The Assessment of Eating Pleasure among Older Adults: Development and Preliminary Validation of the Anticipatory and Consummatory Eating Pleasure (ACEPS).

OBJECTIVE: Maintaining eating pleasure as long as possible is one of the determinants that contributes to and encourages good nutrition in the ageing population. Our study aimed to translate, adapt to the context of food and validate the Temporal Experience of Pleasure Scale (which distinguishes anticipatory and consummatory experiences of pleasure) in a food dependent older French population. DESIGN: Prospective validation study. SETTING: 199 participants dependent for their meals, over 65 years old and living at home. MEASUREMENTS: A pool of 16 self-reported items constituted the initial version of the anticipatory and consummatory eating pleasure scale (ACEPS). Demographic data, nutritional status, appetite and depressive mood were also assessed. RESULTS: The exploratory factorial analysis and also the confirmatory factor analysis highlighted a two-factor model: anticipatory eating pleasure (four items) and consummatory eating pleasure (four items). The ACEPS showed good internal consistency. A higher score on the ACEPS positively correlated with appetite. Consummatory eating pleasure positively correlated with nutritional status and negatively correlated with depressive moods. The oldest-old and also those receiving a meals-on-wheels service had lower scores for anticipatory pleasure (r=-.14, p<.03). CONCLUSION: To our knowledge, the ACEPS is the first comprehensive measure of eating pleasure distinguishing anticipatory and consummatory pleasure. This short measure, easily applicable on older people with vulnerability, allows early identification and intervention preventing malnutrition and decline in health. Specifically, encouraging anticipatory eating pleasure may be a first step to improving food intake among older adults.

Variety enhances food intake in humans: role of sensory-specific satiety.

Twenty-one subjects were studied to evaluate the effect of renewal of sensory stimulations of previously eaten foods on sensory-specific satiety and intake. The subjects ate French fries then brownie cakes ad libitum in three situations: "monotonous" - fries then brownies were consumed alone; "simultaneous" - condiments (ketchup and mayonnaise for the fries, vanilla cream and whipped cream for the brownies) were added during intakes; "successive" - after intake of fries alone, ketchup then mayonnaise were available with fries and, after intake of brownies alone, vanilla cream then whipped cream were offered with brownies. The quantities eaten in the "simultaneous" and "successive" situations were higher (p<0.001) than those in the "monotonous" one (1485+/-582 and 1682+/-777 kcal vs 1195+/-552 kcal, respectively). In the "successive" situation, hedonic ratings for fries diminished during intake but increased after the introduction of ketchup, leading to additional intake of fries. Similarly, hedonic ratings for brownies diminished during intake and increased after the introduction of vanilla cream leading to additional brownie intake (mayonnaise and whipped cream had no significant effect). Food variety, obtained by adding condiments can increase food intake in the short term. The mechanism by which food consumption is increased after the addition of condiments is introduced is at least partly related to the attenuation of sensory-satiety for a given food.

Change in taste preference in undernourished elderly hospitalized subjects during periods of infection and convalescence.

AIM: To determine the impact of taste pleasure supplements on modifications of food intake in hospitalized frail elderly patients. METHODS: Thirty hospitalized frail elderly patients tasted different formulas of a high-protein coffee supplement: -supplement C, commercial version; - supplement CA with artificial coffee flavor; - supplement CS with sucrose and - supplement CAS with sucrose and artificial coffee flavor. The preference for the supplements was analyzed by the Friedman test followed by a post hoc Tukey's test. The food intakes in each period were compared by repeated ANOVA and the food intakes of the two periods were compared using Student's t test. All measurements were made during periods of infection and convalescence. RESULTS: The supplements CAS and CS were significantly more appreciated than the current commercial version C (P < .05). The patients could be classified into two groups: consumers (consuming the supplements) and nonconsumers (just tasting the supplements). Taking supplements can increase the total energy intake for consumers (P < .01), especially during periods of infection; no modification was observed in the non-consumers. CONCLUSION: The use of supplements to increase sensory pleasure can be one feasible way to increase energy intake in hospitalized elderly patients with an infectious disease.

Sensory-specific satiety with simple foods in humans: no influence of BMI?

