Pre-meal Hunger Research Articles

Youth's energy intake during a laboratory-based loss-of-control eating paradigm: Associations with reported current dieting

Dieting is theorized as a risk factor for loss-of-control (LOC)-eating (i.e., feeling a sense of lack of control while eating). Support for this association has largely relied on retrospective self-report data, which does not always correlate with objectively assessed eating behavior in youth. We hypothesized that during a laboratory-based LOC-eating paradigm, children and adolescents who reported current (at the time of the visit) dieting would consume meals consistent with LOC-eating (greater caloric intake, and intake of carbohydrates and fats, but less intake of protein). Participants were presented with a buffet-style meal and instructed to “Let yourself go and eat as much as you want.” Current dieting (i.e., any deliberate change to the amount or type of food eaten to influence shape or weight, regardless of how effective the changes are) was assessed via interview. General linear models were adjusted for fat mass (%), lean mass (kg), height, sex, protocol, race and ethnicity, pre-meal hunger and minutes since consumption of a breakfast shake. Of 337 participants (Mage 12.8 ± 2.7y; 62.3 % female; 45.7 % non- Hispanic White and 26.1 % non-Hispanic Black; MBMIz 0.78 ± 1.11), only 33 (9.8 %) reported current dieting. Current dieting was not significantly associated with total energy intake (F = 1.63, p = .20, ηp2 = 0.005), or intake from carbohydrates (F = 2.45, p = .12, ηp2 = 0.007), fat (F = 2.65, p = .10, ηp2 = 0.008), or protein (F = 0.39, p = .53, ηp2 = 0.001). Contrary to theories that dieting promotes LOC-eating, current dieting was not associated with youth's eating behavior in a laboratory setting. Experimental approaches for investigating dieting are needed to test theories that implicate dieting in pediatric LOC-eating.

FRI007 Kisspeptin Does Not Affect Food Intake In Women With Overweight Or Obesity

Abstract Disclosure: C. Izzi-Engbeaya: None. M. Choudhury: None. B. Patel: None. B. Muzi: None. A. Qayum: None. E.G. Mills: None. M. Ahsan: None. M. Phylactou: None. S. Clarke: None. L. Aslett: None. A.N. Comninos: None. A. Abbara: None. T. Tan: None. W.S. Dhillo: None. Background: Kisspeptin neurons in the hypothalamus are believed to play a role in mediating the interaction between metabolic and reproductive health. Functional neuroanatomical connections exist between kisspeptin neurons and appetite-regulating neurons in the arcuate nucleus of the hypothalamus. Female (but not male) global kisspeptin receptor knockout mice have reduced food intake compared to controls. However, studies of kisspeptin administration have yielded conflicting results, with either decreased, or unchanged food intake reported in rodent studies. Consistent with some of the literature, kisspeptin administration does not influence food intake in men. However, the effects of kisspeptin on food intake have not previously been studied in women. Research Question: What is the effect of kisspeptin administration on food intake in women? Methodology: A randomized controlled crossover study was performed in women with overweight or obesity (BMI >25 kg/m2) who were not in receipt of exogenous oral and/or transdermal estrogens or progestins. Each woman attended two study visits in random order following an overnight fast. During each study visit they received either a 2-hour intravenous infusion of kisspeptin-54 at a rate of 1.0 nmol/kg/hr, or a rate-matched vehicle infusion. The study was single-blinded, with participants unaware of the infusion identity. Participants were given an ad libitum meal 45 minutes after the start of each infusion. Blood samples were taken for reproductive and metabolic profiling, and visual analogue scales (VAS) to assess hunger were completed at regular intervals throughout both study visits. Data are presented as mean±SD. Results: 17 women (age 49±12 years, BMI 34±7 kg/m2) completed both study visits. As expected, LH levels were higher during kisspeptin than during vehicle infusion (p<0.01), confirming bioactivity of the kisspeptin dose. Pre-meal estradiol levels were similar during kisspeptin and vehicle infusions (p=0.34). There were no differences in pre-meal hunger VAS scores 30 mins after the start of the infusion (kisspeptin 5.2±2.7 vs vehicle 5.9±2.3, p=0.33) or bodyweight-adjusted food intake (kisspeptin 6.8±3.7 kcal/kg vs vehicle 6.2±2.8 kcal/kg, p=0.33). There were also no differences in glucose (p=0.97) or insulin (p=0.68) levels between kisspeptin and vehicle infusions. Conclusions: Acute intravenous administration of a biologically active dose of kisspeptin did not affect food intake or hunger in women with overweight or obesity. Furthermore, kisspeptin administration did not alter fasting or post-prandial glucose levels. This is the first study to examine the effects of kisspeptin on hunger and food intake in women and provides reassuring safety data for the ongoing development of kisspeptin-based therapeutics. Presentation: Friday, June 16, 2023

