A low glycaemic load breakfast can attenuate cognitive impairments observed in middle aged obese females with impaired glucose tolerance.

BACKGROUND AND AIMS: There has been no systematic investigation of the individual and combined effects of impaired glucose tolerance (IGT) and obesity on cognitive function in the absence of ageing. The aims were to examine the effects of IGT and increased waist circumference on cognitive function in ostensibly healthy adults, and to investigate whether a low glycaemic load (GL) breakfast can attenuate cognitive impairments in these populations. METHODS AND RESULTS: Sixty five females aged 30-50 years were classified into one of four groups following waist circumference (WC) measurements and an oral glucose tolerance test: NGT/low WC (n = 25), NGT/high WC (n = 22), IGT/low WC (n = 9), IGT/high WC (n = 9). Memory, psychomotor and executive functions were examined 30 and 120 min after consuming low GL, high GL and water breakfasts according to a randomised, crossover, counterbalanced design. IGT was associated with impairment of verbal and spatial memory, and psychomotor function relative to females with NGT, independent of waist circumference. Increased waist circumference was associated with impairment of verbal memory and executive function relative to females with low WC, independent of IGT. Consumption of the LGL breakfast attenuated verbal memory impairment in the IGT/high WC group relative to the HGL breakfast and no energy control. CONCLUSION: Increased central adiposity and abnormalities in glucose tolerance preceding type 2 diabetes can have demonstrable negative effects on cognitive function, even in ostensibly healthy, middle-aged females. The potential for GL manipulations to modulate glycaemic response and cognitive function in type 2 diabetes and obesity merits further investigation.

Psychological benefits of weight loss following behavioural and/or dietary weight loss interventions. A systematic research review.

It is generally accepted that weight loss has significant physiological benefits, such as reduced risk of diabetes, lowered blood pressure and blood lipid levels. However, few behavioural and dietary interventions have investigated psychological benefit as the primary outcome. Hence, systematic review methodology was adopted to evaluate the psychological outcomes of weight loss following participation in a behavioural and/or dietary weight loss intervention in overweight/obese populations. 36 Studies were selected for inclusion and were reviewed. Changes in self-esteem, depressive symptoms, body image and health related quality of life (HRQoL) were evaluated and discussed. Where possible, effect sizes to indicate the magnitude of change pre- to post- intervention were calculated using Hedges' g standardised mean difference. The results demonstrated consistent improvements in psychological outcomes concurrent with and sometimes without weight loss. Improvements in body image and HRQoL (especially vitality) were closely related to changes in weight. Calculated effect sizes varied considerably and reflected the heterogeneous nature of the studies included in the review. Although the quality of the studies reviewed was generally acceptable, only 9 out of 36 studies included a suitable control/comparison group and the content, duration of intervention and measures used to assess psychological outcomes varied considerably. Further research is required to improve the quality of studies assessing the benefits of weight loss to fully elucidate the relationship between weight loss and psychological outcomes.

Potential benefits of satiety to the consumer: scientific considerations.

Foods and dietary patterns that enhance satiety may provide benefit to consumers. The aim of the present review was to describe, consider and evaluate research on potential benefits of enhanced satiety. The proposal that enhanced satiety could only benefit consumers by a direct effect on food intake should be rejected. Instead, it is proposed that there is a variety of routes through which enhanced satiety could (indirectly) benefit dietary control or weight-management goals. The review highlights specific potential benefits of satiety, including: providing appetite control strategies for consumers generally and for those who are highly responsive to food cues; offering pleasure and satisfaction associated with low-energy/healthier versions of foods without feeling 'deprived'; reducing dysphoric mood associated with hunger especially during energy restriction; and improved compliance with healthy eating or weight-management efforts. There is convincing evidence of short-term satiety benefits, but only probable evidence for longer-term benefits to hunger management, possible evidence of benefits to mood and cognition, inadequate evidence that satiety enhancement can promote weight loss, and no evidence on which consumers would benefit most from satiety enhancement. The appetite-reducing effects of specific foods or diets will be much more subtle than those of pharmaceutical compounds in managing hunger; nevertheless, the experience of pharmacology in producing weight loss via effects on appetite suggests that there is potential benefit of satiety enhancement from foods incorporated into the diet to the consumer.