OBJECTIVE: Olfacto-gustatory sensory-specific satiety plays an important role in the termination of food ingestion. A defect in this mechanism, by increasing food intake, could be a factor in development of overweight. The present study was conducted to explore whether sensory-specific satiety in the overweight may be different from that in normal-weight subjects. SUBJECTS: 144 subjects (half men, half women; age range: 17-62 years; BMI range: 17-39 kg m(-2)). MEASUREMENTS: Olfactory pleasure (OP) and flavor pleasure (FP) were evaluated before and after ingestion of a single chosen food. Six foods from three classes were offered: cucumber and tomato, pineapple and banana, and peanut and pistachio. According to the subjects' preference for one of them, subjects were classified into six groups (24 subjects each with equal sex ratio). The experimental sequence was (1) evaluation of the six foods (OP), (2) ad libitum intake of the preferred food (FP) and (3) second evaluation of the six foods (OP). RESULTS: Food intake was limited by sensory-specific satiety (that is, a decline in FP for the ingested food) in overweight subjects just as it was in the leanest. There was no significant correlation between BMI and hedonic parameters (OP and FP) or intakes (quantity and volume). Pre-ingestive OP and FP correlated with the ingested food's weight (OP: r=0.468; FP: r=0.415; P<0.01), volume (OP: r=0.428; FP: r=0.407; P<0.01) and intake duration (OP: r=0.184; FP: r=0.343; P<0.05). The decline in OP, but not in FP, correlated with ingested weight (r=0.271, P<0.01) and volume (r=0.263, P<0.01) but not with duration. CONCLUSION: After intake of a single food, olfacto-gustatory sensory-specific satiety correlated with the ingested food's weight and volume and with the duration of ingestion, but not with bodyweight. This suggests that overweight and lean subjects have similar hedonic control of food intake with simple foods.

A 6-month follow-up of nutritional status in institutionalized patients with Alzheimer's disease.

OBJECTIVE: A follow up of nutritional status in institutionalized patients with Alzheimer's disease. DESIGN: Observational study. SETTING: Specialized unit for patients with Alzheimer's disease in Dijon hospital, France. SUBJECTS: Fourteen women, aged 72-92 years. ASSESSMENTS: On admission of patients to the specialized unit for dementia, body weight, body mass index, arm muscle circumference (AMC) and triceps skin fold (TSF) were measured. Serum concentrations of albumin, prealbumin, homocysteine, orosomucoide, calcium, folates, vitamins B12 and B6 and C-reactive protein were recorded. The same clinical and biological measurements were repeated at day 30, 90 and 180. RESULTS: Both mean weight and mean BMI increased throughout the study with significant differences between day 0 and day 90, and day 180 (p<0.01). The weight gain was associated with a significant increase in AMC and TSF (p<0.01 and p<0.001, respectively). There was no significant difference for values of both mean serum levels of albumin and prealbumin between day 0 and day 180. Whatever the period, serum concentrations of folates and vitamin B12 were in the normal range, while mean levels of vitamin B6 were lower than the normal range; For all these values, there was no significant difference between day 0, 30, 90, 180. Mean levels of C-reactive protein and orosomucoide and lymphocyte counts were in the normal range both at admission and day 180. No significant difference was noted between value of homocysteine at admission and at day 180. CONCLUSION: In this special care unit, the patients with Alzheimer's disease who take part in daily activities and particularly preparation of the meal don't lose weight. It is certain that future studies recording food intake and energy expenditure are necessary to explain the benefits in the nutritional status observed in patients showing dementia when they are institutionalized in a special unit.

Influence of repeated consumption of beverages containing sucrose or intense sweeteners on food intake.

