Beverage consumption, appetite, and energy intake: what did you
Bridget A Cassady, Robert V Considine, and Richard D Mattes
Background: Beverage consumption is implicated in the overweight/
obesity epidemic through the weaker energy compensation response it
elicits compared with solid food forms. However, plausible mecha-
nisms are not documented.
Objective: This study assessed the cognitive and sensory contributions
of differential postingestive responses to energy- and macronutrient-
matched liquid (in beverage form) and solid food forms and identifies
physiologic processes that may account for them.
Design: Fifty-two healthy adults [mean 6 SD age: 24.7 6 5.5 y; BMI
(in kg/m2): 26.3 6 6.3] completed this randomized, 4-arm crossover
study. Participants consumed oral liquid and solid preloads that they
perceived, through cognitive manipulation, to be liquid or solid in their
stomach (ie, oral liquid/perceived gastric liquid, oral liquid/perceived
gastric solid, oral solid/perceived gastric liquid, or oral solid/perceived
gastric solid). However, all preloads were designed to present a liquid
gastric challenge. Appetite, gastric-emptying and orocecal transit
times, and selected endocrine responses were monitored for the fol-
lowing 4 h; total energy intake was also recorded.
Results: Oral-liquid and perceived gastric-liquid preloads elicited
greater postprandial hunger and lower fullness sensations, more rapid
gastric-emptying and orocecal transit times, attenuated insulin and
glucagon-like peptide 1 release, and lower ghrelin suppression than
did responses after oral-solid and perceived gastric-solid treatments
(all P , 0.05). Faster gastric-emptying times were significantly asso-
ciated with greater energy intake after consumption of perceived
gastric-liquid preloads (P , 0.05). Energy intake was greater on days
when perceived gastric-liquid preloads were consumed than when
perceived gastric solids were consumed (2311 6 95 compared with
1897 6 72 kcal, P = 0.007).
Conclusions: These data document sensory and cognitive effects of
food form on ingestive behavior and identify physical and endocrine
variables that may account for the low satiety value of beverages.
They are consistent with findings that clear, energy-yielding bever-
ages pose a particular risk for positive energy balance. This study
was registered atclinicaltrials.govas NCT01070199.
AmJ Clin Nutr
“Wecannot entertain a doubt that every change in our sensations and
ideas must be accompanied by some corresponding change in the
organic matter of the body.” —Sir Humphry Davy
The rise in obesity and overweight closely parallels the in-
crease in energy-yielding beverage consumption over the past 3
decades (1–3). Children and adults now consume ;400 kcal/d of
energy-yielding beverages, accounting for ;20–25% of daily
energy intake (3). The contribution of energy-yielding beverages
to the promotion of positive energy balance and weight gain
remains controversial. However, most studies reveal that bev-
erages, particularly clear varieties, hold weak satiety properties
and evoke limited compensatory dietary responses (ie, failure to
adjust intake at subsequent eating occasions for energy supplied
beverages, evidence that beverages containing different energy
sources elicit weak dietary compensation (6–9) suggests that the
food form (ie, liquid in beverage form compared with semisolid
or solid physical state), and not the macronutrient or energy
source (ie, carbohydrate, fat, or protein), is likely responsible for
the association between energy-yielding beverage consumption
and positive energy balance (10).
Conversely, a small body of evidence fails to support the link
between energy-yielding beverages and weak appetitive or dietary
responses (11, 12). Discrepant findings between studies could be
attributable to variations in study design, most notably failure to
isolate effects offood form on postprandial responses (11, 13, 14).
Comparisons of dissimilar foods and beverages are confounded
by expectations and properties such as palatability and nutrient
sources. There is a need for direct comparison between responses
for beveragesand solidswiththeuseofappropriatelydesigned test
loads (ie, equally palatable, isocaloric, macronutrient-matched). In
addition, mechanistic explanations of why food forms elicit dif-
ferential regulatory responses are lacking. Beverages require less
oral processing, have more rapid gastric-emptying and orocecal
transit times (15, 16), and evoke lower expected satiation values
(17) (ie, the degree to which an individual expects a particular
food to be satiating) (18). Short-term feeding studies show that
cognitive manipulations (eg, time, energy content, food labeling,
portion size) significantly influence appetitive ratings and sub-
sequent energy intake (19–22). Indeed, the perceived energy
content of a food may better predict self-reported appetitive
1From the Department of Nutrition Science, Purdue University, West
Lafayette, IN (BAC and RDM), and the Department of Medicine, Indiana
University, Indianapolis, IN (RVC).
2Supported by NIH grant 1R01DK079913.
3Address correspondence to RD Mattes, Purdue University, Department
of Nutrition Science, Stone Hall, Room 212, 700 West State Street, West
Lafayette, IN 47907-2059. E-mail: email@example.com.
Received August 17, 2011. Accepted for publication December 6, 2011.
First published online January 18, 2012; doi: 10.3945/ajcn.111.025437.
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COGNITIVE INFLUENCES OF FOOD FORM