Richard D. Mattes

Dietary Compensation by Humans for Supplemental Energy Provided as Ethanol or Carbohydrate in Fluids

Dietary compensation for energy provided as ethanol is reportedly limited. Whether this is a function of the ethanol or other aspect of the medium in which it is ingested is not known. Eight male and eight female adults ingested 1.08 liters of beer (5.0% ethanol w/v, 1891kJ), light beer (2.9% ethanol w/v, 1197kJ), no-alcohol beer (0.1% ethanol w/v, 816kJ), cola (1749kJ) or carbonated water (0kJ) every 3-4 days with a midday meal. Diet records were kept the preceding day and day of beverage ingestion. Energy intake was significantly higher each day an energy-bearing beverage was consumed relative to its preceding day. A literature review revealed dietary compensation for modifications of energy intake via fluids is less precise than when solid foods are manipulated. These findings demonstrate dietary adjustment for energy derived from ethanol is imprecise, but also indicate energy from carbohydrate elicits little dietary response when ingested in a beverage.

Hunger ratings are not a valid proxy measure of reported food intake in humans

Hunger ratings have been used as proxy measures of food intake although their validity has not been established. To address this issue, 12 female and 12 male adults of normal weight recorded food intake and hunger ratings every waking hour for 7 consecutive days. Discrepancies were noted in the correlation between hunger ratings and computed energy intake on weekdays vs. weekends, and no significant correlations were observed for individual subjects. Eating often occurred when hunger ratings were low or had not increased, and few individuals displayed a significant correlation between hunger ratings and number of eating occurrences. It was concluded that hunger ratings are not a valid index of energy intake computed from food records or number of eating occurrences.

The taste for salt in humans.

Accumulating evidence indicates that the taste of salt is innately appealing to humans, although responses to salty foods are strongly influenced by environmental factors. Except in instances of severe, prolonged sodium depletion, a sodium-specific appetite has not been documented in humans. Limited data reveal no clear association between early exposure to salt and various hedonic responses to salt later in life, but recent exposure markedly alters a persons preferred salt content of foods. Restricting exposure for 8-12 wk can enhance the appeal of reduced-sodium foods in both normotensive and hypertensive individuals. Although the appeal of the taste of salt is one factor contributing to its intake, the extent to which such a hedonic shift promotes long-term adherence to a reduced-sodium diet has not been determined. There is little evidence supporting a relation between either taste sensitivity or hedonic responses to salt and blood pressure.

Dietary assessment of patients with chemosensotyr disorders

OBJECTIVE To identify individuals who are at nutritional risk because of taste and/or smell disorders. DESIGN Patients referred by a private physician for evaluation of a chemosensory complaint underwent an extensive battery of taste and smell tests, otorhinolaryngologic tests, and, in some cases, periodontal examinations and completed a dietary/health questionnaire, a 24-hour recall, and a 2-day diet record. SETTING Patients were interviewed at the Monell-Jefferson Chemosensory Clinical Research Center, Philadelphia, Pa. SUBJECTS We studied 310 patients (142 men and 168 women) with a primary complaint of chemosensory disorder. Mean age was 50.5 +/- 15.7 (range = 15 to 93 years). Normative data were provided by an additional 79 healthy control subjects (42 men and 37 women) with no taste or smell complaint. Their mean age was 48.8 +/- 18.8 years (range = 20 to 83 years). MAIN OUTCOME MEASURES Chemosensory disorder-related changes in food habits (determined by questionnaire responses), nutrient intake (analysis of 3-day food records), and body weight (self-reported). STATISTICAL ANALYSES Analysis of covariance, followed by post hoc analysis of adjusted means with the Tukey honestly significant difference test, was used to explore group differences in nutrient intake and body weight. chi 2 Analysis and the Pearson correlation coefficient were used to evaluate relationships between variables. RESULTS When groups were classified according to chemosensory diagnosis, group differences were observed on global appetitive questions, but complaints were high in all groups. Approximately 65% (203 of 310) of patients had self-reported body weights within 5% of their predisorder weight, but clinically meaningful weight gains or losses were observed in each group. Patients with multiple chemosensory disorders were most likely to lose weight, whereas the incidence of weight gain was highest in patients with anosmia. Patient report of a change in eating patterns was the best predictor of weight change among the variables examined. CONCLUSIONS Dietary responses to chemosensory disorders vary widely and may place patients at nutritional risk. Until better prognostic indexes are identified, dietitians should query patients about disorder-related alterations in eating patterns and provide appropriate individualized counseling.

Influences on acceptance of bitter foods and beverages.

