Effects of snack portion size on anticipated and experienced hunger, eating enjoyment, and perceived healthiness among children.

BACKGROUND: Large portion sizes encourage overconsumption. Prior studies suggest that this may be due to errors in anticipating the effects of portion size, although the studies were limited to adults and energy-dense foods. OBJECTIVE: Our aim was to investigate potential anticipation errors related to the effects of portion size on hunger, eating enjoyment, and healthiness ratings among 8-to-11-year-old children, for snacks differing in energy density and healthiness perception, and as a function of initial hunger. METHODS: In a within-subject design, 83 children aged 8 to 11 years old were first asked to anticipate how much they would enjoy, how hungry they would feel after eating, and how healthy it would be to eat a recommended serving size, a 50% larger portion, and a 125% larger portion of brownie or applesauce. Over six subsequent sessions, the children were asked to eat all of each of these portions and then rate their post-intake enjoyment, residual hunger, and healthiness perceptions. We also measured hunger at the beginning of each session. RESULTS: For both snacks, larger portions reduced anticipated and experienced residual hunger similarly. In contrast, larger portions increased anticipated but not experienced eating enjoyment for both snacks; although larger portions increased anticipated and experienced enjoyment ratings among extremely hungry children. All children under-anticipated how much they would enjoy the smaller portion sizes. Healthiness ratings were unaffected by portion size for both snacks but differed across foods (applesauce vs. brownie). CONCLUSIONS: Children anticipate the effects of portion size on hunger change accurately, overestimate the effects of portion size on eating enjoyment, and rate food healthiness on food type and not portion size. Helping children better anticipate the enjoyment from smaller (recommended) portion sizes and understand that food quantity, not just quality, matters for healthy eating may be a solution to improve portion control.

Portion size selection in children: Effect of sensory imagery for snacks varying in energy density.

Food sensory imagery - creating a vivid mental image of the sensory experience of eating - can lead to the selection of smaller portions because it serves as a reminder that eating enjoyment does not necessarily increase with portion size. The evidence is mostly limited to adults and to energy-dense foods for which it is particularly difficult to predict the satiating effects of consumption quantity. The objective was to study how food sensory imagery influences portion size selection of foods varying in energy density (brownie and applesauce) by 7- to 11-year-old children. During after-school time, 171 children were randomized into two conditions. Children in the food sensory imagery condition were asked to imagine the taste, smell, and texture of eating palatable foods, i.e., chocolate cereal, chocolate waffle, and chocolate candies. Children in the control condition performed a similar sensory imagery task for non-food-related activities. Children were then asked to choose between the recommended serving size, a 50% larger portion, and a 125% larger portion of either brownie or applesauce. One week later, they were placed in the same condition for the other food. Compared to the control condition, food sensory imagery led children to choose 7.1% less brownie but had no effect on applesauce portion selection. Exploratory findings showed that the food sensory imagery intervention was especially effective at reducing brownie portion size selection among children who were moderately hungry, who usually eat fast, and whose parents pressure them to eat. In conclusion, food sensory imagery may be a useful intervention to nudge children towards healthier portion size choices because it reduces the selected portion size of an energy-dense snack without reducing the selected portion size of a healthier snack.

Weanling Infants Prefer the Odors of Green Vegetables, Cheese, and Fish When Their Mothers Consumed These Foods During Pregnancy and/or Lactation.

Infants' olfactory experience begins before birth and extends after birth through milk and complementary foods. Until now, studies on the effects of chemosensory experience in utero and/or through human milk focused on experimentally controlled exposure to only 1 target food bearing a specific odor quality and administered in sizeable amounts. This study aimed to assess whether early olfactory experience effect was measurable in "everyday conditions" of maternal food intake during pregnancy and lactation, and of infant intake at weaning, leading to expose the infant to corresponding odors as fetus, neonate, and infant up to 8 and 12 months of age. Infants' early food exposures were assessed by asking mothers to fill out diaries about their food consumption during pregnancy and breastfeeding, and about their infant's consumption during complementary feeding. To test odor liking, odorants representing a priori pleasant and unpleasant food odors, as well as odorless stimuli, were presented. The infant's exploratory behavior toward odorized bottles and nonodorized control bottles was measured in terms of mouthing duration, which is thought to reflect attraction and/or appetence. At age 8 months only, positive correlations were found between liking of some unpleasant odors and early exposure to these odors through mother's diet. No correlations were found between infants' liking of the pleasant odors and early exposures to the foods bearing these odors. This study highlights that early exposure to unpleasant food odors may increase subsequent liking (or reduce subsequent dislike) of these food odors at least until the age of 8 months.

