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Effects of Two Weeks’ Mandatory Snack Consumption on Energy Intake and Energy Balance*

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Effects of Two Weeks’ Mandatory Snack Consumption on Energy Intake and Energy Balance*

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Our goal was to compare the effects of mandatory consumption of commercial snack products (CSPs) on energy intakes and energy balance in free-living adults and to assess the interaction between habitual level of CSP consumption and the interventions. Four groups of 18 subjects (lean and overweight, males and females) were studied using a crossover design. Subjects consumed one type of CSP (high-carbohydrate, high-fat, or mixed composition) at three manipulations of energy 0 MJ (control), 1.5 MJ (low-energy), and 3.0 MJ (high-energy) each day during three 14-day interventions. The study design was parallel for type of CSP (macronutrient composition) and within-subjects for energy level. Subjects self-recorded food intakes between Days 8 and 14, and body weights were investigator-recorded on Days 1, 8, and 15 of each intervention period. Daily energy expenditure was estimated by heart rate monitoring. Daily energy intakes increased from 10.4 MJ (control) to 11.1 MJ (low-energy) and 11.5 MJ (high-energy) (p < 0.001), resulting in a trend (not significant) for body weight gain. Energy balance was more positive when subjects were not recording their food intakes than when they were (p < 0.001). There was a trend (not significant) for greater increases in energy intake with increasing fat content, and energy density, of the interventions. Frequent CSP consumers compensated more for the interventions than did infrequent CSP consumers (R2 = 0.125, p = 0.003). Subjects partially compensated for energy when supplemented with CSPs over 14-day periods, although this was insufficient to prevent some increase in energy balance. The level of compensation correlated with habitual energy intake from CSPs.

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... Eighteen additional observational studies (see below) used eating frequency as a surrogate definition of snacking but were not necessarily designed to examine this practice per se. Finally, six intervention studies were identified that examined the effect of providing snacks on weight management (Yates et al., 1997;Kirk and Cursiter, 1999;Waller et al., 2004;Whybrow et al., 2007;Poston et al., 2005;Vander Wal et al., 2006). In effect, these studies defined snacking as the intervention provided to the subjects and, therefore, did not require the use of an a priori definition of this practice. ...
... The authors concluded, "Eating ready-to-eat cereal after the evening meal may attenuate caloric intake in night snackers and promote weight loss in compliant individuals." Whybrow et al. (2007) conducted a crossover design study among four groups of 18 subjects each composed of lean (mean BMI ∼22) and overweight (mean BMI ∼29) men and women (mean age ∼35 years) living in the UK. These four groups were randomized to receive snacks containing one of three energy levels-0 MJ (control), ∼360 kcal (low-energy), or ∼720 kcal (high energy) for 14 days. ...
... Despite the limitations the lack of a universally accepted definition imposes on interpretation of the observational data discussed above, evidence from six intervention studies that examined the effect of providing snacks on body weight as part of ad libitum or energy-restricted diets provides support for the premise that snacking is not associated with obesity (Yates et al., 1997;Kirk and Cursiter, 1999;Waller et al., 2004;Whybrow et al., 2007;Poston et al., 2005;Vander Wal et al., 2006). As noted previously, interpretation of these studies is not encumbered by the lack of a common definition of snacking. ...
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Snacking is a ubiquitous practice that has increased in recent years. However, the impact of snacking on the diet is difficult to assess because a variety of approaches have been used to define snacking (and snack foods) in the literature. This lack of a universally accepted definition complicates interpretation of the literature and limits the development of science-based recommendations for consumers. The purpose of this review is to illustrate this problem by showing that the conclusions derived from the literature are heavily dependent on the definition used or implied by the authors. It is suggested that the a universally accepted definition for snacking be developed by a coalition of stakeholders to provide a template for future research, guidance for the food industry and to enable the development of well-substantiated dietary recommendations.
... This is of interest because a recent (as yet unpublished) analysis of Slimming World members' diets, in association with the DiOGenes study (Larsen et al. 2009;Moore et al. 2009) reveals that the average ED of 117 members' diets, each measured twice using a 3-day food diary, is 1.2 kcal/g. As a further reference, we compared this with the average ED (all excluding beverages) of British consumers following their normal diet in two studies [~2.0 (n = 72) (Whybrow et al. 2007), 1.8 (n = 60) (Whybrow et al. 2006]. In all these cases, the ED of the Slimming World diets was significantly and quantitatively lower than the other diets (P < 0.001). ...
... In all these cases, the ED of the Slimming World diets was significantly and quantitatively lower than the other diets (P < 0.001). In the case of the other diet groups, the first participated in an intervention where they ate commercial snack foods and ED increased as more snacks were consumed (Whybrow et al. 2007), In the second intervention ED dropped to 1.4 kcal/g when subjects incorporated into their diet 300 g/day, and to 1.3 kcal/g when subjects ate 600 g of fruit and vegetables per day (Whybrow et al. 2006). The ED and EIs for all of these groups are given in Figures 6 and 7, respectively. ...
... This combination is most common in commercial processed and snack foods (Stubbs et al. 1997;Levine et al. 2003;Drewnowski 2007;van Baak & Astrup 2009). • The orosensory properties of foods need to be maintained to encourage people to select healthy foods, so that they become a practical option for the development (Whybrow et al. 2007)]. In all these cases, the ED of the Slimming World diets was significantly and quantitatively lower than the other diets (P < 0.001, except for 600 g of fruits and vegetables which was P < 0.05). ...
Article
A healthy rate of weight loss of 0.5–1.0 kg/week can be achieved by invoking an energy deficit of 450–900 kcal/day. This assumes an energy cost of weight loss of 6300 kcal/kg. This value will increase with percent body fat. Diet and physical activity strategies should be combined to lose weight. However, dietary approaches to weight management appear most efficacious for initial weight loss. Energy density should be the cornerstone of dietary weight reduction strategies because it helps people develop and optimise healthy eating habits that are sustainable in the longer-term. However, healthy diets for weight management should be seen as a package including reduced fat, energy density, sugars and salt, increased fibre, protein and water content of foods. Healthy diets also have to be palatable, to maintain interest in healthy eating. Monotherapies for weight loss are subject to the laws of diminishing returns. Practical approaches to weight management should be focused on a package of weight loss and maintenance strategies, including relapse prevention. It is important to provide consumers with a flexible approach to behaviour change and lifestyle solutions that they can match to their individual lifestyle needs. Evidence from studies of successful weight-loss maintainers shows that people can work this out for themselves if they can access the right tools, continuing care, guidance and social support to achieve sustainable lifestyle change.
... The studies were from various geographical locations with a range of intervention periods (Table 1). All the studies included overweight and/or obese (BMI range 26-49·9 kg/m 2 ) adults, and two studies (18,19) included lean subjects (BMI <25 kg/m 2 ). Three studies (20)(21)(22) included female subjects only. ...
... Three studies (20)(21)(22) included female subjects only. In all, twelve studies were identified where food was provided as part of the dietary intervention to at least one intervention group (18,19,21,(23)(24)(25)(26)(27)(28)(29)(30)(31) . In two of these studies, beverages were the dietary variable of interest (26,28) . ...
... In these studies, the supplemented foods were integrated into the dietary prescription, whereas the control groups were advised to continue with usual diets. Seven studies integrated a prescribed amount of the supplemented foods within a reduced-energy prescription to facilitate weight loss (18,20,22,28,(30)(31)(32) , whereas two studies provided the supplemented food to replace usual food choices (19,33) . Studies that did not provide a reduced-energy dietary prescription encouraged integration or replacement of usual food choices with the supplemented foods (23)(24)(25)(26)29) or gave suggestions for integrating the supplemented foods into usual diets by providing an overview of a healthy eating dietary pattern/food model (21,27) . ...
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Dietary trials provide evidence for practice and policy guidelines, but poor adherence may confound results. Food supplementation may improve adherence to dietary interventions, but the impact of supplementation on study outcomes is not known. The aim of this review was to examine the impact of food supplementation on weight loss in dietary intervention trials. The databases Scopus, PubMed and the Cochrane Library were searched for dietary intervention trials published between January 2004 and March 2015 using the following keyword combinations: 'trial' OR 'intervention', 'food' OR 'diet', 'weight loss' and 'adherence' OR 'adherence'. Studies were included if food was provided to at least one study group and both 'weight change' and 'adherence' were reported. Random effects meta-analyses were conducted to assess weighted mean differences (WMD) in body weight (change or final mean values). The included studies formed two groups: trials involving an intervention group supplemented with a food and a control without food supplementation (food v. no food), and trials in which food was provided to all subjects (food v. food) (PROSPERO registration: CRD42015017563). In total, sixteen studies were included. Significant weight reduction was reported in the food v. no food studies (WMD -0·74 kg; 95 % CI -1·40, -0·08; P=0·03, I 2=63 %). A non-significant increase in weight was found among the food v. food studies (WMD 0·84 kg; 95 % CI -0·60, 2·27; P=0·25, I 2=0 %). Food supplementation appeared to result in greater weight loss in dietary trials. Energy restrictions and intensity of interventions were other significant factors influencing weight loss.
... Consuming a protein supplement between meals may decrease compensatory eating behaviors, thereby increasing energy intakes and body weight. 13 Conversely, consuming a protein supplement twice daily with meals led to complete energetic compensation in adults who performed resistance training, although body composition was not affected. 14 Consequently, the timing of protein supplementation may be of particular importance, depending on the desired body weight and body composition outcome. ...
... 62 In one 2-week trial, mandatory snacking promoted weight gain in free-living adults. 13 This effect was shown to be exacerbated when the snacks were consumed as beverages, 63,64 the predominant form of protein supplement among the groups included in this review. Consuming protein supplements between meals or as a snack may also increase eating frequency, which may promote higher body weight. ...
Article
Context The impact of timing the consumption of protein supplements in relation to meals on resistance training–induced changes in body composition has not been evaluated systematically. Objective The aim of this systematic review was to assess the effect of consuming protein supplements with meals, vs between meals, on resistance training–induced body composition changes in adults. Data Sources Studies published up to 2017 were identified with the PubMed, Scopus, Cochrane, and CINAHL databases. Data Extraction Two researchers independently screened 2077 abstracts for eligible randomized controlled trials of parallel design that prescribed a protein supplement and measured changes in body composition for a period of 6 weeks or more. Results In total, 34 randomized controlled trials with 59 intervention groups were included and qualitatively assessed. Of the intervention groups designated as consuming protein supplements with meals (n = 16) vs between meals (n = 43), 56% vs 72% showed an increase in body mass, 94% vs 90% showed an increase in lean mass, 87% vs 59% showed a reduction in fat mass, and 100% vs 84% showed an increase in the ratio of lean mass to fat mass over time, respectively. Conclusions Concurrently with resistance training, consuming protein supplements with meals, rather than between meals, may more effectively promote weight control and reduce fat mass without influencing improvements in lean mass.
... The USDA has identified solid fats and added sugars (SoFAs) as the main sources of "empty" calories, contributing ample energy but few nutrients [7,8]. Snacking between meals is consistently listed among potential causes of obesity and weight gain [9][10][11] and is an issue of public health concern. ...
... Frequent between-meal snacking has long been an issue of public health concern [48,49]. In several past studies, increased snacking frequency has been linked to rising obesity rates [9,10]. First, more frequent snacking has been associated with consuming more calories overall [8]. ...