Bitterness is generally viewed as an undesirable attribute of foods and beverages, yet segments of the population regularly ingest items with a prominent bitter taste. The influence of taste sensitivity, exposure, selected personality traits (i.e., neophobia, variety seeking, sensation seeking) and pharmacological reactivity on alcohol and caffeine consumption, two widely consumed bitter substances, was assessed in 20 healthy adults (10 male, 10 female). Self-reported alcohol use was positively correlated with measured ethanol taste detection threshold and pharmacological reactivity (self-reported behavioral effects). The latter accounted for 23% of the variance in alcohol intake. Caffeine intake was significantly associated with personality traits. Sensation seeking status and self-reported reactivity to caffeine accounted for 46% of the variance in caffeine intake. Pleasantness ratings for novel bitter and sour foods were unaffected by 10 exposures whereas increased ratings were given to sweet and salty items. Variation in the influence of these factors between individuals and across products may explain individual differences in the acceptability and use of foods and beverages containing alcohol, caffeine and other bitter compounds.

Effects of aspartame and sucrose on hunger and energy intake in humans

Physiological and behavioral responses to high intensity sweeteners have been poorly characterized, leading to questions regarding their utility in weight management regimens. To address this issue, studies must independently control attributes such as the taste properties, chemical composition and energy contribution of a given sweetener, as well as subject expectations of its effects. In the present study, 24 adults of normal weight consumed breakfasts including unsweetened or sweetened (sucrose or aspartame) cereal for 5 days, during which hunger and energy intake were monitored. The cereals were rated as equally sweet and pleasant and were equicaloric. Half of the subjects were aware of the cereal composition. Neither sweet taste nor aspartame alone significantly affected reported hunger, daily energy intake or subsequent selection of foods with varying taste qualities. Energy intake tended to be more strongly influenced by perceptions of the energy value of the experimental breakfast. Thus, this study failed to find an appetite stimulating effect of either sweetness or sweetener (aspartame or sucrose).

Bypassing the first-pass effect for the therapeutic use of cannabinoids.

An oral formulation of delta-9-tetrahydrocannabinol (THC) in sesame oil (Marinol) is at present used for the management of chemotherapy-related nausea and emesis. However, due partly to poor bioavailability, its efficacy is variable. To circumvent possible metabolism in the gut and a first-pass effect by the liver, a suppository formulation of THC hemisuccinate ester was prepared. Administration of the suppository containing 11.8 mg of the hemisuccinate ester (equivalent to 9 mg THC) to three adult females (two of whom had previously exhibited low plasma drug levels following a 10-mg dose of the oral formulation) led to a marked and sustained elevation of plasma drug levels. Areas under the curves for plasma THC were more than 30-fold higher than after oral dosing. The suppository was well tolerated. The higher and more sustained plasma drug level achieved with this new formulation should enhance its antiemetic efficacy.

Learned food aversions among cancer chemotherapy patients. Incidence, nature, and clinical implications

The current study documents the incidence of chemotherapy‐related food aversions in defined patient populations and characterizes selected aspects of the problem. The association between the incidence of food aversions and patient outcome was also evaluated. Seventy‐six primarily breast and lung cancer patients were interviewed before and at stipulated time points for 6 months after their initial course of chemotherapy. Learned food aversions (LFA) were documented via open‐ended questionnaires and ratings for foods ingested during the 48‐hour period surrounding the first day of treatment. Treatment‐related aversions were observed in over 50% of the patients and involved all food groups. The aversions generally occurred shortly after the first course of chemotherapy, were food‐specific and of short duration. No strong association was observed between the incidence of food aversions and treatment outcome measures, but quality of life issues warrant further consideration.

Salt taste and hypertension: A critical review of the literature

Studies of the salt taste sensitivity, responsiveness, preference, and appetite of normotensive and hypertensive individuals have yielded therapeutic, diagnostic, predictive, and mechanistic findings related to hypertension. Following a brief description of the nature of these taste parameters, findings pertaining to the association between each and hypertension are critically reviewed. Potential clinical implications of this information, as well as the need to exercise caution in the translation of taste data into dietary practice are also discussed.

A Figurative Measure of Subjective Hunger Sensations

In an attempt to better characterize the subjective experience of hunger, we assessed the locus and extent of sensations associated with varying degrees of hunger. In the first study, 83 subjects indicated by marking on a drawing of a human figure where they felt hungry under hypothetical conditions of slight to extreme hunger. Approximately 55% of subjects indicated an abdominal locus with slight hunger, a proportion which increased somewhat with increasing levels of imagined hunger. The proportion of subjects indicating other or additional body sites grew significantly with increasing hunger states; for example, those identifying the head region increased from about 10-35%. In a second study, 14 subjects were fasted for 22 h and then refed. Using the drawn figures, they outlined body areas where they experienced hunger during and after fasting. The size of the abdominal area and the total body area associated with hunger sensations expanded with increasing food deprivation and contracted after refeeding. The size of the area of hunger sensation did not necessarily correlate with the degree of hunger as assessed by standard rating scales. The results indicate that the extent and locus of hunger sensations vary with fasting and feeding, and suggest that the site and size of the body areas associated with hunger sensations may provide qualitative and quantitative measures of the subjective experience of hunger not captured by analogue rating scales.