Ultra-Processing or Oral Processing? A Role for Energy Density and Eating Rate in Moderating Energy intake from Processed Foods

ABSTRACT Background Recent observational data and a controlled in-patient crossover feeding trial show that consumption of “ultra-processed foods” (UPFs), as defined by the NOVA classification system, is associated with higher energy intake, adiposity, and at a population level, higher prevalence of obesity. A drawback of the NOVA classification is the lack of evidence supporting a causal mechanism for why UPFs lead to overconsumption of energy. In a recent study by Hall the energy intake rate in the UPF condition (48 kcal/min) was >50% higher than in the unprocessed condition (31 kcal/min). Extensive empirical evidence has shown the impact that higher energy density has on increasing ad libitum energy intake and body weight. A significant body of research has shown that consuming foods at higher eating rates is related to higher energy intake and a higher prevalence of obesity. Energy density can be combined with eating rate to create a measure of energy intake rate (kcal/min), providing an index of a food's potential to promote increased energy intake. Objective The current paper compared the association between measured energy intake rate and level of processing as defined by the NOVA classification. Methods Data were pooled from 5 published studies that measured energy intake rates across a total sample of 327 foods. Results We show that going from unprocessed, to processed, to UPFs that the average energy intake rate increases from 35.5 ± 4.4, to 53.7 ± 4.3, to 69.4 ± 3.1 kcal/min (P < 0.05). However, within each processing category there is wide variability in the energy intake rate. Conclusions We conclude that reported relations between UPF consumption and obesity should account for differences in energy intake rates when comparing unprocessed and ultra-processed diets. Future research requires well-controlled human feeding trials to establish the causal mechanisms for why certain UPFs can promote higher energy intake.

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Consistency of Eating Rate, Oral Processing Behaviours and Energy Intake across Meals

Nutrients ◽

10.3390/nu9080891 ◽

2017 ◽

Vol 9 (8) ◽

pp. 891 ◽

Cited By ~ 27

Author(s):

Keri McCrickerd ◽

Ciaran Forde

Keyword(s):

Energy Intake ◽

Eating Rate ◽

Oral Processing

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Consumption of Foods With Higher Energy Intake Rates is Associated With Greater Energy Intake, Adiposity, and Cardiovascular Risk Factors in Adults

Journal of Nutrition ◽

10.1093/jn/nxaa344 ◽

2020 ◽

Author(s):

Pey Sze Teo ◽

Rob M van Dam ◽

Clare Whitton ◽

Linda Wei Lin Tan ◽

Ciarán G Forde

Keyword(s):

Risk Factors ◽

Body Composition ◽

Energy Density ◽

Energy Intake ◽

Disease Risk ◽

Asian Population ◽

High Energy ◽

High Energy Density ◽

Intake Rate ◽

Eating Rate

ABSTRACT Background Both high energy density and fast eating rates contribute to excess energy intakes. The energy intake rate (EIR; kcal/min) combines both the energy density (kcal/g) and eating rate (g/min) of a food to quantify the typical rate at which calories of different foods are ingested. Objectives We describe the EIRs of diets in a multi-ethnic Asian population, and examine relationships between the consumption of high-EIR foods and total energy intake, body composition, and cardio-metabolic risk factors. Methods Diet and lifestyle data from the Singapore Multi-Ethnic Cohort 2 (n = 7011; 21–75 y), were collected through interviewer-administrated questionnaires. The EIR for each of the 269 foods was calculated as the product of its eating rate and energy density. Multivariable models were used to examine associations between the relative consumption of foods with higher and lower EIRs and energy intake, body composition, and cardio-metabolic risks, after adjusting for age, sex, ethnicity, education level, physical activity, smoking status, and alcohol drinking status. Results Individuals with higher daily energy intakes and with obesity consumed a significantly larger percentage of their energy from high-EIR foods, with a smaller relative intake of lower-EIR foods. Individuals with raised serum cholesterol also consumed a significantly higher proportion of high-EIR foods, whereas those without hypertension consumed a larger percentage of energy intake from low-EIR foods. Individuals classified as having a “very high” dietary EIR had a significantly 1.3 kg higher body weight (95% CI, 0.2–1.5; P = 0.013), 0.4 kg/m2 higher BMI (95% CI, 0.03–0.8; P = 0.037), and 1.2 cm larger waist circumference (95% CI, 0.2–2.2; P = 0.010), and were more likely to have abdominal overweight (OR, 1.3; 95% CI, 1.1–1.5; P < 0.001) than those with a “low” dietary EIR. Conclusions Comparing foods by their EIRs summarizes the combined impact of energy density and eating rate, and may identify foods and dietary patterns that are associated with obesogenic eating styles and higher diet-related cardiovascular disease risk in an Asian population.