Dimensions of sleep quality are related to objectively measured eating behaviors among children at high familial risk for obesity.

The aim of this study was to evaluate whether dimensions of sleep quality were associated with homeostatic and hedonic eating behaviors among children with healthy weight (BMI-for-age < 90%) but varying maternal weight status. A total of 77 children (mean [SD], age: 7.4 [0.6] years; BMI z score: -0.10 [0.7]) with healthy weight and high (n= 32) or low (n= 45) familial obesity risk based on maternal weight status were served an ad libitum meal (homeostatic eating) followed by palatable snacks to assess eating in the absence of hunger (EAH; hedonic eating). Habitual sleep quality was quantified from seven nights of wrist actigraphy. Partial correlations, adjusted for child energy needs, pre-meal hunger, food liking, and socioeconomic status, evaluated associations of sleep with meal intake and EAH. Additionally, sleep-by-obesity risk interactions were assessed. Greater sleep fragmentation was associated with higher homeostatic meal energy intake, but only among children at high familial obesity risk (p value for interaction=0.001; β high risk=48.6, p= 0.001). Sleep fragmentation was not associated with total EAH but was related to higher and lower intake of carbohydrates (r= 0.33, p= 0.003) and fat (r= -0.33, p= 0.003), respectively. Adverse associations of poor sleep with energy intake may be amplified among children already predisposed to obesity. Furthermore, that fragmented sleep relates to preferential intake of carbohydrates over fat during EAH may suggest alterations in taste preferences with poor sleep.

Confusion of Alcohol Craving With Food Hunger in Alcohol-Dependent Individuals Entering In-Patient Drug Treatment.

To identify the distinguishing characteristics of alcohol dependent patients who confuse alcohol cravings with pre-meal hunger. Data were collected at interview on sociodemographic status, clinical status and anthropometry in 179 patients (163 men and 16 women) undergoing in-patient treatment for alcohol dependence. A comparison of the patient subgroups studied showed that patients who did not confuse, and those who did confuse, alcohol craving with pre-meal hunger differed significantly in terms of alcohol craving scale scores (9 vs. 4 points). Patients confusing alcohol cravings with pre-meal hunger were more likely to recognize that experiencing severe pre-meal hunger can cause relapse (67.9 vs. 22.8%) and that not being able to distinguish between the sensations under study also increases the risk of breaking abstinence (75.0% vs. 50.4%). This was independent of severity of dependence and intensity of recent alcohol consumption. Alcohol-dependent persons who confuse alcohol craving with pre-meal hunger differ from those who do not confuse these hunger pangs in terms of feeling stronger alcohol craving and more frequent occurrence of symptoms accompanying the feeling of alcohol craving during pre-meal hunger. At the start of treatment for alcohol withdrawal, alcohol-dependent individuals who report confusing alcohol cravings with pre-meal hunger are less confident of maintaining abstinence. This is relevant to treatment. The role of possible confounders (depressive symptoms, cognitive and educational deficiency) could not be elucidated definitively.

The effects of wholegrain processing on appetite: randomised crossover trial in adults with type 2 diabetes.

