Sugar-sweetened Soft Drinks Research Articles

Associations between dietary intake and body fat independent of genetic and familial environmental background

To determine whether habitual dietary intake was associated with body fat mass and body fat distribution, independently of possible confounding by the genetic and shared environmental background. We examined correlations between intrapair differences in specific dietary composition and intake of foods and macronutrients in relation to differences in anthropometric phenotypes in a population-based sample of monozygotic twins. Data originated from a cross-sectional study, conducted in 1997-2000, of healthy twin pairs with measured anthropometry and information from food frequency questionnaire supplemented by self-reported weight from 1994 to 2002 and self-reported waist circumference from 2002. For this study, 153 men and 158 women identical twin pairs were included. Intrapair differences in dietary factors and anthropometry were studied using correlation analyses. Only few statistically significant correlations between intrapair differences in dietary intake and anthropometry were found. Consistent positive associations were found between intake of sugar-sweetened soft drinks and body fat in men, but not in women. Intake of vegetable oil was inversely associated with waist change in men. Only the latter finding remained significant when accounting for multiple testing. Only few associations between individually modifiable dietary factors and body fat measures were found, and only among men. Intake of vegetable oil was inversely related to waist change and intake of sugar-sweetened soft drinks was directly related to body fat in men.

Sugar and fat intake among children in Scotland: what is needed to reach the dietary targets?

To assess the intake and sources of non-milk extrinsic sugars (NMES) and fat among children in Scotland in relation to socio-economic status, and to estimate the changes in diet required to achieve recommended levels of intake. Cross-sectional survey with diet assessed by semi-quantitative FFQ. Eighty postcode sectors across Scotland. Children (n 1398) aged 3-17 years recruited from the Child Benefit register (76 % of those contacted). The mean intake of NMES of 17.4 (95 % CI 17.0, 17.8) % food energy was considerably higher than the UK recommended population average of 11 % food energy. The mean intake of total fat of 32.9 (95 % CI 32.7, 33.2) % food energy met the recommended population average of no more than 35 % food energy, while the mean intake of SFA of 13.8 (95 % CI 13.7, 14.0) % food energy was above the recommended population average of no more than 11 % food energy. Despite clear socio-economic gradients in the mean daily consumption of many 'healthy' and 'unhealthy' food groups, socio-economic differences in NMES as a percentage of food energy were limited and there was no significant variation in the intake of total fat or SFA as a percentage of food energy with socio-economic status. Modelling of the data showed that removing sugar-sweetened soft drinks and increasing fruit and vegetable intake by 50 % would not restore the intake of NMES and SFA to recommended levels. Major changes in the intake of many food groups will be required to bring the NMES and saturated fat intake in line with current dietary recommendations.

Use of artificial sweeteners and fat-modified foods in weight loss maintainers and always-normal weight individuals

ObjectiveThe purpose of this study was to compare the dietary strategies and use of fat and sugar-modified foods and beverages in a weight loss maintainer group (WLM) and an always normal weight group (NW).SubjectsWLM (N = 172) had maintained ≥ 10% weight loss for 11.5 yr, and had a BMI of 22.0 kg/m2. NW (N=131) had a BMI of 21.3 kg/m2 and no history of overweight. Three, 24-h recalls on random, non-consecutive days were used to assess dietary intake.ResultsWLM reported consuming a diet that was lower in fat (28.7% vs. 32.6%, p < .0001) and used more fat-modification strategies than NW. WLM also consumed a significantly greater percentage of modified dairy (60% vs. 49%; p = .002) and modified dressings and sauces (55% vs. 44%; p = .006) than NW. WLM reported consuming three times more daily servings of artificially sweetened soft drinks (0.91 vs. 0.37; p = .003), significantly fewer daily servings of sugar-sweetened soft drinks (0.07 vs. 0.16; p =.03), and more daily servings of water (4.72 vs 3.48; p=.002) than NW.ConclusionsThese findings suggests that WLM use more dietary strategies to accomplish their weight loss maintenance, including greater restriction of fat intake, use of fat- and sugar-modified foods, reduced consumption of sugar-sweetened beverages, and increased consumption of artificially sweetened beverages. Ways to promote the use of fat-modified foods and artificial sweeteners merits further research in both prevention and treatment controlled trials.

