Adhesión a la dieta mediterránea y conducta alimentaria en escolares españoles / Adherence to the Mediterranean diet and eating behaviour in Spanish schoolchildren

Introducción: las conductas alimentarias pueden modular o influir en la calidad de la dieta y el grado de adherencia a la dieta mediterráneade niños y adolescentes.Objetivos: investigar la asociación entre la calidad de la dieta y el comportamiento alimentario en un grupo de escolares españoles.Métodos: se trata de un estudio transversal descriptivo en una muestra de 283 escolares españoles de seis a 16 años. Cada sujeto fue evaluadomediante el cuestionario KIDMED de adherencia a la dieta mediterránea y el cuestionario Children’s Eating Behaviour Questionnaire (CEBQ) paraevaluar el comportamiento alimentario.Resultados: un 12,80 % de la muestra presentó baja adherencia a la dieta mediterránea; un 59,80 %, adherencia mejorable; y un 27,40 %,adherencia alta. Al relacionar las conductas alimentarias con la calidad dietética, los escolares con mayor disfrute por los alimentos y menosexigencia con la comida presentan el doble de adherencia a la dieta mediterránea, por un consumo de casi el doble de vegetales, frutos secoso pescado, así como menor ingesta de procesados de baja calidad (golosinas y dulces). La respuesta a la saciedad y la velocidad de ingestatambién tuvieron un papel importante en las elecciones alimentarias.Conclusiones: las conductas alimentarias pueden tener un importante papel en la calidad de la dieta de los escolares, destacando el disfrute y laaceptación o rechazo por los alimentos. Dada la naturaleza bidireccional de los efectos entre las conductas alimentarias y la calidad de la dieta, elanálisis conjunto puede ser la base de futuras investigaciones con el objetivo de un mejor abordaje nutricional desde las edades más tempranas.(AU)

Introduction: eating behaviors may modulate or influence diet quality and the degree of adherence to the Mediterranean diet in children andadolescents.Aims: to investigate the association between diet quality and eating behavior in a group of Spanish schoolchildren.Methods: descriptive cross-sectional study of 283 Spain schoolchildren aged six to 16. Each subject was assessed using the KIDMED question-naire for adherence to the Mediterranean diet and the Children’s Eating Behaviour Questionnaire (CEBQ) questionnaire to assess eating behavior.Results: of the sample, 12.80 % had low adherence to the Mediterranean diet, 59.80 % had poor adherence, 59.80 % could be improved, and27.40 % had high adherence. When relating eating behavior to dietary quality, it was found that, generally, schoolchildren with greater enjoymentof food and less demand for food have double the adherence to the Mediterranean diet due to almost twice the consumption of vegetables,nuts, and fish, and a lower intake of low-quality processed foods (sweets). The response to satiety and the speed of ingestion also played animportant role in food choices.Conclusions: eating behaviors may play an essential role in the quality of school children’s diets highlighting the enjoyment and acceptance orrejection of food. Given the bidirectional nature of the effects between eating behaviors and diet quality, the joint analysis may be the basis forfuture research with the aim of a better nutritional approach from the earliest ages.(AU)

Seeking satiety: From signals to solutions.

Remedies for the treatment of obesity date to Hippocrates, when patients with obesity were directed to "reduce food and avoid drinking to fullness" and begin "running during the night." Similar recommendations have been repeated ever since, despite the fact that they are largely ineffective. Recently, highly effective therapeutics were developed that may soon enable physicians to manage body weight in patients with obesity in a manner similar to the way that blood pressure is controlled in patients with hypertension. These medicines have grown out of a revolution in our understanding of the molecular and neural control of appetite and body weight, reviewed here.

Intraduodenal nutrient infusion differentially alters intestinal nutrient sensing, appetite, and satiety responses in lean and obese subjects.

