Effect of Polydextrose on Subjective Feelings of Appetite

19 Pages·2016·0.7 MB·English

nutrients
Review
Effect of Polydextrose on Subjective Feelings of
Appetite during the Satiation and Satiety Periods:
A Systematic Review and Meta-Analysis
AlvinIbarra1,*,NerysM.Astbury2,KaisaOlli1,EsaAlhoniemi3andKirstiTiihonen1
Received:5October2015;Accepted:18December2015;Published:14January2016
1 ActiveNutrition,DuPontNutrition&Health,Sokeritehtaantie20,Kantvik02460,Finland;
[email protected](K.O.);[email protected](K.T.)
2 NuffieldDepartmentofPrimaryCareHealthSciences,UniversityofOxford,RadcliffeObservatoryQuarter,
WoodstockRoad,OxfordOX26GG,UK;[email protected]
3 AvoltusOy,Joukahaisenkatu1C,Turku20520,Finland;[email protected]
* Correspondence:[email protected];Tel.:[phone];Fax:[phone]
Abstract: Introduction: Subjectivefeelingsofappetitearemeasuredusingvisualanaloguescales
(VAS)incontrolledtrials. However,themethodsusedtoanalyzeVASduringtheSatiation(pre-to
post-meal)andSatiety(post-mealtosubsequentmeal)periodsvarybroadly,makingitdifficultto
compare results amongst independent studies testing the same product. This review proposes a
methodologytoanalyzeVASduringboththeSatiationandSatietyperiods,allowingustocompare
resultsinameta-analysis. Methods: AmethodologytoexpressVASresultsasincrementalareas
underthecurve(iAUC)forboththeSatiationandSatietyperiodsisproposedusingpolydextrose
asacasestudy. Further,asystematicreviewandmeta-analysisonsubjectivefeelingsofappetite
wasconductedfollowingthePRISMAmethodology. Meta-analyseswereexpressedasStandardized
Mean Difference (SMD). Results: Seven studies were included in the meta-analysis. There were
importantdifferencesinthemethodsusedtoanalyzeappetiteratingsamongstthesestudies. The
separatesubjectivefeelingsofappetitereportedwereHunger,Satisfaction,Fullness,ProspectiveFood
Consumption,andtheDesiretoEat. Themethodproposedhereallowedtheresultsofthedifferent
studies to be homogenized. The meta-analysis showed that Desire to Eat during the Satiation
period favors polydextrose for the reduction of this subjective feeling of appetite (SMD = 0.24,
I2<0.01,p=0.018);thiseffectwasalsosignificantinthesub-analysisbysexforthemalepopulation
(SMD=0.35,I2<0.01,p=0.015). Therewerenoothersignificantresults. Conclusion: Itispossible
tocompareVASresultsfromseparatestudies. TheassessmentofiAUCforboththeSatiationand
Satietyperiodsgeneratesresultsofhomogeneousmagnitudes. Thiscasestudydemonstrates,forthe
firsttime,thatpolydextrosereducestheDesiretoEatduringtheSatiationperiod. Thismayexplain,
atleastinpart,theobservedeffectsofpolydextroseonthereductionoflevelsofenergyintakeat
subsequentmeals.
Keywords: appetite;iAUC;meta-analysis;polydextrose;VAS
1. Introduction
Thedefinitionofappetitecoversthewholefieldoffoodintakeincludingselection,motivation,and
preference.Italsorefersspecificallytoqualitativeaspectsofeating,sensoryaspects,andresponsiveness
toenvironmentalstimulationthatcanbecontrastedwiththehomeostaticviewbasedoneatingin
responsetophysiologicalstimuliandanenergydeficit[1]. Appetiteismeasuredbyseveralmeans
includingtheassessmentofsubjectivefeelings,foodintake,gastrointestinalhormones,andthegastric
emptyingrate,tomentionthemostrelevantones.
Nutrients2016,8,45;doi:10.3390/nu8010045 www.mdpi.com/journal/nutrients
Nutrients2016,8,45 2of19
SatiationandSatietyareprocessesthatgovernthebody’sappetitecontrolsystem[2]. Satiationis
theprocessthatleadstotheterminationofeating,controllingthemealsize[1,2];whileSatietyisthe
processthatleadstotheinhibitionoffurthereating,adeclineinhunger,andanincreaseinthefeeling
offullnessafteramealhasfinished[1,2]. SatiationandSatietyarebothinfluencedbyenergydensity,
macronutrientcomposition,physicalstructure,andthesensoryqualityofingestedfood.