Aims: Recent observational data indicate higher ultra-processed food intakes are associated with a broad range of adverse health outcomes. Experimental studies on why this might be are lacking. We have considered the effects of wholegrain processing on measures of appetite in free-living adults with type 2 diabetes. Materials and methods: Participants were randomised to two interventions of two-weeks duration, separated by washout. Interventions were nutrient-matched wholegrain foods that differed by the amount of processing. Self-reported hunger and satiety were indicated on visual analogue scales before or after meals for four days at baseline and the end of each intervention. Metabolite markers of appetite were measured pre and post intervention in fasting plasma. Results: 31 adults (63 ± 13 years old, BMI 32.4 ± 7, HbA1c 7.5 ± 3.4% (59 ± 14 mmol mol-1)) commenced the trial, 28 (90%) completed both interventions. Wholegrain consumption, as measured by alkylresorcinols, was balanced between interventions. Self-reported pre-meal hunger was consistently lower at breakfast (MD, mean difference 0.49/10 95% CI 0.03 to 0.94), lunch (MD 0.67/10 95% CI 0.09 to 1.25), and dinner (MD -0.71/10 95% CI 0.19 to 1.23) during the intervention of less processed whole grains when compared with pre-intervention measures, however this did not result in a difference between interventions. Change in metabolite markers of appetite did not differ between interventions. Conclusions: A significant difference in hunger or satiety between less and more processed whole grains over intervention periods of two weeks was not detected within the current trial. Further experimental studies are needed to consider the potential effects of food processing on physiological processes such as appetite to provide mechanistic understanding behind observations of highly processed food intakes and adverse health outcomes.

Association Between State-Based and Trait-Based Responsiveness to Satiety Cues Differs by Child Risk for Overweight/Obesity

ObjectivesThe relationship between parentally reported satiety responsiveness (i.e., trait) and laboratory-assessed satiety responsiveness (i.e., state) in children is not known, making it difficult to interpret and generalize lab-based findings. In addition, while many studies have shown weight-related differences in children’s eating behaviors, less is known about appetitive traits that are present before obesity develops. Therefore, we examined associations between trait- and state-based satiety responsiveness among children with healthy weight who differed by familial risk for obesity. MethodsData from an ongoing longitudinal study were analyzed for 59 healthy-weight, 7–8 year-old children (BMI-for-age% < 85). Familial risk for obesity was determined by parental weight status as low-risk (N = 34, both parents’ BMIs < 25 kg/m2) or high-risk (N = 25, mothers’ BMI ≥ 30 kg/m2; fathers’ BMI ≥ 25 kg/m2). Parents completed the Children’s Eating Behavior Questionnaire to assess satiety responsiveness (SR), a measure of children’s tendency to stop eating once sated (trait). To assess state-based satiety, the Satiety Quotient (SQ) was calculated from an ad-libitum laboratory meal [(Pre-meal hunger – post-meal hunger)/meal intake in grams]. A higher SQ indicates a greater reduction in hunger per gram (i.e., better satiety responsiveness). ResultsOverall, SR and SQ were not correlated (P = 0.57). However, a linear regression controlling for pre-meal hunger and child BMI percentile revealed a risk status-by-SR interaction (β = 0.804, P = 0.04) such that SR was positively associated with SQ in high-risk children (95% CI [0.003, 0.430]), but there was no relationship between SR and SQ in low-risk children (95% CI [–0.203, 0.085]). No differences in SR, SQ, pre-meal hunger, or post-meal hunger were observed between risk groups. ConclusionsParentally reported (trait-based) satiety was positively associated with laboratory-assessed satiety, but only among healthy weight children at high-familial risk for obesity. Parents of children who are at high-risk for developing obesity may be more observant of children’s appetitive traits compared to parents of low-risk children, and this may be helpful in the prevention of obesity. Funding SourcesNIH RO1: DK110060.

Methodological issues in assessing change in dietary intake and appetite following gastric bypass surgery: A systematic review.

SummaryGastric bypass surgery is an effective long‐term treatment for individuals with severe obesity. Changes in appetite, dietary intake, and food preferences have all been postulated to contribute to postoperative body weight regulation, however, findings are inconsistent. The aim of this systematic review was to evaluate the current literature on changes in dietary intake and appetite following gastric bypass surgery, in the context of the methodology used and the analysis, interpretation, and presentation of results. Four databases were systematically searched with terms related to “gastric bypass surgery,” “appetite,” and “dietary intake,” and 49 papers (n = 2384 patients after gastric bypass) were eligible for inclusion. The evidence indicated that only a reduction in overall energy intake and an increase in postprandial satiety are maintained beyond 6‐month post‐surgery, whereas relative macronutrient intake and premeal hunger remain unchanged. However, available data were limited by inconsistencies in the methods, analysis, presentation, and interpretation of results. In particular, there was a reliance on data collected by subjective methods with minimal acknowledgment of the limitations, such as misreporting of food intake. There is a need for further work employing objective measurement of appetite and dietary intake following gastric bypass surgery to determine how these mechanisms may contribute to weight regulation in the longer term.