BACKGROUND: Intestinal nutrient sensing regulates food intake and energy metabolism by acting locally and relaying nutritional status to the brain. It is unclear whether these mechanisms are altered in obese humans. OBJECTIVES: We aimed to investigate differences in duodenal nutrient sensing in humans with or without obesity and the effects of transiently blocking vagal transmission on nutrient sensing, hunger, and appetite. METHODS: In a single-blinded, randomized, cross-over design, subjects with or without obesity (n = 14 and n = 11, respectively) were infused intraduodenally with saline or a combination of glucose and oleic acid for 90 min (glucose load: 22.5 g, 1 kcal/min; oleic acid load: 10 g, 1 kcal/min) in the presence or absence of local anesthetic (benzocaine). Blood was sampled at 10-min intervals (120-240 min) and 15-min intervals until termination of the study for measurements of gut hormones, insulin, leptin, and C-peptide. Hunger and satiety sensations were scored using the visual analog scale, and hepatic glucose production and glucose oxidation rates were measured. RESULTS: Duodenal nutrient infusion in lean subjects led to a 65% drop in acyl ghrelin release and robustly increased cholecystokinin 8 (CCK-8) release (65%; P = 0.023); benzocaine infusion delayed this response (2-factor repeated-measures analysis of variance, P = 0.0065). In contrast, subjects with obesity had significantly blunted response to nutrient infusion, and no further effects were observed with benzocaine. Additionally, significant delays were observed in peptide YY (3-36), pancreatic polypeptide, glucose inhibitory peptide, and glucagon-like peptide 1 (7-36) response. No significant interactions were found between body mass index (BMI) or baseline hormone levels and areas under the curve for hormones except CCK-8 (BMI, P = 0.018; baseline CCK, P = 0.013). Nutrient-induced hunger and satiety sensations were impeded by benzocaine only in the lean cohort. Hunger and satiety sensations in subjects with obesity were not responsive to nutrient entry into the duodenum, and no additional effects were observed by blocking neural signaling. CONCLUSION: Nutrient-induced gut hormone release and response to transient vagal blockade are significantly blunted in subjects with obesity. This trial was registered at clinicaltrials.org as NCT02537314.

Food Order and Timing Effects on Glycaemic and Satiety Responses to Partial Fruit-for-Cereal Carbohydrate Exchange: A Randomized Cross-Over Human Intervention Study.

Postprandial glycaemic response amplitude plays a critical role in diabetic complications, but is subject to food order and temporal separation within a meal. Effects of partial fruit-for-cereal carbohydrate exchange on glycaemic and appetite responses, as affected by food order and separation, were examined using kiwifruit (KF) and wheaten breakfast cereal biscuit (WB). In a randomized cross-over intervention study, 20 subjects ingested 51.7 g of available carbohydrate as 74 g WB alone, or as 200 g KF and 37 g WB, each delivering 25.85 g of available carbohydrate. The 200 g KF was partially exchanged for 37 g of WB, at 90 min and 30 min before, at the same time as, or 30 min after, ingesting WB. Incremental satiety responses were derived from appetite scores measured using a visual analogue scale, and capillary blood glucose responses were monitored. In all exchanges, KF reduced the glycaemic response (iAUC) by 20-30% with no loss of total satiation. The incremental glycaemic and satiety responses to food ingestion followed each other closely. Glycaemic response amplitudes were reduced almost 50% compared with 74 g WB when KF ingestion preceded WB ingestion by 30 min, and less when the KF was ingested with or 30 min after the cereal. The results suggest that fruit most effectively suppresses the digestion of cereal carbohydrates if ingested long enough before the cereal to prevent overlap of the glycaemic responses, but close enough for fruit components that impede carbohydrate digestion or uptake to interact with the ingested cereal in the gut. Ethics approval was obtained from the Human and Disabilities Ethics Committee (HDEC) of the New Zealand Ministry of Health. The trial was registered with the Australian New Zealand Clinical Trials Registry (Trial ID: ACTRN12615000744550).

Proglucagon signalling in the rat Dorsomedial Hypothalamus - Physiology and high-fat diet-mediated alterations.