Subjectivefeelingsofappetitetypicallyincludenotionsofhunger,fullness,satisfaction,aswell
asthedesiretoeat,andtheprospectiveamountoffoodthatanindividualiswillingtoeat[3]. Basic
scaledesignsforcapturingself-reportsofsubjectivefeelingsofappetitecompriseuni-andbipolar
structuredandunstructuredlines,verbalcategories,andnumericalscoring[1]. Themostcommon
methodistheunipolarunstructuredlineknownasvisualanaloguescale(VAS),whichismostoften
composedoflineswithwordsanchoredateachendwhichdescribetheextremes;subjectsareaskedto
markthelinecorrespondingtotheirfeelings[1,3]. Subjectivefeelingsofappetitearetypicallyassessed
to observe the effects of foods on appetite before and after its consumption. However, on a VAS,
themagnitudesofthefeelingsduringtheSatiationandSatietyperiodshaveoppositedirections,i.e.,
duringtheSatiation,themaximumintensitythatafoodcanprovideisreached. DuringtheSatiety,that
intensityfades. Therefore,itisofinteresttodevelopmethodologiesthatallowforthemeasurementof
thesubjectivefeelingsofappetiteduringeachperiod. Further,thiswillfacilitatethecomparisonof
resultsbyameansofameta-analysis.
Themethodologyusedtoconductameta-analysisiswell-established[4]. However,itrequires
thatallstudiesarereportedusingthesamemeasurementscalesinordertomakeafaircomparison
amongstthem. ThisischallenginginthecaseofVASresultswhendifferentmethodologieshavebeen
usedinindependentstudiesforthesamefoodproduct. Moreover,notallmethodologiesallowfora
meaningfulcomparisonofresultsfortheSatiationandSatietyperiods. Forinstance,theparametric
Student’st-testisaclassicalmethodusedtocomparespecifictimepoints. Theirpairedorimpaired
variantscanbeusedtoestimateifthebaselinesoftwoindividualstudiesarehomogeneousdepending
onthestudydesign,thoughitisoftenusedtocompareseveraltimepointsindependentlyalongthe
trial [1]. However, analyzing appetite ratings data on a single time point basis does not take into
accountthatappetiteresponsesareafunctionofmultipletimepoints,andthesetimepointsarenot
physiologicallyorstatisticallyindependent.
Perhaps,themostwidespreadmethodtoanalyzeVAS(basedonthenumberofcitationsfound
duringthescreeningofthisreview)istheparametricanalysisofvariance(ANOVA),whichallowsus
tocompareresultswithoutfurtheradjustmentoftheoriginaldata[3]. Itisusedtocomparepre-meal
values,pre-topost-prandialeffects(Satiation),andpost-prandialeffects(Satiety). Nevertheless,itonly
indicatesifthereisadifferencebetweengroupsanddoesnotallowustoquantifyanydifferencesin
magnitude(i.e.,%ofincreaseordecreaseofanappetitefeelingwithrespecttoacontrol). Ithasalso
notfacilitatedthecomparisonamongindependentstudieswithdifferentlengthsofVAS.Anextension
ofthismethodistherepeatedmeasuresanalysisofcovariance(RMANCOVA).Thismixedmodel
approachallowsustoincludecovariatesintheanalysis(e.g.,baseline,age,BMI,etc.)[1,5]. Despite
that,itiscommonthatthepre-mealtimepointisusedasabaselineinthismethod,whichmixesthe
effectsoftheSatiationandSatietyperiodswithintheanalysis.
Recently,thetimetoreturntobaseline(TRTB)methodhasgainednotoriety. Itisusedtoestimate
the time it takes to return to the initial level of appetite after food has been eaten [1,6]. However,
inconveniently,theindividualresponsecurvesrarelyhaveaclearU-shape[1]butapplyingWeibull
modellinggivesusameaningfulstatisticalandpracticalapproach[6]. Nevertheless,thismethoddoes
notallowustoestimatetheeffectsduringtheSatiationandSatietyperiodsindependently,nordoesit
allowustoobservetheentireeffectofaspecificfoodduringtheSatietyperiod.