Validation of the Diet Satisfaction Questionnaire: a new measure of satisfaction with diets for weight management.

OBJECTIVE: The Diet Satisfaction Questionnaire was developed to fill the need for a validated measure to evaluate satisfaction with weight-management diets. This paper further develops the questionnaire, examining the factor structure of the original questionnaire, cross-validating a revised version in a second sample and relating diet satisfaction to weight loss during a 1-year trial. METHODS: The 45-item Diet Satisfaction Questionnaire (DSat-45) uses seven scales to assess characteristics that influence diet satisfaction: Healthy Lifestyle, Convenience, Cost, Family Dynamics, Preoccupation with Food, Negative Aspects, and Planning and Preparation. It was administered five times during a 1-year weight-loss trial (n = 186 women) and once as an online survey in a separate sample (n = 510 adults). Confirmatory factor analysis was used to assess and refine the DSat-45 structure, and reliability and validity data were examined in both samples for the revised questionnaire, the DSat-28. Associations were examined between both DSat questionnaires and weight loss in the trial. RESULTS: Internal consistency (reliability) was moderate for the DSat-45. Confirmatory factor analysis showed improved fit for a five-factor structure, resulting in the DSat-28 that retained four of the original scales and a shortened fifth scale. This revised questionnaire was reliable in both samples. Weight loss across the year-long trial was positively related to satisfaction with Healthy Lifestyle, Preoccupation with Food, and Planning and Preparation in both versions of the questionnaire. CONCLUSIONS: Measures of reliability and validity were improved in the more concise DSat-28 compared to the DSat-45. This shorter measure should be used in future work to evaluate satisfaction with weight-management diets.

No effects of ingesting or rinsing sucrose on depleted self-control performance.

Self-control tasks appear to deplete a limited resource resulting in reduced subsequent self-control performance; a state of ego depletion. Evidence of reduced peripheral glucose by exertion of self-control, and attenuation of ego depletion by carbohydrate metabolism underpins the proposition that this macronutrient provides the energetic source of self-control. However, the demonstration of positive, non-metabolic effects on ego depletion when merely sensing carbohydrates orally contradicts this hypothesis. Recent studies have also failed to support both metabolic and non-metabolic accounts. The effects of ingesting or rinsing a carbohydrate (sucrose) and an artificially sweetened (sucralose) solution on capillary blood and interstitial glucose, and depleted self-control performance were examined in older adults. Forty, healthy, adults (50-65years) ingested and rinsed sucrose and sucralose solutions in a 2 (method)×2 (source), fully counterbalanced, repeated measures, crossover design. Capillary blood and interstitial glucose responses were assayed. Depleted self-control performance (induced by the Bakan visual processing task) on an attention switch task was assessed under each study condition. Ego depletion had no consistent effects on peripheral glucose levels and no significant effects of ingesting or rinsing sucrose on self-control were observed. The act of rinsing the solutions, independent of energetic content, resulted in a small, non-significant enhancement of performance on the attention switch task relative to ingesting the same solutions (RT: p=.05; accuracy: p=.09). In conclusion, a metabolic account of self-control was not supported. Whilst a positive effect of rinsing on depleted self-control performance was demonstrated, this was independent of energetic content. Findings suggest glucose is an unlikely physiological analogue for self-control resources.

Resistance and susceptibility to weight gain: individual variability in response to a high-fat diet.