Infant Dietary Exposures to Sweetness and Fattiness Increase during the First Year of Life and Are Associated with Feeding Practices.

BACKGROUND: Taste is a strong determinant of food intake. Previous research has suggested that early taste exposures could influence preferences and later eating behavior, but little is known about the factors related to this. OBJECTIVES: The aims of this study were to describe infants' exposure to sweetness and fattiness and to examine whether maternal and infant characteristics and feeding practices are related to these exposures in participants from the OPALINE [Observatoire des Préférences Alimentaires du Nourrisson et de l'Enfant (Observatory of Infant and Child Food Preferences)] cohort study. METHODS: Food consumption frequency was assessed with a 7-d food record completed monthly over the first year. Dietary taste exposure was defined by the consumption frequency of each food multiplied by the intensity of its taste, summed over all foods. The daily sweetness exposure (SweetExp) and fattiness exposure (FatExp) were calculated at 3-6, 7-9, and 10-12 mo of age for 268 infants from complementary feeding initiation (CFI) to 12 mo. Associations between taste exposure and potential factors were tested by multiple linear regressions. RESULTS: Both FatExp and SweetExp increased from 3-6 mo to 10-12 mo (mean ± SD: 7.5 ± 2.3 to 12.2 ± 2.5 and 6.8 ± 2.8 to 14.7 ± 4.1, respectively). Breastfeeding duration ≥6 mo was associated with higher SweetExp at all ages, with a decreasing ß [ß (95% CI): 2.6 (1.8; 3.4) at 3-6 mo and 1.3 (0.1; 2.4) at 10-12 mo]. CFI at <6 mo was associated with higher SweetExp at all ages but with higher FatExp only at 3-6 mo. Higher SweetExp and FatExp were associated with a higher use of all complementary food types. Boys were more likely to be exposed to SweetExp at 10-12 mo and to FatExp at 3-6 mo and 10-12 mo than were girls. Maternal higher education attainment and return to work after 6 mo were linked with higher FatExp and higher FatExp and SweetExp, respectively. CONCLUSION: SweetExp and FatExp increased from CFI until 12 mo and were associated with feeding practices in OPALINE infants. Studying early taste exposure longitudinally should provide new insights regarding the development of food preferences.

Effect of sensory exposure on liking for fat- or sugar-reduced biscuits.

This study investigates the effect of exposure to fat- or sugar-reduced biscuits on liking for these products. Two sets of biscuits were manufactured, each including a standard variant and 4 variants differing by the level of reduction of either fat or sugar content, to 33% of fat content or 28% of sugar content. Biscuit consumers were recruited to eat either the fat (n = 113) or the sugar-reduced set of biscuits (n = 106). They participated in 5 testing sessions, once a week, in laboratory conditions. During each session, they rated their liking of the 5 variants. At the end of each of the 4 first sessions, consumers were given 16 biscuits for their home consumption during the week. Participants were split into 3 groups of exposure: every week, a control group received the standard variant, a "direct" group received the most reduced variant and a "stepwise" group received a more and more reduced variant. After both control and stepwise exposure, almost no evolution of liking was observed. At the end of the direct exposure period to the 33% fat-reduced variant, liking for this variant significantly improved. On the contrary, after the direct exposure to the 28% sugar-reduced variant, liking only improved for 9 and 16% sugar-reduced variants.

Development and validation of a web application to collect food supply data associated with their nutritional composition and environmental impacts.

Measuring what people eat is a major methodological challenge. We developed and validated a new web-based method to record actual food supply data that would be less time consuming than the original method (i.e., food supply diary). Through the COD-Appro web application, participants can enter their food supplies by selecting a food item from a list based on items included in French food databases; thus automatically associated with nutrient composition and environmental impacts data. We recruited 102 participants who used COD-Appro during one month, among which 30 also used a classical paper-based food supply diary to be able to compare the two methods. A feedback questionnaire was completed by all the participants. The two methods showed no difference between the price and the quantity of food purchases when compared by food groups (n = 10) which confirms that the new method was robust compared to the original method. In addition, participants reported good usability of the COD-Appro web application and its use saved a considerable amount of time to the experimenters by integrating data entry and pairing with food databases (nutrient composition and environmental impacts) into the data collection step performed by the participants themselves.•Web-based food supply data collection•Association with nutrient composition and environmental impacts•External validity compared to original method (i.e., food supply diary).