Theestimationoftheareaunderthecurve(AUC)hasbeenextensivelyusedintheanalysisof
VAS[1,7]. Ithastheadvantageofproducingauniquemagnitudethatintegratesboththeintensityof
thesubjectivefeelingofappetiteandthelengthofthetest,makingitanidealcandidateforcomparing
independent studies of different test period lengths. However, AUC does not adjust to baseline,
Nutrients2016,8,45 3of19
makingitdifficulttocomparestudiesusingdifferentlengthsofVASscales(e.g.,100mmpaperand
pencilvs. 64mmelectronicsystem). Further,theAUCusuallyreportsbothSatiationandSatietyas
integratedperiodsintheanalysis.
The incremental AUC (iAUC) has many characteristics of the AUC but has the advantage of
adjusting the values at baseline [7]. Unfortunately, in many studies, this adjustment is done at
thepre-mealtimepoint,integratingbothSatiationandSatietyperiodsintheanalysis. Itwouldbe
preferrable to analyze them separately. Therefore, the aim of this review is to find and propose a
methodologybasedoniAUCduringtheindividualSatiationandSatietyperiods. Thiswillgenerate
homogenousmagnitudesfromtheindependentstudiesandallowustocomparethesubjectivefeelings
ofappetiteinameta-analysis.
The use of iAUC/AUC in meta-analysis may seem challenging due to the differences in
observation period length in the studies. However, since all the observation periods of the
studiescontainthephenomenaofinterestandtheuseofStandardizedMeanDifference(SMD)in
calculationoftheeffectsizecompensatesforthedifferencesintheexperimentalsettingsofthestudies,
commensurableeffectsizesforthestudiesareobtained[8].
Thestudiesconductedonappetitesuppressionusingpolydextroseareproposedasacasestudy.
Recently,ameta-analysisshowedthatpolydextroseeffectivelyreducesvoluntaryenergyintakeat
a subsequent meal, especially when it is administered as part of a mid-morning preload before
an ad libitum lunch [9]. Polydextrose has also been associated with lower levels of ghrelin, and
higherincreasesinglucagon-likepeptide1(GLP-1)andpeptidetyrosine-tyrosine(PYY)[10,11]. This
evidencemakesthisfoodingredientanidealcandidatetotestnewmethodologicalconceptstoassess
appetitesuppression.
2. Methodology
2.1. ProtocolRegistration
ThisreviewwasconductedaccordingtothemethodologydescribedbythePreferredReporting
Items for Systematic Reviews and Meta-Analyses: PRISMA Statement [4]. The Protocol was
registeredattheInternationalProspectiveRegisterofSystematicReviews(PROSPERO)withnumber
CRD42013005261 on 9 August 2013. The methodology was used to analyze the available data on
theeffectsofpolydextroseonsubjectivefeelingsofappetiteandlevelsofenergyintake. Thisreport
communicatestheresultsonthesubjectivefeelingsofappetite. Resultsondifferentlevelsofenergy
intakearecommunicatedinaseparatereport[9].
2.2. EligibilityCriteriaandInformationSources
Eligiblestudydesignswereacuteorchronic,randomized,andusedplacebo-controllednutritional
interventionswherepolydextrosewasadministeredaloneorincombinationwithotherfoodsorfood
ingredientsincludingsupplements. Participantsweremalesandfemalesratedasnormal,overweight,
orobese,butotherwisehealthy. Thechoseninterventionswerethoseintendedtoassesstheeffects
ofpolydextroseonappetiteratingsandenergyintakewhenavailable. Subjectivefeelingsofappetite
included,butwerenotlimitedtoHunger,Satisfaction,Fullness,ProspectiveFoodConsumption,and
theDesiretoEat.
Eligiblereportsincludedpapersfromscientificjournals,conferenceabstracts,andthesesreported
in English-language literature before 31 July 2013, except for a full report provided by Nerys
Astburyoriginallypublishedasanabstract[12],andamanuscriptfromKaisaOlli,laterpublished
as Olli et al. [11]. Searches were conducted on the following databases: BIOSIS Previews, CAB
Abstracts, Foodline: Science, FSTA, Medline, SciSearch, Science Direct, Wiley Online Library, and
www.ClinicalTrials.gov. Furtherinformationonrecentlycompletedtrials,unpublishedresearch,and
research reported in grey literature was identified by searches for relevant documents hosted on
GoogleScholar.
Nutrients2016,8,45 4of19
TableS1oftheSupplementaryMaterialsshowsthegenericsearchstrategyusedinthescreening
ofstudies.
