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Division of Human Nutrition, Wageningen University, 6700 EV Wageningen, The Netherlands
* To whom correspondence should be addressed. E-mail: mirre.vandongen{at}wur.nl.
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ABSTRACT |
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 TOP ABSTRACT IntroductionSubjects and MethodsResultsDiscussionLITERATURE CITED |
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Introduction |
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TOPABSTRACTIntroductionSubjects and MethodsResultsDiscussionLITERATURE CITED |
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The consequence of this disconnection between sensory and metabolic signals is that consumption of high-fat and energy-dense foods may not lead to adequate adjustments in food intake (8–11). Consumption of such foods stimulates passive overconsumption, predisposing people to becoming overweight. Several experimental studies have shown that after overfeeding, in many cases people do not adjust their energy intake adequately to maintain energy balance (12–15). This indicates an inability to detect a high energy intake, which may result from sensory signals that are not in accordance with the actual nutrient content of the food.
Until now, it has to our knowledge remained uncertain whether the intake of high-fat foods that do provide more appropriate sensory signals would indeed be lower, and therefore would play a potential role in preventing overweight, than the intake of similar foods without these sensory signals.
In Study 1, we investigated the effects of a fixed lunch either high in visible or hidden fats on subsequent dietary compensation. In Study 2, we investigated the effects of the sensory perception of fat on the ad libitum energy intake during the meal itself.
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Subjects and Methods |
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TOPABSTRACTIntroductionSubjects and MethodsResultsDiscussionLITERATURE CITED |
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Participants were recruited using flyers and mailing lists. In both studies, we included men and women aged 18–30 y with a BMI of 20–23 kg/m2 who ate breakfast on a daily basis (Supplemental Table 1). Exclusion criteria were restraint eating, based on the Dutch Eating Behavior Questionnaire [males >2.90, females >3.40 (16)]; weight change of >1 kg during the last 6 mo; lack of appetite; smoking; following an energy-restricted diet; and suffering from any metabolic, endocrine, or gastrointestinal disorder. Weight-stable individuals with a normal BMI were selected in order to study dietary compensation in a situation where the regulation of food intake is likely to be accurate. All participants gave their written informed consent. The Ethics Committee of Wageningen University approved the study protocols. Participants in both studies were not informed about the true purpose of the studies. Instead, they were told that the study aimed to identify aspects that influence the palatability of meals. Study 1 began with 64 participants. Seven participants stopped because of poor compliance, participation was too much of a burden, or because of personal reasons. The final sample consisted of 57 participants. Study 2 consisted of 51 participants who were not involved in Study 1. There were no drop-outs.
Study design
Study 1. Participants visited Wageningen University on 6 d, separated by at least 48 h, to consume a mandatory test lunch and an ad libitum dinner and breakfast the next morning. The experiment used 3 x 2 conditions of the lunches in a randomized cross-over design. Lunches varied in energy content (3 levels) and fat condition (2 levels).
Study 2. Participants in Study 2 visited the university twice, with a minimal wash-out period of 48 h, to consume an ad libitum lunch. This study had a randomized cross-over design. The 2 lunches varied in fat condition (2 levels).
Test meals
Study 1.
Lunch
Lunch consisted of 3 energy levels: 100, 200, and 300% of the energy intake of a standard lunch, which is 
22% of the daily energy intake (17). This daily intake was based on the individual energy requirement, calculated by the basal metabolic rate (BMR) and the physical activity level (18). Physical activity level was estimated by a retrospective questionnaire. BMR was estimated by the following equation:
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For logistical reasons, 3 energy groups were formed based on the individual energy requirement (<11 MJ; 11–13 MJ, >13 MJ).
Within each energy level, the fat condition of the lunches varied. The main focus was the visibility of fat, but because it was not possible to vary just the appearance of foods, other sensory properties, like texture and taste, varied as well. Because visibility was most important, the fat conditions were labeled visible fat and hidden fat. Macronutrient composition of the lunches were similar. To create the fat conditions, we manipulated foods or selected specific products suitable for that condition (Supplemental Table 2). We accurately calculated the macronutrient and fatty acid content of each lunch in advance, based on the Dutch Food Composition Table (19). To check for the actual composition, we performed chemical analyses (Table 1).
