Rule-based systems to automatically count bites from meal videos.

Eating behavior is a key factor for nutritional intake and plays a significant role in the development of eating disorders and obesity. The standard methods to detect eating behavior events (i.e., bites and chews) from video recordings rely on manual annotation, which lacks objective assessment and standardization. Yet, video recordings of eating episodes provide a non-invasive and scalable source for automation. Here, we present a rule-based system to count bites automatically from video recordings with 468 3D facial key points. We tested the performance against manual annotation in 164 videos from 15 participants. The system can count bites with 79% accuracy when annotation is available, and 71.4% when annotation is unavailable. The system showed consistent performance across varying food textures. Eating behavior researchers can use this automated and objective system to replace manual bite count annotation, provided the system's error is acceptable for the purpose of their study. Utilizing our approach enables real-time bite counting, thereby promoting interventions for healthy eating behaviors. Future studies in this area should explore rule-based systems and machine learning methods with 3D facial key points to extend the automated analysis to other eating events while providing accuracy, interpretability, generalizability, and low computational requirements.

Short and Long-Term Innovations on Dietary Behavior Assessment and Coaching: Present Efforts and Vision of the Pride and Prejudice Consortium.

Overweight, obesity and cardiometabolic diseases are major global health concerns. Lifestyle factors, including diet, have been acknowledged to play a key role in the solution of these health risks. However, as shown by numerous studies, and in clinical practice, it is extremely challenging to quantify dietary behaviors as well as influencing them via dietary interventions. As shown by the limited success of 'one-size-fits-all' nutritional campaigns catered to an entire population or subpopulation, the need for more personalized coaching approaches is evident. New technology-based innovations provide opportunities to further improve the accuracy of dietary assessment and develop approaches to coach individuals towards healthier dietary behaviors. Pride & Prejudice (P&P) is a unique multi-disciplinary consortium consisting of researchers in life, nutrition, ICT, design, behavioral and social sciences from all four Dutch Universities of Technology. P&P focuses on the development and integration of innovative technological techniques such as artificial intelligence (AI), machine learning, conversational agents, behavior change theory and personalized coaching to improve current practices and establish lasting dietary behavior change.

Effects of Oro-Sensory Exposure on Satiation and Underlying Neurophysiological Mechanisms-What Do We Know So Far?

The mouth is the first part of the gastrointestinal tract. During mastication sensory signals from the mouth, so-called oro-sensory exposure, elicit physiological signals that affect satiation and food intake. It has been established that a longer duration of oro-sensory exposure leads to earlier satiation. In addition, foods with more intense sweet or salty taste induce earlier satiation compared to foods that are equally palatable, but with lower taste intensity. Oro-sensory exposure to food affects satiation by direct signaling via the brainstem to higher cortical regions involved in taste and reward, including the nucleus accumbens and the insula. There is little evidence that oro-sensory exposure affects satiation indirectly through either hormone responses or gastric signals. Critical brain areas for satiation, such as the brainstem, should be studied more intensively to better understand the neurophysiological mechanisms underlying the process of satiation. Furthermore, it is essential to increase the understanding of how of highly automated eating behaviors, such as oral processing and eating rate, are formed during early childhood. A better understanding of the aforementioned mechanisms provides fundamental insight in relation to strategies to prevent overconsumption and the development of obesity in future generations.

Concept Development and Use of an Automated Food Intake and Eating Behavior Assessment Method.