2.3. StudySelectionandQualityAssessment
One researcher (Alvin Ibarra) screened and selected the records. The authors of the
selected original articles were requested to provide any missing information and full data sets on
anthropometricmeasurements,subjectivefeelingsofappetite,andthelevelsofenergyintake.Asecond
independentresearcher(KaisaOlli),checkedtheassessment,andanydiscrepancieswereresolvedby
consultingathirdresearcher(KirstiTiihonen). Thereviewedarticlesthatwereconsiderednotrelevant
forthisstudywerenotedalongwiththereasonfortheirexclusion.
Asimilarsystemwasfollowedtoassesstheriskbiasofeachincludedstudy. Theassessment
followed the procedure described in the Cochrane Handbook for Systematic Reviews of
Interventions[8].
2.4. StrategyforDataSynthesis
Thedataanalysiswasdividedintotwomainsections. First,anarrativesynthesisfocusingonthe
subjectivefeelingsofappetitewasconductedtocomparethemethodologiesused. Forexample,the
descriptionofthewaythatsubjectivefeelingsofappetiteweremeasuredwasscrutinized,thekindsof
foodsthatwereprovidedduringthestudies,andthemannerinwhichpolydextrosewasadministered
wereconsidered. Thesecondsectionfocusedontheanalysisofthesubjectivefeelingsofappetiteusing
themethodologiesproposedinthisreview.
2.5. DefinitionofSatiationandSatietyPeriods
Theperiodsaredefinedasfollows:
Satiation: VASscoresimmediatelybeforetoimmediatelyafterthemealconsumption.
Satiety: VAS scores immediately after the meal consumption until immediately before the
nextmeal.
Forpracticalreasons,allpointsofmeasurementbeforeorafterbothperiods(incasetheyexist)
werediscardedortreatedasseparatecases.
2.6. iAUCEstimationandInterpretation
Oncetheperiodsweredefined,alltheVASscoresweretransformedtothesamescale(0–100)
andthepost-mealtimepointwasshiftedtotimepoint0. Then,theVASscoreattimepoint0was
subtracted from all the VAS scores in the Satiation and Satiety periods. In other words, the curve
consistingofVASscoreswasshiftedto0intimepoint0. Afterthat,theiAUCvalueswerecalculated
separatelyfortheSatiation(iAUC )andSatiety(iAUC )periodsusingthetrapezoidalrule.
Satiation Satiety
iAUCabovethezeroreferencewasassignedapositivevalueandbelowwasassignednegativeone,
andbothwereexpressedasminutestimesmillimeter(min.mm).
FigureS1oftheSupplementaryMaterialsprovidesanexampleforHunger,ProspectiveFood
Consumption, and the Desire to Eat; Figure S2 provides an example for Satisfaction and Fullness.
Thesefiguresexemplifythebehaviorofanidealappetitesuppressiveverumascomparedtoaplacebo
control. NoticethatthemagnitudesforthesamesubjectivefeelingofappetiteduringtheSatiation
andSatietyperiodsareopposites. Thisisanimportantpointtotakeintoconsiderationforthecorrect
interpretationofiAUC andiAUC valuesofaspecificsubjectivefeelingovertheappetite
Satiation Satiety
suppressiveeffectofagivenfoodproduct.
Using the following rule, it is possible to correct the opposite values of iAUC and
Satiation
iAUC for each subjective feeling of appetite in order to ensure that the potential effect of a
Satiety
foodproductasanappetitesuppressingagentisinterpretedcorrectly:
Nutrients2016,8,45 5of19
Multiply iAUC by ´1: to indicate that negative values for Hunger “reduce hunger”;
Satiation
forProspectiveFoodConsumption,“lowertheamountexpectedtoeat”;andfortheDesiretoEat,
“reducethedesiretoeat”.
MultiplyiAUC by´1: toindicatethatpositivevaluesforSatisfaction“increasesatisfaction”;
Satiety
andforFullness,“increasefullness”.
Note that the adjustments made to the methodology do not affect the significance of
themeta-analysis.
2.7. Meta-Analysis
Forthismeta-analysis,datasetswereinvestigatedusingarandomeffectsmodelwhichconsiders
ourchosenstudiestobeasampleofalargeruniverseofstudies. Themodelwaschosenbecausethere
wereminordifferencesinbothstudydesignandtheparticipants’characteristics. Therefore,acommon
effect size could not be assumed for all the studies. The treatment-effect size was analyzed using
SMDwitha95%confidenceinterval. TheeffectsizewasestimatedusingHedges’gmeasure. The
between-studyvariationwasestimatedusingarestrictedmaximumlikelihoodapproach. Theresults
ofthemeta-analysiswasvisualizedusingaForestplot,whichillustratestheresultsoftheindividual
studiesaswellasthesummaryrandomeffect. Thenumbersofeffectsizes,K,werereported;andthe
totalheterogeneityinthedatasetwastestedusingtheQandHigginsI2statistics. Thepublicationbias
wasanalyzedvisuallyusingFunnelplotsandassessedusingtheEgger’stest.