Sweets and sugar-sweetened soft drink intake in childhood in relation to adult BMI and overweight. The Cardiovascular Risk in Young Finns Study

To investigate the associations of BMI and overweight in adulthood with consumption of sweets and sugar-sweetened soft drinks in childhood and with the change in consumption between childhood and adulthood. Longitudinal 21-year follow-up study of Finnish children and adolescents from childhood to adulthood. The Cardiovascular Risk in Young Finns Study, comprising participants from both eastern and western Finland. Boys (n 967) and girls (n 1172) aged 3-18 years at baseline in 1980. The increase in consumption of sugar-sweetened soft drinks from childhood to adulthood was directly associated with BMI in adulthood in women (b = 0.45, P = 0.0001) but not in men. In women, BMI increased by 0.45 kg/m2 for every 10-unit increase per month. Consumption of sweets and sugar-sweetened soft drinks in childhood and adolescence was not associated with BMI in adulthood. The change in consumption of sweets was not associated with BMI in adulthood. The increase in the consumption of sugar-sweetened soft drinks from childhood to adulthood was associated with being overweight (OR = 1.90, 95 % CI 1.38, 2.61) in women, but not in men. No association was found between overweight (BMI >or= 25 kg/m2) in adulthood and consumption of sweets in childhood or the change in consumption from childhood to adulthood. We conclude that direct associations exist between adulthood overweight and BMI and an increase in consumption of sugar-sweetened soft drinks in women. Thus sugar-sweetened soft drinks consumption may be important when considering weight management in women.

Update on factors predisposing to gout

Recent genetic, epidemiological and clinical studies have confirmed multiple factors predisposing to gout. Polymorphisms have been identified in genes encoding renal urate transporters and inflammatory cytokines. Epidemiological studies have established alcohol, dietary factors, hypertension, obesity, insulin resistance, diuretic therapy and chronic renal disease as independent risk factors predisposing to gout. In addition to the well-recognized influence of dietary purines, causative roles have been suggested for fructose and sugar-sweetened soft drinks, and protective roles for dairy products, coffee and vitamin C. Gout makes an independent contribution to the development of diabetes and cardiovascular disease. Osteoarthritis appears to predispose to local crystal deposition, but is not a risk factor for the development of gout per se.

Sugar-sweetened soft drinks and obesity: a systematic review of the evidence from observational studies and interventions

Sugar-sweetened soft drinks (SSD) are a special target of many obesity-prevention strategies, yet critical reviews tend to be more cautious regarding the aetiological role of SSD in promoting excess body weight. Since ongoing evaluation of this issue is important, the present systematic review re-examined the evidence from epidemiological studies and interventions, up to July 2008. Database searches of Medline, Cochrane reviews, Google scholar and a hand search of cross-references identified forty-four original studies (twenty-three cross-sectional, seventeen prospective and four intervention) in adults and children, as well as six reviews. These were critically examined for methodology, results and interpretation. Approximately half the cross-sectional and prospective studies found a statistically significant association between SSD consumption and BMI, weight, adiposity or weight gain in at least one subgroup. The totality of evidence is dominated by American studies where SSD consumption tends to be higher and formulations different. Most studies suggest that the effect of SSD is small except in susceptible individuals or at high levels of intake. Methodological weaknesses mean that many studies cannot detect whether soft drinks or other aspects of diet and lifestyle have contributed to excess body weight. Progress in reaching a definitive conclusion on the role of SSD in obesity is hampered by the paucity of good-quality interventions which reliably monitor diet and lifestyle and adequately report effect sizes. Of the three long-term (>6 months) interventions, one reported a decrease in obesity prevalence but no change in mean BMI and two found a significant impact only among children already overweight at baseline. Of the six reviews, two concluded that the evidence was strong, one that an association was probable, while three described it as inconclusive, equivocal or near zero. Reasons for some discrepancies are presented.

Soft drinks and 'desire to drink' in preschoolers.

