Jacklyn Jones

A randomised trial of the impact of energy density and texture of a meal on food and energy intake, satiation, satiety, appetite and palatability responses in healthy adults

BACKGROUND & AIMS Texture modified diets may be enriched to optimise the opportunity for individuals to meet their required energy intakes; however there is insufficient evidence supporting this strategy. Thus we sought to investigate the effect of texture and energy density on food (g) and energy intakes (kcal), appetite (satiation and satiety), and palatability in healthy adults. METHODS A single blind within-subjects randomised crossover design, where 33 healthy adults consumed a test meal with either its texture and/or energy density altered, until satiation was reached whilst rating their appetite parameters. Subsequent intakes were recorded in a food diary to determine the effect of the treatments on satiety and identify any evidence of energy compensation. RESULTS Test meal energy intakes (kcal) were significantly higher with energy enrichment of both meals (standard texture; 315 kcal and texture modified; 303 kcal (p = 0.001)) and remained higher over the day for both (260 kcal/d and, 225 kcal/d respectively (p < 0.05)). Area under the curve (AUC) did not differ between meals for hunger, fullness, or desire to eat however palatability was significantly reduced with texture modification. CONCLUSIONS Enriching meals (standard texture and texture modified) is an effective method to increase short term energy intakes in healthy adults over a 24 h period and may have application to optimise energy intakes in a clinical setting.

Morphological and health-related changes associated with a 12-week self-guided exercise programme in overweight adults: a pilot study

Abstract Over 12 weeks, supervised physical activity (PA) interventions have demonstrated improvements in morphological and health parameters, whereas community walking programmes have not. The present study piloted a self-guided programme for promoting PA and reducing sedentary behaviour in overweight individuals and measured its effect on a range of health outcomes. Six male and 16 female sedentary adults aged 48.5 ± 5.5 years with body mass index (BMI) 33.4 ± 6.3 kg m−2 were assessed for anthropometric variables, blood pressure, functional capacity, well-being and fatigue. After an exercise consultation, participants pursued their own activity and monitored PA points weekly. At baseline, mid-point and 12 weeks, eight participants wore activity monitors, and all participants undertook a 5-day food diary to monitor dietary intake. In 17 completers, mass, BMI, sit-to-stand, physical and general fatigue had improved by 6 weeks. By 12 weeks, waist, sagittal abdominal diameter (SAD), diastolic blood pressure, well-being and most fatigue dimensions had also improved. Throughout the intervention, PA was stable, energy intake and lying time decreased and standing time increased; thus, changes in both energy intake and expenditure explain the health-related outcomes. Observed changes in function, fatigue and quality of life are consistent with visceral fat loss and can occur at levels of weight loss which may not be considered clinically significant.

The investigation of the effects of food texture and energy density on appetite and food intakes at a single eating occasion in older adults: A pilot study

dsignificantly different vs. meal 2 p = 0.01. It appears that texture modification results in reduced food intake of both a standard and an energy enriched meal at a single eating occasion. Energy intake at a single eating occasion may be increased by energy enrichment in both standard and texture modified meals, but whether this results in increased daily energy and nutrient intakes remains to be determined. This and further investigation into the impact of the aesthetic attributes of texture modified and energy enriched meals on food and energy intakes is required to inform optimisation of food and fluid provision.

An investigation into food provision and consumption in an orthopaedic rehabilitation hospital in Scotland, UK

BAPEN report the ‘risk of’ malnutrition in individuals admitted to hospitals to be 28%, with this rising to 40% in medicine for the elderly. Food and fluid provision have a central role to play in the management of malnutrition within institutions. Nutrient and foodbased guidance for food provision in hospitals in Scotland has been published to assist health boards meet NHS QIS clinical standards for nutritional care. The aim of this study was to evaluate food provision and consumption in an elderly orthopaedic rehabilitation setting to determine the role different eating occasions play in energy and nutrient intakes in this setting. Weighed plate-wastage method was used to assess food provision and consumption for patients in three orthopaedic rehabilitation wards in a hospital in Scotland. A plated-food service system was in operation and three main meals and three snacks were provided daily with midday and evening meals consisting of two courses each. All foods provided over a 24 hr period were weighed prior to being served and any left-over items were weighed after the patient had finished eating. Snack consumption was observed and recorded. Total food intakes were used to estimate energy and nutrient intakes using WinDiets dietary analysis software and these were compared against standards for food provision in hospitals in Scotland using one-sample t-test. Consumption figures were also determined for each eating occasion as a proportion of food provided. Food provision and consumption were assessed for 58 patients (>65 years; 12 m: 46f). Results show all patients were provided with adequate protein to meet the standards for nutrient provision. For energy, males were provided with adequate energy (mean = 2260 164 kcal, NS) but this was not the case for females (mean = 1630 60 kcal p<0.001).

Grip strength is associated with nutritional status and energy intake in healthy community living older adults

The UK has an ageing population and this will place large demands on future health and social care systems (1) . In an attempt to minimise this increase in expenditure, it is important to encourage the ageing population to optimise their health and ability to live independently. The functional marker grip strength, determined by handgrip dynamometry (HGD), has been shown to be a predictor of all cause mortality (2) , disability (3) and thus dependency and in older adults. While dietary intake and nutritional supplementation has been shown to improve function in the rehabilitation phase of care (4) , the association dietary intake has with nutritional and functional status has not be fully investigated in the community dwelling older adult population. Handgrip may provide an indication of health status in this ever expanding population. The aim of the study was to determine whether an association exists between energy intake, nutritional status and HGD. Healthy, cognitively intact, community dwelling adults aged 65 + years were recruited from community networks. Energy intake (1 kcal = 4.184 kJ) was recorded by a 7-d self-administered unweighed food diary. Anthropometric measurements (weight, height, BMI, waist circumference (WC), tricep skin-fold thickness (TSF) and arm muscle circumference (AMC)), were measured using standard methodology. HGD was measured using a Takei grip strength dynamometer in the non-dominant arm. BMI was compared to age-specific norms, and TSF, AMC, WC and HGD were compared to gender-specific norms. Correlation analysis was used to identify associations between variables. Twenty-one people, 11 men and 10 women, aged 65–82 years (mean 74, SD 4.9), with mean BMI of 27.1 kg/m 2 (SD 2.3) were recruited. When compared to a BMI of 27 kg/m 2 (considered normal in this population (5) there was no significant difference. With the exception of women in relation to TSF there was no significant difference in, WC (cm), TSF (mm), AMC (cm) and HGD (kg) in comparison to normal values (WC: men mean 104.7, SD 9.8, women mean 87.6, SD 9.8, TSF: men mean 12.4, SD 4.5, women mean 18.9, SD 3.0, AMC: men mean 25.6, SD 2.6, women mean 23.4, SD 2.03, HGD men mean 38.0, SD 5.1, women mean 22.4, SD 5.1). HGD correlated with energy intake (r = 0.775, P < 0.001) (see Figure). HGD also correlated with weight (r = 0.576, P < 0.01), height (r = 0.656, P < 0.01), WC (r = 0.66, P < 0.01), TSF (r = - 0.562, P < 0.01) and AMC (r = 0.465, P < 0.05). As HGD is a simple measure and an important marker in monitoring functional change and predicting functional decline the relationship between HGD and diet, particularly in relation to energy intake, it needs further investigation.