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Background Replacing typical American snacks with tree nuts may be an effective way to improve diet quality and compliance with the 2015–2020 Dietary Guidelines for Americans (DGAs). Objective To assess and quantify the impact of replacing typical snacks with composite tree nuts or almonds on diet metrics, including empty calories (i.e., added sugars and solid fats), individual fatty acids, macronutrients, nutrients of public health concern, including sodium, fiber and potassium, and summary measures of diet quality. Methods Food pattern modeling was implemented in the nationally representative 2009–2012 National Health and Examination Survey (NHANES) in a population of 17,444 children and adults. All between-meal snacks, excluding beverages, were replaced on a per calorie basis with a weighted tree nut composite, reflecting consumption patterns in the population. Model 1 replaced all snacks with tree nuts, while Model 2 exempted whole fruits, non-starchy vegetables, and whole grains (>50% of total grain content). Additional analyses were conducted using almonds only. Outcomes of interest were empty calories (i.e., solid fats and added sugars), saturated and mono- and polyunsaturated fatty acids, fiber, protein, sodium, potassium and magnesium. The Healthy Eating Index-2010, which measures adherence to the 2010 Dietary Guidelines for Americans, was used as a summary measure of diet quality. ResultsCompared to observed diets, modeled food patterns were significantly lower in empty calories (−20.1% and −18.7% in Model 1 and Model 2, respectively), added sugars (−17.8% and −16.9%), solid fats (−21.0% and −19.3%), saturated fat (−6.6% and −7.1%)., and sodium (−12.3% and −11.2%). Modeled patterns were higher in oils (65.3% and 55.2%), monounsaturated (35.4% and 26.9%) and polyunsaturated fats (42.0% and 35.7%), plant omega 3 s (53.1% and 44.7%), dietary fiber (11.1% and 14.8%), and magnesium (29.9% and 27.0%), and were modestly higher in potassium (1.5% and 2.9%). HEI-2010 scores were significantly higher in Model 1 (67.8) and in Model 2 (69.7) compared to observed diets (58.5). Replacing snacks with almonds only produced similar results; the decrease in sodium was more modest and no increase in plant omega-3 fats was observed. Conclusion Replacing between-meal snacks with tree nuts or almonds led to more nutrient-rich diets that were lower in empty calories and sodium and had more favorable fatty acid profiles. Food pattern modeling using NHANES data can be used to assess the likely nutritional impact of dietary guidance.
... Poppitt et al (32) observed that the energy intake during lunch was not affected by high-carbohydrate and high-fat preloads consumed 90 min before lunch. However, medium-term intervention studies showed that a partial energy compensation took place after the consumption of EDS foods (33,34). An intervention study of 9 d in 8 young men who consumed 3 types of ad libitum diets (high fat, high protein, high carbohydrates, and no snacking) showed that, when subjects were required to eat snacks as part of the 3 diets, their total energy intakes were not significantly higher compared with normal intakes (33). ...
... An intervention study of 9 d in 8 young men who consumed 3 types of ad libitum diets (high fat, high protein, high carbohydrates, and no snacking) showed that, when subjects were required to eat snacks as part of the 3 diets, their total energy intakes were not significantly higher compared with normal intakes (33). This was confirmed by a 14-d intervention study by Whybrow et al (34) in which partial energy compensation took place after the compulsory consumption of EDS foods. Furthermore, a recent Dutch, 8-wk intervention study in healthy, nonrestrained, normal-weight young adults showed that the consumption of EDS snacks did not increase body weight, which suggests that energy compensation took places when EDS snacks were consumed (35). ...
Article
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There is conflicting evidence regarding an association between the consumption of energy-dense snack (EDS) foods and the development of overweight. In the current study, we examined whether there was an association between the intake of EDS foods and annual weight and waist circumference changes in normal-weight and overweight Dutch adults. The study population included 9383 men and women from the MORGEN-EPIC (Monitoring Project on Risk Factors for Chronic Diseases in the Netherlands-European Prospective Investigation into Cancer and Nutrition) study, which is a population-based cohort study in 3 towns in the Netherlands (Amsterdam, Maastricht, and Doetinchem), who had a body mass index (in kg/m(2)) <30 and who were not dieting. Participants were enrolled between 1993 and 1997 and followed for an average of 8.1 y (Amsterdam and Maastricht: 9.9 y; Doetinchem: 4.9 y). Intake of EDS foods (sweets, cakes and pastries, and savory snacks) was assessed at baseline by using a validated food-frequency questionnaire. Multivariate linear and multinomial logistic regression models were applied and stratified by center to examine the association between energy from EDS foods (kcal) and annual weight and waist circumference changes. The mean (±SD) daily energy intake from EDS foods was 294 ± 192 kcal. In Amsterdam and Maastricht, the annual weight change was 168 ± 572 g/y, whereas in Doetinchem, the annual weight change was 444 ± 816 g/y. In the multivariate regression analysis adjusted for follow-up duration and anthropometric, dietary, and lifestyle factors, there was some, but inconsistent, evidence of an association of EDS-food consumption with annual weight change. Our study provides some, but inconsistent, evidence that consumption of EDS foods is positively associated with an increase in annual weight in normal- to overweight Dutch adults.
... food high in fat and sugar) need to be eaten in smaller volumes than those that are less energy-dense. 14 Energy-dense food and drinks that have been shown to be associated with increased energy intake include fast food, 15,16 snacks and sweets, 17,18 sugary soft-drinks, [19][20][21][22] and alcoholic drinks. 23,24 Moreover, experimental studies have shown that eating rate and energy density have independent yet additive effects on overeating (eg., 25 ). ...
Article
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Background Impulsive processes driving eating behaviour can often undermine peoples’ attempts to change their behaviour, lose weight and maintain weight loss. Aim To develop an impulse management intervention to support weight loss in adults. Methods Intervention Mapping (IM) was used to systematically develop the “ImpulsePal” intervention. The development involved: (1) a needs assessment including a qualitative study, Patient and Public advisory group and expert group consultations, and a systematic review of impulse management techniques; (2) specification of performance objectives, determinants, and change objectives; (3) selection of intervention strategies (mapping of change techniques to the determinants of change); (4) creation of programme materials; (5) specification of adoption and implementation plans; (6) devising an evaluation plan. Results Application of the IM Protocol resulted in a smartphone app that could support reductions in unhealthy (energy dense) food consumption, overeating, and alcoholic and sugary drink consumption. ImpulsePal includes inhibition training, mindfulness techniques, implementation intentions (if-then planning), visuospatial loading, use of physical activity for craving management, and context-specific reminders. An “Emergency Button” was also included to provide access to in-the-moment support when temptation is strong. Conclusions ImpulsePal is a novel, theory- and evidence-informed, person-centred app that aims to support impulse management for healthier eating. Intervention Mapping facilitated the incorporation of app components that are practical operationalisations of change techniques targeting our specific change objectives and their associated theoretical determinants. Using IM enabled transparency and provided a clear framework for evaluation, and enhances replicability and the potential of the intervention to accomplish the desired outcome of facilitating weight loss through dietary change.
... Snack food is not part of our basic diet, but is frequently consumed additionally to other meals. Moreover, snacks show only a weak satiety effect and their calorie content is not or only partially compensated by reduced ingestion of standard meals (Whybrow et al., 2007;Chapelot, 2011). Thus, it can be concluded that snack food consumption leads to increased total energy intake. ...
Article
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Snack food like potato chips substantially contributes to energy intake in humans. In contrast to basic food, snacks are consumed additionally to other meals and may thereby lead to non-homeostatic energy intake. Snack food is also frequently associated with hedonic hyperphagia, a food intake independent from hunger. Analysis of brain activity patterns by manganese-enhanced MRI has previously revealed that the intake of potato chips in ad libitum fed rats strongly activates the reward system of the rat brain, which may lead to hedonic hyperphagia. The purpose of the present study was to develop a two-choice preference test to identify molecular determinants of snack food triggering extra food intake in ad libitum fed rats. Different kinds of test food were presented three times a day for 10 min each time. To minimize the influence of organoleptic properties, each test food was applied in a homogenous mixture with standard chow. Food intake as well as food intake-related locomotor activity were analyzed to evaluate the effects induced by the test foods in the two-choice preference test. In summary, fat (F), carbohydrates (CH), and a mixture of fat and carbohydrates (FCH) led to a higher food intake compared to standard chow. Notably, potato chip test food (PC) was highly significantly preferred over standard chow (STD) and also over their single main macronutrients F and CH. Only FCH induced an intake comparable to PC. Despite its low energy density, fat-free potato chip test food (ffPC) was also significantly preferred over STD and CH, but not over F, FCH, and PC. Thus, it can be concluded that the combination of fat and carbohydrates is a major molecular determinant of potato chips triggering hedonic hyperphagia. The applied two-choice preference test will facilitate future studies on stimulating and suppressive effects of other food components on non-homeostatic food intake.
... Body weight was recorded on days 1, 8 and 15 allowing changes in EB due to the observation effect alone to be assessed. It was clear subjects altered their intake during the recording week relative to the week before, and this effect was in the order of 3MJ/day (42) . ...
Article
To date, no study has directly and simultaneously measured the discrepancy between what people actually eat and what they report eating under observation in the context of energy balance (EB). The present study aimed to objectively measure the 'extent' and 'nature' of misreporting of dietary intakes under conditions in which EB and feeding behaviour were continuously monitored. For this purpose, a total of fifty-nine adults were recruited for 12 d, involving two 3 d overt phases and two 3 d covert phases of food intake measurement in a randomised cross-over design. Subjects had ad libitum access to a variety of familiar foods. Food intake was covertly measured using a feeding behaviour suite to establish actual energy and nutrient intakes. During the overt phases, subjects were instructed to self-report food intake using widely accepted methods. Misreporting comprised two separate and synchronous phenomena. Subjects decreased energy intake (EI) when asked to record their food intake (observation effect). The effect was significant in women ( - 8 %, P< 0·001) but not in men ( - 3 %, P< 0·277). The reported EI was 5 to 21 % lower (reporting effect) than the actual intake, depending on the reporting method used. Semi-quantitative techniques gave larger discrepancies. These discrepancies were identical in men and women and non-macronutrient specific. The 'observation' and 'reporting' effects combined to constitute total misreporting, which ranged from 10 to 25 %, depending on the intake measurement assessed. When studied in a laboratory environment and EB was closely monitored, subjects under-reported their food intake and decreased the actual intake when they were aware that their intake was being monitored.
... A balanced eating behaviour encompasses eating recommended portions at fixed hours guaranteeing healthy feelings of hunger and a routine that promotes physiological growth and energy expenditure. However, a trend of snacking in the absence of hunger is observed among families in western society that may contribute to obesity via the intake of excess energy [1] . ...
Article
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Objective: This paper introduces health professionals to the different psychological models thought to influence eating behaviour in the absence of hunger in children who are obese and to propose a method of assessing these behaviours in practice. Methods: Clinical researchers from the European Childhood Obesity Group (ECOG) adopted an evidence-based approach to examine the literature concerning the assessment of eating behaviour in children who are obese. Studies published in English were filtered out of the medical and psychological literature from 1960 to the present, and the resulting bibliography was searched for relevant articles. Key themes from the current evidence were compiled and classified according to the underpinning psychological models. Based on the current evidence and the authors' combined clinical experience, a three-staged approach to assessment was agreed by consensus. Results: Valid and reliable tools for assessing and monitoring each of the three identified models (Dietary Restraint Theory, Emotional Eating and the Diathesis-Stress Model) are suggested for use in clinical practice, and the ECOG three-staged approach to assessing eating behaviours in the absence of hunger is described. Conclusions: This paper presents practical guidance on how to assess eating behaviour in the absence of hunger in children who are clinically obese and suggests a focus for future research.
... Randomized, controlled trials do not support this presumption. 24 Even observational studies have not shown a consistent association between snacking and obesity or increased BMI. ...
... Furthermore, most subjects tend to be in a negative energy balance (as estimated by change in body weight) when completing food intake records. [14][15][16] The use of energy intake to BMR ratios to identify low reported energy intakes has also been compared with that of using biomarkers of diet, the most widely used being the ratio of urinary to dietary nitrogen, 17 a method that is also not without its limitations. Thus, self-reported dietary intakes have been compared with indirect measures of energy expenditure (as an indirect measure of energy intake assuming energy balance) or indirect measures of protein intake (as an indirect measure of energy intake). ...