Interest in soft drink consumption has increased following a dramatic rise in intake over recent years. Research to date has focused primarily on general trends in consumption or on understanding the mechanism by which soft drink consumption may be linked to weight gain. It is clear however that there is considerable individual variability in the extent to which soft drinks are consumed and factors potentially influencing intake have received little attention. This study examines how the Child Eating Behaviour Questionnaire (CEBQ) construct 'Desire to Drink' (DD) relates to drink consumption, preferences and BMI-SDS.Three hundred and forty six same-sex twin children (mean age 11.2 years; s.d. 0.54; 56% female; 53% dizygotic) were weighed, measured and reported their liking for milk, water, fruit juice, fruit squash and sweetened soft drinks. Mothers reported on their child's drink consumption and completed the CEBQ.Scores on the CEBQ DD subscale were not significantly related to child BMI-SDS in this sample. Children scoring higher on DD had higher preferences for sugar-sweetened soft drinks (p = 0.016), fruit squash (p = 0.042) and milk (p = 0.020) than children scoring lower on the scale. DD was also positively related to more frequent consumption of sugar-sweetened soft drinks (p = 0.017) and low calorie soft drinks (p = 0.003). No relationship was observed between DD scores and liking for or intake of water or 100% fruit juice.These findings suggest that the construct desire to drink in children is related to a liking for consuming sweetened drinks, and does not appear to simply denote greater thirst or hunger. This may have important implications for the ongoing development of dietary patterns and weight status in the longer term through an increased preference for sweet things in the mouth and a failure to compensate for calories provided by drinks.

Consumption of ‘extra’ foods by Australian adults: types, quantities and contribution to energy and nutrient intakes

To identify the types and quantities of 'extra' foods, or energy-dense, nutrient-poor foods, consumed by Australian adults, and assess their contribution to total energy and nutrient intakes. We used 24-h recall data from 10 851 adults, aged 19 years and over, who participated in the nationally representative 1995 National Nutrition Survey. 'Extra' foods were defined using principles outlined in the Australian Guide to Healthy Eating and by applying cut points for maximum amounts of fat and sugar within each food category. 'Extra' foods contributed to 36% of daily energy intake with the highest contributors being fried potatoes (2.8%), margarine (2.6%), cakes and muffins (2.5%), beer (2.4%), sugar-sweetened soft drinks (2.4%), and meat pies (2.2%). Both age and sex were important determinants of 'extra' foods intake; younger adults were more likely to consume sugar-sweetened soft drinks, fried potatoes, meat pies and savoury pastries, pizza, crisps, lollies and chocolate; whereas older adults were more likely to consume sweet and savoury biscuits, cakes and muffins, margarine and butter. In all age groups, 'extra' foods contributed more to energy intake for men than women. Overall, 'extra' foods contributed 16% protein, 41% total fat, 41% saturated fat, 47% sugar and approximately 20% of selected micronutrients to the diet. 'Extra' foods contribute excessively to the energy, fat and sugar intakes of Australian adults, while providing relatively few micronutrients. This is of concern for the increasing risk of overweight and chronic disease and poor micronutrient status.

Sugar-Sweetened Beverages and Incidence of Type 2 Diabetes Mellitus in African American Women

Type 2 diabetes mellitus is an increasingly serious health problem among African American women. Consumption of sugar-sweetened drinks was associated with an increased risk of diabetes in 2 studies but not in a third; however, to our knowledge, no data are available on African Americans regarding this issue. Our objective was to examine the association between consumption of sugar-sweetened beverages, weight gain, and incidence of type 2 diabetes mellitus in African American women. A prospective follow-up study of 59,000 African American women has been in progress since 1995. Participants reported on food and beverage consumption in 1995 and 2001. Biennial follow-up questionnaires ascertained new diagnoses of type 2 diabetes. The present analyses included 43,960 women who gave complete dietary and weight information and were free from diabetes at baseline. We identified 2713 incident cases of type 2 diabetes mellitus during 338,884 person-years of follow-up. The main outcome measure was the incidence of type 2 diabetes mellitus. The incidence of type 2 diabetes mellitus was higher with higher intake of both sugar-sweetened soft drinks and fruit drinks. After adjustment for confounding variables including other dietary factors, the incidence rate ratio for 2 or more soft drinks per day was 1.24 (95% confidence interval, 1.06-1.45). For fruit drinks, the comparable incidence rate ratio was 1.31 (95% confidence interval, 1.13-1.52). The association of diabetes with soft drink consumption was almost entirely mediated by body mass index, whereas the association with fruit drink consumption was independent of body mass index. Regular consumption of sugar-sweetened soft drinks and fruit drinks is associated with an increased risk of type 2 diabetes mellitus in African American women. While there has been increasing public awareness of the adverse health effects of soft drinks, little attention has been given to fruit drinks, which are often marketed as a healthier alternative to soft drinks.