An obesigenic environment is a potent force for promoting weight gain. However, not all people exposed to such an environment become obese; some remain lean. This means that some people are susceptible to weight gain (in a weight-promoting environment) and others are resistant. Identifying the characteristics of appetite control and food motivation in these two groups could throw light on the causes of weight gain and how this can be either treated or prevented. We have investigated the issue experimentally by identifying people who habitually consume a high-fat diet (greater than 43% fat energy). These individuals have been termed high-fat phenotypes. We have compared individuals, of the same age (mean=37 years old) and gender (male), who have gained weight (BMI=34) or who have remained lean (BMI=22). The susceptible individuals are characterised by a cluster of characteristics including a weak satiety response to fatty meals, a maintained preference for high-fat over low-energy foods in the post-ingestive satiety period, a strong hedonic attraction to palatable foods and to eating, and high scores on the TFEQ factors of Disinhibition and Hunger. The analysis of large databases suggests that this profile of factors contributes to an average daily positive energy balance from food of approximately 0.5 MJ. This profile of characteristics helps to define the symptomatology of a thrifty phenotype.

Dietary fat and the control of energy intake: evaluating the effects of fat on meal size and postmeal satiety.

Three separate experiments in lean subjects confirmed that a 1.52-MJ (362-kcal) carbohydrate supplement at breakfast suppressed appetite 90 min later but had no effect on a test meal given after 270 min. A 1.52-MJ (362-kcal) fat supplement produced no detectable action on measures of appetite at any time point. Therefore, fat and carbohydrate do not have identical effects on the appetite profile. In a further study in obese subjects, a novel experimental design was used to assess the satiating efficiency and compensatory response of fat. Eating from a range of either high-fat or high-carbohydrate foods, obese subjects voluntarily consumed twice as much energy from the fat items, thereby indicating a weak action of fat on satiation. In turn, this large intake of fat exerted a disproportionately weak effect on satiety. These studies suggest that the appetite-control system may have only weak inhibitory mechanisms to prevent the passive overconsumption of dietary fat. The results indicate how this action could induce a positive energy balance and lead to a gradual upward drift in body mass index.

5-HT manipulation and dietary choice: variable carbohydrate (Polycose) suppression demonstrated only under specific experimental conditions.

The effects of six 5-HT anorectic agents, d-fenfluramine (5-HT releaser and reuptake inhibitor), fluoxetine (5-HT reuptake inhibitor), mCPP (5-HT1B/5-HT1C receptor agonist), RU24969 (5-HT1A/5-HT1B receptor agonist), MK212 (5-HT1C receptor agonist) and DOI (5-HT2/5-HT1C receptor agonist), and two non-5-HT anorectic agents, salbutamol (beta 2-adrenergic agonist) and d-amphetamine (catecholaminergic agonist), were examined in an experimental procedure designed to disclose selective effects on carbohydrate consumption. In this procedure, a revised version of what we have termed "The Classic Sclafani Paradigm", animals are presented with powdered Polycose as an optional carbohydrate supplement to hydrated chow (nutritionally complete diet). All drugs produced significant reductions in total (hydrated chow plus powdered Polycose) intake. However, only the 5-HT drugs DOI and fluoxetine exerted significantly stronger anorectic effects on intake of powdered Polycose than on intake of hydrated chow. d-Fenfluramine also showed a tendency to selectively suppress Polycose intake but this effect marginally failed to reach significance. These results suggest that when experimental conditions are favourable, what appears to be selective carbohydrate (Polycose) suppression can be demonstrated with certain 5-HT drugs. They also suggest that a selective effect on carbohydrate intake is not the most prominent feeding response to 5-HT drugs.

Serotonin and dietary fat intake: effects of dexfenfluramine.

Traditionally, serotonin (5-HT) has been most commonly linked with carbohydrate (CHO) intake. However, in recent years it has been demonstrated that serotoninergic drugs such as dexfenfluramine also reduce energy intake and reverse body weight gain in rats exposed to weight-increasing high-fat diets. Dexfenfluramine is also effective in decreasing food intake and body weight gain of rats that gain weight on a high-fat cafeteria diet. The basic science studies indicate that serotoninergic activity--induced by dexfenfluramine--can act as a sufficient stimulus for the reduction of fat consumption. High-fat diets do not appear to impede the suppressive effect of dexfenfluramine on food intake. In human studies with dexfenfluramine, it has often been the case that the fat content of test foods has been held constant--with only protein and CHO allowed to vary. These studies therefore cannot display any direct effect on fat. However, when food choice is not limited by experimental constraints, a significant reduction of fat intake by dexfenfluramine has been demonstrated in obese patients. In other experimental studies, dexfenfluramine has suppressed fat intake to a greater extent than other macronutrients when free selection of foods has been permitted. Taken together, these studies demonstrate that dexfenfluramine is effective at reducing energy intake with a diet high in fat and may under certain conditions cause a selective avoidance of high-fat foods.