A relatively new pharmacological target in obesity treatment has been the preproglucagon (PPG) signalling, predominantly with glucagon-like peptide (GLP) 1 receptor agonists. As far as the PPG role within the digestive system is well recognised, its actions in the brain remain understudied. Here, we investigated PPG signalling in the Dorsomedial Hypothalamus (DMH), a structure involved in feeding regulation and metabolism, using in situ hybridisation, electrophysiology, and immunohistochemistry. Our experiments were performed on animals fed both control, and high-fat diet (HFD), uncovering HFD-mediated alterations. First, sensitivity to exendin-4 (Exn4, a GLP1R agonist) was shown to increase under HFD, with a higher number of responsive neurons. The amplitude of the response to both Exn4 and oxyntomodulin (Oxm) was also altered, diminishing its relationship with the cells' spontaneous firing rate. Not only neuronal sensitivity, but also GLP1 presence, and therefore possibly release, was influenced by HFD. Immunofluorescent labelling of the GLP1 showed changes in its density depending on the metabolic state (fasted/fed), but this effect was eliminated by HFD feeding. Interestingly, these dietary differences were absent after a period of restricted feeding, allowing for an anticipation of the alternating metabolic states, which suggests possible prevention of such outcome.

Regulation of Satiety by Bdnf-e2-Expressing Neurons through TrkB Activation in Ventromedial Hypothalamus.

The transcripts for Bdnf (brain-derived neurotrophic factor), driven by different promoters, are expressed in different brain regions to control different body functions. Specific promoter(s) that regulates energy balance remain unclear. We show that disruption of Bdnf promoters I and II but not IV and VI in mice (Bdnf-e1-/-, Bdnf-e2-/-) results in obesity. Whereas Bdnf-e1-/- exhibited impaired thermogenesis, Bdnf-e2-/- showed hyperphagia and reduced satiety before the onset of obesity. The Bdnf-e2 transcripts were primarily expressed in ventromedial hypothalamus (VMH), a nucleus known to regulate satiety. Re-expressing Bdnf-e2 transcript in VMH or chemogenetic activation of VMH neurons rescued the hyperphagia and obesity of Bdnf-e2-/- mice. Deletion of BDNF receptor TrkB in VMH neurons in wildtype mice resulted in hyperphagia and obesity, and infusion of TrkB agonistic antibody into VMH of Bdnf-e2-/- mice alleviated these phenotypes. Thus, Bdnf-e2-transcripts in VMH neurons play a key role in regulating energy intake and satiety through TrkB pathway.

Applying behavioral economics-based approaches to examine the effects of liquid sucrose consumption on motivation.

Overconsumption of sugar contributes to obesity in part by changing the activity of brain areas that drive the motivation to seek out and consume food. Sugar-sweetened beverages are the most common source of excess dietary sugar and contribute to weight gain. However, very few studies have assessed the effects of liquid sucrose consumption on motivation. This is due in part to the need for novel approaches to assess motivation in pre-clinical models. To address this, we developed a within-session behavioral economics procedure to assess motivation for liquid sucrose. We first established and validated the procedure: we tested several sucrose concentrations, evaluated sensitivity of the procedure to satiety, and optimized several testing parameters. We then applied this new procedure to determine how intermittent vs. continuous access to liquid sucrose (1 M) in the home cage affects sucrose motivation. We found that intermittent liquid sucrose access results in an escalation of sucrose intake in the home cage, without altering motivation for liquid sucrose during demand testing (1 M or 0.25 M) compared to water-maintained controls. In contrast, continuous home cage access selectively blunted motivation for 1 M sucrose, while motivation for 0.25 M sucrose was similar to intermittent sucrose and control groups. Thus, effects of continuous home cage liquid sucrose access were selective to the familiar sucrose concentration. Finally, effects of sucrose on motivation recovered after removal of liquid sucrose from the diet. These data provide a new approach to examine motivation for liquid sucrose and show that escalation of intake and motivation for sucrose are dissociable processes.

Secretin modulates appetite via brown adipose tissue-brain axis.