Salt Intake Is Related to Soft Drink Consumption in Children and Adolescents: A Link to Obesity?

To the Editor: The hypothesis that salt intake is a driver of soft drink consumption1 is an interesting one, but unfortunately this study takes us no further than speculation. Having experience in epidemiological analysis of the National Diet and Nutrition Survey, I beg to differ with the calculations in this article and also the authors’ interpretations. Specifically, I suggest the following: (1) the energy from soft drinks in the National Diet and Nutrition Survey is half what these authors estimate; (2) their study does not “demonstrate that salt is a major determinant of fluid and sugar-sweetened soft drink consumption during childhood” (only ≈2% of the …

Lifestyle and gout

This review summarizes recent epidemiologic research findings on gout, and attempts to put them into the context of clinical and public health decision-making aimed at prevention and improved management of gout. A large prospective study found that coffee consumption was inversely associated with risk of gout and that consumption of sugar-sweetened soft drinks or fructose was strongly associated with an increased gout risk. Studies based on the Third National Health and Nutrition Examination Survey (NHANES III) suggest that these consumptions affect serum uric acid levels parallel to the direction of gout risk. Furthermore, data from NHANES III show a remarkably high prevalence of the metabolic syndrome among individuals with gout. Prospective studies found an increased risk of myocardial infarction and cardiovascular mortality in gout patients. Lifestyle and dietary recommendations for gout patients should consider other health benefits, since gout is often associated with major chronic disorders such as the metabolic syndrome and an increased risk for cardiovascular disease and mortality. In addition to recent dietary recommendations, gout patients should be advised to limit fructose intake. The inverse link between coffee and the risk of gout suggests that coffee could be allowed among gout patients.

Salt Intake Is Related to Soft Drink Consumption in Children and Adolescents

Dietary salt is a major determinant of fluid intake in adults; however, little is known about this relationship in children. Sugar-sweetened soft drink consumption is related to childhood obesity, but it is unclear whether there is a link between salt and sugar-sweetened soft drink consumption. We analyzed the data of a cross-sectional study, the National Diet and Nutrition Survey for young people in Great Britain. Salt intake and fluid intake were assessed in 1688 participants aged 4 to 18 years, using a 7-day dietary record. There was a significant association between salt intake and total fluid, as well as sugar-sweetened soft drink consumption (P<0.001), after adjusting for potential confounding factors. A difference of 1 g/d in salt intake was associated with a difference of 100 and 27 g/d in total fluid and sugar-sweetened soft drink consumption, respectively. These results, in conjunction with other evidence, particularly that from experimental studies where only salt intake was changed, demonstrate that salt is a major determinant of fluid and sugar-sweetened soft drink consumption during childhood. If salt intake in children in the United Kingdom was reduced by half (mean decrease: 3 g/d), there would be an average reduction of approximately 2.3 sugar-sweetened soft drinks per week per child. A reduction in salt intake could, therefore, play a role in helping to reduce childhood obesity through its effect on sugar-sweetened soft drink consumption. This would have a beneficial effect on preventing cardiovascular disease independent of and additive to the effect of salt reduction on blood pressure.

Fructose intake as a risk factor for kidney stone disease

Taylor and Curhan report that consumption of fructose is independently associated with an increased risk of incident kidney stones. What could be the mechanisms underlying the relation between fructose intake and stone risk? And how should we incorporate this finding into the dietary advice that we give to our patients to prevent kidney stone formation?

Fructose Consumption and Risk for Gout

In recent decades, consumption of sugar-sweetened soft drinks (which contain high-fructose corn syrup) has increased dramatically in the U.S., and, at the same time, the prevalence and incidence of gout also have increased. Since fructose consumption rapidly increases blood uric-acid levels, might fructose consumption contribute to risk for …

Sugar‐sweetened soft drinks, diet soft drinks, and serum uric acid level: The third national health and nutrition examination survey