The effect of d-fenfluramine on intake of carbohydrate supplements is influenced by the hydration of the test diets.

The effect of d-fenfluramine on carbohydrate intake in the rat has been investigated using a dietary paradigm in which a pure carbohydrate supplement is presented in addition to the normal balanced chow diet. This experimental strategy has been used as an alternative to the macronutrient selection model in an attempt to increase the sensitivity of the measurement of drug effects on carbohydrate intake. This issue is important because of the postulated theoretical relationship between brain serotonin (5-HT) and carbohydrate intake. The effect of d-fenfluramine was dependent upon the texture and density of the supplement (hydrated vs. non-hydrated) and upon the nature of the carbohyhdrate employed - either sucrose (sweet-tasting) or Polycose (bland-tasting). Selective carbohydrate suppression, by d-fenfluramine, was detected (as predicted by the 5-HT/carbohydrate theory) but only under specific environmental conditions, namely hydrated chow supplemented with dry Polycose. Therefore, suppression of carbohydrate may depend, not on any inherent biological link between carbohydrate consumption and brain 5-HT activity, but on a shift in relative preference for the diet choices available.

5-HT and carbohydrate suppression: effects of 5-HT antagonists on the action of d-fenfluramine and DOI.

The effects of several 5-hydroxytryptamine (5-HT) receptor antagonists on the anorectic effect of d-fenfluramine and the 5-HT2/5-HT1C agonist 1-(2,5-dimethoxy-4-iodophenyl)-2-aminopropane (DOI) were examined in a dietary paradigm that appears to be sensitive to 5-HT-induced carbohydrate suppression. In this paradigm, deprived rats are provided with a nutritionally complete hydrated chow mash diet together with an optional carbohydrate supplement of powdered Polycose. Both d-fenfluramine and DOI produced a clear suppression of total energy intake and carbohydrate (Polycose) intake. However, the mechanisms underlying these effects are different. The effect of d-fenfluramine in this paradigm was attenuated by the 5-HT1/5-HT2 receptor antagonist metergoline and partially attenuated by the 5-HT1A/5-HT1B receptor antagonist (+/-)cyanopindolol. In contrast, d-fenfluramine's effect was not antagonised by the 5-HT2 receptor antagonist ketanserin, the 5-HT3 receptor antagonist (3 alpha-tropanyl)-1H-indole-3-carboxylic acid ester (ICS-205,930), the 5-HT2/5-HT1C receptor antagonist ritanserin, or the peripheral 5-HT receptor antagonist xylamidine. However, the effect of DOI in this paradigm was significantly attenuated by ketanserin but was not antagonised by either ritanserin or (+/-)cyanopindolol. Therefore, the suppressive effect of these two 5-HT drugs on total and Polycose intake appears to be mediated, respectively, by 5-HT1B/5-HT1C receptors (d-fenfluramine) and 5-HT2 receptors (DOI).

The 5-HT2 receptor agonist MK-212 reduces food intake and increases resting but prevents the behavioural satiety sequence.