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Effects of Apple Form on Energy Intake During a Mid-Afternoon Snack: A Preload Paradigm Study in School-Aged Children

Frontiers in Nutrition ◽

10.3389/fnut.2021.620335 ◽

2021 ◽

Vol 8 ◽

Author(s):

Camille Schwartz ◽

Ophélie Person ◽

Emilie Szleper ◽

Sophie Nicklaus ◽

Carole Tournier

Keyword(s):

Food Intake ◽

Energy Intake ◽

Cottage Cheese ◽

Oral Exposure ◽

Eating Rate ◽

School Aged Children ◽

Ad Libitum ◽

Oral Processing ◽

The Individual ◽

Eating Fast

Consuming foods with a form or a texture that requires longer oral processing is a way to decrease food intake. Although this approach is promising for leveraging healthier eating patterns in adults, it has never been explored in children. This study evaluated whether starting a mid-afternoon snack by eating either apple segments or applesauce would modify hunger and subsequent food intake during this meal. Forty-four children (8–10 years old) participated in two videotaped mid-afternoon snacks, during which they received one of the two forms of apple as a food preload followed 10 min later by ad libitum consumption of sweetened cottage cheese. They self-reported their level of hunger throughout consumption, and the weight of cottage cheese consumed was determined at the end of the snack. Children's chewing capabilities and eating traits were parent-reported. Eating a raw apple increased oral exposure time and decreased bite size compared to eating applesauce. However, neither the reported hunger nor consecutive food intake were modified. Regardless of the meal, children eating fast had a higher ad libitum energy intake. The individual eating rate for the cottage cheese was correlated with the eating rate observed for applesauce but not for apple segments, the latter being associated with children's chewing difficulties. This study suggests that the form of a fruit offered at the start of a mid-afternoon snack does not impact food intake; the findings clearly call for more exploration of satiation mechanisms related to food texture properties among children and indicate the need to consider children's oral processing skills.

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Consumption of ultra-processed foods and nutritional profile in a health promotion service of Primary care

Public Health Nutrition ◽

10.1017/s1368980021002202 ◽

2021 ◽

pp. 1-41

Author(s):

Suellen Fabiane Campos ◽

Luana Caroline dos Santos ◽

Mariana Souza Lopes ◽

Patrícia Pinheiro de Freitas ◽

Aline Cristine Souza Lopes

Keyword(s):

Health Promotion ◽

Energy Density ◽

Energy Intake ◽

Cross Sectional Study ◽

Processed Foods ◽

Omega 3 ◽

Cross Sectional ◽

Fiber Consumption ◽

Belo Horizonte ◽

Public Health Promotion

Abstract Objective: Describing the consumption of Ultra-processed foods (UPFs) and their association with the nutritional profiles among users of a health promotion service in a Brazilian city. Design: Cross-sectional study. Setting: Public health promotion service of Primary Health Care in Belo Horizonte, Minas Gerais, Brazil. Participants: 3372 participants Results: UPFs were found to contribute to 27.7% of the diet’s total energy. The highest consumption was associated with higher values for energy intake (1561,8 vs. 1331,8 kcal/d; p <0,01), energy density (1,7 vs. 1,4 kcal/g; p <0,01), total (32,5 vs. 27,3 %; p <0,01) and trans fats (2,1 vs. 1,2 %; p <0,01), and sodium (1001,6 vs. 758,9 mg/1000 kcal; p <0,01), and with lower values for proteins (14,9 vs. 19,6 %; p <0,01), mono-unsaturated fats (16,1 vs. 20,1%; p=0,02), omega-3 (0,9 vs. 1,1 %; p <0,01), and some vitamins and minerals when comparing individuals in the last quintile of energy contribution from UPFs in relation to the first one. The prevalence rate of nutrient inadequacy aimed at preventing NCDs increased between 30% and 100% when compared the values of the fifth to the first quintile of UPFs consumption(p<0,001). However, the participants had lower energy intake, energy density and sodium; and higher fiber consumption when compared to Brazilian population. Conclusions: Participants showed a high consumption of UPFs, but also positive diet characteristics when compared to the national data. The results suggest the importance of Health promotion services to promote healthy food and the need to include approaches to reduce UPFs consumption.