Sugar-sweetened soft drinks contain large amounts of fructose, which may significantly increase serum uric acid levels and the risk of gout. Our objective was to evaluate the relationship between sugar-sweetened soft drink intake, diet soft drink intake, and serum uric acid levels in a nationally representative sample of men and women. Using data from 14,761 participants age>or=20 years from the Third National Health and Nutrition Examination Survey (1988-1994), we examined the relationship between soft drink consumption and serum uric acid levels using linear regression. Additionally, we examined the relationship between soft drink consumption and hyperuricemia (serum uric acid level>7.0 mg/dl for men and >5.7 mg/dl for women) using logistic regression. Intake was assessed by a food-frequency questionnaire. Serum uric acid levels increased with increasing sugar-sweetened soft drink intake. After adjusting for covariates, serum uric acid levels associated with sugar-sweetened soft drink consumption categories (<0.5, 0.5-0.9, 1-3.9, and >or=4 servings/day) were greater than those associated with no intake by 0.08, 0.15, 0.33, and 0.42 mg/dl, respectively (95% confidence interval 0.11, 0.73; P<0.001 for trend). The multivariate odds ratios for hyperuricemia according to the corresponding sweetened soft drink consumption levels were 1.01, 1.34, 1.51, and 1.82, respectively (P=0.003 for trend). Diet soft drink consumption was not associated with serum uric acid levels or hyperuricemia (multivariate P>0.13 for trend). These findings from a nationally representative sample of US adults suggest that sugar-sweetened soft drink consumption is associated with serum uric acid levels and frequency of hyperuricemia, but diet soft drink consumption is not.

Carbohydrate intake and obesity

The prevalence of obesity has increased rapidly worldwide and the importance of considering the role of diet in the prevention and treatment of obesity is widely acknowledged. This paper reviews data on the effects of dietary carbohydrates on body fatness. Does the composition of the diet as related to carbohydrates affect the likelihood of passive over-consumption and long-term weight change? In addition, methodological limitations of both observational and experimental studies of dietary composition and body weight are discussed. Carbohydrates are among the macronutrients that provide energy and can thus contribute to excess energy intake and subsequent weight gain. There is no clear evidence that altering the proportion of total carbohydrate in the diet is an important determinant of energy intake. However, there is evidence that sugar-sweetened beverages do not induce satiety to the same extent as solid forms of carbohydrate, and that increases in sugar-sweetened soft drink consumption are associated with weight gain. Findings from studies on the effect of the dietary glycemic index on body weight have not been consistent. Dietary fiber is associated with a lesser degree of weight gain in observational studies. Although it is difficult to establish with certainty that fiber rather than other dietary attributes are responsible, whole-grain cereals, vegetables, legumes and fruits seem to be the most appropriate sources of dietary carbohydrate.

The influence of dietary intake and meal pattern on blood glucose control in children and adolescents using intensive insulin treatment

We studied dietary factors and their association with blood glucose control in type 1 diabetic children and adolescents using intensive insulin treatment. A total of 550 children and adolescents with type 1 diabetes mellitus (age 2-19 years) recorded their diet for 4 days in pre-coded food diaries. Of the study group, 34% used insulin pumps, 43% used four or more injections and 16% three injections per day. HbA(1c) was related to targets of optimal blood glucose control defined by the International Society for Pediatric and Adolescent Diabetes (ISPAD). Adolescents with optimal glucose control (HbA(1c) < or = 7.5%) had a lower intake of added sugar (7.7 vs 9.1% of energy intake, p = 0.004), a higher intake of fibre (19.3 vs 17.0 g/day, p = 0.01) and a higher intake of fruits and vegetables (257 vs 227 g/day, p = 0.04) than those with suboptimal metabolic control (HbA(1c) > 7.5%). Multiple regression analysis in adolescents showed that fibre and meal pattern were significantly associated with blood glucose control (effect fibre intake = -0.02, p = 0.04, effect having breakfast regularly = -0.89, p = 0.009). In children meal pattern was associated with blood glucose control (effect having dinner regularly = -0.66, p = 0.02, effect having supper regularly = -0.78, p = 0.03). In diabetic adolescents both intake of fibre and having a regular meal pattern are associated with blood glucose control. Lower intake of added sugar and sugar-sweetened soft drinks and higher intake of fruits and vegetables are observed among those with optimal compared with those with suboptimal blood glucose control. Dietary guidance should be intensified during adolescence to improve dietary intake and blood glucose control.