Article
Comparing reported energy intakes with estimated energy requirements as multiples of basal metabolic rate (Ein:BMR) is an established method of identifying implausible food intake records. The present study aimed to examine the validity of self-reported food intakes believed to be plausible. One hundred and eighty men and women were provided with all food and beverages for two consecutive days in a residential laboratory setting. Subjects self-reported their food and beverage intakes using the weighed food diary method (WDR). Investigators covertly measured subjects' actual consumption over the same period. Subjects also reported intakes over four consecutive days at home. BMR was measured by indirect calorimetry. Average reported energy intakes were significantly lower than actual intakes (11.2 and 11.8 MJ/d, respectively, P<0.001). Two-thirds (121) of the WDR were under-reported to varying degrees. Only five of these were considered as implausible using an Ein:BMR cut-off value of 1.03*BMR. Under-reporting of food and beverage intakes, as measured by the difference between reported and actual intake, was evident at all levels of Ein;BMR. Reported energy intakes were lower still (10.2 MJ/d) while subjects were at home. Under-recording of self-reported food intake records was extensive but very few under-reported food intake records were identified as implausible using energy intake to BMR ratios. Under-recording was evident at all levels of energy intake.European Journal of Clinical Nutrition advance online publication, 29 July 2015; doi:10.1038/ejcn.2015.124.
... Dietary data were taken from two existing datasets; 115 men and 125 women from a residential study ostensibly examining the relationships between diet and lifestyle (22) . A further 36 men and 36 women from a snacking intervention study (23) . Dietary data from both studies were taken from the baseline data collection when subjects were consuming their normal diet. ...
Article
The UK Eatwell Plate is consumer based advice recommending the proportions of five food groups for a balanced diet: starchy foods, fruit and vegetables, dairy foods, nondairy sources of protein and foods and drinks high in fat or sugar. Many foods comprise ingredients from several food groups and consumers need to consider how these fit with the proportions of the Eatwell Plate. This involves disaggregating composite dishes into proportions of individual food components. The present study aimed to match the diets of adults in Scotland to the Eatwell Plate dietary recommendations and to describe the assumptions and methodological issues associated with estimating Eatwell Plate proportions from dietary records. Foods from weighed intake records of 161 females and 151 males were assigned to a single Eatwell group based on the main ingredient for composite foods, and the overall Eatwell Plate proportions of each subject's diet were calculated. Food group proportions were then recalculated after disaggregating composite foods. The fruit and vegetables and starchy food groups consumed were significantly lower than recommended in the Eatwell Plate, whereas the proportions of the protein and foods high in fat or sugar were significantly higher. Failing to disaggregate composite foods gave an inaccurate estimate of the food group composition of the diet. Estimating Eatwell Plate proportions from dietary records is not straightforward, and is reliant on methodological assumptions. These need to be standardised and disseminated to ensure consistent analysis. © 2015 The British Dietetic Association Ltd.
... The current literature does not contain any universally accepted definition of snacking, but two main approaches have been used to define the term 'snack' (6) . The first approach focuses on the food consumed; foods are identified as snacks by their nutrient content or because they are commonly associated with snacking (6,19) . The second approach focuses on the time of food consumption (6) . ...
Article
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Objective: We examined associations between snack frequency, sociodemographic characteristics, BMI, dietary and eating behaviour. In order to identify whether various subgroups of high-frequency snack consumers exist, we investigated underlying food patterns and lifestyle factors. Design: The data were based on the Swiss Food Panel Questionnaire of 2010, which included an FFQ, questions relating to sociodemographics and lifestyle factors. Data were examined using ANOVA, regression analysis and hierarchical cluster analysis. Gender differences were also investigated in the analysis of the data. Setting: A sample of 6189 adults participating in the Swiss Food Panel filled in a questionnaire (response rate 30%). Subjects: The sample consisted of both men and women, with a mean age of 54?4 (SD 13?5) years. Results: There was no association between snack frequency and BMI. Consumption frequency of sweets and savouries as well as fruit intake increased with increasing snack frequency. Additionally, three different subgroups of high-frequency snack consumers could be revealed: healthy, moderate and unhealthy dietary-pattern groups. The latter included respondents who were less health-conscious and was characterized by high alcohol consumption frequency, daily breakfast skipping and watching television during the main meal. Conclusions: High snack frequency occurred in the context of healthy as well as unhealthy dietary behaviour and lifestyle patterns. Women made healthier dietary food choices and were more likely to consume fruits as snacks, while men chose unhealthy foods, such as sweets and savouries, more often.
... The cause of controversies is likely the lack of a universal definition for the snacking and the multifactorial nature of obesity which makes extracting a clear and factual conclusion on the issue difficult [37,38]. Nevertheless, what makes the difference in the effect of snacking on weight is probably the amount of energy provided by snacks [39] and the compensation (if any) which is made in the energy intake by subsequent meals and snacks [40,41]. As most of the participants (91.9%) consumed breakfast we could not assess the association between consuming breakfast and BMI, but did assess the association between breakfast frequency and overweight and did not observe a relationship. ...
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Obesity is an epidemic nutritional disease caused mainly by excessive dietary intake and/or insufficient exercise. The purpose of this study was to investigate associations between a number of demographic characteristics and eating habits with prevalence of overweight and obesity in hospital employees. The study was cross-sectional performed on employees of Namazi Hospital in Shiraz, Iran. Subjects were selected from different departments of the hospital. Demographic characteristics, eating habits, and exercise were questioned by interview. Overweight and obesity was defined as a body mass index ≥ 25 kg/m 2. The rate of overweight/obesity was 30.2%. Among demographic characteristics, only age (OR=5.6 for older ages, p=0.001) and sex (OR=0.4 for females, p=0.04) were significantly associated with overweight/obesity. Skipping breakfast was not associated with overweight/obesity, but skipping meals (OR=2.8, p=0.08) and consuming ≥ 3 snacks per day (OR=0.2, p=0.05) had associations with it, although non-significantly. Performing ≥ 60 min/day (but not ≥ 45 min/day) exercise was associated with a lower risk of overweight/obesity (OR=0.1, p=0.01). The association between exercise and overweight/obesity existed in both sexes, but the association between skipping meals and obesity was present only in females (OR=3.8, p=0.05). Females skipped meals especially breakfast more frequently than males (p=0.001) but snack consumption and exercise was not statistically different between the two sexes. Eating 3 meals and at least 3 snacks per day and performing 1 hour or more exercise may be introduced as helpful strategies in prevention of obesity.
... On average, American children consume between two and three snacks a day, which account for more than a quarter of their daily energy intake. 1 Children's snacks often consist of foods high in sugar, fat, and sodium. 1 Snacking or eating outside the standard three daily meals (breakfast, lunch, and dinner) 2,3 is frequently implicated as a cause of excessive energy intake and a contributor to an unhealthy weight status. 4 However, observational studies and randomized controlled trials have been unable to establish a consistent association between snacking and weight gain or obesity. 4,5 Some studies, such as the Bogalusa Heart Study, report a positive association between snacking and overweight status in children, 2,3,6-11 whereas other studies have demonstrated an inverse association [12][13][14][15][16] or no relationship at all. [17][18][19][20][21][22][23][24][25] The interaction of snacking with another lifestyle factor, such as watching television 26,27 or having at least one overweight parent, 27 has been proposed as a possible explanation for the inverse association found between snacking and obesity. ...
Article
Objective: To examine the impact of adherence to a healthy snacking component of a 6 month school-based intervention program for overweight and obese children. Design: Randomized controlled intervention trial Methods: Mexican American children who were ≥ 85th percentile for body mass index (BMI) were recruited between 2005-2012 from three Houston schools. Children participated in a 12-week instructor led intensive intervention program that included nutrition education, physical activity, and a snacking component which consisted of a daily choice of peanuts and/or peanut butter snacks. Children (12±0.6 years) (n= 257) were divided into either low or high snacking adherence groups based on their responses on a peanut food frequency questionnaire. The low adherence group reported consuming peanuts or peanut butter ≤ once per week and the high adherence group > once per week over 6 months. Change of BMI, standardized BMI (zBMI), triceps skinfold, and weight were compared at six months of children reporting high and low levels of adherence to the snacking component. Analysis: T-tests were performed with SPSS version 22 with level of significance set at P
... Several previous studies found that exercise inhibited food intake, hunger and appetite [27][28][29]. Others found no effects [30,31] or increases [32]. Mackelvie et al. [33] suggested there may be some participants who are compensators and others who are noncompensators, with the latter not increasing their energy intake after exercise. ...
Article
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Background The aim of this study was to determine the acute effects of exercise intensity on anxiety, mood states and hunger in obese adolescents. Methods Subjects were eight male obese adolescents (age 15.44 ± 2.06y; BMI 33.06 ± 4.78 kg/m2). Each subject underwent three experimental trials: 1) Control, seated for 30 min; 2) Low intensity exercise (LIE) - exercise at 10% below ventilatory threshold (VT); 3) High intensity exercise (HIE) - exercise at 10% above VT. Anxiety (STAI Trait/State), mood (POMS) and hunger (VAS) were assessed before and immediately after the experimental sessions. Comparisons between trials and times were assessed using Kruskal-Wallis and Wilcoxon tests, respectively. Associations between variables were described using a Spearman test. Results The largest increase in hunger was observed after LEI (914.22%). Both exercise sessions increased anxiety, fatigue and decreased vigor (p < 0.05). Conclusions Acute exercise bouts are associated with negative changes in anxiety and mood, and with increases in hunger in obese adolescents.
... A number of studies examined the relationship between obesity and diet in children, and, among dietary patterns, snacks received great attention: indeed, commercially available snack foods are, on average, considerably more energetically dense than most foods in the diet. Thus, snacks act with respect to the average of the overall diet as major contributors to calorie and saturated fat intake (Whybrow et al. 2007). However, even if the percentage of energy from dietary fat is widely believed to be an important determinant of body fat accumulation, the existence of causal relationships between single nutrients or foods and obesity is controversial: prospective cohort studies have frequently failed in finding a correlation, while also factors other than dietary choices, including the speed of ingestion and physical activity, seem to influence obesity (Jordan et al. 1981;Hu et al. 1997;Erkkila et al. 2008). ...
Article
The aim of the present study is to understand how different definitions of snacking influence the estimated probability of obesity in the presence of concurrent risk factors. Factors influencing obesity were evaluated by reviewing the relevant literature through a PUBMED search. Six different modalities to define snack consumption were identified. A Bayesian network model in which nodes represent the variables that the retrieved studies indicate as affecting the probability of obesity was implemented and used to estimate the individual risk of developing obesity taking into account the concurrent effect of the considered risk factors. For a subject with a given profile of factors, the probability of obesity varies according to the chosen definition of snacking, up to maximum of 70%. The variability of the probability of obesity attributable to the chosen definition of snacking is very high and may threaten any conclusion about the effect of snacking, which may be related to the specific definitions adopted in the study.
... A flow chart detailing the participant contribution from each study can be found in the online supplementary material (Supplementary Figure 1). All data were collected at the Rowett Institute, University of Aberdeen, UK between 1998 and 2007, and aspects of these data have been published previously [12][13][14][15][16][17]. The individual studies were originally designed to examine the effects of diet on body composition and health, and subjects were informed that their purpose was to examine the relationships between diet and lifestyle. ...
Article
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Background: While recent studies in humans indicate that fat-free mass (FFM) is closely associated with energy intake (EI) when in energy balance, associations between fat mass (FM) and EI are inconsistent. Objectives: The present study used a cross-sectional design to examine the indirect and direct effects of FFM, FM and resting metabolic rate (RMR) on EI in individuals at or close to energy balance. Methods: Data for 242 individuals (114 males; 128 females; BMI = 25.7 ± 4.9 kg/m2) were collated from the non-intervention baseline conditions of five studies employing common measures of body composition (air-displacement plethysmography), RMR (indirect calorimetry) and psychometric measures of eating behaviours (Dutch Eating Behaviour Questionnaire). Daily EI (weighed dietary records) and energy expenditure (flex heart rate) were measured for 6-7 days. Sub-analyses were conducted in 71 individuals who had additional measures of body composition (dual-energy X-ray absorptiometry) and fasting glucose, insulin and leptin. Results: After adjusting for age, sex and study, linear regression and mediation analyses indicated that the effect of FFM on EI was mediated by RMR (P < 0.05). FM also independently predicted EI, with path analysis indicating a positive indirect association (mediated by RMR; P < 0.05), and a stronger direct negative association (P < 0.05). Leptin, insulin and insulin resistance failed to predict EI, but cognitive restraint was a determinant of EI and partially mediated the association between FM and EI (P < 0.05). Conclusions: While the association between FFM and EI was mediated by RMR, FM influenced EI via two separate and opposing pathways; an indirect 'excitatory' effect (again, mediated by RMR), and a stronger direct 'inhibitory' effect. Psychological factors such as cognitive restraint remain robust predictors of EI when considered alongside physiological determinants of EI, and indeed, have the potential to play a mediating role in the overall expression of EI.
