quickly and not until full. CONCLUSIONS: Among adolescents, fast eating speed was associated with overweight; furthermore, the combination of both fast eating speed and eating until full may have a significant effect on overweight.

Fish oil supplementation is beneficial on caloric intake, appetite and mid upper arm muscle circumference in children with leukaemia.

A randomised trial was carried out to determine the effect of supplementation of fish oil among 51 children with leukaemia aged 4 to 12 years on appetite level, caloric intake, body weight and lean body mass. They were randomly allocated into the trial group (TG) and the control group (CG). At baseline, 30.8% of TG subjects and 44.0% of CG subjects were malnourished and 7.7% of subject from TG and 28.0% from CG were classified as stunted. The majority of subjects from TG and CG were in the mild malnutrition category for mid upper arm muscle circumference (MUAMC)-for-age. The TG group showed significant increment in MUAMC (0.13 cm vs -0.09 cm) compared with CG at 8 weeks (p<0.001). There was a significant higher increase for appetite level (0.12±0.33) (p<0.05) and an increasing trend on energy and protein intake in the TG group (213±554 kcal; 3.64 ±26.8 g) than in the CG group. In conclusion, supplementation of fish oil has a positive effect on appetite level, caloric intake and MUAMC among children with leukaemia.