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Subject: search.filters.subject.Appetite

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    A randomised controlled trial investigating the influences of food form and energy density on appetite, satiation and satiety in healthy adults
    (Queen Margaret University, Edinburgh, 2014) Carroll, Sarah
    Background: Texture and energy density are two physical properties of foods known to impact on eating behaviour. For those with mastication and/or deglutition disorders; diets which have their texture altered are prescribed. Further these texture modified diets may be energy enriched in an effort to optimise the opportunity for individuals prescribed them to meet their required energy intakes. However there is insufficient evidence supporting this strategy. No well controlled studies have been conducted evaluating these alterations (made in line with clinical guidelines), which specifically investigates their impact on eating behaviour. As such despite their intention to facilitate food and energy intakes it is unknown if these diets are in fact fit for purpose. Objective: To investigate the effect of texture modification, and/or energy enrichment of a standard meal developed to meet current recommendations for meal provision in hospitals on appetite parameters and food and energy intakes at a single eating occasion, in healthy adults. Design: A single blind, randomised crossover within-subjects design, where on four occasions 33 healthy adults consumed a test meal at lunch until satiation (i.e. meal termination) was reached whilst rating their appetite parameters. The meal had its texture and/or energy density altered to compare the effects of food form and energy density on appetite and satiation. The quantity of meal consumed was calculated using a plate wastage method. Subsequent intakes were recorded in a food diary to determine the effect of the treatments on satiety and identify any evidence of energy compensation. Food (g) and energy intakes (kcal) consumed during the feeding session were analysed using repeated measures ANOVA. Results: Test meal energy intakes (kcal) were significantly higher with energy enrichment of both meals (standard texture (ST); 315 kcal and texture modified (TM); 303 kcal (p=0.001)). Area under the curve (AUC) did not differ between meals for hunger, fullness, or desire to eat however palatability was significantly reduced with texture modification. Regardless of the composition and quantity consumed at the test meal, post-meal energy and macronutrient intakes remained the same across all days. Evidence of partial energy compensation was revealed (15 % (ST) and 22% (TM)) thus energy intakes remained higher over the day for both (260 kcal and 225 kcal respectively) (p<0.05). Conclusions: Enriching a meal, suitable for provision in a hospital setting results in significantly greater energy content without impacting on rated palatability. In a well-controlled, healthy sample, this enriched meal was sufficient to increase energy intakes (kcal) at an individual eating occasion for both ST and TM meals without affecting absolute food intake (g) or appetite responses (between meals) at the testing session. Incomplete subsequent energy compensation resulted in daily energy intakes remaining significantly higher with consumption of the enriched meals. Thus energy enrichment at a single meal, appropriate for provision for patients requiring a “Texture C” diet appears to be a suitable method to optimise short term energy intakes, in a healthy sample not confounded by disease state. Further investigation into enrichment of these meals in a clinical setting is justified.
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    Integrating components of energy intake in impaired glucose tolerant and type 2 diabetic populations
    (Queen Margaret University, 2008) Sommerville, Jill
    Objective - During feeding there is an integrated 'whole body' response which endeavours to maintain energy homeostasis. The integrated response consists of sensory, postingestive, postabsorptive and cognitive feedback which exerts control over ingestive behaviour. It is accepted that when an imbalance in this integrated response occurs and may promote an increased fat mass and ultimately can lead to obesity which is known to play an important role in the development of IGT and type 2 diabetes. This study investigated the integrated responses of a test meal to determine any differences between IGT, type 2 diabetics and controls in their integrated response mechanisms. This knowledge may be important in both predicting the onset of these diseases and in the treatment of them. Research Design and Methods - IGT and type 2 diabetics with a BMI greater than 30 and were recruited together with a group of healthy controls. The study assessed habitual energy intakes and energy expenditure in all groups. All participants' height, weight, BMI and WHR were measured. A taste test assessed the sensory component of food intake. The metabolic response and parallel changes in appetite to the meal were recorded at baseline and at 15, 30, 60, 90 and 120 minutes. Results - Control participants had significantly lower weight (p<0.01), BMI (p<0.01), waist (p<0.01) and hip (p<0.01) measurements compared to IGT and the type 2 diabetic groups. Habitual diet diaries indicated a lower sugar intake in the type 2 diabetic group compared with IGT and control groups. Percentage protein intake was significantly lower in control participants (14.4%, p<0.05) compared to IGT (17.2%) and type 2 diabetics (18.5%). Activity diaries highlighted an indication of increased strenuous/physical activity in the control participants compared to IGT participants however, this was not statistically significant. The control group showed greater sensitivity to PROP followed by type 2 diabetics and then IGT participants (p<0.05). Throughout the study the control participants rated themselves the most hungry compared to IGT (p<0.05) and type 2 diabetics (p<0.01) respectively and controls were also the least satiated (p<0.05). There was no difference in fullness ratings. Control participants rated prospective consumption the highest compared to IGT and then type 2 diabetics (p<0.05) respectively. The differences in EE measured by calorimetry when normalised for body weight indicated that IGT (p<0.01) and type 2 diabetic participants (p<0.01) had significantly lower EE than control participants. CHO oxidation rates were significantly lower in IGT and type 2 diabetics (p<0.05). Investigating the blood parameters showed no differences in plasma ghrelin responses, that IGT participants had the highest overall plasma glucose (p<0.01) and insulin (p<0.05) responses. Conclusions - It is clear that there are subtle differences in the pathways of energy balance in IGT and type 2 diabetics compared to controls; including sensitivity to taste, subjective feelings of appetite, EE, oxidation rates and differing blood parameters. Taste appears to be an important contributor to the sensory control of food intake and is associated with an increased sugar intake. Furthermore, differences between IGT and type 2 diabetics demonstrate that the degree of management of the disease can influence the effectiveness of the metabolic pathways controlling food intake. It is not clear which component is the most influential in the control of food intake and it is likely that the synergistic effects are what potentiate the diseases and make them difficult to combat.