... Overweight and obesity are preventable and reversible, and one key target behaviour for achieving good weight management is to reduce the consumption of excess energy [7]. Key factors contributing to increased energy intake include the consumption of fast foods [8,9], snacks and sweets [10,11], larger portion sizes [12][13][14] sugary soft-drinks [15][16][17][18], and alcoholic drinks [19,20]. Snacking has been defined as eating any food outside of meal times, except for fruit [21]. ...
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BACKGROUND Impulsive processes driving eating behaviour can often undermine peoples’ attempts to lose weight and maintain weight loss. OBJECTIVE To develop an impulse management intervention to support weight loss in adults. METHODS Intervention Mapping (IM) was used to systematically develop the “ImpulsePal” intervention. The development involved: 1) a needs assessment including a qualitative study, service user workshops, a systematic review of impulse modification techniques, and consultations with intervention design and delivery experts; 2) specification of performance objectives, determinants, and change objectives; 3) selection of intervention strategies (mapping of taxonomy-related change techniques to the determinants of change); 4) creation of programme materials; 5) specification of adoption and implementation plans; 6) devising an evaluation plan. RESULTS Application of the IM Protocol resulted in a smartphone app-based intervention aimed at reducing unhealthy snacking, overeating, and alcoholic and sugary drink consumption. The app includes inhibition training, mindfulness techniques, implementation intentions (if-then planning), visuospatial loading, use of physical activity as a craving-management technique, and context-specific reminders. An “Emergency Button” was also included to provide access to in-the-moment support when temptation is strong. CONCLUSIONS ImpulsePal is a novel, theory- and evidence-informed, person-centred app to improve impulse management and promote healthier eating. Intervention Mapping ensured that all app components are practical operationalisations of change techniques that target our specific change objectives and their associated theoretical determinants. Using this approach enhances transparency, provides a clear framework for analysis and increases replicability as well as the potential of the intervention to accomplish the desired outcome of supporting weight loss.
... In total, 242 subjects (114 males; 128 females; BMI = 25.7 ± 4.9 kg/m 2 ) were included in the present cross-sectional analyses (see Table 1), which combined data from the baseline, non-intervention control conditions of five previous studies employing common experimental procedures (Supplementary Figure 1) [24][25][26][27][28][29]. These studies were originally designed to examine the effect of diet on body composition, eating behaviour and health, and had no a priori hypotheses about the effects of body composition or EE as determinants of food intake. ...
Article
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Background: There is evidence that the energetic demand of metabolically active tissue is associated with day-to-day food intake (EI). However, the extent to which behavioural components of total daily energy expenditure (EE) such as activity energy expenditure (AEE) are also associated with EI is unknown. Therefore, the present study examined the cross-sectional associations between body composition, resting metabolic rate (RMR), AEE and EI. Methods: Data for 242 individuals (114 males; 128 females; BMI = 25.7 ± 4.9 kg/m2) were collated from the baseline control conditions of five studies employing common measures of body composition (air displacement plethysmography) and RMR (indirect calorimetry). Daily EI (weighed-dietary records) and EE (FLEX heart rate) were measured over 6-7 days, and AEE was calculated as total daily EE minus RMR. Results: Linear regression indicated that RMR (ß = 0.39; P < 0.001), fat mass (ß = -0.26; P < 0.001) and AEE (ß = 0.18; P = 0.002) were independent predictors of mean daily EI, with AEE adding ≈3% of variance to the model after controlling for age, sex and study (F(10, 231) = 18.532, P < 0.001; R2 = 0.445). Path analyses indicated that the effect of FFM on mean daily EI was mediated by RMR (P < 0.05), while direct (β = 0.19; P < 0.001) and indirect (β = 0.20; P = 0.001) associations between AEE and mean daily EI were observed. Conclusions: When physical activity was allowed to vary under free-living conditions, AEE was associated with mean daily EI independently of other biological determinants of EI arising from body composition and RMR. These data suggest that EE per se exerts influence over daily food intake, with both metabolic (RMR) and behavioral (AEE) components of total daily EE potentially influencing EI via their contribution to daily energy requirements.
... A similar definition has been used by Niven et al. [12]. Many commercially available discretionary snack foods are energy-dense, processed and act as major contributors to calorie and saturated fat intake [13][14][15]. ...
Article
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A Physical Activity Calorie Equivalent (PACE) label shows the minutes of physical activity required to burn off the caloric content of a particular food. This study investigated the influence of PACE labelling on liking and consumption of discretionary snack foods in a group of more health focused and less health focused consumers. Participants (n = 97) tasted and rated (i.e., liking, prospective consumption) a range of snack foods with or without a PACE label. Total sampling consumption was also measured. Participants completed a shortened version of the International Physical Activity Questionnaire and the General Health Interest Scale questionnaire. Paired samples t-test, independent samples t-tests, a General Linear Model and Chi-Square tests were used to check for statistical significance. For more health focused participants (n = 57), the PACE label decreased only liking (p = 0.02). The PACE label was not effective in reducing liking (p = 0.49), prospective consumption (defined as the amount of the sample participants thought that they could consume) (p = 0.10) or consumption (p = 0.41) of energy-dense discretionary snack foods for less health focused individuals (n = 40). The level of participants’ physical activity did not facilitate the influence of PACE labelling on liking, consumption or prospective consumption. The PACE label was found to not be effective among less health focused individuals or the overall sample population. Therefore, the PACE label may not be an effective labelling strategy to reduce the liking or consumption of discretionary snack foods.
... but few differences in qualitative dietary characteristics or the reported time of eating main meals. We found one report of partial compensatory snack-energy adjustment in a 14-d crossover snack intervention trial, where both lean and overweight adults compensated for roughly half of the snack energy (48). Other published laboratory-based crossover studies have reported either no compensation or complete compensation (27)(28)(29)(30)32). ...
Article
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Background: Most Americans snack and some snack several times a day; however, compensatory dietary and eating behaviors associated with snacking in free-living individuals are poorly understood. Objective: The aim of the study was to examine within-person differences in reported energy intake and eating patterns on a snack day relative to a no-snack day. Methods: We used 2 d of dietary recall data from the NHANES 2007-2014 to replicate the crossover nutrition study paradigm in a natural setting. Respondents reporting a snack episode in only one of two available dietary recalls were eligible for inclusion in the study (n = 1,917 men and 1,860 women). We used multivariable regression methods to compare within-person differences in quantitative, qualitative, and eating pattern outcomes between the snack and no-snack recall days. Results: On the snack day, snack episodes provided (mean difference and 95% CI) 493 (454, 532) kcal of energy in men and 360 (328, 392) kcal in women. The 24-h energy intake on snack day was higher by 239 (140, 337) kcal in men and 219 (164, 273) kcal in women (P < 0.0001). On the snack day, both men and women were more likely to skip main meals and reported lower energy intake from main meals (P < 0.0001); however, the energy density of foods or beverages reported on the snack compared with no-snack days were not different. Fruit servings were higher on the snack day (P ≤ 0.0004), but intakes of vegetables and key micronutrients did not differ. The 24-h ingestive period was longer on the snack day (P < 0.0001). Conclusions: Free-living men and women partially compensated for snack energy by decreasing energy intake from main meals without adverse associations with qualitative dietary characteristics or time of meal consumption. Women compensated to a smaller extent than men. Thus, over the long term, snack episodes may contribute to positive energy balance, and the risk may be higher in women.
... The aetiology of obesity is multifactorial. However, two factors that may precipitate weight gain by causing an energy imbalance are the overconsumption of snacks (energy dense non-meal food items, e.g., potato crisps, chocolate), coupled with reduced levels of physical activity (Astrup, Bovy, Nackenhorst, & Popova, 2006;Whybrow, Mayer, Kirk, Mazlan, & Stubbs, 2007). This highlights the need to gain an enhanced understanding of the psychological processes involved in the relationship between energy intake and expenditure, specifically the processes that influence individuals' choices following the consumption of energy dense snacks. ...
Article
The Compensatory Health Beliefs Model proposes that individuals may believe that an unhealthy behaviour can be compensated for by subsequent engagement in a healthy behaviour. The present study aimed to test this proposition, specifically by examining the influence of snack consumption (healthy, unhealthy) on type of activity selected (physical, sedentary). A sample of 100 female undergraduate students (Mage = 20.41 years) were randomly assigned to consume either healthy or unhealthy snacks of comparable nutritional value. To assess potential compensatory behaviour, participants were then given the choice to engage in either a physical activity (exercise on a treadmill) or a sedentary activity (a game on an iPad). Results showed that a significantly higher proportion of participants who consumed the unhealthy snacks selected the physical activity as opposed to the sedentary activity. Perceived healthiness of the snacks, but not perceived caloric intake, mediated the relationship between snack type and activity selection. The findings provide empirical evidence for compensation proposed by the Compensatory Health Beliefs Model, whereby an unhealthy behaviour (unhealthy snack consumption) led to subsequent engagement in a healthy behaviour (physical activity).
... Asking overweight people to record their food intake is a method used to help change behaviour and food choice to create a negative energy balance (25,26) . Completing a food diary results in a significant weight loss over 7 d even in participants who are not aiming to lose weight (27,28) . The results of this study suggest that the effect is similar in lean people also. ...
Article
From 2008 the UK's National Diet and Nutrition Survey (NDNS) changed the method of dietary data collection from a 7-d weighed diary to a 4-d unweighed diary, partly to reduce participant burden. This study aimed to test whether self-reported energy intake changed significantly over the 4-d recording period of the NDNS rolling programme. Analyses used data from the NDNS years 1 (2008/2009) to 8 (2015/2016) inclusive, from participants aged 13 y. and older. Dietary records from participants who reported unusual amounts of food and drink consumed on one or more days were excluded, leaving 6932 participants. Mean daily energy intake was 7107kJ (1698kcal), and there was a significant decrease of 164kJ (39kcal) between days one and four (P < 0.001). There was no significant interaction of sex or low-energy reporter status (estimated from the ratio of reported energy intake to BMR) with the change in reported energy intake. The decrease in reported energy intake on day four compared to day one was greater (P < 0.019) for adults with higher BMIs (> 30kg/m ² ) than it was for leaner adults. Reported energy intake decreased over the 4-d recording period of the NDNS rolling programme suggesting that participants change their diet more, or report less completely, with successive days of recording their diet. The size of the effect was relatively minor, however.
... However, this of course is only the case if additional caloric intake between meals (from snacking) is effectively compensated for in caloric intake within meals. Unfortunately, other studies demonstrate that consumers are not particularly effective in this process of energy compensation after eating a snack (Marmonier, Chapelot, Fantino, & Louis-Sylvestre, 2002; Whybrow, Mayer, Kirk, & Stubbs, 2007; Zandstra, Stubenitsky, de Graaf, & Mela, 2002). Snacking is a complex, poorly understood and underresearched phenomenon. ...