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Snacks Participants received several sweet and savory snacks for the evening, all of which were commercially available in standardized packages of 1 portion size. No other snacks were allowed. Participants had to provide drinks themselves, but alcohol was not allowed.
Breakfast Breakfast was presented buffet-style. Customary breakfast products were offered in standardized portion sizes and were marked to enable us to measure how much of each product was consumed.
Study 2. The lunches consumed in Study 2 varied in fat condition: a visible and a hidden fat condition. Lunches were offered in 3 courses to mimic a customary Dutch meal: tomato soup, sandwiches, and a dessert. The energy density of the courses was calculated in advance and chemical analyses were performed to check for the actual energy density (Supplemental Table 3).
Questionnaires
In both studies, participants rated their hunger, fullness, appetite, appetite for something sweet, appetite for something savory, prospective consumption, and thirst on a 10-point scale ranging from "not at all" to "extremely," at several moments during a test day. They were also asked to rate the palatability and the perceived fatness of each meal and its courses after an initial taste on a 10-point scale.
Procedure
During the study period of both studies, participants were asked to maintain a normal level of physical activity and to consume their normal breakfast before 0900 on the morning of a test day. After breakfast, and until the test lunch, participants were asked to refrain from eating. Only water, coffee, or tea (without milk or sugar) was allowed. Every meal was served in the dining room of the university. Participants were divided throughout the room in such a way that any interaction between the participants was minimized. They were instructed not to talk to each other to reduce the effects of presence of others on food intake. During the meals, there was no interaction except with the researchers, when they gave instructions and served meals.
Study 1. Lunch started at 1230. Participants received instructions about the study protocol. Before and after lunch, at 1400, 1500, and 1600, and before and after dinner, appetite parameters had to be rated. Participants were instructed to finish the entire lunch. After lunch, they left the laboratory and returned again at 1715 when dinner was served. Participants were asked to refrain from eating in the afternoon; only water, coffee, and tea without milk or sugar was allowed. During dinner, participants were instructed to eat until they were comfortably full. They received snacks after dinner to take home for the evening and were instructed to eat the snacks ad libitum, to bring back leftovers, and to report consumption of beverages in a diary. Breakfast the next morning was served at 0800 and participants were again instructed to eat until they were comfortably full.
Study 2. Lunches were served at 1230. Participants were instructed to rate appetite parameters before lunch and after each course and to eat from all 3 of the courses until they were comfortably full. Participants were given 10 min to consume the soup and the dessert and 15 min for the sandwiches. We introduced these timed sessions so participants took their time to eat from each course.
Energy intake
The amount of food and drink consumed during the dinner (Study 1) and lunch (Study 2) was weighed to the nearest 1.0 g. The energy and macronutrient intake was calculated by the Dutch Food Composition Table and adjusted for the chemical analyses. We measured the consumption in the evening by checking the leftover snacks and the diary with the recorded beverage intake. The consumption during breakfast was measured by counting each consumed breakfast items. We calculated the energy intake based on these consumption data and the Food Composition Table.
Data analysis
For data analysis, we used the SAS version 9.1.2 (SAS Institute). Variables on energy intake (MJ) and the ratings of appetite (scale 1–10) are presented as means ± SEM unless stated otherwise. In Study 1, the energy intake during dinner, in the evening, during breakfast the next morning, and the palatability and fat perception were compared between the 3 energy levels and the 2 fat conditions. This was done by an ANOVA. The energy level and fat condition and the interaction term were fixed factors; participants were treated as a random factor. Tukey's test was used for post hoc analyses. The dietary compensation was calculated as the predicted energy intake if no compensation occurred following overconsumption minus actual energy intake divided by the extra energy ingested in the 200% and 300% energy levels, compared with the intake in the 100% energy level (20). In Study 2, the energy intake, palatability, and fat perception were compared by means of a paired comparisons t test. To adjust for palatability of the meals, we added these ratings to the model as covariates.
For the ratings of appetite, we performed a repeated-measures ANOVA and included time and fat condition and the interaction terms as fixed factors and participants as a random factor. In Study 1, the energy level and the accompanying interaction terms were included as fixed factor as well. To adjust for baseline ratings, we added these to the model as covariates. P-values < 0.05 were considered significant.