Parental practices perceived by children using a French version of the Kids' Child Feeding Questionnaire.

About 18% of 6-11-year-old French children are overweight, of whom 3.3% are obese. Parental feeding practices, especially restriction and pressure-to-eat, seem to promote overeating in children. Since no tool was available for the perception of parental feeding practices of French children, our aim was to validate a French version of the Kids'Child Feeding Questionnaire (KCFQ, Carper, Orlet Fischer, & Birch, 2000), and to determine the relationship between KCFQ's dimensions and children's standardised body mass index (BMI z-scores). The questionnaire was completed by 240 normal-weighted or overweight children between the age of 9 and 11. The validation was based on a confirmatory factor analysis. The internal consistency of factors was confirmed using Cronbach's coefficients. After deleting some items (3 for the pressure-to-eat subscale and 3 for the restriction subscale), the two-factor model (pressure-to-eat, restriction) provided an acceptable fit (χ² (34)=64; RMSEA=.06; CFI=0.93; NNFI=.90), and satisfactory internal consistency. Children's perception of restriction was significantly and positively correlated with BMI z-scores (r=36, p<.001), whereas their perception of pressure-to-eat was not significantly associated with BMI z-scores (r=-.09, p=.24). This scale appears to be a sound tool for highlighting children's perceptions of parental feeding practices, and their links to weight status.

Associations between Infant Dietary Intakes and Liking for Sweetness and Fattiness Sensations in 8-to-12-Year-Old Children.

An exposure to sweetened and fatty foods early in life may be involved in high liking later in life. The objective is to investigate the association between dietary exposure to carbohydrate, sugars and fat in infancy, with liking for sweetness, fattiness and fattiness-and-sweetness sensations at 8-to-12-year-old. Analyses were conducted on 759 French children from the EDEN mother-child cohort. Carbohydrate, sugar or fat intake, being a consumer of added sugars or added fats were assessed at 8 and 12 months using 3-day food records. The liking score (0-10) for the different sensations was assessed through an online child-completed questionnaire. Associations were tested by linear regressions adjusted for main confounders and the interaction with sex was tested. None of the early dietary exposure variables was related to fattiness liking. Carbohydrate intake at 8 months was positively but weakly associated with liking for sweetness-and-fattiness. In girls only, carbohydrate intake at 12 months was positively associated with liking for sweetness. Globally, no marked associations were observed between infant dietary exposure to sweet and fat and liking for sweetness and fattiness in young children. The positive link in girls between early carbohydrate exposure and later liking for sweetness needs to be confirmed in further studies.

[Surgical removal of a follicular carcinoma of the thyroid gland in a snakehead (Channa barca, HAMILTON, 1822)]. / Chirurgische Entfernung eines untypischen follikulären Schilddrüsenkarzinoms bei einem Schlangenkopffisch (Channa barca, HAMILTON, 1822).

Inflammatory processes, neoplastic growths or rare dysontogenetic malformations may cause mass formation in the gills of fish. In the present case, a follicular carcinoma of the thyroid gland in a Barca snakehead and its surgical removal are reported, and neoplasms in fish are discussed. Following clinical, radiological, cytological and sonographic examinations, the gill-associated partly cystic mass was incompletely removed surgically. The subsequent histological examination identified the mass partly as a follicular carcinoma of the thyroid gland. Because the main alterations of the surgical specimen were non-neoplastic, the development from a rare preexisting hamartoma is discussed. No bacteriological or mycological secondary infections were identified. This report is the first description of a follicular carcinoma and its surgical removal in a snakehead.

Traditional medicine, delays and hospital mortality of children under five years of age in the rural district of Kigoma, western Tanzania: an observational hospital-based study.

The use of traditional medicine in the treatment of 596 children aged 0-60 months before admission was common (41.4 %). Children were more likely to die if they had first been treated with traditional medicine (50/244; 20.5% vs 29/342; 8.5%) or were younger (median 9 vs 12 months old.) Children who had received traditional medicine were younger (median 11 vs. 13 months), came later for hospital treatment (median three vs. five days), had a longer journey on foot to reach the health centre (3.4 vs. 2.9 h), and died from common diseases and not from an obvious toxic syndrome.