Article
The aim of this study is to gain more insight into how consumers' perceptions of the satiety value of snack products influence their choice of such products and to get a better understanding of consumer terminology and perceptions about product-related satiety. Participants were asked to indicate their individual product choice in response to a scenario. Scenarios varied as a between-subject factor in terms of whether information on the time gap till the next meal occasion (favorite main dish) was provided or not, and whether this meal would be eaten after one hour or four hours. To get a better understanding of consumer terminology a repertory grid task was used to elicit consumer attributes relating to satiety. This research shows that, when consumers are confronted with situations that vary in satiety requirements, they do not make significantly different snack products choices. But they do have specific ideas about the product features that influence the perceived satiety level of a product. Products perceived as fat, high in protein, with a savory taste and in one piece are expected to have a higher level of satiety compared to sweet products and products that exist of multiple small items.
... A balanced eating behaviour encompasses eating recommended portions at fixed hours guaranteeing healthy feelings of hunger and a routine that promotes physiological growth and energy expenditure. However, a trend of snacking in the absence of hunger is observed among families in western society that may contribute to obesity via the intake of excess energy [1] . ...
Article
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Objective: This paper introduces health professionals to the different psychological models thought to influence eating behaviour in the absence of hunger in children who are obese and to propose a method of assessing these behaviours in practice. Methods: Clinical researchers from the European Childhood Obesity Group (ECOG) adopted an evidence-based approach to examine the literature concerning the assessment of eating behaviour in children who are obese. Studies published in English were filtered out of the medical and psychological literature from 1960 to the present, and the resulting bibliography was searched for relevant articles. Key themes from the current evidence were compiled and classified according to the underpinning psychological models. Based on the current evidence and the authors' combined clinical experience, a three-staged approach to assessment was agreed by consensus. Results: Valid and reliable tools for assessing and monitoring each of the three identified models (Dietary Restraint Theory, Emotional Eating and the Diathesis-Stress Model) are suggested for use in clinical practice, and the ECOG three-staged approach to assessing eating behaviours in the absence of hunger is described. Conclusions: This paper presents practical guidance on how to assess eating behaviour in the absence of hunger in children who are clinically obese and suggests a focus for future research.
Article
Aims: Although our current weight management guidelines suggest eating regularly, speculation about whether snacking assists with managing weight occurs widely among the media, weight loss clients and health professionals. We aim to examine whether there is adequate scientific evidence available to support the manipulation of eating frequently for improving body weight, diabetes and cardiovascular risk markers, and theories that link eating frequently with weight management. Methods: Relevant papers from nutrition and dietetics journals and other sources were used to assess the association between eating frequency and weight and health. Results: Longer-term evidence suggests eating frequency does not affect weight, glucose, insulin control, hunger or energy expenditure in intentional weight losers and maintainers. There is consistent short-term evidence of an inverse association between blood lipid levels and eating frequency during weight maintenance. Many of the common theories that suggest manipulating eating frequency for weight management are not supported by the literature. Sustaining a change to eating frequency also may be challenging over the longer term. Conclusions: Overall current evidence does not suggest that manipulating eating frequency greatly benefits weight and health. Health professionals may not need to manipulate eating frequency for weight management.
Article
Sales of nutrition bars increased almost 10-fold to $1.7billion over the past decade yet few studies have examined the impact of bar ingestion on dietary parameters. In this crossover trial, 24-h energy intakes were assessed in free-living college students ingesting a high-protein (HP, 280kcal) or a high-carbohydrate (HC, 260kcal) nutrition bar upon waking. Fifty-four students entered the trial, and 37 participants completed the three test days. Daily energy intakes ranged from 1752±99kcal for the non-intervention day to 1846±75 and 1891±110kcal for the days the HP and HC bars were consumed respectively (p=0.591). However, for individuals who reported high levels of physically activity (n=11), daily energy intakes increased significantly compared to the control day for the HC bar day (+45%; p=0.030) and HP bar day (+22%; p=0.038). Macro- and micro-nutrient intakes differed significantly across test days in the total sample mirroring the nutrient profile of the specific bars. These data suggest that young adults adjust caloric intakes appropriately following the ingestion of energy-dense nutrition bars over a 24-h period. Moreover, nutrition bars may represent a unique opportunity to favorably influence nutrient status of young adults.
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Many beliefs about obesity persist in the absence of supporting scientific evidence (presumptions); some persist despite contradicting evidence (myths). The promulgation of unsupported beliefs may yield poorly informed policy decisions, inaccurate clinical and public health recommendations, and an unproductive allocation of research resources and may divert attention away from useful, evidence-based information. Using Internet searches of popular media and scientific literature, we identified, reviewed, and classified obesity-related myths and presumptions. We also examined facts that are well supported by evidence, with an emphasis on those that have practical implications for public health, policy, or clinical recommendations. We identified seven obesity-related myths concerning the effects of small sustained increases in energy intake or expenditure, establishment of realistic goals for weight loss, rapid weight loss, weight-loss readiness, physical-education classes, breast-feeding, and energy expended during sexual activity. We also identified six presumptions about the purported effects of regularly eating breakfast, early childhood experiences, eating fruits and vegetables, weight cycling, snacking, and the built (i.e., human-made) environment. Finally, we identified nine evidence-supported facts that are relevant for the formulation of sound public health, policy, or clinical recommendations. False and scientifically unsupported beliefs about obesity are pervasive in both scientific literature and the popular press. (Funded by the National Institutes of Health.).
Article
Energy intake is a function of the quantity of energy consumed per ingestive event and the number of these events. The marked increase of energy intake and body weight over the past 35years indicates there has been poor precision in the reciprocity of these two facets of intake. With recent study of the associations between gut "satiation" peptides and energy intake, there has been an emphasis on the contribution of portion size to positive energy balance. However, this orientation may not appropriately weight the contribution of ingestive frequency. Gut peptides are not purely satiation factors and metabolic and environmental cues may more strongly guide the onset and number of ingestive events. Evidence is presented that while both portion size and ingestive frequency have increased in the population, the latter may be more problematic for weight gain. The magnitude and time course of increments in ingestive frequency better map onto energy intake and BMI trends than changes of portion size. This may occur, in part, because dietary compensation and thermogeinic effects are weaker for increases in ingestive frequency than portion size. Though not to the exclusion of consideration of portion size effects, improved weight management may be achieved with greater attention to the drivers of eating and drinking frequency.
Article
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A 'healthy eating' diet of low-energy density is one of the most effective ways of achieving long-term weight-loss and weight-loss maintenance. Highly energy dense (processed) foods tend to be cheaper, in terms of energy per unit cost, and per serving, than foods that are of low-energy density, such as fruits and vegetables. Therefore, the apparent cost of selecting a low-energy density, and healthier, diet may be a barrier to long-term weight-loss. This study compared the food purchase costs of a commercial healthy eating weight-loss (HEWL) programme (Slimming World) to habitual diets consumed to approximate energy balance. Adult women (117) completed weighed intake food diaries over 3 d. Data from 188 women collected during three previous studies were used as representative of habitual diets (1–3). Mean daily food purchase costs (p/d) and energy adjusted costs (p/MJ) were calculated from food prices collected during December 2009 and June 2010. Dietary energy density (ED), and weight, were calculated both including and excluding the contribution of drinks. BMR was estimated (4). Differences between the two groups were compared using Student's t-tests.
Chapter
The prevalence of snacking and the number of snacks consumed per day have increased in the past three decades in the United States. These trends have been implicated in the incidence and prevalence of overweight/obesity. However, establishment of a quantitative relationship has been hampered by methodological issues. This chapter begins with a discussion of the strengths and limitations of various definitions of snacking. It then summarizes current snacking prevalence and how it plays a role in human energy balance acutely and body weight over the longer term. Although not consistent, the literature supports the view that snacking is positively related to body weight, especially when it is unplanned and contains energy-yielding beverages. The chapter concludes with a consideration of the role of snacking in weight management and how snacks can be incorporated in a healthy diet.
Article
Metabolic disorders, like diabetes, as well as maternal diet, alter nutrient availability in utero, inducing adaptations in the offspring. Whether the effects of maternal hyperglycemia are modulated by diet, however, has yet to be explored. In the current study, we examined this issue by giving females rats, treated neonatally with STZ to induce mild hyperglycemia, and control littermates either ad libitum access to standard chow (Control n = 17; STZ n = 16) or standard chow and snacks (Control-snack n = 18; STZ-snack n = 19) (potato chips and a red fruit-flavored sucrose syrup solution 1.5%) throughout pregnancy and lactation. We hypothesized that the maternal glucose intolerance typically seen in female rats treated neonatally with STZ would be exacerbated by snack intake and, further, the combination of snack intake and STZ treatment would lead to alterations in maternal behavior and offspring development. Maternal body weight and food intake were measured daily through pregnancy and lactation and litter weight throughout lactation. At birth, litter size, offspring weight, body length, and anogenital distance were obtained and offspring were classified according to their weight. Measures of nursing and retrieval behavior, as well as exploration in the open field and the elevated plus-maze were also recorded. As predicted, snack intake tended to aggravate the glucose intolerance of STZ-treated rats during pregnancy. Both Control and STZ-treated females that had access to snacks ate more calories and fat but less carbohydrate and protein than females having access to chow alone. Overall, STZ-treated dams gave birth to fewer pups. Chow-fed STZ females gave birth to a greater proportion of large for pregnancy age pups, whereas dams in the Control-snack group gave birth to a greater proportion of small pups. The birth weight classification of pups born to STZ-snack rats, however, resembled that of the Control chow-fed females. Although all litters gained weight during lactation, litters from snack-fed dams gained less weight regardless of maternal hyperglycemia and did not show catch-up growth by weaning. Overall, STZ rats spent more time nest building whereas the average inter milk ejection interval was higher in snack-fed females. STZ-snack dams retrieved the complete litter faster than dams in the other groups. Together, these data suggest that when mild hyperglycemic females are given access to snacks throughout pregnancy and lactation their intake is similar to that of Control females given snack access. The combination of hyperglycemia and snack access tended to decrease glucose tolerance in pregnancy, and normalized birth weight classification, but produced few other effects that were not seen as a function of snack intake or hyperglycemia alone. Since birth weight is a strong predictor of health issues, future studies will further investigate offspring behavioral and metabolic outcomes later in life.
Article
Objective This study aimed to examine the relationship between eating frequency (EF), meal frequency (MF), and snacking frequency (SF), and the body weight status of postmenopausal women. We tested how MF and SF were related to macronutrient intake and how different definitions of snacking affected the study results. Research Methods & Procedures Dietary intake was assessed using a three-day food diary in 302 women aged 45–65. Body weight, body fat percentage, and waist circumference were measured and the body mass index (BMI) was computed. Women were classified as overweight-to-obese or of normal weight. Eating occasions providing at least 50 kcal were classified as meals or snacks, based on 3 definitions: 1) contribution to total energy intake (EI) (≥15% as a meal, <15% as a snack), 2) self-reported, and 3) based on time. Results When adjusted for some confounders, and additionally for the EI:estimated energy requirement (EER) a negative association was seen between EF, self-reported SF, and BMI. EF and self-reported SF were negatively associated with EI. Between-group differences in the dietary composition of the snacks were seen when they were identified by participants themselves. Specifically, the percentage energy from total sugar and alcohol in self-reported snacks was significantly lower, while dietary fiber density (DFD) was significantly higher among the normal-weight than among the overweight-to-obese women. Conclusion Higher EF and self-reported SF, independently of EI:EER, is associated with lower BMI and EI in postmenopausal women. Snacking may improve the DFD of the diet. An objective definition for snacking needs to be used in nutritional studies.
Chapter
Simply put, obesity is a result of energy imbalance. Energy expenditure and energy intake are the two main factors in the energy balance equation. However, considerable disagreement occurs over the importance of energy expenditure in terms of obesity. The role that reduction in physical activity levels plays in stemming the rising obesity epidemic and the effectiveness of exercise in treating obesity are heavily debated topics. However, there is little argument that diet is a central issue in both the increasing prevalence of obesity and in the management of this disease. Although nutrition plays a straightforward role in its development and treatment, changing the diet of an individual is not so straightforward.