All statistical analyses were performed using software “R” version 3.2.2 (R Core Team,
R Foundation for Statistical Computing, Vienna, Austria) [13], and metafor package version 1.9-8
(Wolfgang Viechtbauer, Maastricht, The Netherlands) [14]. The “R” code is available online at
https://github.com/avoltusfi/pdx_vas_meta.
3. Results
3.1. IncludedStudies
TableS2oftheSupplementaryMaterialsshowsthenumberofhitsobtainedineachdatabase
duringthescreening. Twenty-twocompletestudiesontheeffectsofpolydextroseonenergyintakes
andsubjectivefeelingsofappetitewereassessedforeligibilityforinclusioninthesystematicreview
and meta-analysis using the same criteria. The meta-analysis on energy intakes is published [9].
Inthepresentreportonsubjectivefeelingsofappetite,fifteenstudieswereexcludedwithreasons
as provided by Ibarra et al. [9], the lack of original data being the main cause for exclusion. Most
ofthedatausedinthismeta-analysiswasdeliveredbyauthorsoftheoriginalpublicationsunder
confidentialityagreements.
TheflowdiagramonFigure1demonstratesthescreeningprocessusedtodeterminehowthe
includedstudieswereselected.
Seven studies were included for the assessment of subjective feelings of appetite: Olli et al.
(2015)[11],Astburyetal. (2013)[15],Ranawanaetal. (2013)[16],Hulletal. (2012)[17],Astburyetal.
(2008)[12],Schwabetal. (2006)[18]andKingetal. (2005)[19]. Inthepreviousmeta-analysisonenergy
intakes[9],twoofthesestudieswerenotincluded[11,18]becausetheydidnotmeasurefoodintake.
Theoriginaldataonsubjectivefeelingsofappetiteofoneofthestudies[10]wasnotaccesible.
Thestudiesincludedinthisanalysisrepresentauniverseof135participants,ofwhich66were
malesand59werefemales. Thedosesofpolydextrosetestedinthesestudiesrangedfrom6.25to
25.0grams. Table1summarizesthedesign, procedures, andmainoutcomesofthesestudieswith
respecttosubjectivefeelingsofappetite.
Nutrients2016,8,45 6of19
Nutrients 2016, 8, 45 6/18

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Nutrients2016,8,45 7of19
Table1.Summaryofstudiesincludedforsystematicreviewandmeta-analysisofsubjectivefeelingsofappetite.
MainOutcomesonSubjective
Study InvestigationalProducts Population Design Procedure
FeelingsofAppetite
Participantswereadvisedtoavoidstrenuous
exerciseandnottodrinkalcohol24hbeforethe
400mLcoladrink(0.0gPDX)
Acute,randomized, testday.Experimentbeganthenextmorning
400mLcoladrink(15.0gPDX) PDXreducediAUCforHunger
double-blinded, aftera10–12hfast.Anintravenouscatheterwas
Coladrinks(833kJand800kJ, by40%(p=0.03)and
5Men(41.4years,33.2Kg/m2) placebo-controlled,and insertedintheantecubitalveinandthen
withandwithoutPDX,Litesse marginallyincreased
Ollietal.[11] Ultra®,DuPont)were 13Women(42.7years,33.8Kg/m2) crossover(10daysof participantswereaskedtoeatthemealin20min. Satisfactionby22.5%(p=0.08)
18Total(42.0years,33.6Kg/m2) washout)study Bloodsamplesweretakenfivetimesafterthe
consumedtogetherwitha duringthepost-meal
conductedinKuopioand studymeal(at30,60,120,240,and360min).
hamburger(2071kJ)and satietyperiod.
Vierumäki,FI Appetiteratingsweremeasuredbeforethemeal
Frenchfries(1423kJ)
and40,70,140,and280minafter.Post-meal
energyintakeswerenotmeasuredinthisstudy.