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Correlation of instrumental texture properties from textural profile analysis (TPA) with eating behaviours and macronutrient composition for a wide range of solid foods

Food & Function ◽

10.1039/c8fo00791h ◽

2018 ◽

Vol 9 (10) ◽

pp. 5301-5312 ◽

Cited By ~ 25

Author(s):

May Sui Mei Wee ◽

Ai Ting Goh ◽

Markus Stieger ◽

Ciarán G. Forde

Keyword(s):

Energy Intake ◽

Profile Analysis ◽

Eating Rate ◽

Eating Behaviours ◽

Macronutrient Composition ◽

Solid Foods ◽

Texture Properties ◽

Wide Range ◽

Oral Processing ◽

Instrumental Texture

The correlation between instrumental texture properties and oral processing provides guidance on the parameters that produce ‘faster’ and ‘slower’ versions of foods, and suggests how texture modifications can be applied to moderate eating rate and energy intake within meals.

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Independent and combined effects of eating rate and energy density on energy intake, appetite, and gut hormones

Obesity ◽

10.1002/oby.20075 ◽

2013 ◽

Vol 21 (3) ◽

pp. E244-E252 ◽

Cited By ~ 31

Author(s):

J. Philip Karl ◽

Andrew J. Young ◽

Jennifer C. Rood ◽

Scott J. Montain

Keyword(s):

Energy Density ◽

Energy Intake ◽

Gut Hormones ◽

Combined Effects ◽

Eating Rate

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Ultra-processed foods and recommended intake levels of nutrients linked to non-communicable diseases in Australia: evidence from a nationally representative cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2019-029544 ◽

2019 ◽

Vol 9 (8) ◽

pp. e029544 ◽

Cited By ~ 15

Author(s):

Priscila P Machado ◽

Euridice M Steele ◽

Renata B Levy ◽

Zhixian Sui ◽

Anna Rangan ◽

...

Keyword(s):

Energy Density ◽

Energy Intake ◽

Cross Sectional Study ◽

Processed Foods ◽

Processed Food ◽

Sectional Study ◽

Energy Contribution ◽

Cross Sectional ◽

Free Sugars ◽

Non Communicable Diseases

ObjectiveThis study aimed to describe the consumption of ultra-processed foods in Australia and its association with the intake of nutrients linked to non-communicable diseases (NCDs).DesignCross-sectional study.SettingNational Nutrition and Physical Activity Survey (2011-2012).Participants12,153 participants aged 2+ years.Main outcome measuresAverage dietary content of nutrients linked to NCDs and the prevalence of intake outside levels recommended for the prevention of NCDs.Data analysisFood items were classified according to the NOVA system, a classification based on the nature, extent and purpose of industrial food processing. The contribution of each NOVA food group and their subgroups to total energy intake was calculated. Mean nutrient content of ultra-processed food and non-ultra-processed food fractions of the diet were compared. Across quintiles of the energy contribution of ultra-processed foods, differences in the intake of nutrients linked to NCDs as well as in the prevalence of intakes outside levels recommended for the prevention of NCDs were examined.ResultsUltra-processed foods had the highest dietary contribution (42.0% of energy intake), followed by unprocessed or minimally processed foods (35.4%), processed foods (15.8%) and processed culinary ingredients (6.8%). A positive and statistically significant linear trend was found between quintiles of ultra-processed food consumption and intake levels of free sugars (standardised β 0.43, p<0.001); total (β 0.08, p<0.001), saturated (β 0.18, p<0.001) and trans fats (β 0.10, p<0.001); sodium (β 0.21, p<0.001) and diet energy density (β 0.41, p<0.001), while an inverse relationship was observed for dietary fibre (β -0.21, p<0.001) and potassium (β -0.27, p<0.001). The prevalence of non-recommended intake levels of all studied nutrients increased linearly across quintiles of ultra-processed food intake, notably from 22% to 82% for free sugars, from 6% to 11% for trans fat and from 2% to 25% for dietary energy density, from the lowest to the highest ultra-processed food quintile.ConclusionThe high energy contribution of ultra-processed foods impacted negatively on the intake of non-ultra-processed foods and on all nutrients linked to NCDs in Australia. Decreasing the dietary share of ultra-processed foods would substantially improve the diet quality in the country and help the population achieve recommendations on critical nutrients linked to NCDs.

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