Chapter
The prevalence of snacking has increased over the past decades. These trends have been implicated in the incidence and prevalence of overweight/obesity. This chapter begins with a description of snacking dimensions and definitions. It then summarizes the current prevalence of snacking and how it impacts on energy balance. This chapter highlights that snacking is associated with both beneficial/neutral and negative effects on energy balance. Numerous methodological issues could explain discrepancies between studies investigating the impact of snacking on energy balance. These include snacking definitions and assessments, timing, food quality, food perceptions, attention while snacking, underreporting, and lifestyle habits. Although more intervention studies are needed to clarify the impact of snacking on energy balance, the literature supports the view that healthy snacking can be part of a healthy lifestyle without promoting body weight gain. The chapter concludes with consideration and recommendation on how snacking can be incorporated into a healthy diet.
Article
Assessment of the tolerability, and appetite suppressing effect, of a midmorning snack containing high molecular weight polysaccharides, which form a gel in the stomach - Volume 73 Issue OCE1 - E. J. Simpson, E. Woods, S. Gaunt, D. Park, T. I. Foster, A. Macdonald
Article
Snacking, or the habit of eating little and often, has been postulated to have a range of health benefits in relation to appetite control, bodyweight management and improved blood glucose control in diabetics and pre‐diabetics. However, there is widespread agreement that our current obesogenic environment is encouraging overeating in response to increased food portion sizes, palatability and/or energy‐density of foods, alongside the many social and psychological cues to eat. In this context, and as findings on the health effects of snacking are conflicting, the question remains as to whether more frequent eating and snacking can be of benefit to health. Snacks, if added to habitual meal intake, with no compensation for snack energy contribution, are likely over time to lead to positive energy balance. Hence, snacking might be a contributing factor to the obesity epidemic, in addition to more established factors, such as food choice and physical activity. This paper explores the existing evidence concerning the impact of snacking on bodyweight and the behavioural and metabolic response to snacking. The impact of snacking on cognitive function is also discussed. The review highlights the need for further research as, despite many years of scientific interest in snacking, the lack of consistency in study design and snacking definitions and the array of potential confounding factors (e.g. physical activity levels) makes interpretation of findings difficult and has led to little consensus about the optimum number and composition of meals and/or snacks for bodyweight control, health and wellbeing on a population‐wide basis.
Article
Preventing obesity (OB) among adults is a public health priority. One factor that seems to contribute to OB, due to the extra energy intake it involves, is the greater consumption of snacks. Whether snacking promotes OB in adults is however a source of controversy in the literature at present. The aim of this paper was to evaluate the effects of snacking on body weight status, along with contextual factors such as snacking location, food source, timing, and social context of snacking. To better understand the nature of snacking behavior, seven currently used definitions of snacking were described. Studies published prior to November 2020 were identified by searching the PubMed and Scopus databases, with thirty-three observational studies being identified and included. The consumption of energy-dense snacks may contribute to higher energy intake and weight in adult populations. The context in which adults snacks—such as eating alone, outside home or work, late in the day, in front of a TV or computer—is also important for this behavior. However, the lack of consensus on the definition of snacks in the literature makes these considerations suggestive rather than objective. Better-designed research is needed to determine the prospective association between snacking behavior and weight status in adults. Snacking may be an important behavior that can be modified to prevent obesity on the population level. Social education focusing on promoting morning snacks and replacing energy-dense snacks by more nutritious ones, e.g. fruit and vegetables, may thus be beneficial.
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The relationship between dietary patterns and chronic disease is underexplored in indigenous populations. We assessed diets of 424 American Indian (AI) adults living in 5 rural AI communities. We identified four food patterns. Increased prevalence for cardiovascular disease was highly associated with the consumption of unhealthy snacks and high fat-food patterns (OR 3.6, CI = 1.06, 12.3; and OR 6.0, CI = 1.63, 22.1), respectively. Moreover, the food-consumption pattern appeared to be different by community setting (p < .05). We recommend culturally appropriate community-intervention programs to promote healthy behavior and to prevent diet-related chronic diseases in this high-risk population.
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In self-reported diets of free living individuals, frequent eating is associated with higher energy intake, yet beliefs about the possible beneficial effect of higher eating frequency for managing body weight persist. Prospective cohort studies and controlled trials of manipulation of eating frequency published by 31 December 2012 were reviewed to assess whether variation in eating frequency may be an adjunct to weight management. Four prospective cohort studies were identified; 2 of these included adults followed for 10 y and 2 followed pre-adolescent/adolescent girls for 6 or10 y. Within each age category, the findings of the 2 studies were contradictory. Six controlled trials with adult subjects serving as their own controls found no significant changes in body weight due to manipulation of eating frequency interventions lasting 6-8 wk. In 6 additional intervention trials of 8-52 wk duration, free-living adults were counseled to change the eating frequency of self-selected food intake with no significant differences in weight loss attributable to eating frequency. Overall, the consistency of the null findings from controlled trials of manipulation of eating frequency for promoting weight loss suggests that beliefs about the role of higher eating frequency in adult weight management are not supported by evidence. Interpretation of the evidence from published observational studies is complicated by differences in definition of eating frequency and limited knowledge of systematic and random errors in measurement of eating frequency.
Article
Background: Public health and clinical interventions for obesity in free-living adults may be diminished by individual compensation for the intervention. Approaches to predict weight outcomes do not account for all mechanisms of compensation, so they are not well suited to predict outcomes in free-living adults. Our objective was to quantify the range of compensation in energy intake or expenditure observed in human randomized controlled trials (RCTs). Methods: We searched multiple databases (PubMed, CINAHL, SCOPUS, Cochrane, ProQuest, PsycInfo) up to 1 August 2012 for RCTs evaluating the effect of dietary and/or physical activity interventions on body weight/composition. Inclusion criteria: subjects per treatment arm ≥5; ≥1 week intervention; a reported outcome of body weight/body composition; the intervention was either a prescribed amount of over- or underfeeding and/or supervised or monitored physical activity was prescribed; ≥80% compliance; and an objective method was used to verify compliance with the intervention (for example, observation and electronic monitoring). Data were independently extracted and analyzed by multiple reviewers with consensus reached by discussion. We compared observed weight change with predicted weight change using two models that predict weight change accounting only for metabolic compensation. Findings: Twenty-eight studies met inclusion criteria. Overfeeding studies indicate 96% less weight gain than expected if no compensation occurred. Dietary restriction and exercise studies may result in up to 12-44% and 55-64% less weight loss than expected, respectively, under an assumption of no behavioral compensation. Interpretation: Compensation is substantial even in high-compliance conditions, resulting in far less weight change than would be expected. The simple algorithm we report allows for more realistic predictions of intervention effects in free-living populations by accounting for the significant compensation that occurs.
Article
Observational studies show an inverse relationship between fat and sugar within diets, described as the ‘fat-sugar seesaw’. It has been suggested however, that this is a consequence of expressing macronutrient intakes as percentages of energy intake rather than by the dietary choices made by individuals. To test this we examined the associations between macronutrient intakes in the diets of adults (n = 1724) participating in the UK National Diet and Nutrition Survey (NDNS) and within the same adults across different days of the week. Pearson's correlations were calculated between the macronutrient intakes from fat, total sugar, intrinsic sugars, non-milk extrinsic sugars (NMES), non-sugar carbohydrate, protein and alcohol. Energy intakes relative to estimated basal metabolic rate (BMR) were calculated to partially account for differences in energy requirements. Pearson's correlations also examined associations between the same macronutrients in foods from the Nutrient Databank (ND), used to analyse dietary intakes in the NDNS. Correlations between fat and sugar(s) were calculated in five ways: (i) percentage energy between individuals; (ii) amount (g) between individuals; (iii) amount (g) relative to BMR between individuals; (iv) within individuals over seven days; and (v) between food items in the ND. Negative correlations were obtained between mean daily percentage energy intakes of fat and, total sugars, NMES and intrinsic sugars (all P < 0.001). However, when mean daily macronutrient intakes were expressed in weight (g)/day, these were all positively correlated (all P < 0.001). Mean estimated correlations between macronutrient intakes (g/day) for each individual across the days of the week were also positive, indicating a lack of fat-sugar seesaw effect. Within the ND, the correlation between fat and total sugar (g/100g of food) was weakly positive (P = 0.006). Only when examining the correlation between fat and sugar(s) between individuals in percentage terms (% energy) was the fat-sugar seesaw evident; in all other methods the correlations between fat and sugar(s) were positive. Examination of the effects of using percentage energy values to describe the macronutrient composition demonstrated that the fat-sugar seesaw is only an inevitable mathematical consequence, rather than the result of dietary choice. Comparing diet composition in percentage terms alone can therefore be misleading. It is only when examined as absolute values (weight), as well as percentage contributions to energy, that the interrelationships between macronutrients can be studied fully.
Article
The goal of this research synthesis was to separate and articulate questions that had clear meaning, were empirically addressable, and were germane to the broad question "Is fat fattening?" Four such questions addressing the effect of varying the proportion of dietary fat on body weight and body fat were formulated. A comprehensive review of electronic citation databases was conducted to identify studies that addressed each question. The results of the studies addressing each question were tabulated and summarized, and an answer for each question was formulated. The results indicated that whether "fat is fattening" depends on exactly what one means by the question. It is apparent that under conditions of energy deficit, high-fat diets lead to greater weight loss than low-fat diets, but under ad libitum feeding conditions, instructing persons to follow a low-fat diet promotes loss of body weight and body fat. For one question, studies were few but convincing that altering the proportion of energy from fat in daily snacks has no effect on weight, while for another there were not enough studies available to answer the question with confidence. General recommendations to reduce dietary fat to promote weight loss or maintenance in all circumstances may merit reconsideration.
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To investigate the relationships between eating frequency (EF) and body weight status and to determine whether these relationships can be explained in terms of differences in physical activity levels, macronutrient intakes or energy compensation. Cross-sectional design; free-living subjects, 48 men and 47 women (aged 20-55 y, body mass index (BMI) 18-30), recruited in a workplace setting. Height and weight; skinfold thickness (four sites); EF, energy and macronutrient intakes (food diary, unweighed, recorded for seven consecutive days); physical activity (7 d activity diary and heart rate monitoring over 48 h period). In men there was a significant negative correlation between EF and body weight, and an inverse relationship with body mass index (BMI). EF was positively correlated with % energy from carbohydrate, although not with total energy intake. In women, there was no relationship between EF and body weight status; however, there were significant positive correlations between EF and total energy intake, and between EF and intakes of total carbohydrate and sugars. For both men and women, there were associations between EF and physical activity levels, approaching statistical significance. In men, the association between increased EF and lower body weight status may have been influenced by increased physical activity levels. As energy intake did not increase with EF, men appear to have compensated by reducing the mean energy consumed per eating episode. Energy compensation did not take place in women, with women who ate most frequently having the highest energy intakes, although this did not lead to higher BMIs. Physical activity, through participation in active leisure pursuits, may have been an important factor in weight control in women. The % contribution of carbohydrate to total energy was positively correlated with EF in both men and women, and further analysis showed that snack foods provided a higher proportion of carbohydrate than did foods eaten as meals. These results indicate that a high EF is likely to lead to a high carbohydrate diet, which may be favourable for weight control. Our findings suggest that in this population, a high EF was associated with leanness in men, and there was no link between EF and body weight status in women.