Participantswereaskedtoconsumea
standardizeddinnerat20:00thedaybeforethe
testandtorefrainfromconsumingalcoholand
400mLpreload(0.0gPDX)
undertakingvigorousexercise.Thedayofthe
400mLpreload(6.3gPDX) Acute,randomized,
test,theyhadastandardizedbreakfastathome
400mLpreload(12.5gPDX) single-blinded,
(10%dailyenergyexpenditure),arrivedatthe Therewerenosignificant
400mLpreload(25.0gPDX) 12Men(22.5years,23.2Kg/m2) placebo-controlled,and
Astbury laboratoryat10:45andwereservedapreloadat differencesonsubjective
Preloadswere 9Women(24.7years,22.3Kg/m2) crossover(1weekof
etal.[15] 11:00.Appetiteratingswerecollectedat feelingsofappetitebetween
chocolate-flavoredliquids 21Total(23.3years,22.3Kg/m2) washout)study
baseline,0min(immediatelyafterpreload)and PDXgroupsandcontrol.
(837kJ).PDX(LitesseUltra®, conductedin
30,60,90minlater,and0(immediatelyafter),
DuPont)wascompensatedwith Nottingham,UK.
30and60minafterthetestmeal.Thetestmeal
maltodextrininthecontrol.
wasadlibitum(657kJ/100g).Then,participants
wereinstructedtocompletefooddiariesforthe
restoftheday.
Participantswereaskedtorefrainfrom
400gpreload(0.0gPDX) consumingalcoholandundertakingvigorous
400gpreload(12.0gPDX) Acute,randomized, exercise.Thedayofthetest,theyarrivedat8:00
Preloadswerefruitsmoothies single-blinded, atthelaboratory,after10hfast.Appetiteratings Therewerenosignificant
26Men(28.0years,24.1Kg/m2)
Ranawana (870.8kJand883.4kJforthe placebo-controlled,and weredeterminedbeforethebreakfast,afterthe differencesonsubjective
0Women
etal.[16] controlandtreatment, crossover(>2daysof breakfast,1hafterthebreakfast,beforepreload feelingsofappetitebetweenthe
26Total(28.0years,24.1Kg/m2)
respectively).PDX(Litesse washout)study and15,30,45and60(justbeforeadlibitum PDXgroupandcontrol.
Two®,DuPont)wasnot conductedinOxford,UK. lunch)minafterthepreload,andafterthelunch.
compensatedinthecontrol. Thesizeofthefirstbreakfastmealwasmeasured
andthesamesizewasusedforthenextsession.
Nutrients2016,8,45 8of19
Table1.Cont.
MainOutcomesonSubjective
Study InvestigationalProducts Population Design Procedure
FeelingsofAppetite
Intheperiodbetweenpreload
Participantswereaskedtoconsumea
andlunch,6.25gPDXreduced
standardizeddinnerat20:00thedaybeforethe
theDesiretoEat(p<0.001),
testandtorefrainfromconsumingalcoholand
Hunger(p<0.03),and
undertakingvigorousexercise.Thedayofthe
increasedSatisfaction(p<0.02),
200gpreload(0.0gPDX) test,theyarrivedatthelaboratoryat08:00and
Acute,randomized, while12.5gPDXalsoreduced
200gpreload(6.25gPDX) wereservedabreakfast(consistentmealsizes
single-blinded, Hunger(p<0.02)and
200gpreload(12.5gPDX) 10Men(32.8years,23.8Kg/m2) wereusedforsubsequentsessions).Appetite
placebo-controlled,and ProspectiveFoodConsumption
Hulletal.[17] Preloadswereyogurts(671kJ). 24Women(38.7years,22.5Kg/m2) ratingswerecollectedat0(beforebreakfast),
crossover(1weekof (p<0.03).Intheperiod
PDX(LitesseTwo®,DuPont) 34Total(36.9years,22.9Kg/m2) 15(afterbreakfast),45,75,105,135,150(before
washout)study betweenpreloadanddinner
wascompensatedwithglucose preload),165(afterpreload),180,195,210,225,
conductedinSurrey,UK. 6.25gPDXreducedtheDesire
syrupinthecontrol. 240(beforelunch),270(afterlunch),300,330,
toEat(p=0.002),and12.5g
360,390,420,450,480,510,540,570(before
PDXincreasedSatisfaction
dinner),and600(afterdinner)min.Lunch
(p<0.006);however,both
(984kJ/100g)anddinner(523kJ/100g)were
concentrationsreduced
adlibitum.
