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Concept: Ad libitum

205

BACKGROUND: A number of studies have shown that bite and sip sizes influence the amount of food intake. Consuming with small sips instead of large sips means relatively more sips for the same amount of food to be consumed; people may believe that intake is higher which leads to faster satiation. This effect may be disturbed when people are distracted. OBJECTIVE: The objective of the study is to assess the effects of sip size in a focused state and a distracted state on ad libitum intake and on the estimated amount consumed. DESIGN: In this 3×2 cross-over design, 53 healthy subjects consumed ad libitum soup with small sips (5 g, 60 g/min), large sips (15 g, 60 g/min), and free sips (where sip size was determined by subjects themselves), in both a distracted and focused state. Sips were administered via a pump. There were no visual cues toward consumption. Subjects then estimated how much they had consumed by filling soup in soup bowls. RESULTS: Intake in the small-sip condition was ∼30% lower than in both the large-sip and free-sip conditions (P<0.001). In addition, subjects underestimated how much they had consumed in the large-sip and free-sip conditions (P<0.03). Distraction led to a general increase in food intake (P = 0.003), independent of sip size. Distraction did not influence sip size or estimations. CONCLUSIONS: Consumption with large sips led to higher food intake, as expected. Large sips, that were either fixed or chosen by subjects themselves led to underestimations of the amount consumed. This may be a risk factor for over-consumption. Reducing sip or bite sizes may successfully lower food intake, even in a distracted state.

Concepts: Nutrition, Food, Estimation, Restaurant, Distraction, Cost underestimation, Ad libitum

40

It has been suggested that the use of nonnutritive sweeteners (NNSs) can lead to weight gain, but evidence regarding their real effect in body weight and satiety is still inconclusive. Using a rat model, the present study compares the effect of saccharin and aspartame to sucrose in body weight gain and in caloric intake. Twenty-nine male Wistar rats received plain yogurt sweetened with 20% sucrose, 0.3% sodium saccharin or 0.4% aspartame, in addition to chow and water ad libitum, while physical activity was restrained. Measurements of cumulative body weight gain, total caloric intake, caloric intake of chow and caloric intake of sweetened yogurt were performed weekly for 12weeks. Results showed that addition of either saccharin or aspartame to yogurt resulted in increased weight gain compared to addition of sucrose, however total caloric intake was similar among groups. In conclusion, greater weight gain was promoted by the use of saccharin or aspartame, compared with sucrose, and this weight gain was unrelated to caloric intake. We speculate that a decrease in energy expenditure or increase in fluid retention might be involved.

Concepts: Real number, E number, Aspartame, Sweeteners, Ad libitum, Sucralose, Saccharin, Equal

27

BACKGROUND: Elevated levels of fibroblast growth factor 23 (FGF23) are associated with increased risk of adverse outcomes in patients with CKD. Reducing dietary phosphate intake or absorption may decrease FGF23 levels, but data on the combined effects of dietary phosphate restriction and phosphate binders in CKD are limited. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: In this 2×2 factorial, single-blinded, placebo-controlled, 3-month study, conducted between July 2009 and March 2012, 39 patients with CKD stages 3 or 4 and normal serum phosphate levels were randomly assigned to one of four groups: ad libitum diet plus lanthanum carbonate (LC) placebo (n=10), 900-mg phosphate diet plus LC placebo (n=10), ad libitum diet plus LC (n=11), or 900-mg phosphate diet plus LC (n=8). The dose of LC was 1000 mg three times daily with meals. Dietary restriction was accomplished with outpatient counseling. The primary end point was change in FGF23 levels from baseline. RESULTS: Compared with ad libitum diet, the 900-mg phosphate diet did not significantly reduce FGF23 levels (diet × time interaction, P=0.05). Compared with placebo, LC alone also did not significantly reduce FGF23 levels (LC × time interaction, P=0.21). However, the dual intervention significantly decreased FGF23 levels throughout the study period (diet × LC × time interaction, P=0.02), resulting in a 35% (95% confidence interval, 8%-62%) reduction by study end. CONCLUSION: The combination of LC plus counseling for a phosphate-restricted diet decreased FGF23 levels in patients with CKD stages 3-4 and normal serum phosphate levels.