PURPOSE: Secretin activates brown adipose tissue (BAT) and induces satiation in both mice and humans. However, the exact brain mechanism of this satiety inducing, secretin-mediated gut-BAT-brain axis is largely unknown. METHODS AND RESULTS: In this placebo-controlled, single-blinded neuroimaging study, firstly using [18F]-fluorodeoxyglucose (FDG) PET measures (n = 15), we established that secretin modulated brain glucose consumption through the BAT-brain axis. Predominantly, we found that BAT and caudate glucose uptake levels were negatively correlated (r = -0.54, p = 0.037) during secretin but not placebo condition. Then, using functional magnetic resonance imaging (fMRI; n = 14), we found that secretin improved inhibitory control and downregulated the brain response to appetizing food images. Finally, in a PET-fMRI fusion analysis (n = 10), we disclosed the patterned correspondence between caudate glucose uptake and neuroactivity to reward and inhibition, showing that the secretin-induced neurometabolic coupling patterns promoted satiation. CONCLUSION: These findings suggest that secretin may modulate the BAT-brain metabolic crosstalk and subsequently the neurometabolic coupling to induce satiation. The study advances our understanding of the secretin signaling in motivated eating behavior and highlights the potential role of secretin in treating eating disorders and obesity. TRIAL REGISTRATION: EudraCT no. 2016-002373-35, registered 2 June 2016; Clinical Trials no. NCT03290846, registered 25 September 2017.

Imagined eating - An investigation of priming and sensory-specific satiety.

While obesity remains a pressing issue, the wider population continues to be exposed to more digital food content than ever before. Much research has demonstrated the priming effect of visual food content, i.e., exposure to food cues increasing appetite and food intake. In contrast, some recent research points out that repeated imagined consumption can facilitate satiate and decrease food intake. Such findings have been suggested as potential remedies to excessive food cue exposure. However, the practically limitless variety of digital food content available today may undermine satiation attempts. The present work aims to replicate and extend prior findings by introducing a within-subjects baseline comparison, disentangling general and (sensory-) specific eating desires, as well as considering the moderating influence of visual and flavour stimulus variety. Three online studies (n = 1149 total) manipulated food colour and flavour variety and reproducibly revealed a non-linear dose-response pattern of imagined eating: 3 repetitions primed, while 30 repetitions satiated. Priming appeared to be specific to the taste of the exposed stimulus, and satiation, contrary to prior literature, appeared to be more general. Neither colour nor flavour variety reliably moderated any of the responses. Therefore, the results suggest that a more pronounced variety may be required to alter imagery-induced satiation.

Hunger and satiety responses to diets enriched with cottonseed oil vs. olive oil.

Studies suggest that the type of dietary fat consumed habitually may modulate appetite and further influence weight management. The purpose of this study was to evaluate the impact of an 8-week diet intervention enriched with either cottonseed oil (CSO; polyunsaturated fat-rich) or olive oil (OO; monounsaturated fat-rich) on appetite responses in adults with high cholesterol. This was a parallel design, randomized partial outpatient feeding trial designed to provide approximately 60% of participants daily energy needs with ∼30% of energy needs as CSO (n = 21, BMI 27.3 ± 0.92 kg/m2, age 53 ± 2y) or OO (n = 21, BMI 27.6 ± 1.20 kg/m2, age 54 ± 2y). A high saturated fat meal challenge was completed at pre- and post-intervention visits with 5 h postprandial blood draws and visual analog scales (VAS) for cholecystokinin (CCK), peptide YY (PYY), ghrelin, and subjective appetite, respectively. Participants also completed VAS questionnaires hourly and recorded dietary intake after leaving the lab for the remainder of the day. There was a greater increase in fasting CCK (CSO: 0.54 ± 0.03 to 0.56 ± 0.04; OO: 0.63 ± 0.07 to 0.60 ± 0.06 ng/ml p = 0.05), a greater suppression of postprandial ghrelin (p < 0.01), and a greater increase in postprandial VAS fullness (p = 0.04) in CSO compared to OO. Additionally, there was a greater decrease in self-reported energy intake in CSO compared to OO (CSO: 2464 ± 123 to 2115 ± 123; OO: 2263 ± 147 to 2,434 ± 184 kcal/d p = 0.02). Only postprandial VAS prospective consumption showed greater suppression (p = 0.03) in OO vs. CSO. Altogether, these data show that CSO has a greater effect on appetite suppression than OO diet enrichment and may be beneficial for weight maintenance, especially in a population at-risk for chronic disease. Registered at clinicaltrials.gov: NCT04397055.