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Results |
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TOPABSTRACTIntroductionSubjects and MethodsResultsDiscussionLITERATURE CITED |
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Lunches in Study 1 were rated significantly different for fat perception, indicating that manipulation of the fat condition was successful. The palatability of the lunches differed significantly as well (Table 2).
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Energy intake at breakfast following the 100% level was 2.35 ± 0.11 MJ for visible fat and 2.36 ± 0.10 MJ for hidden fat. In the 200% level, the intake was 2.24 ± 0.12 MJ for the visible fat and 2.32 ± 0.11 MJ for the hidden fat condition. In the 300% level, intake was 2.31 ± 0.12 MJ and 2.16 ± 0.10 MJ for the visible and hidden fat condition, respectively. Energy intake did not differ between energy levels or fat conditions.
Participants showed additional dietary compensation in the evening and during breakfast. In the 200% energy level, dietary compensation was increased to 32% in the visible fat condition and 17% in the hidden fat condition. In the 300% energy level, compensation was 37 and 38% in the visible and hidden fat condition, respectively. There was a main effect of energy level (P < 0.0001); the differences between fat conditions did not reach significance (P = 0.077).
Ratings of appetite. The 6 lunches resulted in clear differences in all appetite ratings. Here, we only show the results of fullness, because the other parameters show similar results. Fullness differed between all 3 energy levels (all P < 0.0001) (Fig. 2). Fullness was higher after the visible fat condition than after the hidden fat condition (P = 0.0012). A significant time x energy level interaction was observed (P = 0.0075), where fullness in the 200 and 300% level increased more after lunch, and did not return to baseline, compared with the 100% level.
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Lunches in Study 2 were rated significantly different for fat perception (Table 2). When looking at the 3 courses separately, we found that the soup and sandwiches differed significantly in fat perception, whereas the difference in the desserts did not reach significance.
The mean palatability of the 2 lunches (comprising all courses) was similar. The palatability of the soup and the dessert did, however, differ significantly between fat conditions (Table 2).
Energy intake. Taking the 3 courses together, participants consumed 9.2% more energy in the hidden fat condition than in the visible fat condition (P = 0.013) (Fig. 3). When we examined the 3 courses separately, we found a significant difference in only the first course, with an intake of 746.2 ± 55.9 kJ in the visible fat condition and 1180.8 ± 72.8 kJ in the hidden fat condition (P < 0.0001). The results did not change after correcting the energy intake for the palatability of the courses, with energy intake differing in only the first course (P < 0.0001). Energy intake in the 2nd course (P = 0.13) and in the 3rd course (P = 0.11) did not differ between fat conditions.
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Discussion |
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TOPABSTRACTIntroductionSubjects and MethodsResultsDiscussionLITERATURE CITED |
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The selection of the study population needs to be taken into account when generalizing our findings. We selected unrestrained young adults with a BMI of 20–23 kg/m2. Restrained subjects have been shown to be more influenced by the perceived caloric content of foods (21) and by receiving information about the fat content (22) than unrestrained subjects. They therefore may also be more affected by the sensory perception of fat. In addition, the participants had to be in energy balance, so it is likely that the regulation of energy intake was adequate. However, we found that dietary compensation was insufficient. It might be expected that compensation in populations with a less optimal regulatory system, such as overweight people, would be even worse compared with this research population.
The external validity of this study needs to be addressed. In real life, it is not likely that overconsumption will occur in such magnitudes as in the present experiment. The same is true for the fat conditions; the presence of visible or hidden fats will be more subtle and, as such, the influences on food intake will be less pronounced. However, the manipulations needed to be sufficient to investigate the occurrence of dietary compensation and the influences of hidden or visible fat on food intake. Another aspect is that, despite the fact that the amount of food the participants received was based on their individual requirements and that we used customary Dutch food products, it is possible that participants were forced to change their habitual eating pattern due to the study protocol. This may have had differential effects on intake between the hidden and visible fat condition. To what extent the energy intake between fat conditions was influenced by this is unknown. Finally, the experiments were performed in a laboratory. In a free living situation, people may pay less attention to their meals due to distraction (23,24) and may be less sensitive to visible fats. Whether our observations would be detectable outside the laboratory needs further investigation.