The 5-HT2c receptor is implicated in the relationship between serotonin and satiety. However, anorexia induced by the 5-HT2 receptor agonist 1-(2,5-dimethoxy-4-iodophenyl)-2-aminopropane (DOI) has been shown to delay, not advance behaviours associated with the onset of satiety, fragmenting eating behaviour, 6-chloro-2-(1-piperazinyl)pryazine (MK-212) is also a selective agonist at the 5-HT2 receptor sites. MK-212 has greater affinity for 5-HT2c receptor sites than DOI. The effects of an ED50 dose of MK-212 (5.0 mg/kg i.p.) on the eating and other behaviours of the fasted rat were continuously monitored following the presentation of food. Continuous monitoring provides the most powerful and valid form of behavioural analysis. Temporal profiles of behaviour duration (dur) and frequency (frq) were generated. Food intake was reduced 54% by MK-212 (p < .001). The frequency of grooming was reduced (p < .01). Locomotion (dur p < .001, frq p < .001), rearing (dur p < .0005, frq p < .005) and sniffing (dur p < .05, frq p < .0001) were all reduced. The duration of resting increased (p < 0.01). This is consistent with enhanced satiety. However, the Behavioural Satiety Sequence was not present after the administration of MK-212 (5.0 mg/kg). The temporal structure of behaviour produced by MK-212 was quite different from that produced by pre-feeding. Initially resting dominated the behavioural profile. Eating increased over time from a suppressed state in the initial stages of the observation period. This lack of appearance of the Behavioural Satiety Sequence is more similar to a state of hyper-sedation than to DOI induced hyper-activity. The time course of this sedation would not have been picked up by a simple categorical analysis of behaviour. Hence, temporal analysis is an essential tool in understanding of drug induced anorexia.

Impact of postprandial glycaemia on health and prevention of disease.

Postprandial glucose, together with related hyperinsulinemia and lipidaemia, has been implicated in the development of chronic metabolic diseases like obesity, type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD). In this review, available evidence is discussed on postprandial glucose in relation to body weight control, the development of oxidative stress, T2DM, and CVD and in maintaining optimal exercise and cognitive performance. There is mechanistic evidence linking postprandial glycaemia or glycaemic variability to the development of these conditions or in the impairment in cognitive and exercise performance. Nevertheless, postprandial glycaemia is interrelated with many other (risk) factors as well as to fasting glucose. In many studies, meal-related glycaemic response is not sufficiently characterized, or the methodology with respect to the description of food or meal composition, or the duration of the measurement of postprandial glycaemia is limited. It is evident that more randomized controlled dietary intervention trials using effective low vs. high glucose response diets are necessary in order to draw more definite conclusions on the role of postprandial glycaemia in relation to health and disease. Also of importance is the evaluation of the potential role of the time course of postprandial glycaemia.

The role of reduced fat diets and fat substitutes in the regulation of energy and fat intake and body weight.

The suggested link between a high intake of dietary fat and obesity has led to a proliferation on the market of reduced fat foods. The preceding year has seen the publication of more long-term studies investigating the effects of reduced fat and fat substituted foods on energy intake, fat intake and body weight. Effects on the proportion of the diet consumed as fat are encouraging (with most studies showing a decrease towards dietary recommendations), whilst effects on energy intake and body weight remain equivocal.

Serotonin, eating behavior, and fat intake.

There is an intimate relationship between nutritional intake (eating) and serotonin activity. Experimental manipulations (mainly neuropharmacological) of serotonin influence the pattern of eating behavior, subjective feelings of appetite motivation, and the response to nutritional challenges. Similarly, nutritional manipulations (food restriction, dieting, or altered nutrient supply) change the sensitivity of the serotonin network. Traditionally, serotonin has been linked to the macronutrient carbohydrate via the intermediary step of plasma amino acid ratios. However, it has also been demonstrated that 5-HT drugs will reduce energy intake and reverse body weight gain in rats exposed to weight increasing high fat diets. 5-HT drugs can also reduce food intake and block weight gain of rats on a high fat cafeteria diet. Some diet selection studies in rats indicate that the most prominent reduction of macronutrient intake is for fat. These data indicate that 5-HT activity can bring about a reduction in fat consumption. In turn, different types of dietary fat can alter brain 5-HT activity. In human studies the methodology of food choice experiments has often precluded the detection of an effect of 5-HT manipulation on fat intake. However, there is evidence that in obese and lean subjects some 5-HT drugs can readily reduce the intake of high fat foods. Data also suggest that 5-HT activation can lead to a selective avoidance of fat in the diet. These effects of 5-HT on the intake of dietary fat may involve a pre-absorptive mechanism and there is evidence that 5-HT is linked to cholecystokinin and enterostatin. These proposals have theoretical and practical implications and suggest possible strategies to intensify or advance fat-induced satiety signals.