Fullness(p<0.05).
Participantswereaskedtoconsumea
standardizeddinnerat20:00thedaybeforethe
testandtorefrainfromconsumingalcoholand
undertakingvigorousexercise.Thedayofthe
400mLpreload(0.0gPDX) Acute,randomized,
test,theyhadastandardizedbreakfastathome
400mLpreload(25.0gPDX) single-blinded,
(10%dailyenergyexpenditure),arrivedtothe Therewerenosignificant
Preloadswere 14Men(25.3years,23.0Kg/m2) placebo-controlled,and
Astburyetal. laboratoryat10:45andwereservedapreloadat differencesonsubjective
chocolate-flavoredmilkshake 0Women crossover(1weekof
[12] 11:00.Appetiteratingswerecollectedat feelingsofappetitebetweenthe
(1047kJ).PDX(LitesseUltra®, 14Total(25.3years,23.0Kg/m2) washout)study
baseline,0min(immediatelyafterpreload)and PDXgroupandcontrol.
DuPont)wascompensatedwith conductedin
30,60,90minlater,and0(immediatelyafter),
maltodextrininthecontrol. Nottingham,UK.
30and60minafterthetestmeal.Thetestmeal
wasadlibitum(657kJ/100g).Then,participants
wereinstructedtocompletefooddiariesforthe
restoftheday.
Appetiteratingsweremeasuredinthesubgroup
atthebeginning(week0)andattheend
400mLdrink(0.0gPDXorSPB) Nodifferenceswerefoundon
6Men(55.3years,30.0Kg/m2); (week12)oftheclinicalintervention.Atweek0,
400mLdrink(16.0gPDX) Chronic(12weeks), appetiteratingsinthesubgroup
18Women(53.8years,29.0Kg/m2) participantsconsumedonlyhalfofthedaily
400mLdrink(16.0gSBP) randomized, exceptforfeelingofHunger
24Total(54.2years,29.2Kg/m2) dose(200mL).Participantsarrivedtothelab
Schwabetal.[18] Drinkscontained469kJ,603kJ double-blindedand (p<0.05)at180minwithinthe
8participantswereassignedto after12hovernightfasting.Appetiteratings
and610kJforthecontrol,PDX parallelstudyconducted PDXgroup(6.0˘3.6vs.
(LitesseUltra®,DuPont)and eachgroup—Thisisasubgroupof inKuopio,FI weremeasuredbeforeandafter15,30,60,120, 3.3˘2.5,week0vs.week12,
a66participantsstudy and180minofthestandardizedbreakfast.
SBP,respectively respectively).
Post-mealenergyintakeswerenotmeasuredin
thisstudy.
Nutrients2016,8,45 9of19
Table1.Cont.
MainOutcomesonSubjective
Study InvestigationalProducts Population Design Procedure
FeelingsofAppetite
Ondays1and10,participantshadabreakfastat
200gpreload(0.0gPDX
8:30atthelaboratory(consistentmealsizeswere
orXYL)
usedforsubsequentsessions).Theywere
200gpreload(25.0gXYL)
instructedtoconsumethepreloadat11:00and
200gpreload(25.0gPDX)
Chronic(10days), nottoconsumeanyotherfoodordrinkbetween
200gpreload(12.5gPDX+
randomized, thebreakfastandlunchinterval.Appetite Therewasnosignificant
12.5gXYL) 7Men(30.7years,23.8Kg/m2)
single-blinded,placebo ratingsweremeasuredat0(beforebreakfast), differenceonsubjectivefeelings
Kingetal.[19] Preloadswereyogurts 8Women(29.5years,21.6Kg/m2)
controlledandcrossover 15(afterbreakfast),90,150(beforepreload),165 ofappetitebetweenthePDX
containing854kJ,686kJ,544kJ, 15Total(30.1years,22.7Kg/m2)
studyconductedin (afterpreload),210,240(beforeadlibitumlunch), group(25.0g)andcontrol.
and611kJforthecontrol,XYL,
Leeds,UK. 255(afteradlibitumlunch),330,390,450,540
PDX,andthecombination,
(beforediner),555(afterdiner),and810min.
respectively.Inthecontrol,
Ondays2–9participantswererequestedto
PDX(LitesseUltra®,DuPont)
drinkapreloadat11:00dailyandtocomplete
wascompensatedwithsucrose.
testfoodintakequestionnaires.
iAUC=IncrementalAreaUndertheCurve;FI=Finland;PDX=Polydextrose;SBP=SugarBeetPectin;UK=UnitedKingdom;VAS=VisualAnalogueScale;XYL=Xylitol.