Improved Appetite Ratings with Addition of Self-monitoring Wearable Device to an 8-week Weight Loss Intervention Focused on Reducing Eating Rate (P16-005-19)

ObjectivesSubjective hunger, satiety, and appetite impact energy intake, so interventions addressing these are needed for weight management. This study examined effects on hunger, satiety, and appetite ratings when adding a self-monitoring wearable device to an 8-week weight loss intervention focused on reducing eating rate and dietary energy density, while increasing energy expenditure. The wrist-worn Eat Less Move More (ELMM) device tracks eating rate in seconds between bites, by time stamp and detection of wrist-roll motion, and tracks bites and steps taken. MethodsSeventy-two adults with overweight or obesity (age, 37.7 ± 15.3 years; BMI, 31.3 ± 3.2 kg/m2) were randomized into two groups: intervention workbook only, or intervention workbook plus device. Before and after the intervention, participants consumed a standardized laboratory test meal after an overnight fast, and rated their hunger, satiety, desire to eat, and thirst on Visual Analog Scales (VAS) pre- and post-meal, 20 minutes post-meal, and 60 minutes post-meal initiation. ResultsA 2 × 2 repeated measures MANOVA with fasting VAS ratings showed a significant time by group interaction (Wilks’ lambda = 0.81, F4,66 = 4.00, P = 0.007, partial eta squared = 0.19). Follow-up analyses showed a significant time by group effect for hunger (F1,69 = 9.56, P = 0.003, partial eta squared = 0.12), satiety (F1,69 = 5.23, P = 0.025, partial eta squared = 0.07), and desire to eat (F1,69 = 5.73, P = 0.02, partial eta squared = 0.08), but not for thirst. Post-meal analyses showed a significant group difference when controlling for total amount consumed (grams) and eating rate (grams/minute) (Wilks’ lambda = 0.75, F4,64 = 5.24, P = 0.001, partial eta squared = 0.25). Follow-up post-meal analyses showed a significant group effect for satiety (F1,67 = 7.02, P = 0.01, partial eta squared = 0.10), but not for hunger, desire to eat or thirst. Thus, participants who had used the self-monitoring device reported reduced pre-meal hunger, increased satiety, and reduced desire to eat, as well as increased post-meal satiety, when compared to those who had not used the device. ConclusionsThese findings demonstrate that the addition of a self-monitoring device to a weight loss intervention focused on reducing eating rate, decreasing energy density, and increasing energy expenditure may be beneficial. Funding SourcesThe Obesity Society.

Restricting carbohydrates at breakfast is sufficient to reduce 24-hour exposure to postprandial hyperglycemia and improve glycemic variability

The breakfast meal often results in the largest postprandial hyperglycemic excursion in people with type 2 diabetes. Our purpose was to investigate whether restricting carbohydrates at breakfast would be a simple and feasible strategy to reduce daily exposure to postprandial hyperglycemia. Adults with physician-diagnosed type 2 diabetes [n=23; mean ± SD age: 59±11 y; glycated hemoglobin: 6.7%±0.6%; body mass index (kg/m2): 31±7] completed two 24-h isocaloric intervention periods in a random order. Participants consumed one of the following breakfasts: 1) a very-low-carbohydrate high-fat breakfast (LCBF;<10% of energy from carbohydrate, 85% of energy from fat, 15% of energy from protein) or 2) a breakfast with dietary guidelines-recommended nutrient profile (GLBF; 55% of energy from carbohydrate, 30% of energy from fat, 15% of energy from protein), with the same lunch and dinner provided. Continuous glucose monitoring was used to assess postprandial glucose responses over 24 h, and visual analog scales were used to assess ratings of hunger and fullness. The LCBF significantly reduced postprandial hyperglycemia after breakfast (P<0.01) and did not adversely affect glycemia after lunch or dinner. As such, overall postprandial hyperglycemia (24-h incremental area under the glucose curve) and glycemic variability (mean amplitude of glycemic excursions) were reduced with the LCBF (24-h incremental area under the glucose curve: -173±361 mmol/L; P=0.03; mean amplitude of glycemic excursions: -0.4±0.8 mmol/L · 24 h; P=0.03) compared with the GLBF. Premeal hunger was lower before dinner with the LCBF than with the GLBF (P-interaction=0.03). A very-low-carbohydrate high-fat breakfast lowers postbreakfast glucose excursions. The effects of this simple strategy appear to be sufficient to lower overall exposure to postprandial hyperglycemia and improve glycemic variability. Longer-term interventions are warranted. This trial was registered at clinicaltrials.gov as NCT02982330.