Mechanisms of appetite control and their abnormalities in obese patients.

Human appetite is a complex mixture of physiological and psychological phenomena which include feelings of hunger, total energy intake, ingestion of particular nutrients, distribution and sizes of meals and snacks, specific cravings and food preferences. These phenomena can be assembled into a profile of motivation and a pattern of eating which represents the way in which appetite fluctuates over time. The satiety cascade shows the processes through which nutrition exerts effects on the biological system and, therefore, on feelings and behaviour. Within the biological system, the control of appetite involves post-ingestive mechanisms, including signals arising from the gastrointestinal tract and the release of hormones when food is processed. Post-absorptive mechanisms include the detection of important products of digestion, such as glucose and amino acids, together with the nature of the fuel mix oxidized and other metabolic variables. In obese patients, evidence points to a defect in the control of fat intake. In these people, dietary fat exerts only a weak action on satiation and satiety; it fails to generate strong responses in the mechanisms of the satiety cascade. An imbalance between fat intake and oxidation favours weight gain. A consideration of the psychobiological system (interactions between behaviour, peripheral physiology and neurochemical profiles) suggests strategies for treating or preventing the development of weight gain in vulnerable individuals.

Serotoninergic manipulation, meal-induced satiety and eating pattern: effect of fluoxetine in obese female subjects.

Twelve nondepressed healthy female obese subjects (BMI > 30 kg/m2) took part in a study which conformed to a double-blind randomized crossover design. Each subject acted as her own control across 2 weeks of treatment with either 60 mg of the 5-HT reuptake inhibitor fluoxetine or matching placebo. On days 7 and 14 of both treatment phases subjects were provided with fixed energy lunch meals high in either CHO or fat. The effect of these meals on satiety during the fluoxetine and placebo phases was assessed by a battery of procedures. Subjects felt less hungry after consuming the high CHO meal than after consuming the high-fat meal. They also felt less hungry when taking fluoxetine than when taking the placebo. Analysis of energy intake from the test meal revealed a main effect of prior lunch meal type (high CHO or high fat) and a main effect of drug treatment. Subjects consumed an average of 574 kcal following the high CHO meal compared to 689 kcal following the high-fat meal. Subjects also consumed an average of 532 kcal when taking fluoxetine compared to 730 kcal when taking the placebo. Fluoxetine did not exert any significant effects on macronutrient selection. Mean daily energy intake, calculated from food diary records, was 1881 kcal when subjects were taking the placebo compared to 1460 kcal when taking fluoxetine (a reduction of 22.4%). Fluoxetine treatment produced a significant weight loss of 1.97 kg over the two weeks of treatment compared to a weight loss of only 0.04 kg on placebo.

A medium-term intervention study on the impact of high- and low-fat snacks varying in sweetness and fat content: large shifts in daily fat intake but good compensation for daily energy intake.