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1. A modified heart rate (HR) method for predicting total energy expenditure (TEE) was cross-validated against whole-body calorimetry (CAL). Minute-by-minute HR was converted to energy expenditure (EE) using individual calibration curves when HR exceeded a pre-determined ‘FLEX’ value designed to discriminate periods of activity. (‘FLEX’ HR was defined as the mean of the highest HR during rest and the lowest HR during the lightest imposed exercise.) Sedentary EE (below FLEX) was calculated as the mean EE during lying down, sitting and standing at rest. Sleeping EE was calculated as basal metabolic rate (BMR) predicted from standard equations. 2. Calibration curves of oxygen consumption v. HR for different postures at rest and during exercise were obtained for twenty healthy subjects (eleven male, nine female); mean r 0.941 (SD 0.04). The mean FLEX HR for men and women were 86 (sd 10) and 96 (SD 6) beats/min respectively. 3. Simultaneous measurements of HR and EE were made during 21 h continuous CAL, which included 4 x 30 min imposed exercise (cycling, rowing, stepping, jogging). HR exceeded FLEX for a mean of 98 (SD 41) min. Mean TEE by CAL (TEE. CAL) was 8063 (sd 1445) kJ. 4. The HR method yielded a mean non-significant underestimate in TEE (TEE. HR) of 1.2 (sd 6.2)% (range−11.4 to + 10.6 %). Regression of TEE. HR ( y ) v. TEE. CAL ( X ) yielded Y = 0.868 X +927 kJ, r 0.943, se of the estimate 458 kJ, n 20. 5. The satisfactory predictive power and low cost of the method makes it suitable for many field and epidemiological applications.
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Total daily energy expenditure (TDEE) and energy expended in activity (EAC) were estimated by the minute-by-minute heart-rate method in 22 (16 men, 6 women) individually calibrated subjects and compared with values obtained by whole-body indirect calorimetry. Subjects followed four activity protocols during the 22 h in the calorimeter; no exercise (n = 6) and 2 (n = 5), 4 (n = 4), and 6 (n = 6) 30-min bouts of exercise on a bicycle ergometer at varying intensities. There were no statistically significant differences between the two methods in TDEE or EAC in any of the sex or protocol groupings. The regression of TDEE by heart rate on TDEE in the calorimeter was y = 0.92x + 1.0 MJ; (r = 0.87, SEE = 0.91 MJ). The heart-rate method also follows the varying activity patterns of individuals and can be used to closely estimate the TDEE and EAC of even small (n = 4-6) groups of subjects. In the present measurements, it gave a maximum error of TDEE for individuals of +20% and -15%.
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To assess meals versus snacks in terms of their contribution to total daily energy intake (TDI), macronutrient composition, and food commodity profile. Meals and snacks were assessed from 220 7-day weighed dietary records. 187 records were obtained from three separate existing studies, and reanalysed. These studies contained data on three different age groups in the British population; elderly group (n = 88), middle-aged group (n = 40), young adult group (n = 59). A separate study of 13-14-year-olds living in Croydon was conducted from which 33 usable diet records were collected (adolescent group). Boys in the adolescent group consumed more of their TDI as snacks (29.0%) compared with men in the young adult (18.9%) and elderly groups (16.6%), but not the middle-aged group (25.8%). Females consumed about the same percentage of their TDI as snacks; adolescent group 23.6%, young adult group 19.4%, middle-aged group 21.4%, elderly group 17.9%. Meals were higher in protein and fat, and lower in total sugars, compared with snacks. Chocolate confectionery, crisps and fizzy drinks and squashes were popular snack foods in the adolescent group. Unlike snacks, the food commodity profiles of meals were similar in all age groups. This study shows that foods and drinks consumed as snacks by the British public, including the elderly, have a relatively high total sugar composition. These results add to the concern relating snack foods with dental caries.
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To examine the association of frequency of eating occasions with prospective, and retrospective weight change. Data from the NHANES I (1971-75) Epidemiologic Follow-up Study (NHEFS, 1982-84) (n = 7147) was used. Weight change was defined as the difference between the weight measured at follow-up in 1982-84 and the weight measured at baseline in 1971-75. Baseline frequency of eating occasions was estimated by summation of actual times at which food was reported consumed in a 24-h dietary recall. Follow-up frequency of eating was estimated from subject responses at follow-up to number of meals and snacks consumed daily. Men and women reported (mean +/- s.e.) baseline frequency of 5.3 +/- 0.06 and 4.9 +/- 0.03 eating occasions, respectively. Frequency of eating occasions at follow-up was 3.6 +/- 0.02 occasions in both men and women. Baseline body mass index and frequency of eating were inversely related in multivariate regression analyses in both men and women (P < 0.02). Regression analyses adjusted for multiple covariates showed no association between weight change and frequency of eating at baseline or follow-up. Baseline frequency and subsequent weight change or follow-up frequency and preceding weight change were unrelated in the NHEFS cohort.
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To assess the relationship between feeding pattern and body mass index in free-living humans. Feeding pattern was assessed from 220 7-day weighed dietary records. 187 records were obtained from three separate existing studies, and reanalysed. These studies contained data on three age groups in the British population; Elderly group (n = 88), Middle-aged group (n = 40), Working age group (n = 59). A separate study of 13-14 year olds living in Croydon was conducted from which 33 usable diet records were collected to produce a fourth, Adolescent group. 'Nibbling' and greater energy intakes at breakfast were associated with a lower body mass index (BMI) in the Adolescent group. In the Middle-aged group, greater energy intakes at breakfast and lower energy intakes during the evening were associated with a lower BMI. However, when diet records which produced unreasonably low energy intakes were removed from the analysis, these relationships disappeared except for energy intakes at breakfast and BMI in the Adolescent group. It is suggested that the relationship between feeding pattern and BMI observed in the Adolescent and Middle-aged groups was caused by underestimation of 'habitual' energy intake from snacks and the omission of breakfast by females and those who were overweight. The lack of relationship in the Working age group was attributed to the fact that more individuals in this group appeared to report valid diet records. Reported energy intake was directly related to BMI in the Working age group, but was not related to BMI in the other three age groups. It is concluded that feeding pattern is not a major factor in determining BMI in humans. Also, since snacks have a relatively high sugar and low fat composition compared with meals, it is suggested that biased under-reporting of snacks by the obese could produce spurious results from free-living studies which show that obesity is related to the proportion of energy from fat in the diet.
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The aim of this study was to examine the relationship between feeding frequency (FFQ) and body mass index (BMI) in a free-living group of teenagers, since recent evidence suggests that this may be an artifact of under-reporting. The data was cross-sectional, and a sample of 731 respondents (M = 298, F = 433) from the 1970 Longitudinal Birth Cohort Study were investigated. An initial significant relationship between FFQ and BMI was found for both males and females. However, the removal of overweight males who were dieting and a group of non-dieting females with BMI < 25 who perceived themselves to be overweight negated this relationship for males and females respectively. In conclusion, the apparent relationship between FFQ and BMI observed in this and other free-living studies appears to be an artifact of dieting and dietary restraint rather than simply under-reporting.
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Two areas of sports nutrition in which the periodicity of eating has been studied relate to: (1) the habitually high energy intakes of many athletes, and (2) the optimization of carbohydrate (CHO) availability to enhance performance. The present paper examines how the timing and frequency of food and fluid intake can assist the athlete and physically-active person to improve their exercise performance in these areas. Frequent eating occasions provide a practical strategy allowing athletes to increase energy intake while concomitantly reducing the gastric discomfort of infrequent large meals. The optimization of CHO stores is a special challenge for athletes undertaking prolonged training or competition sessions. This is a cyclical process with post-exercise CHO ingestion promoting muscle and liver glycogen re-synthesis; pre-exercise feedings being practised to optimize substrate availability and feedings during exercise providing a readily-available source of exogenous fuel as endogenous stores become depleted. The timing and frequency of CHO intake at these various stages are crucial determinants for optimizing fuel availability to enhance exercise capacity.
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This study examined the effect of energy density, independent of fat content and palatability, on food and energy intakes. With use of a within-subjects design, normal-weight women (n = 18) were provided with meals for 2 d during each of three test sessions. During lunch, dinner, and an evening snack, subjects were given free access to a main entree varying in energy density (low, medium, or high). The manipulated main entrees were similar in palatability to their counterparts across conditions. Low-energy compulsory (consumption required) side dishes accompanied each meal. Subjects also consumed a standard, compulsory breakfast. Results showed that subjects consumed a similar amount of food (by weight) across the three conditions of energy density. Thus, significantly more energy was consumed in the condition of high energy density (7532 +/- 363 kJ, or 1800 +/- 86 kcal) than in the medium- (6356 +/- 281 kJ, or 1519 +/- 67 kcal) and low- (5756 +/- 178 kJ, or 1376 +/- 43 kcal) energy-density conditions (P < 0.0001). There were no differences in hunger or fullness before meals, after meals, or over the 2 d across conditions. The results from this study indicate that energy density affects energy intake independent of macronutrient content or palatability, suggesting that the overconsumption of high-fat foods may be due to their high energy density rather than to their fat content.
Article
Epidemiological studies revealed that excessive weight and, in elderly age groups, also hypercholesterolemia, impaired glucose tolerance, and ischemic heart disease was more common among persons with an infrequent meal pattern than among those who customarily ate five or more meals per day. Factors involved in the mechanism of metabolic effects of infrequent feeding are discussed especially with respect to possible pathogenic effects of infrequent feeding in man.
Article
This pilot study was undertaken to assess whether a deliberate increase in eating frequency would cause an increase in overall energy intake and thus potentially contribute to weight gain. Ten adult male subjects were randomly allocated into two groups. One group consumed a given snack 30 minutes and the other 90 minutes before lunch and evening meals for a two-week period. After a washout period, the snacking regimes were reversed. Body weights were measured at baseline and at the end of the two intervention periods. Subjects completed a seven day semi-weighed dietary diary at baseline and a four-day diary during the second week of the two intervention periods. The insertion of snacks between meals resulted in a reduction in energy consumed at subsequent meals. Surprisingly snacks taken 90 minutes before meals resulted in a reduction in energy consumed at subsequent meals. Moreover, the magnitude of the adjustment was greater at evening meals than at lunch. This study provides preliminary evidence that snacking does not necessarily lead to overconsumption and thus contribute to obesity. However, a full-scale study is needed with a longer intervention period to thoroughly evaluate this issue.
Article
Several epidemiological studies have observed an inverse relationship between people's habitual frequency of eating and body weight, leading to the suggestion that a ‘nibbling’ meal pattern may help in the avoidance of obesity. A review of all pertinent studies shows that, although many fail to find any significant relationship, the relationship is consistently inverse in those that do observe a relationship. However, this finding is highly vulnerable to the probable confounding effects of post hoc changes in dietary patterns as a consequence of weight gain and to dietary under-reporting which undoubtedly invalidates some of the studies. We conclude that the epidemiological evidence is at best very weak, and almost certainly represents an artefact. A detailed review of the possible mechanistic explanations for a metabolic advantage of nibbling meal patterns failed to reveal significant benefits in respect of energy expenditure. Although some short-term studies suggest that the thermic effect of feeding is higher when an isoenergetic test load is divided into multiple small meals, other studies refute this, and most are neutral. More importantly, studies using whole-body calorimetry and doubly-labelled water to assess total 24h energy expenditure find no difference between nibbling and gorging. Finally, with the exception of a single study, there is no evidence that weight loss on hypoenergetic regimens is altered by meal frequency. We conclude that any effects of meal pattern on the regulation of body weight are likely to be mediated through effects on the food intake side of the energy balance equation.
Article
Background: Snacking can have the negative image of being detrimental to the diet, because snack foods are commonly thought of as providing only ‘empty calories’—high in energy but low in micronutrients. This observational study looked at the nutrient density of snacks and meals, and at the effect of eating frequency on mean daily nutrient intakes in 44 female students (aged 17–26 years).Methods: Baseline dietary data from an existing intervention study were re-analysed. Eating occasions, taken from 7-day weighed food diaries, were classified as meals or snacks by time of day, and the composition of meals and snacks compared. Subjects were divided into tertiles by eating frequency and their nutrient intakes compared.Results: As eating frequency increased, the number of snacks and the number of different snack items in the diet increased, while the number of meals remained constant. Snacks, overall, were significantly lower in percentage non-alcohol energy from fat and higher in percentage non-alcohol energy from carbohydrate. Snacks had lower nutrient densities than meals for non-starch polysaccharide (NSP), minerals and vitamins except vitamin C. However, there were no significant differences between the top and bottom tertiles of snacking frequency for overall percentage energy from fat, protein or carbohydrate, or intakes of micro-nutrients. The top tertile tended to be leaner and have higher energy intakes than infrequent eaters (not significant). There was a significant negative correlation between eating frequency and body mass index (BMI).Conclusions: It is concluded that snacking per se did not compromise diet quality in this group, and that those with a high snacking frequency were eating more in general and choosing a wider variety of foods, resulting in a balanced intake of nutrients.