Myocardial viability evaluation using magnetocardiography in patients with coronary artery disease.

OBJECTIVE: Magnetocardiography (MCG) has been used to risk stratify patients in terms of sudden death or to detect ischemia. We evaluated the potential of this technique to assess myocardial viability in coronary artery disease. METHODS: Fifteen patients aged 36-75 (median, 59) years with stable single-vessel disease (> or =70% diameter stenosis) and corresponding regional wall-motion abnormality underwent (1) echocardiography to evaluate wall motion, (2) Tl dipyridamole single-photon emission computed tomography to document perfusion and (3) quantitative F-fluorodeoxyglucose positron emission tomography to assess viability in 16 left-ventricular wall segments. MCG was performed in each patient using a shielded prototype 49-channel low-temperature superconducting quantum interference device (SQUID) system. Multiple time and area parameters were extracted automatically from each baseline-corrected data set. RESULTS: Eleven patients had prior myocardial infarction. In each patient, four to 12 (median, seven) segments were lesion dependent, totalling up to 117 out of 240 segments. A total of 88 segments (75%) were viable and 29 segments (25%) represented scar. Patients were divided into three categories: (a) no scar segments (five patients), (b) scar in one to three segments (six patients) and (c) scar in > or = four segments (four patients). The three MCG parameters with the best selectivity were identified using linear discriminant analysis with forward inclusion (P<0.10). The corresponding Fisher's discriminant functions classified all patients correctly (Wilks' lambda=0.079). CONCLUSION: Selected MCG parameters yielded accurate patient classification with regard to the extension of myocardial scar within the viable tissue in retrospect. These findings indicate that MCG may contribute to the assessment of myocardial viability. Further evaluation in a comprehensive multicenter study is warranted.

The effect of curtailed hospitalization on the management and outcome of lumbar discectomy patients in a private practice setting.

With the accelerated development of managed care systems in the 1990s, physician practices experienced curtailed authorization for length of stay (LOS) for in-patient care. Using lumbar discectomy (CPT 63030) as a surgical model, we reviewed records of patients from 1994 and 1996 as these two years were within the period of accelerated managed care penetration in our state. The Chi Square and Fisher Exact tests were used to explore statistical significance and differences in population characteristics, management and outcome in the two years. Factors including age, sex, associated medical conditions, other presenting symptoms and signs, cause of disc herniation, and duration of symptoms were not significantly different. We demonstrated that the shortened LOS did not adversely influence the medical or functional outcome from lumbar discectomy but that there appeared to be a shift of the burden of care to the postoperative outpatient setting. Functional outcome was not significantly different between the two years when assessed by either Prolo Outcome or return-to-work rate. These findings were corroborated with a more recent review of patients operated upon in 2000. As spinal surgery grows in complexity, managed care companies should initiate programs that routinely assist physician offices in accelerating postoperative rehabilitation. In addition, as emphasis grows for evaluation and management services, surgical outcome studies should document the intensity of postoperative management to document better the overall nonoperative care that surrounds any spinal surgery.

Effect of preterm birth and birth weight on eating behavior at 2 y of age.

BACKGROUND: Preterm infants frequently present eating difficulties in early childhood. Determinants of these difficulties are not known. OBJECTIVE: We assessed the influence of neonatal and maternal characteristics on eating behaviors at 2 y of age. DESIGN: The following 2 cohorts were compared: 234 preterm children born <33 wk of gestational age from the POLYmorphisme génétique, Nutrition et Comportement Alimentaire cohort and 245 term children from the Observation des Préférences ALImentaires du Nourrisson et de l'Enfant cohort. Eating behaviors were assessed by using the validated Children's Eating Difficulties Questionnaire, which assesses the following 2 dimensions: a low drive to eat and narrow food repertoire. Each dimension was graded from 2 to 10 with more severe difficulties reflected by a higher score. Children in the upper quintile were classified as having eating disorders. RESULTS: Compared with term children, preterm children had a worse drive-to-eat score (4.3 ± 1.6 compared with 3.6 ± 1.5, respectively; P = 0.001) and a marginally lower food-repertoire score (5.0 ± 1.5 compared with 4.8 ± 1.6, respectively; P = 0.05). In a multilevel logistic regression model, female sex [adjusted OR (aOR): 1.76; 95% CI: 1.08, 2.88; P = 0.025] and birth weight less than -1 z score (aOR: 2.88; 95% CI: 1.47, 5.67; P = 0.002) but not gestational age were associated with a worse drive to eat. A maternal level of education beyond high school was associated with lower risk of a poor food-repertoire score (aOR: 0.54; 95% CI: 0.32, 0.90; P = 0.02). CONCLUSIONS: Preterm children have more eating difficulties than term children do, but after adjustment for maternal and neonatal characteristics, gestational age is not associated with impaired eating behaviors at the age of 2 y. Female sex, a low maternal level of education, and less than -1 SD intrauterine growth are associated with eating difficulties at 2 y of age. This trial was registered at clinicaltrials.gov as NCT 00663572.