Thirty-six normal-weight, habitual snackers (eighteen males, eighteen females) completed a medium-term intervention study designed to examine the tendency of four different types of snacks, varying in nutrient (low- (LF) or high-fat (HF) and sensory properties (sweet (SW) or non-sweet (NSW)), to influence the control of appetite and to adjust daily energy intake. Subjects were exposed to each snack category for a 3-week period and were asked to consume a minimum number of snacks each day so that at least 25% of their daily energy intake would be derived from the test snacks. Energy and macronutrient intakes from the test snacks were calculated every day and also from other eating episodes (using 3 d food diary records) during the third week of snack exposure. Subjects consumed more energy/d from the SW snacks than from the NSW snacks, with most energy being consumed from the HF/SW snacks (3213 kJ) and least energy from the LF/NSW snacks (1628 kJ). This differential snack intake remained stable across the whole snack exposure period. Total daily energy intake did not differ significantly during exposure to any of the four snack types. Furthermore, the encouragement to eat freely from the test snacks did not lead to daily overconsumption of energy when compared with pre-study intakes. Hence, the level of snack consumption was largely compensated for by the energy consumed from the rest of the eating pattern. Although daily energy intake during exposure to the HF snacks was an average of 364 kJ higher (NS) than that during exposure to the LF snacks, the clearest and most significant effect of snack consumption was on daily macronutrient intake. Appreciable consumption of the HF snacks raised the percentage of total daily energy intake consumed as fat from 37 to 41% (P < 0.01). In contrast, the LF snacks reduced daily fat intake to 33.5% (LF/SW, P < 0.05; LF/NSW, NS) of total daily energy. The results, therefore, suggest that, in habitual snackers, generous consumption of LF snacks, when compared with HF snacks, is an effective strategy to reduce fat intake so that it approaches the recommendations of dietary guidelines without increasing total daily energy intake.

Comparison of high-fat and high-carbohydrate foods in a meal or snack on short-term fat and energy intakes in obese women.

The present study aimed to compare the action of high-fat and high-carbohydrate (CHO) foods on meal size (satiation) and post-meal satiety in obese women. A within-subjects design was used; each participant received all four nutritional challenges. Fifteen healthy obese women (age 21-56 years, BMI 35-48 kg/m2) participated; thirteen completed all four test days. On two test days, participants were exposed to a nutritional challenge comprising an ad libitum high-fat or high-CHO lunch. On the other two test days they were exposed to a challenge comprising an ad libitum sweet high-fat or high-CHO mid-afternoon snack. Energy and macronutrient intakes were measured at each eating episode. Visual analogue rating scales were completed periodically to record subjective feelings of appetite. When offered a high-CHO selection of foods at lunch and mid-afternoon participants consumed less energy than when offered a high-fat selection. However, post-meal satiety was similar. Total test-day energy intake was significantly higher when high-fat foods were consumed at lunch, but not as a snack. Consumption of high-fat foods at a lunch and snack increased the amount of fat consumed over the whole test day. In conclusion, energy intake of an eating episode was influenced by nutrient composition in this group of obese women. Consumption of high-fat foods at lunch or as a snack led to overconsumption relative to high-CHO foods. However, high-fat foods at meals may have greater potential to influence daily intake than at snacks, probably because meals are larger eating episodes and therefore give greater opportunity to overconsume.

Dietary fat and appetite control in obese subjects: weak effects on satiation and satiety.

The present study assessed the capacity of both high fat and high carbohydrate (CHO) foods to lead to overconsumption in 12 obese women (mean BMI = 42 kg/m2). Subjects were provided with either a low (527 kcal) or high (985 kcal) energy meal at midday. Energy intake was then measured in a later ad libitum dinner meal in which subjects ate from a range of either high fat or high CHO foods. Energy intake following exposure to these meals was then assessed using food intake diary records which were kept for the rest of the day and for the following 24 h. The energy manipulations at lunch gave rise to different levels in the rated intensity of hunger. At the dinner meal subjects consumed an average of 937 kcal following the high energy lunch and 1026 kcal following the low energy lunch (an increase of 10%). However, average intake from the high CHO dinner meal was only 677 kcal compared to 1336 kcal from the high fat dinner meal (an increase of 97%). Consequently the most important variable influencing dinner meal size was not level of hunger but the nutrient content of the range of foods consumed. Analysis of dinner meal intake revealed a significant interaction between lunch meal size and dinner meal type. This means that when hunger level was high subjects over-ate on the high fat but not the high CHO foods. Average post-dinner intakes following the high fat and high CHO meals did not differ significantly.(ABSTRACT TRUNCATED AT 250 WORDS)