Menu Labels Displaying the Kilocalorie Content or the Exercise Equivalent: Effects on Energy Ordered and Consumed in Young Adults

Determine the effect of menu labels displaying the energy content of food items or the exercise equivalent on energy ordered and consumed at lunch and energy intake for the remainder of the day in young adults. Subjects were randomized to a menu with no labels (no-labels), menu with kilocalorie labels displaying the energy content of the food items (kcal-labels), or menu with exercise labels displaying the minutes of brisk walking needed to burn the food energy (exercise-labels). The study was conducted in one dining area located in a metabolic kitchen at the Texas Christian University and another located in a residence occupied by graduate students. Of the 300 subjects, 55.7% were female, 77.3% were college students, 88% were white, and 88% were non-Hispanic. Mean body mass index and age were 24.2 ± 4.5 kg/m(2) and 21.9 ± 2.3 years, respectively. All menus contained the same food/beverage choices. Subjects ordered and consumed foods/beverages for lunch from the menu to which they were assigned. Subjects were blinded to study purpose. Energy ordered and consumed at lunch were assessed from the weight of the food ordered and consumed, respectively, and the energy content of the same foods available on the restaurant Web site. Postlunch energy intake was assessed by food recall. Analysis of covariance, adjusted for premeal hunger levels and gender, determined the effect of menu type on energy ordered and consumed and postlunch energy intake. Significant menu effect was observed for energy ordered (p = .008) and consumed (p = .04) at lunch. The exercise-labels group ordered significantly (p = .002) less energy (adjusted mean [confidence intervals]: 763 [703, 824] kcal) at lunch, compared to the no-labels group (902 [840, 963] kcal) but not compared to the kcal-labels group (827 [766, 888] kcal). The exercise-labels group also consumed significantly (p = .01) less energy (673 [620, 725] kcal) at lunch, compared to the no-labels group (770 (717, 823) kcal) but not compared to the kcal-labels group (722 [669, 776] kcal). Energy ordered and consumed were not different between kcal-labels and no-labels groups. There was no difference in postlunch energy intake by menu type. The menu with exercise-labels resulted in less energy ordered and consumed and this did not lead to greater energy consumption post lunch, compared to the menu with no-labels in young adults largely made up of normal-weight, non-Hispanic white college students.

Sugar-containing drinks. Why do men compensate more than women?

It has been suggested that sugar consumed in a drink fails to suppress appetite; however, studies have typically found at least some reduction in test meal intake after a drink containing sugar compared with an intense sweetener (or plain water). Recently we have observed a gender difference in such compensation (Proc. Nutr. Soc. 70 (OCE6), E401). This was replicated in the present study ( n = 96) in which men and women ate respectively 175 kcal ( p = .002) and 26 kcal (ns) less in a test meal after a sugar-sweetened compared with a sucralose-sweetened blackcurrant drink (energy difference between drinks = 161 kcal). This gender difference in compensation was not accounted for by differences in disinhibited eating, or a mixed pattern of habitual intake of ‘diet’ and sugar-sweetened soft drinks. Nor did women appear to lack sensitivity to the presence of sugar in the drink, as this suppressed their pre-meal hunger to the same extent as it did in men. Instead we propose that the explanation lies in greater cognitive versus physiological control of test meal intake in women than in men. Consistent with this women scored higher on dietary restraint, and in another study women showed a reduction in test meal intake after a milk preload (perhaps perceived as ‘food’) but not after an equi-caloric sugar-containing drink, whereas men showed full compensation after both (Ranawana & Henry, Appetite 55, 137). Funded by Sugar Nutrition UK.