Consumption of ‘extra’ foods by Australian children: types, quantities and contribution to energy and nutrient intakes

To measure the types and quantities of energy-dense, nutrient-poor 'extra' foods consumed by Australian children and adolescents and their contribution to total energy and nutrient intakes. We used data from 3007 children, aged 2-18 years, who participated in the nationally representative 1995 National Nutrition Survey. Intake was determined by 24-h recall and 'extra' foods were defined using principles outlined in the Australian Guide to Healthy Eating (AGHE) and by applying cut points for maximum amounts of fat and sugar within each food category. All children (99.8%) consumed at least one 'extra' food and the most commonly consumed were margarine, sugar-sweetened soft drinks, cordials and sugar. 'Extra' foods contributed 41% of daily energy intake. Those foods contributing most to energy intake were fried potatoes (4.2%), sugar-sweetened soft drinks (3.3%), ice cream/ice confection (3.1%) and cordials (2.7%). Age and sex were important determinants of 'extra' food intake, with males and older children generally consuming more and different types of, 'extra' foods than females and younger children. 'Extra' foods contributed 19% protein, 47% total fat, 47% saturated fat, 54% sugar, and approximately 20-25% of selected micronutrients to the diet. Calcium and zinc intakes from core foods were below 70% of the recommended dietary intakes for adolescent girls. 'Extra' foods are over-consumed at two to four times the recommended limits and contribute excessively to the energy, fat and sugar intakes of Australian children, while providing relatively few micronutrients. This is of concern in terms of children's weight and nutrient status.

Sugar-sweetened and artificially sweetened soft drinks in association to restrained, external and emotional eating

We studied sugar-sweetened soft drinks and light soft drinks in their associations to psychological constructs of eating behavior and demographic data for adults and children. Soft drink intakes were assessed by consumption of soft drinks in number of days the last week, and eating behavior was measured by the Dutch Eating Behaviour Questionnaire (DEBQ). The sample included 3265 men and women, and their 12-year old children, originating from Swedish national databases. Associations to younger age and lower education in adults were in particular apparent for sugar-sweetened soft drinks. Consumption of sugar-sweetened soft drinks was further associated to less restrained and more external eating in adults. In contrast, light soft drinks were associated with higher BMI, more restrained eating and also more emotional eating in adults. For the children these associations were generally weaker. Sugar-sweetened soft drinks are consumed by persons with a lower education, who furthermore are less prone to attempt to restrict their calorie intake, and by some of those who are sensitive to external stimuli of foods. Light soft drinks are rather chosen by the more heavy persons who try to restrict their energy intake perhaps in order to control the body weight, and more unexpectedly, by adults who eat for comfort. Being more sensitive to an external stimulus of food such as taste seems to imply proneness to consume sugar-sweetened soft drinks instead of the light versions. Light soft drinks may be perceived as an adequate substitute in the use of foods for comfort, meaning the sweet taste may be sufficient for this purpose.

Increased satiety after intake of a chocolate milk drink compared with a carbonated beverage, but no difference in subsequent ad libitum lunch intake

The rising rate of obesity has been blamed on increased consumption of sugar-sweetened soft drinks, such as carbonated sodas, which fail to satisfy hunger. The objective of the present study was to compare the effect on appetite and energy intake of a sugar-sweetened beverage (cola) and a chocolate milk drink, matched for energy content and volume. It was hypothesised that chocolate milk may be more satiating because of its protein content. Twenty-two healthy young men (age 23 (SD 1 x 8) years) of normal weight (BMI 22 x 2 (SD 1 x 5) kg/m2) were recruited to the randomised cross-over study. Visual analogue scales were used to record subjective appetite ratings every 30 min on each of two test days. A drink of 500 ml cola or chocolate milk (900 kJ) was ingested 30 min before an ad libitum lunch. Satiety and fullness were significantly greater (P=0 x 0007, P=0 x 0004, respectively) 30 min after chocolate milk than after cola. Ratings of prospective consumption and hunger were significantly greater after cola than after chocolate milk, both immediately after preload intake (P=0 x 008, P=0 x 01, respectively) and 30 min afterwards (P=0 x 004, P=0 x 01, respectively). There was no significant difference (P=0 x 42) in ad libitum lunch intake after ingestion of chocolate milk (3145 (SD 1268) kJ) compared with cola (3286 (SD 1346) kJ). The results support the hypothesis that sweetened soft drinks are different from milk products in their impact on short-term hunger and satiety, although differences in subjective appetite scores were not translated into differences in energy intake.