The mitochondrial UPR regulator ATF5 promotes intestinal barrier function via control of the satiety response.

Organisms use several strategies to mitigate mitochondrial stress, including the activation of the mitochondrial unfolded protein response (UPRmt). The UPRmt in Caenorhabditis elegans, regulated by the transcription factor ATFS-1, expands on this recovery program by inducing an antimicrobial response against pathogens that target mitochondrial function. Here, we show that the mammalian ortholog of ATFS-1, ATF5, protects the host during infection with enteric pathogens but, unexpectedly, by maintaining the integrity of the intestinal barrier. Intriguingly, ATF5 supports intestinal barrier function by promoting a satiety response that prevents obesity and associated hyperglycemia. This consequently averts dysregulated glucose metabolism that is detrimental to barrier function. Mechanistically, we show that intestinal ATF5 stimulates the satiety response by transcriptionally regulating the gastrointestinal peptide hormone cholecystokinin, which promotes the secretion of the hormone leptin. We propose that ATF5 protects the host from enteric pathogens by promoting intestinal barrier function through a satiety-response-mediated metabolic control mechanism.

Greater protein quality of an egg breakfast may be inadequate to induce satiety during weight loss, compared with a cereal breakfast of equal protein quantity.

We compared the effects of consuming egg-breakfast of superior protein quality to cereal-breakfast of similar energy density and protein quantity, but lower protein quality. Two, two-week randomised crossover clinical trials included 30 otherwise healthy women with overweight or obesity. Subjects received counselling to follow a reduced-calorie diet. Under supervision, participants consumed either breakfast for one-week then crossed over to the opposite breakfast. Experiment-1 outcome variables included post-breakfast appetite hormones, glucose and insulin, subjective markers of satiety and energy intake at lunch and dinner. In Experiment-2, an appealing food (brownies) was included in lunch. Following the breakfasts, Experiment-1 showed no significant differences in outcome variables. In Experiment-2, the egg-breakfast increased fullness (p = 0.038), but lunch-time energy intake was not different. If these findings apply to other breakfasts, it suggests that in comparing two breakfasts with similar protein quantity, the greater protein quality of a breakfast may not be adequate to induce satiety.

Impaired Brain Satiety Responses After Weight Loss in Children With Obesity.

CONTEXT: Obesity interventions often result in increased motivation to eat. OBJECTIVE: We investigated relationships between obesity outcomes and changes in brain activation by visual food cues and hormone levels in response to obesity intervention by family-based behavioral treatment (FBT). METHODS: Neuroimaging and hormone assessments were conducted before and after 24-week FBT intervention in children with obesity (OB, n = 28), or children of healthy weight without intervention (HW, n = 17), all 9- to 11-year-old boys and girls. We evaluated meal-induced changes in neural activation to high- vs low-calorie food cues across appetite-processing brain regions and gut hormones. RESULTS: Among children with OB who underwent FBT, greater declines of BMI z-score were associated with lesser reductions after the FBT intervention in meal-induced changes in neural activation to high- vs low-calorie food cues across appetite-processing brain regions (P < 0.05), and the slope of relationship was significantly different compared with children of HW. In children with OB, less reduction in brain responses to a meal from before to after FBT was associated with greater meal-induced reduction in ghrelin and increased meal-induced stimulation in peptide YY and glucagon-like peptide-1 (all P < 0.05). CONCLUSION: In response to FBT, adaptations of central satiety responses and peripheral satiety-regulating hormones were noted. After weight loss, changes of peripheral hormone secretion support weight loss, but there was a weaker central satiety response. The findings suggest that even when peripheral satiety responses by gut hormones are intact, the central regulation of satiety is disturbed in children with OB who significantly improve their weight status during FBT, which could favor future weight regain.