The Effect of Menu Labels, Displaying Minutes of Brisk Walking Needed to Burn Food Calories, on Calories Ordered and Consumed in Young Adults

The effect of menu labels displaying amount of exercise needed to burn the food calories on foods ordered and consumed is unknown. Three hundred (18–30 y) men and women were randomly assigned to a menu without calorie labels (NCL) (n=99), a menu with calorie labels (CL) (n=99), or a menu with labels on the minutes of brisk walking needed to burn the food calories (EL) (n=102). All menus contained the same food/beverage options. Subjects were blinded to study purpose. Analysis of covariance, adjusted for pre‐meal hunger levels and sex, was used to examine the effect of the study menu condition on the outcome variables. There was a menu main effect for calories ordered (p=0.008) and consumed (p=0.04). Fewer calories were ordered (adjusted mean (CI): 763 (703, 824) vs. 902 (840, 963) kcal, respectively; p=0.002) and consumed (673 (620, 725) vs. 770 (717, 823) kcal respectively; p=0.01) by the EL compared to NCL group. There was no difference between the CL and NCL groups in food calories ordered (827 (766, 888) vs. 902 (840, 963) kcal, respectively; p=0.09) and consumed (722 (669, 776) vs. 770 (717, 823) kcal, respectively; p=0.21). Calories ordered (p=0.15) and consumed (p=0.19) were not different between the CL and EL groups. There was no difference in post lunch calorie intake by menu condition (p=0.39). In conclusion, EL menu led to fewer calories ordered and consumed compared to the NCL menu condition. Study was supported by TCU.

Influence of environmental factors on food intake and choice of beverage during meals in teenagers: a laboratory study

Environmental conditions influence meal size in adults and children. Intake of sweet drinks could contribute significantly to energy intake and potentially affect body weight, particularly in young individuals. The objectives of the present study were to measure the lunch intake of food and drinks under controlled laboratory settings in teenagers and to compare the influence of different meal conditions. Normal-weight adolescents (fourteen males and fifteen females) participated in four standardised lunches, scheduled 1 week apart. The same popular items (meat dish, dessert, water, juice, soda) were served at all meals. Ad libitum intake was measured under four conditions: subjects ate alone; in groups; alone while viewing television; alone while listening to music. Visual analogue scales were used to assess pre- and post-meal hunger and thirst and meal palatability. Energy, solid food and fluid intake was different (significantly lower) only in the 'eating in group' condition, in spite of identical intensity of pre-meal hunger. More soda was consumed when participants were watching television, and more water was consumed while listening to music. Across all conditions, more soda than water was consumed. Post-meal ratings of hunger, thirst and palatability did not differ between conditions. We concluded that, in teenagers, a 'social inhibition' effect appears rather than the 'social facilitation' previously reported in adults. Although teenagers do not respond to the presence of television or another 'distractor' such as music by eating more, they do ingest more soda when the television is on. The social significance of meals, conditioned responses and habituation to 'distractors' may be different between adolescents and adults.

Increases in energy, protein and fat intake following the addition of sauce to an older person’s meal

Energy intake in 15–20% of the UK older population is currently thought to be inadequate for health. Based on the suggestion that increases in food pleasantness and familiarity can increase intake, this study investigated the impact of the addition of sauce to an older person’s meal on subsequent intake. Twenty-eight older people consumed two meals with sauce and the same two meals without sauce on different occasions, and amount consumed in terms of weight, energy and energy consumed from carbohydrate, fat and protein were compared. Pre-meal hunger and desire to eat, post-meal pleasantness and familiarity and participants’ expectations of the effects of sauces were also measured. Compared to meals without sauce, meals with sauce were found to result in greater intakes of energy, energy consumed from protein and energy consumed from fat (smallest t(27) = 2.13, p = 0.04). No differences between conditions were found in measures of pre-meal hunger and desire to eat, or post-meal pleasantness and familiarity (largest t(27) = 1.47, p = 0.15). Similar effects were also found when participant expectations were taken into account, and no differences between participants who expected sauces to affect intake vs. those who did not expect sauces to affect intake were found (largest F(1, 26) = 1.70, p = 0.20). These findings suggest that the addition of sauce to an older person’s meal can result in increases in intake and may be beneficial for preventing or treating under-nutrition in these individuals, although the mechanisms by which sauces can increase intake are unlikely to be related to pleasantness and familiarity.