OBJECTIVE: To investigate the influence of ingestion of beverages with sucrose or with intense sweeteners on food intake (FI) and on hunger ratings in before and after a month of daily consumption of beverages. DESIGN: Experimental study. SETTING: Department of Physiology, University Hospital, Dijon, France. SUBJECTS: In all, 12 men and 12 women, aged 20-25 y. INTERVENTION: Four beverages contained either sucrose (E+:100 g/l, 1672 kJ) or intense sweeteners (E-: null energy content) and were flavoured with either orange (O) or raspberry (R). FI was measured in the lab during two 2-consecutive-day periods, carried out on 2 successive weeks (session 1). The subjects drank 2 l of either E+ or E- beverages on the first day of both weekly periods, according to a balanced randomised design. E+ was paired with O for 50% of subjects and with R for the other 50%. Subjects were then habituated over a 4-week period to both beverages, consuming 1 l of E+ beverage on odd days and 1 l of E- drink on even days. After this period, the measurements of session 1 were repeated (session 2, weeks 7-8). Finally, FI was measured for two more 2-day periods (weeks 9-10) after the association between flavour and energy content was reversed (session 3). RESULTS: The E- drinks were less palatable than the E+ drinks. Besides, we observed that FI was not reduced in response to a liquid extra caloric load and there was no change in hunger ratings after the beverages in any of the sessions. CONCLUSION: Ingestion of caloric beverages induced a positive energy balance and the continuous exposure phase to these beverages over 1 month did not improve FI adaptation in response to the extra energy provided by the beverages.

Substrate oxidation and control of food intake in men after a fat-substitute meal compared with meals supplemented with an isoenergetic load of carbohydrate, long-chain triacylglycerols, or medium-chain triacylglycerols.

BACKGROUND: It has been suggested that hunger may be delayed and food intake reduced under metabolic conditions that spare carbohydrate oxidation. OBJECTIVE: Our objective was to examine the role of glucose metabolism in the control of food intake in men by using medium-chain triacylglycerols (MCTs) to spare carbohydrate oxidation. DESIGN: In 10 male volunteers, isolated and deprived of any time cues, we studied the effects of 4 lunches on hunger ratings, the duration of satiety, the amount of food ingested at dinner, energy expenditure, substrate oxidation, and plasma variables until the time of the dinner request. One lunch was a basic 2310-kJ meal containing 40 kJ fat substitute (Sub lunch). The 3 other lunches consisted of the same basic meal supplemented with either 1200 kJ long-chain triacylglycerols (LCT lunch), 1200 kJ MCTs (MCT lunch), or 900 kJ carbohydrate plus 300 kJ LCTs (Cho lunch). RESULTS: Energy expenditure was not significantly different after the different lunches, but carbohydrate oxidation was lower after the MCT and LCT lunches than after the Cho lunch. Fat oxidation was greater after the MCT and LCT lunches. The time of the dinner request was significantly delayed after the Cho lunch. Food intake at dinner was significantly lower after the MCT lunch than after the Sub and Cho lunches, but the dinner meal request was not delayed. CONCLUSION: Carbohydrate may have a greater role in the duration of satiety than does fat, but MCTs may play an active role in other aspects of the control of food intake, especially in satiation at the next meal.

Influence of medium-chain and long-chain triacylglycerols on the control of food intake in men.

Hunger may be delayed and food intake reduced under metabolic conditions that spare carbohydrate oxidation, especially during oxidation of medium-chain triacylglycerols (MCTs) or monounsaturated triacylglycerols. In 12 healthy, adult, male volunteers isolated and deprived of any time cues, we compared the effects of 4 high-carbohydrate breakfasts (1670 kJ) supplemented either with a fat substitute (Sub; 70 kJ) or with 1460 kJ fat as monounsaturated long-chain triacylglycerols (LCT-U), saturated long-chain triacylglycerols (LCT-S), or MCTs. In the first session we investigated the effects of these breakfasts on the following food intake variables: hunger ratings at repeated intervals, the time until the spontaneous request for the next 2 free-choice meals, and the amount of food consumed. In a second session with fixed lunches, we studied the effects of the same breakfasts on plasma glucose, insulin, triacylglycerol, fatty acid, and beta-hydroxybutyrate concentrations. The addition of any of the fats to the high-carbohydrate breakfasts did not alter hunger ratings, but significantly delayed the request for lunch compared with the low-fat breakfast. The free-choice lunch eaten after the MCT breakfast was also significantly smaller. Blood glucose and insulin concentrations were lower after the 3 fat breakfasts, followed by larger increases in glucose and enhanced insulin responses 30 min after the lunch. No differences were observed between the LCT-U and LCT-S conditions. We conclude that MCTs decreased food intake by a postabsorptive mechanism, although the exact effect of these lipids on carbohydrate oxidation will require further studies involving nutrient balance measurements.