Table2.Characteristicsofthemethodologiestomeasuresubjectivefeelingsofappetiteusedinthestudiesselectedforthisreview.
Scale
Study Period Method Question LowerSet UpperSet System StatisticalAnalysis
Length/Magnitude
Hunger
Kuinkanälkäiseksitunnet Enolelainkaan iAUCfortheSatiation
Olenerittäin
Ollietal. 40min(Satiation); itsesitällähetkellä? nälkäinen andSatietyperiodsand
[3,20] nälkäinen 100mm Paperandpencil
[11] 280min(Satiety) Howhungrydoyoufeelat Iamnotatall comparedgroupsusing
Iamveryhungry
themoment? hungry Student’spairedt-test
Changesfrombaseline
~15min(Satiation);
Electronic-Suss-ex (betweenpreloadtothe
Astburyetal. 90min(Satiety);
[21,22] Howhungrydoyoufeel? Notatall Extremely 100mm/500points IngestionPattern nextmeal)using
[12,15] 165min(full
Monitor two-wayrepeated
experiment)
measuresANOVA
iAUCandcompared
Ranawana ~15min(Satiation); Notatall
[2,7] Howhungrydoyoufeel? Extremelyhungry 100mm Paperandpencil groupsusingStudent’s
etal.[16] 60min(Satiety) hungry
pairedt-test
Nutrients2016,8,45 10of19
Table2.Cont.
Scale
Study Period Method Question LowerSet UpperSet System StatisticalAnalysis
Length/Magnitude
Changesfrombaseline
~15min(Satiation); Electronic-hand (betweenpreloadtothe
Hulletal.
90min(Satiety);450 [3] Howhungryareyou? Notatall Extremely 64mm/100points heldcomputer nextmeal)using
[17]
min(fullexperiment) iPAQs two-wayrepeated
measuresANOVA
Enolelainkaan Olenniinnälkäinen Specifictimepoints
Kuinkanälkäiseksitunnet
Schwabetal. ~15min(Satiation); nälkäinen kuinvoinolla comparisonbetween
[3] itsesi? 100mm Paperandpencil
[18] 180min(Satiety) Iamnothungry IamashungryasIcan groupsusingStudent’s
Howhungrydoyoufeel?
atall be pairedt-test
Changesfrombaseline
~15min(Satiation); ElectronicAppetite (betweenpreloadtothe
Kingetal. Notatall AshungryasI've
90min(Satiety);810 [23,24] Howhungrydoyoufeel? 66mm/100points RatingsSystem nextmeal)using
[19] hungry everfelt
min(fullexperiment) (EARS) two-wayrepeated
measuresANOVA
Satisfaction
Kuinkakylläiseksitunnet Enolelainkaan iAUCfortheSatiation
Olenerittäin
Ollietal. 40min(Satiation);280 itsesitällähetkellä? kylläinen andSatietyperiodsand
[3,20] kylläinen 100mm Paperandpencil
[11] min(Satiety) Howsatisfieddoyoufeelat Idonotfeel comparedgroupsusing
Ifeelverysatisfied
themoment? satisfiedatall pairedStudent’st-test
Changesfrombaseline
~15min(Satiation); Electronic-hand (betweenpreloadtothe
Hulletal.
90min(Satiety);450 [3] Howsatiatedareyou? Notatall Extremely 64mm/100points heldcomputer nextmeal)using
[17]
min(fullexperiment) iPAQs two-wayrepeated
measuresANOVA
Enolelainkaan Olenniinkylläinen Specifictimepoints
Kuinkakylläiseltäolosi
Schwabetal. ~15min(Satiation); kylläinen kuinvoinolla comparisonbetween
[3] tuntuu? 100mm Paperandpencil
[18] 180min(Satiety) Iamnotsatisfied IamassatisfiedasIcan groupsusingStudent’s
Howsatisfieddoyoufeel?
atall be pairedt-test
Fullness
Changesfrombaseline
~15min(Satiation);
Electronic-Suss-ex (betweenpreloadtothe
Astburyetal. 90min(Satiety);
[21,22] Howfulldoyoufeel? Notatall Extremely 100mm/500points IngestionPattern nextmeal)using
[12,15] 165min
Monitor two-wayrepeated
(fullexperiment)
measuresANOVA