The role of taste in food acceptance at the beginning of complementary feeding.

Introduction of solid foods is a major step in the establishment of eating behavior and is likely to affect children's health. However, the role of taste in acceptance of new foods, in particular in the first months of complementary feeding, is not fully understood and was the aim of the present study. Infants had to be in good health to participate (N=74). First, the infants' reactions to new foods were recorded by their parents between the ages of 5 and 7 months using a 4-point-scale ranging from very negative to very positive. Taste intensities of infant foods were scored by a trained panel and foods were clustered into groups showing similar taste profiles. Infants' reactions were used to calculate new food acceptance (NFA) defined as the average reaction towards a group of foods showing a similar taste profile. Second, preferences for the five basic tastes over water were measured using a 4-bottle test at 6 months old comparing intake of tastant solutions to water. Taste acceptance was evaluated through ingestion ratio (IR=intake of tastant solutions/intake of tastant solutions and water). NFAs were compared across food groups. Kendall correlations were calculated between NFA and IR. Most reactions (88%) to new foods were positive. However, NFA varied according to the taste profile of the foods: vegetables in which salt or a salty ingredient was added were more accepted than plain vegetables (P<0.01). On average no rejection of basic tastes was observed. For sweet, sour and umami tastes, significant positive correlations were observed between NFA and IR. Healthy foods like vegetables could be easily introduced in the diet of most, but not all infants. The role of taste preferences in new food acceptance was highlighted: a higher acceptance for a taste was associated to an enhanced acceptance of foods bearing this taste.

Mucin gene expression is not regulated by estrogen and/or progesterone in the ocular surface epithelia of mice.

PURPOSE: Dry eye syndrome is prevalent in post-menopausal women, and post-menopausal women secrete less mucus in their reproductive tracts. Using a mouse model, the purpose of this study was to determine if estrogen and/or progesterone regulates Muc4 and Muc5AC gene expression in the ocular surface epithelia, as the hormones do in reproductive tract epithelia. METHODS: Adult C57BL/6 mice were ovariectomized, and 19 days later, pellets containing estrogen, progesterone, or a combination were inserted subcutaneously. Ocular surface and reproductive tract tissues were harvested following seven days of hormone treatment. A control group consisted of ovariectomized mice that received no hormone treatment. Real-time reverse transcription-polymerase chain reaction was used to determine the tissue expression levels of mucin mRNA of each treatment group relative to the control. Muc4 mRNA expression levels were determined for the reproductive tract, and both Muc4 and Muc5AC expression levels were determined for the ocular surface epithelia. Muc4 and Muc5AC gene expression in ocular surface and Muc4 in reproductive tract epithelia was demonstrated by In Situ hybridization, and Muc4 and Muc5AC protein was demonstrated in the epithelia of animals in the experimental groups. RESULTS: The mRNA expression levels of Muc4 and Muc5AC and the immunofluorescence localization pattern in the ocular surface epithelia were not significantly different in any hormone treatment group when compared to the control ovariectomized group. By comparison, mice that were administered estrogen had a significant increase of Muc4 mRNA in the reproductive tract epithelia, progesterone given in combination with estrogen antagonized the upregulatory effects of estrogen in the reproductive tract, and the amount of Muc4 mRNA in the reproductive tract of progesterone-treated animals was not different from ovariectomized controls. Immunofluorescence localization of Muc4 in the reproductive tract epithelia of the experimental groups correlated to message levels, with lack of Muc4 protein detected in the control and progesterone groups. CONCLUSION: In comparison to reproductive tract epithelia, Muc4 and Muc5AC are not hormonally regulated by estrogen or progesterone in the ocular surface epithelia of mice. These data demonstrate that regulation of epithelial mucin genes is tissue specific.