Influence of exclusive breastfeeding on hippocampal structure, satiety responsiveness, and weight status.

Longer exclusive breastfeeding duration has been associated with differences in neural development, better satiety responsiveness, and decreased risk for childhood obesity. Given hippocampus sensitivity to diet and potential role in the integration of satiety signals, hippocampus may play a role in these relationships. We conducted a secondary analysis of 149, 7-11-year-olds (73 males) who participated in one of five studies that assessed neural responses to food cues. Hippocampal grey matter volume was extracted from structural scans using CAT12, weight status was assessed using age- and sex-adjusted body mass index (%BMIp85 ), and parents reported exclusive breastfeeding duration and satiety responsiveness (Children's Eating Behaviour Questionnaire). Separate path models for left and right hippocampus tested: (1) the direct effect of exclusive breastfeeding on satiety responsiveness and its indirect effect through hippocampal grey matter volume; (2) the direct effect of hippocampal grey matter volume on %BMIp85 and its indirect effect through satiety responsiveness. %BMIp85 was adjusted for maternal education, yearly income, and premature birth while hippocampal grey matter volume was adjusted for total intercranial volume, age, and study from which data were extracted. Longer exclusive breastfeeding duration was associated with greater bilateral hippocampal grey matter volumes. In addition, better satiety responsiveness and greater left hippocampal grey matter volume were both associated with lower %BMIp85 . However, hippocampal grey matter volumes were not associated with satiety responsiveness. Although no relationship was found between breastfeeding and child weight status, these results highlight the potential impact of exclusive breastfeeding duration on the hippocampal structure.

Glycemic response, satiety, gastric secretions and emptying after bread consumption with water, tea or lemon juice: a randomized crossover intervention using MRI.

PURPOSE: Numerous studies, including our previous work with lemon juice, have reported that low-pH meals reduce the glycemic response to starchy foods. However, the underlying mechanism is not yet understood. Tea, for its polyphenol content, has also been investigated. The main objective of this research was to concurrently study gastric emptying, appetite perceptions and glycemic responses to bread consumed with water, tea, or lemon juice. METHODS: In this randomized, crossover intervention, ten participants consumed equal portions of bread (100 g) with 250 mL of water, water-diluted lemon juice, or black tea at breakfast. Gastric volumes, blood glucose concentrations and appetite perceptions were alternately assessed over 180 min using magnetic resonance imaging, the finger-prick method and visual analogue scales, respectively. RESULTS: Compared to water, lemon juice led to a 1.5 fold increase of the volume of gastric contents, 30 min after the meal (454.0 ± 18.6 vs. 298.4 ± 19.5 mL, [Formula: see text] ± SEM P < 0.00001). Gastric emptying was also 1.5 times faster (P < 0.01). Conversely, lemon juice elicited a lower glycemic response than water (blood glucose concentrations at t = 55 min were 35% lower, P = 0.039). Tea had no effect. Changes in appetite perceptions and gastric volumes correlated well, but with no significant differences between the meals. CONCLUSIONS: Lemon juice lowered the glycemic response and increased both gastric secretions and emptying rate. The results are compatible with the hypothesis that the reduction of the glycemic response is mainly due to the interruption of starch hydrolysis via the acid-inhibition of salivary α-amylase. TRIAL REGISTRATION NUMBER: NCT03265392, August 29, 2017.

Impact of food processing on postprandial glycaemic and appetite responses in healthy adults: a randomized, controlled trial.