The vast majority of dietary and eating behavior assessment methods are based on self-reports. They are burdensome and also prone to measurement errors. Recent technological innovations allow for the development of more accurate and precise dietary and eating behavior assessment tools that require less effort for both the user and the researcher. Therefore, a new sensor-based device to assess food intake and eating behavior was developed. The device is a regular dining tray equipped with a video camera and three separate built-in weighing stations. The weighing stations measure the weight of the bowl, plate, and drinking cup continuously over the course of a meal. The video camera positioned to the face records eating behavior characteristics (chews, bites), which are analyzed using artificial intelligence (AI)-based automatic facial expression software. The tray weight and the video data are transported at real-time to a personal computer (PC) using a wireless receiver. The outcomes of interest, such as the amount eaten, eating rate and bite size, can be calculated by subtracting the data of these measures at the timepoints of interest. The information obtained by the current version of the tray can be used for research purposes, an upgraded version of the device would also facilitate the provision of more personalized advice on dietary intake and eating behavior. Contrary to the conventional dietary assessment methods, this dietary assessment device measures food intake directly within a meal and is not dependent on memory or the portion size estimation. Ultimately, this device is therefore suited for daily main meal food intake and eating behavior measures. In the future, this technology based dietary assessment method can be linked to health applications or smart watches to obtain a complete overview of exercise, energy intake, and eating behavior.

Endocrine Cephalic Phase Responses to Food Cues: A Systematic Review.

Cephalic phase responses (CPRs) are conditioned anticipatory physiological responses to food cues. They occur before nutrient absorption and are hypothesized to be important for satiation and glucose homeostasis. Cephalic phase insulin responses (CPIRs) and pancreatic polypeptide responses (CPPPRs) are found consistently in animals, but human literature is inconclusive. We performed a systematic review of human studies to determine the magnitude and onset time of these CPRs. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used to develop a search strategy. The terms included in the search strategy were cephalic or hormone response or endocrine response combined with insulin and pancreatic polypeptide (PP). The following databases were searched: Scopus (Elsevier), Science Direct, PubMed, Google Scholar, and The Cochrane Library. Initially, 582 original research articles were found, 50 were included for analysis. An insulin increase (≥1µIU/mL) was observed in 41% of the treatments (total n = 119). In 22% of all treatments the increase was significant from baseline. The median (IQR) insulin increase was 2.5 (1.6-4.5) µIU/mL, 30% above baseline at 5± 3 min  after food cue onset (based on study treatments that induced ≥1 µIU/mL insulin increase). A PP increase (>10 pg/mL) was found in 48% of the treatments (total n = 42). In 21% of the treatments, the increase was significant from baseline. The median (IQR) PP increase was 99 (26-156) pg/mL, 68% above baseline at 9± 4 min  after food cue onset (based on study treatments that induced ≥1 µIU/mL insulin increase). In conclusion, CPIRs are small compared with spontaneous fluctuations. Although CPPPRs are of a larger magnitude, both show substantial variation in magnitude and onset time. We found little evidence for CPIR or CPPPR affecting functional outcomes, that is, satiation and glucose homeostasis. Therefore, CPRs do not seem to be biologically meaningful in daily life.

Unaware of the amount consumed: Systematic error in estimating food- and drink intake.

BACKGROUND: Our current food environment promotes overconsumption due to the overrepresentation of foods that have a high calorie density and can be easily consumed. These food characteristics lead to limited oro-sensory exposure, which may lead to overconsumption due to insufficient perception of the amount consumed. Better perception of the amount eaten and thus a better ability to estimate intake may help control actual food intake through prolonged inter-meal interval and smaller meal sizes. OBJECTIVE: The aim of this study was to determine whether food form, flavor and portion size influence the error in estimated intake (EiE). METHOD: Participants (n = 72) were recruited at a science festival where the study was also performed. The experiment had a 2 × 2 × 3 design with a reference condition. Experimental conditions differed in food form (liquid vs. solid stimuli), taste category (savory vs. sweet) and portion size (small, medium, large). Water was used as a reference condition. RESULTS: Participants overestimated the amount consumed of all stimuli. The overestimation was ten times greater for solid compared to liquid products (104 ±â€¯12 vs 12 ±â€¯9% overestimation) and was more pronounced for sweet (75 ±â€¯9%) than for savory products (41 ±â€¯12%). There was a trend for larger EiE% of smaller portions. No differences were found among the differently flavored liquids including the water reference. CONCLUSION: People overestimate the amount they consume of solid and sweet products more than that of liquid and savory products. This overestimation may be due to overvaluation of the oro-sensory stimulation when visual cues and intake effort are controlled for or because of learned associations. However, the uncontrolled setting of the experiment should be taken into account when drawing conclusions. Future research may replicate the study in a more controlled setting and should determine whether the overestimation of sweet solid product intake also leads to lower intake at a subsequent meal.