Article
The contribution of snacks to dietary intakes was investigated in a sample of 136 7–8-year-old children. Mean daily energy and nutrient intakes were estimated using the 7-day weighed inventory method and the contribution of snacks was analysed separately. Snacks contributed 26% of energy intake and a large proportion of macronutrient intakes. The influence of a high intake of snacks on overall diet was investigated by classifying children as low or high snackers based on the proportion of daily energy intakes from snacks. There were no significant differences in anthropometry, and few significant differences in energy and nutrient intakes between children classified as ‘low’ and ‘high’ snackers. This was partly because ‘high’ snackers had a lower energy and macronutrient intake from meals, although this does not explain the lack of significant differences in micronutrient intakes between the snacking groups given that snacks were less nutrient dense than meals. It is concluded that snacks made an important contribution to energy and nutrient intakes in this sample but that further research is required to investigate how a high intake of snacks affects the quality of children's diets.
Article
Background: Studies on children and adolescents suggest a large increase in the role of snacking; however, little is know about changes in the snacking behavior of young adults. Methods: USDA's nationally representative surveys from 1977-1978 to 1994-1996 are used to study snacking trends among 8,493 persons 19-29 years old. Results: Snacking prevalence increased from 77 to 84% between 1977-1978 and 1994-1996. The nutritional contribution of snacks to total daily energy intake went from 20 to 23%, primarily because energy consumed per snacking occasion increased by 26% and the number of snacks per day increased 14%. The mean daily caloric density (calorie per gram of food) of snacks increased from 1.05 to 1.32 calories. The energy contribution of high-fat desserts to the total calories from snacking decreased (22 to 14%), however, this food group remained the most important source of energy. The energy contribution of high-fat salty snacks doubled. Sweetened and alcoholic beverages remained important energy contributors. Conclusion: This large increase in total energy and energy density of snacks among young adults in the United States may be contributing to our obesity epidemic.
Article
This paper reports a study of gender differences in the components of the Theory of Reasoned Action in relation to eating sweet snacks, and the role of these components in predicting sweet-snacking in women and men. Totals of 65 women and 64 men completed questionnaires assessing attitudes and behaviours towards eating sweet snacks. Women were more ambivalent towards eating sweet snacks than men, perceiving eating sweet snacks to be significantly less healthy (t(127)=−2·43,p<0·02), and more pleasant (t(127)=2·52,p<0·01). There were no statistically significant gender differences in outcome beliefs×evaluations, subjective norms, normative belief×motivation to comply, or in behavioural intention, although some gender differences were found within components. Women scored significantly higher (t(127)=5·54,p<0·0005) on restraint items from the Dutch Eating Behaviour Questionnaire, including those on snacking (t(127)=5·04;p<0·0005), but did not differ significantly from men on reported frequency of eating sweet snacks. There were gender differences in the predictive power of components of the Theory of Reasoned Action. Women's intentions to eat sweet snacks were predicted by perceived social pressure and attitudes towards sweet snacks. Men's intentions were only predicted significantly by attitudes. It is concluded that men's sweet-snacking is less influenced by social pressure than is women's.
Article
We assessed the effect of no exercise (Nex; control) and high exercise level (Hex; 4 MJ/day) and two dietary manipulations [a high-fat diet (HF; 50% of energy, 700 kJ/100 g) and low-fat diet (LF; 20% of energy, 300 kJ/100 g)] on compensatory changes in energy intake (EI) and energy expenditure (EE) over 7-day periods. Eight lean men were each studied four times in a 2 x 2 randomized design. EI was directly quantified by weight of food consumed. EE was assessed by heart rate (HR) monitoring. Body weight was measured daily. Mean daily EE was 17.6 and 11.5 MJ/day (P < 0.001) on the pooled Hex and Nex treatments, respectively. EI was higher on HF diets (13.4 MJ/day pooled) compared with the LF diets (9.0 MJ/day). Regression analysis showed that these energy imbalances induced significant compensatory changes in EB over time of 0.3-0.4 MJ/day (P < 0.05). These were due to changes in both EI and EE in the opposite direction to the perturbation in energy balance. These changes were significant, small but persistent, amounting to 0.2 and 0.35 MJ/day for EI and EE, respectively.
Article
The relationship between frequency of eating and adiposity was studied in a cross-sectional population of about 1000 men and 1000 women ages 35 to 69. A detailed 24-hr diet recall interview was administered by trained interviewers. Frequency of eating--eight categories--was determined by computer program using reported actual eating times and food consumed. The adiposity variable was an index using two skinfold measurements, height and weight. An analysis of covariance removing the effect of caloric intake showed that frequency of eating was related inversely to the adiposity index for men and women separately with statistical significance at the 1% level.
Article
The hypothesis that meal frequency is associated with plasma cholesterol was tested in a population-based sample of 2034 white men and women aged 50-89 y. Total, low-density-lipoprotein (LDL) and high-density-lipoprotein (HDL) cholesterol and triglycerides were measured after a 12-h fast in a Lipid Research Clinic laboratory and meal frequency was obtained by questionnaire. The age-adjusted total cholesterol concentrations for men and women reporting greater than or equal to 4 meals/d averaged 0.23 mmol/L lower than for those who reported 1-2 meals/d (P = 0.01). Similarly, LDL concentrations were lower in those reporting higher meal frequency (0.16 mmol/L, P = 0.06). These associations persisted after adjustment for smoking, alcohol, waist-to-hip ratio, systolic blood pressure, body mass index, and dietary nutrients. These results suggest that cholesterol reductions might be achieved by modest increases in meal frequency without an increase in caloric intake.
Article
Nutrient intakes from 7-d diet records were compared with hydrostatically determined body composition in 155 sedentary obese men aged 30-59 y. Percent body fats ranged from 18.6 to 40.3. The men ate (mean +/- SD) 2570 +/- 514 kcal/d: 15.6 +/- 2.6% from protein, 40.7 +/- 5.7% from fat, 37.5 +/- 6.9% from carbohydrate, and 6.2 +/- 6.0% from alcohol. Percent body fat correlated positively (p less than 0.05) with g/1000 kcal intake of total, saturated, and monounsaturated fatty acids and negatively with carbohydrates and plant protein. Total calories, number of meals, and distribution of calories were unrelated to percent body fat, total weight, or fat-free mass. The higher proportion of fat and carbohydrate in the diet may contribute to obesity in men. The modest caloric intake of these men and the lack of correlation between percent body fat and total calories suggest that calorie differences are not the major cause of the variations in obesity in these men.
Article
1. Thirteen adult females and two males were overfed a total of 79–159 MJ (1900–38 000 kcal) during a 3-week period at the Clinical Research Center, Rochester. The average energy cost of the weight gain was 28 kJ (6.7 kcal)/g, and about half the gain consisted of lean body mass (LBM) as estimated by ⁴⁰ Kcounting. 2. A survey of the literature disclosed twenty-eight normal males and five females who had been overfed a total of 104–362 MJ (2500–87000 kcal) under controlled conditions: twenty-five of these had assays of body composition, and three had complete nitrogen balances. 3. When these values were combined with those from our subjects (total forty-eight), there was a significant correlation between weight gain and total excess energy consumed ( r 0.77, P < 0.01) and between LBM gain and excess energy ( r 0.49, P < 0.01). Based on means the energy cost was 33.7 kJ (8.05 kcal)/g gain and 43.6% of the gain was LBM; from regression analysis these values were 33.7 kJ (8.05 kcal)/g gain and 38.4% of gain as LBM. 4. Individual variations in the response could not be explained on the basis of sex, initial body-weight or fat content, duration of overfeeding, type of food eaten, amount of daily food consumption or, in a subset of subjects, on smoking behaviour. 5. The average energy cost of the weight gain was close to the theoretical value of 33.8 kJ (8.08 kcal)/g derived from the composition of the tissue gained.
Article
This report describes the construction of a questionnaire to measure three dimensions of human eating behavior. The first step was a collation of items from two existing questionnaires that measure the related concepts of 'restrained eating' and 'latent obesity', to which were added items newly written to elucidate these concepts. This version was administered to several populations selected to include persons who exhibited the spectrum from extreme dietary restraint to extreme lack of restraint. The resulting responses were factor analyzed and the resulting factor structure was used to revise the questionnaire. This process was then repeated: administration of the revised questionnaire to groups representing extremes of dietary restraint, factor analysis of the results and questionnaire revision. Three stable factors emerged: (1) 'cognitive restraint of eating', (2) 'disinhibition' and (3) 'hunger'. The new 51-item questionnaire measuring these factors is presented.
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1. Skinfold thicknesses at four sites – biceps, triceps, subscapular and supra-iliac – and total body density (by underwater weighing) were measured on 209 males and 272 females aged from 16 to 72 years. The fat content varied from 5 to 50% of body-weight in the men and from 10 to 61% in the women.2. When the results were plotted it was found necessary to use the logarithm of skinfold measurements in order to achieve a linear relationship with body density.3. Linear regression equations were calculated for the estimation of body density, and hence body fat, using single skinfolds and all possible sums of two or more skinfolds. Separate equations for the different age-groupings are given. A table is derived where percentage body fat can be read off corresponding to differing values for the total of the four standard skinfolds. This table is subdivided for sex and for age.4. The possible reasons for the altered position of the regression lines with sex and age, and the validation of the use of body density measurements, are discussed.
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Twelve obese and four lean subjects increased their energy expenditure by 100 kcal/day by cycling on a bicycle ergometer. The order of testing was alternated so that half of the subjects did exercise on the first three days and the remainder on the last three days. Ad lib energy intake was measured over six days using an automated food dispensing machine. The obese subjects ate 1196 +/- 517 kcal/day and the lean subjects ate 1162 +/- 301 kcal/day and showed no overall significant difference in energy intake or eating patterns. However, these obese subjects ate 18 kcal/day less and the lean subjects ate 155 kcal/day more during the exercise period. The difference in response confirms the hypothesis that lean subjects tend to regulate energy intake more accurately than obese subjects. Exercise increased the frequency of eating and drinking and decreased hunger and appetite for all subjects. There was a significantly greater decrease in hunger and appetite with exercise for the obese subjects. However, as there was no accompanying decrease in energy intake and some subjects had difficulty in completing the exercise, the value of small increases in voluntary exercise in the treatment of obesity is questioned.
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Since compulsive eating occurs in approximately 30% of obese females and is associated with earlier relapse following weight loss, we compared daily energy intake, dietary composition and energy expenditure among obese binge eaters and obese non-bingers. Nine obese bingers (33 +/- 4 yrs, 95 +/- 6 kg, 39 +/- 1% fat) and nine obese non-bingers (47 +/- 3 yrs, 93 +/- 5 kg, 40 +/- 1% fat) were admitted for 12 days to a metabolic unit. Binge eaters were defined as scoring > 25 on the binge eating scale (BES). During the initial 8 days, subjects ate ad libitum from two computerized vending machines offering a variety of foods and beverages. A weight maintenance diet was then provided for the next 4 days. Twenty-four hour energy expenditure (24EE) and respiratory quotient (24Q) were measured on the last day of both feeding periods in a respiratory chamber. Obese bingers showed a wider range of energy intake compared to non-bingers, but the mean daily energy intake was similar between the two groups (2587 +/- 454 vs 2386 +/- 201 kcal/d) during 8 days of ad libitum intake. 24EE was not different between bingers and non-bingers after 8 days of ad libitum intake (2298 +/- 147 vs 2109 +/- 97 kcal/d, P = 0.3) or 4 days of weight maintenance diet, even more so after adjustment for differences in fat-free mass, fat mass and age. Resting metabolic rate, sleeping metabolic rate, and macronutrient intake and oxidation were also similar between groups.(ABSTRACT TRUNCATED AT 250 WORDS)