Chickpeas are among the lowest glycaemic index carbohydrate foods eliciting protracted digestion and enhanced satiety responses. In vitro studies suggest that mechanical processing of chickpeas significantly increases starch digestion. However, there is little evidence regarding the impact of processing on postprandial glycaemic response in response to chickpea intake in vivo. Therefore, the aim of this study was to determine the effect of mechanical processing on postprandial interstitial glycaemic and satiety responses in humans. In a randomised crossover design, thirteen normoglycaemic adults attended 4 separate laboratory visits following an overnight fast. On each occasion, one of four test meals, matched for available carbohydrate content and consisting of different physical forms of chickpeas (whole, puree, and pasta) or control (mashed potato), was administered followed by a subsequent standardised lunch meal. Continuous glucose monitoring captured interstitial glucose responses, accompanied by periodic venous blood samples for retrospective analysis of C-peptide, glucagon like peptide-1 (GLP-1), ghrelin, leptin, resistin, and cortisol. Subjective appetite responses were measured by Visual Analogue Scale (VAS). Postprandial glycaemic responses were comparable between chickpea treatments albeit significantly lower than the control (p < 0.001). Similarly, all chickpea treatments elicited significantly lower C-peptide and GLP-1 responses compared to the control (p < 0.05), accompanied by enhanced subjective satiety responses (p < 0.05), whilst no significant differences in satiety hormones were detected among different intervention groups (p > 0.05). Chickpea consumption elicits low postprandial glycaemic responses and enhanced subjective satiety responses irrespective of processing methods.

Hibiscus sabdariffa tea affects diet-induced thermogenesis and subjective satiety responses in healthy men but not in women: a randomized crossover trial.

The aim of this study was to investigate the effect of Hibiscus sabdariffa tea on energy expenditure, satiety response and food intake. This is an open-label, crossover, randomized clinical trial that comprised 21 subjects (11 women, 10 men). The individuals were evaluated at acute moments (fasting and after eating standardized breakfast accompanied by water or H. sabdariffa tea). Resting energy expenditure was measured by indirect calorimetry, subjective satiety responses were evaluated with a visual analogue scale and food intake was assessed by using food records. The volunteers who drank the H. sabdariffa tea had lower perception of hunger (p = 0.002) and greater feeling of satiety (p = 0.01) and fullness (p = 0.009) compared to control. Men who ingested the H. sabdariffa tea had an increase in nitrogen energy expenditure (water: 1501 ± 290.7 kcal, H. sabdariffa tea: 1619 ± 288.9 kcal; p = 0.029). In comparison to control, men presented less perception of hunger (p = 0.003) and desire to eat (p = 0.016), increased satiety (p = 0.021) and fullness (p = 0.01), and women oxidized more fat (p = 0.034) when they drank H. sabdariffa tea. There was no difference between treatments regarding the energy and macronutrient intake from the first meal and throughout the day (p > 0.05) for all participants. The H. sabdariffa tea only affected energy expenditure and satiety responses in men. Clinical trial registry: ReBEC Platform of the Brazilian Clinical Trials Registry (https://ensaiosclinicos.gov.br/) - RBR-5HZ86T. Novelty: H. sabdariffa tea promoted an increase in energy expenditure and caused less perception of hunger/desire to eat in men. H. sabdariffa tea intake increased postprandial fat oxidation in women.

Alimentação responsiva na primeira infância como fator de autorregulação do apetite e prevenção de obesidade infantil: uma revisão sistemática / Responsive feeding in early childhood as a factor in appetite self-regulation and prevention of childhood obesity: a systematic review