Sensory analysis of characterising flavours: evaluating tobacco product odours using an expert panel.

OBJECTIVES: Tobacco flavours are an important regulatory concept in several jurisdictions, for example in the USA, Canada and Europe. The European Tobacco Products Directive 2014/40/EU prohibits cigarettes and roll-your-own tobacco having a characterising flavour. This directive defines characterising flavour as 'a clearly noticeable smell or taste other than one of tobacco […]'. To distinguish between products with and without a characterising flavour, we trained an expert panel to identify characterising flavours by smelling. METHODS: An expert panel (n=18) evaluated the smell of 20 tobacco products using self-defined odour attributes, following Quantitative Descriptive Analysis. The panel was trained during 14 attribute training, consensus training and performance monitoring sessions. Products were assessed during six test sessions. Principal component analysis, hierarchical clustering (four and six clusters) and Hotelling's T-tests (95% and 99% CIs) were used to determine differences and similarities between tobacco products based on odour attributes. RESULTS: The final attribute list contained 13 odour descriptors. Panel performance was sufficient after 14 training sessions. Products marketed as unflavoured that formed a cluster were considered reference products. A four-cluster method distinguished cherry-flavoured, vanilla-flavoured and menthol-flavoured products from reference products. Six clusters subdivided reference products into tobacco leaves, roll-your-own and commercial products. CONCLUSIONS: An expert panel was successfully trained to assess characterising odours in cigarettes and roll-your-own tobacco. This method could be applied to other product types such as e-cigarettes. Regulatory decisions on the choice of reference products and significance level are needed which directly influences the products being assessed as having a characterising odour.

Exacting Responses: Lack of Endocrine Cephalic Phase Responses Upon Oro-Sensory Exposure.

Oro-sensory exposure (OSE) to food plays an important role in the regulation of food intake. One proposed underlying mechanism is the occurrence of cephalic phase responses (CPRs). CPRs include the pre-digestive endocrine responses induced by food-related sensory input. Yet, whether OSE duration or sweetness intensity affects CPRs is unknown. The objective of this study was to determine the independent and interactive effects of oro-sensory duration (chewing) and stimulation intensity (sweetness) on endocrine CPRs and satiation. Eighteen males (22 ± 2 years, BMI 22 ± 2 kg/m2) participated in a 2 × 2 randomized study with a control condition. Each session participants performed modified sham feeding (MSF) with one of the four gel-based model foods. During the control session no MSF was performed. Model foods differed in chewing duration (hard or soft texture) and sweetness (low or high intensity). During each session, eight blood samples were collected up till 25 min after MSF onset. Subsequently, food intake from an ad libitum lunch was measured. No typical CPR was found for insulin, pancreatic polypeptide (PP), and ghrelin. However, the overall PP response was 1.1 times greater for the hard sweet MSF condition compared to control (p = 0.02). Overall ghrelin responses were 1.1 times greater for the hard model food compared to the soft model food conditions (p = 0.003). These differences in endocrine response were not associated with differences in food intake at the subsequent meal. Exploratory sub-analysis of the responsive insulin curves showed that after 2.5 min of MSF the hard texture model foods insulin concentrations were 1.2 greater compared to the soft texture. These findings indicate that texture hardness and sweetness increase the overall PP response and that MSF on hard texture increases the overall ghrelin response compared to soft texture model foods. However, MSF on model foods does not lead to a typical CPR. This study, among others, shows that there are major dissimilarities in the endocrine responses to food stimulation between individuals. This emphasizes the importance of considering cephalic responders and non-responders. More research is needed to understand CPRs in relation to food texture and taste properties.