Greater energy, protein and fat intake following the addition of sauce to an older adult's meal

). The present study has investigated the impact of the addition of sauce to an olderadultOs meal on short-term intake.Twenty-eight individuals aged > 65 years were recruited from Þve residential homes in Belfast, UK. All participants undertook thestudy on four separate occasions during the main meal of the day. On two occasions each participant received their main meal with nosauce, on the other two occasions each participant received the same main meal with sauce (gravy, white sauce, mustard sauce andtomato-based sauce). Intake during each meal was calculated based on weight consumed of all individual food items. Pleasantness andfamiliarity were measured following consumption, using Þve-point Likert scales. Hunger and desire to eat were also measured before thestart of each meal to ensure against confounding, again using Þve-point Likert scales. Sauce v. no-sauce conditions were compared usingrepeated measured t tests.Compared with meals with no sauce, meals with sauce were found to result in signiÞcantly greater intakes of energy (t(27) 2.18,P = 0.04), energy consumed from protein (t(27) 2.97, P < 0.01) and energy consumed from fat (t(27) 2.62, P = 0.01). No differences werefound between meals with and without sauce in weight of food consumed and energy consumed from carbohydrate (largest t(27) - 0.85,P = 0.40). No differences were found between meals with and without sauce in pre-meal hunger or desire to eat (largest t(27) 0.58,P = 0.57), or in amount of food provided (t(109) 0.13, P = 0.89). Post-meal ratings of pleasantness or familiarity were also found not todiffer between meals with and without sauce (largest t(27) 1.47, P = 0.15). A similar pattern of results was also found when participantexpectations were taken into account, with no differences between individuals who expected sauces to have an effect on intake andindividuals who expected no effects (largest F(1,26) 3.38, P = 0.08).The Þndings of the study suggest that the addition of sauce to an older adultOsO meal can result in increases in total energy consumedand in energy consumed from protein and fat. These Þndings suggest that sauces may provide a potential means of increasing energyintake in older adults. Similar Þndings have also been suggested elsewhere using condiments

Change in hunger, fullness, ghrelin, PYY and GLP-1 in relation to a fixed test meal pre and post Rou-en-Y gastric bypass (RYGBS).

Bariatric surgery is the most effective treatment for achieving long-term weight loss in clinically severe obese patients. This study examines changes in hunger, fullness and appetite hormones in relation to a fixed meal in patients pre and 5 months post-RYGBS. There were 10 severely obese, otherwise healthy premenopausal women, BMI=45.3±6.8 SD, % body fat (BODPOD)=53.6±6.0, age=35±9.3. Ratings of hunger and fullness immediately preceded blood draws at 0, 15, 30, 60 min in relation to a fixed complete liquid meal of Glytrol, 250 ml, 1kcal/ml, consumed at 0–10 min. The meal was presented at 2 pm following an overnight 18-h fast. Results revealed a decline in hunger prior to the meal ( p =.013) and an increase ( p =.009) in area under the curve (AUC) for fullness from pre to post 5 months. However, fasting ghrelin and AUC for ghrelin did not change from pre to post-5 months. AUC for PYY ( p =.009) and GLP-1 ( p =.004) increased from pre- to 5 months post-surgery. However, the change in hunger did not correlate with the change in fasting ghrelin and the change in fullness AUC did not correlate with the changes in AUC for GLP-1 or PYY. Moreover, the reduction in stomach capacity itself would not be able to help explain the reduction in premeal hunger post-surgery. Thus, other biological mechanisms to explain the changes in hunger and fullness post-RYGBS should be explored. Supported by NIH DK 61519 and MO1 RROO64529.