A obesidade infantil é um problema de saúde pública global que afeta cerca de 41 milhões de crianças menores de cinco anos e pode ser causada por diversos fatores. O objetivo deste estudo foi avaliar o efeito da abordagem de alimentação responsiva na primeira infância na autorregulação do apetite e prevenção de obesidade infantil. Foi realizada revisão sistemática da literatura e a síntese e extração de dados foram conduzidas de acordo com as diretrizes PRISMA. Para a pesquisa bibliográfica utilizou-se quatro bases de dados: PubMed, Scopus, Web of Science e EMBASE, sem restrição de idiomas, entre os anos 2012 e 2022. A seleção dos artigos foi realizada por pares e em duas etapas: leitura dos resumos (207) e leitura dos artigos completos (60), tendo sido selecionados 14 artigos. Os critérios de inclusão foram: estudos publicados em periódicos, entre 2012 e 2022, sem restrição por idioma, estudos observacionais e intervencionais que avaliaram a associação entre autorregulação da ingestão alimentar, responsividade dos cuidadores a alimentação das crianças e status de peso em crianças de zero a cinco anos. Foram excluídos os artigos com população de crianças com comorbidade, estudos de bebês com condições que afetam a alimentação e o crescimento, bebês muito prematuros, baixo peso ao nascer (BPN) <2.500 kg. A maioria dos estudos utilizou questionários de alimentação para avaliar comportamentos alimentares infantis e adultos, práticas alimentares parentais e escalas de apetite e saciedade. As medidas antropométricas foram avaliadas através de procedimentos padrão, autorreferidos ou prontuários. Os estudos demonstraram que os estilos parentais que apresentam maior controle e pressão para a criança comer interferem na autorregulação do seu apetite ou controle da saciedade e consequente ganho de peso. Concluiu-se que os comportamentos alimentares dos pais têm impacto na autorregulação alimentar, controle da saciedade e peso da criança. No entanto, pesquisas mais aprofundadas sobre abordagens alimentares dos pais são necessárias para elucidar o comportamento das crianças e sua influência na prevenção da obesidade infantil.

Childhood obesity is a global public health problem that affects approximately 41 million children under five years of age and can be caused by several factors. The aim of this study was to evaluate the effect of the early childhood responsive feeding approach on appetite self-regulation and prevention of childhood obesity. A systematic literature review was performed and data synthesis and extraction were conducted according to PRISMA guidelines. For the bibliographic research, four databases were used: PubMed, Scopus, Web of Science and EMBASE, with no language restriction, between the years 2012 and 2022. The selection of articles was carried out by pairs and in two stages: reading of abstracts (207) and reading the complete articles (60), with 14 articles selected. Inclusion criteria were: studies published in journals, between 2012 and 2022, without restriction by language, observational and interventional studies that evaluated the association between self-regulation of food intake, caregivers' responsiveness to children's feeding and weight status in children aged zero to five years. Articles with a population of children with comorbidity, studies of babies with conditions that affect feeding and growth, very premature babies, low birth weight (LBW) <2,500 kg were excluded. Most studies used feeding questionnaires to assess child and adult eating behaviors, parental eating practices, and appetite and satiety scales. Anthropometric measurements were assessed using standard procedures, self-reported or medical records. Studies have shown that parenting styles that have greater control and pressure for the child to eat interfere with the self-regulation of their appetite or control of satiety and consequent weight gain. It was concluded that parents' eating behaviors have an impact on food self regulation, satiety control and child weight.

Lower Energy-Dense Ready Meal Consumption Affects Self-Reported Appetite Ratings with No Effect on Subsequent Food Intake in Women.

Slimming World (SW), a commercial weight management organisation, has designed a range of low energy-dense ready meals (LEDRMs) in line with their programme. This randomised crossover study compared commercially available equicaloric ready meals differing in energy density on satiety and food intake. It was hypothesised that the LEDRM would reduce energy intake (EI) whilst increasing fullness and reducing hunger compared to higher energy-dense ready meal (HEDRM, control). A total of 26 female participants (aged 18-65 years; body mass index of 28.8 ± 3.0 kg·m-2) attended two test days. The participants ate a standard breakfast, and four hours later, ate either a LEDRM or HEDRM at lunch. EI was measured four hours later at an ad libitum tea. Satiety measurements were recorded throughout the day using visual analogue scales and a weighed food diary was completed for the remainder of the day. The results revealed that the LEDRM reduced hunger and increased fullness (both p < 0.001). There was no difference in EI at the evening meal between the ready meals (p > 0.05), however, during the whole LEDRM testing day, the participants consumed significantly less fat (7.1%) and saturated fat (3.6%) (both p < 0.01), but significantly more carbohydrates, sugars, fibre, protein, and salt (all p < 0.01). The results indicate that the participants felt more satiated after consuming ready meals of the same energy content but larger portion size. Despite no significant difference in short-term EI between the ready meals, the results indicated that the LEDRM produced beneficial subjective satiety responses and, therefore, can help to improve the nutritional content of meals i.e., reduce saturated fat consumption.