Lunches differed in palatability between fat conditions. Such differences may influence (subsequent) energy intake and appetite ratings (25–27). We therefore corrected the ad libitum energy intake for the palatability of the lunches. This did not affect our results, indicating that our observations were merely the result of differences in fat perception.
In Study 2, the energy intake was higher during only the first course of the hidden fat condition. During the 2nd course, intake did not differ despite differences in fat perception. However, the intake of a course cannot be viewed separately from previous courses. The higher intake during the first course of the hidden fat condition likely reduced the intake in the 2nd course to a greater extent than in the visible fat condition. This may have overridden the effects of fat perception.
Despite accurate calculations of the macronutrient composition of the lunches with the Dutch Food Composition Table (19), chemical analyses revealed some deviations. The data in the composition table are based on commercial products. Several products used in our studies were provided by a local bakery using different recipes, which may have caused the deviations. Small variations in energy intake do not affect subsequent intake (28,29). Because the differences in composition of the lunches were marginal, we do not think that this influenced the results.
Previously, Davidson and Swithers (4) hypothesized that if the ability to use the sensory signals of food to predict the energetic consequences of intake would deteriorate, this might contribute to overconsumption and subsequent weight gain. The results of our studies support this hypothesis. When sensory signals are disconnected from their metabolic properties (as is the case with hidden fats), people tend to overeat. Food intake may be better regulated, at least in the short term, when the sensory signals are in accordance with the actual nutrient content, as we found in the visible fat condition. Sensory signals may have an influence on food intake through previously learned associations with the postingestive consequences (1,30). This has also been shown in studies that focus on the use of fat replacers, where sensory signals suggest a high fat intake, whereas actual fat intake is low (31–34). Consumption of these foods did not result in a compensatory increase in food intake, which emphasizes the contribution of sensory signals in the regulation of food intake. This contribution of sensory signals has also been demonstrated in a study, where the intake of soup increased by 73% when the visual signals that enabled people to monitor their intake were partially removed (35). In our studies, we manipulated the appearance of the foods, but with this manipulation, taste, texture, and other sensory signals differed as well. The effects can therefore not be attributed to visual cues alone but rather to a mixture of sensory and cognitive cues. The impact of manipulating just 1 of the sensory signals or any other food property on food intake is unknown.
Previously, it has been shown that providing information about the energy or fat content influences food intake (36,37). This suggests that beliefs people have about foods are involved in food intake. In our studies, the visible fat may have influenced the belief of a high fat intake. It remains unclear whether this effect on energy intake was due to an explicit cognitive process, where participants were truly aware of a high fat intake, or to a more subconscious process initiated through associative learning.
After overconsumption during lunch, participants decreased their energy intake during dinner and in the course of the evening. This contrasts with the results of others, where no compensation was found or only after high levels of overconsumption (12,14). In these studies, overconsumption was induced by increasing energy density. It has been reported previously that the volume of food affects satiety and energy intake to a greater extent than energy density does (38–40). In our study, we created overconsumption by increasing the volume of food while keeping the energy density stable. In addition, our study population had an apparently adequate energy regulation. This may explain the dietary compensation we found. This response, however, was not sufficient to fully compensate, at least in the short term. It is possible that energy balance is maintained over a few days rather than during a single day.
Based on our observations, we conclude that the sensory perception of fat does influence food intake. In addition, it is involved in the short-term compensatory response after overfeeding. A question that remains unanswered is to what extent sensory signals of fats are involved in food intake regulation in a free living situation, where sensory signals are less pronounced and mixed with other signals. Considering the current obesity problem, it is worth looking into the effects of sensory signals on food intake regulation and the underlying mechanisms in more detail. This may contribute to the development of strategies to decrease energy intake and prevent weight gain.
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FOOTNOTES |
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2 Author disclosures: M. Viskaal-van Dongen, C. de Graaf, E. Siebelink, and F. J. Kok, no conflicts of interest.
3 Supplemental Tables 1–3 are available with the online posting of this paper at jn.nutrition.org.
Manuscript received 10 July 2008. Initial review completed 18 August 2008. Revision accepted 19 November 2008.
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LITERATURE CITED |
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