Ghrelin and Energy Balance: Focus on Current Controversies

Ghrelin is an enteric peptide that is the only known circulating appetite stimulant. This feature of the hormone has garnered widespread attention, as reflected by more than 1000 scientific papers featuring ghrelin that have been published since the first reports of its orexigenic actions, approximately four years ago. In this review, we discuss data that support roles for ghrelin in the short-term regulation of pre-meal hunger and meal initiation, functioning as a unique orexigenic counterpart to short-acting gastrointestinal satiation factors, such as cholecystokinin (CCK). We also highlight evidence indicating that ghrelin satisfies recognized criteria to be viewed as a participant in long-term body-weight regulation--a potential anabolic counterpart to the traditional adiposity hormones, leptin and insulin. We then discuss the following controversial questions in ghrelin research and offer our opinions regarding these debates. (1) Is ghrelin synthesized within the brain? (2) How does ghrelin increase food intake? (3) Does des-acyl ghrelin have a physiologic function? (4) Are there receptors for ghrelin other than GHS-R1a? (5) Does ghrelin regulate insulin secretion? (6) Does ghrelin regulate gastrointestinal motility? (7) Can ghrelin or ghrelin-receptor agonists be used to treat wasting conditions? Finally, we offer a speculative model of ghrelin as a thrifty gene product that evolved to help animals consume and store fat well, thereby increasing their chances of survival during times of famine. We suggest that ghrelin is a "saginary" hormone, from the Latin, saginare, which means, "to fatten".

Roles for ghrelin in the regulation of appetite and body weight

Ghrelin, the only known circulating appetite stimulant, has garnered widespread scientific interest and is currently featured in more than 2.3 new publications per day. Antagonists and agonists of its receptor are vigorously being developed by pharmaceutical companies to treat obesity and wasting conditions respectively. Here, the authors summarize the current state of knowledge regarding ghrelin's roles in energy homeostasis. Ghrelin is an acylated peptide produced primarily by the stomach and proximal small intestine. Circulating levels sharply increase before, and decrease after, meals. These and other findings implicate ghrelin in pre-meal hunger and meal initiation. Moreover, ghrelin satisfies established criteria for an adiposity-associated hormone involved in long-term body weight regulation. Blood levels correlate with energy stores and display compensatory changes in response to alterations of those stores. Ghrelin influences neuronal activity in brain areas critical to energy homeostasis. Excessive ghrelin signaling durably increases food intake and decreases energy expenditure, thereby promoting weight gain. Conversely, acute ghrelin blockade in adult animals reduces food intake and body weight, although the effects of lifelong genetic deletions are very subtle. Overproduction of ghrelin is etiologically implicated in Prader-Willi syndrome, whereas defective secretion may contribute to weight loss after gastric bypass surgery. Ghrelin appears to participate in mealtime hunger and meal initiation, as well as in long-term energy balance. Whether these roles are sufficiently important that ghrelin blockade will prove to be an effective antiobesity modality is a pivotal question that should soon be answered as ghrelin receptor antagonists are developed. Ghrelin agonists hold promise in the treatment of wasting conditions, for which few medications currently exist.

Effects of short-term overfeeding on hunger, satiety, and energy intake in thin and reduced-obese individuals

Background Certain individuals appear to be resistant to weight gain in an obesigenic environment, yet the mechanisms for this adaptation are unclear. These individuals may sense positive energy balance more appropriately than those individuals prone to weight gain. Research methods and procedures Thirteen thin (7 women, 6 men) and 9 reduced-obese (5 women, 4 men) individuals were studied. Measures of intake were obtained using visual analog scales before and after each meal during eucaloric feeding and during three days of 50% overfeeding. Ad libitum energy intake was measured post-overfeeding. Results Overfeeding resulted in a significant reduction in pre-meal hunger in the thin (68±6 to 41±6 mm, p<0.0001) compared to the reduced-obese individuals (63±7 to 65±7 mm, p=0.67). There was a significantly greater increase ( p=0.0016) in post-meal satiety scores during overfeeding in the thin (65±4 to 88±4 mm, p<0.0001) compared to the reduced-obese individuals (72±5 to 80±5 mm, p=0.04). Thin women had a 30% reduction in daily energy intake (1831±47 to 1273±79 kcal/day, p=0.005) after overfeeding while no difference was seen in the thin men or reduced-obese group. Discussion Thin individuals appear to sense positive energy balance more appropriately with changes in measures of intake than reduced-obese individuals. These findings are especially true in thin women.

Appetite regulation: from the gut to the hypothalamus.

these proportions had increased to 26% and 22%, respectively, with 55% of women and 66% of men being overweight (BMI > 25 kg/m 2 ; Health Survey for England, 2001), reflecting a worldwide trend which is most marked in, but not restricted to, the developed world. Most of us in affluent countries live in a privileged land of plenty where high calorie foods are easily available and in which we have a limited need for exercise. The rising prevalence of obesity in children is of particular concern (Chinn & Rona, 2001).