Concepts: Nutrition, Fibroblast growth factor, Confidence interval, Normal distribution, Diet, Growth factors, Ad libitum, Lanthanum carbonate

26

Athletes competing in ultra-endurance events are advised to meet energy requirements, to supply appropriate amounts of carbohydrates (CHO), and to be adequately hydrated before and during exercise. In practice, these recommendations may not be followed because of satiety, gastrointestinal discomfort, and fatigue. The purpose of the study was to assess energy balance, macronutrient intake and hydration status before and during a 1,230-km bike marathon. A group of 14 well-trained participants (VO2max: 63.2 ± 3.3 ml/kg/min) completed the marathon after 42:47 hours. Ad libitum food and fluid intake were monitored throughout the event. Energy expenditure (EE) was derived from power output and urine and blood markers were collected before the start, after 310, 618, 921 km, after the finish, and 12 hours after the finish. Energy intake (EI; 19,749 ± 4,502 kcal) was lower than EE (25,303 ± 2,436 kcal) in 12 of 14 athletes. EI and CHO intake (average: 57.1 ± 17.7 g/h) decreased significantly after km 618 (p<0.05). Participants ingested on average 392 ± 85 ml/h of fluid, but fluid intake decreased after km 618 (p<0.05). Hydration appeared suboptimal before the start (urine specific gravity: 1.022 ± 0.010 g/ml) but did not change significantly throughout the event. The results show that participants failed to maintain in energy balance and that CHO and fluid intake dropped below recommended values during the second half of the bike marathon. Individual strategies to overcome satiety and fatigue may be necessary to improve eating and drinking behavior during prolonged ultra-endurance exercise.

Concepts: Eating, Muscle, Trigraph, Carbohydrate, Exercise physiology, TheStart, Drinking, Ad libitum

23

Acute exercise does not elicit compensatory changes in appetite parameters in lean individuals; however, less is known about responses in overweight individuals. This study compared the acute effects of moderate-intensity exercise on appetite, energy intake and appetite-regulatory hormones in lean and overweight/obese individuals.

Concepts: Obesity, Overweight, Acute accent, Ad libitum

12

Huntington’s disease (HD) patients suffer from a progressive neurodegeneration that results in cognitive, psychiatric, cardiovascular, and motor dysfunction. Disturbances in sleep/wake cycles are common among HD patients with reports of delayed sleep onset, frequent bedtime awakenings, and fatigue during the day. The heterozygous Q175 mouse model of HD has been shown to phenocopy many HD core symptoms including circadian dysfunctions. Because circadian dysfunction manifests early in the disease in both patients and mouse models, we sought to determine if early intervention that improve circadian rhythmicity can benefit HD and delay disease progression. We determined the effects of time-restricted feeding (TRF) on the Q175 mouse model. At six months of age, the animals were divided into two groups: ad libitum (ad lib) and TRF. The TRF-treated Q175 mice were exposed to a 6-h feeding/18-h fasting regimen that was designed to be aligned with the middle of the time when mice are normally active. After three months of treatment (when mice reached the early disease stage), the TRF-treated Q175 mice showed improvements in their locomotor activity rhythm and sleep awakening time. Furthermore, we found improved heart rate variability (HRV), suggesting that their autonomic nervous system dysfunction was improved. Importantly, treated Q175 mice exhibited improved motor performance compared to untreated Q175 controls, and the motor improvements were correlated with improved circadian output. Finally, we found that the expression of several HD-relevant markers was restored to WT levels in the striatum of the treated mice using NanoString gene expression assays.

Concepts: Better, Gene, Improve, Striatum, Circadian rhythm, Huntington's disease, Mice, Ad libitum

5

Intermittent severe energy restriction (SER) can induce substantial weight loss, but the appetite regulatory responses to SER are unknown and may dictate long-term dietary adherence.

Concepts: Obesity, Weight loss, Regulation, Appetite, Ad libitum

3

Despite exercising in cool environments, ice hockey players exhibit several dehydration risk factors. Individualized fluid plans (IFPs) are designed to mitigate dehydration by matching an individual’s sweat loss in order to optimize physiological systems and performance.

Concepts: Avicenna, Management, Ice hockey, Ad libitum, Hockey

2

Drinking ad libitum during exercise often leads to dehydration ranging from -1 to -3% of body weight.

Concepts: Cycling, Ad libitum

2

The orexin (OX) system has been implicated in food reinforced behaviour, food-seeking and food overconsumption. Recent evidence suggests that OX signaling might influence consumption of palatable foods with high reinforcing value depending upon the caloric status of the animal. The present study evaluates from a pharmacological and a molecular approach the contribution of OX to excessive binge-like consumption of highly preferred palatable substances (sucrose and saccharin) in ad libitum-fed C57BL/6J mice. The main findings in the study are: (1) intraperitoneal (ip) injection of SB-334867 (10, 20 or 30mg/kg), a selective OXR1 antagonist, significantly decreased binge-like consumption of sucrose (10% (w/v)) and saccharin (0.15% (w/v)) during the test day in a Drinking in the Dark procedure in ad libitum fed animals, without evidence of any significant alteration of locomotor activity. 2) 4 repetitive, 2-h daily episodes of sucrose and saccharin (but not water) binge-like drinking significantly dampened OX mRNA expression in the LH. Present findings show for the first time a role for OXR1 signaling in binge-like consumption of palatable substances in animals under no caloric needs. Targeting OXR1 could represent a novel pharmacological approach to treat binge-eating episodes.

Concepts: Present, Time, The Canon of Medicine, Messenger RNA, Food, Carbohydrate, Reinforcement, Ad libitum