Oral Processing, Satiation and Obesity: Overview and Hypotheses

Figures & data

Table 1 Postprandial Hormone Levels as a Function of Eating or Chewing Fast or Slow

Study	Subjects	Food Cue and Exposure	Effect on Hunger and Hormone Levels
Kokkinos et al^Citation21	17 healthy adult males	300mL of ice cream eaten over 5 min (fast) versus 30 min (slow)	Higher pp curve for PYY and GLP-1 for slow versus fast eating. No difference in ghrelin
Rigamonti et al^Citation22	18 adolescents and adults with obesity	10 kcal/Kg of ice cream eaten over 5 min (fast) versus 30 minutes (slow)	No stimulation of pp GLP-1 with fast-eating, whereas slow eating increased pp GLP-1 only in adolescents. Slow eating stimulated greater pp PYY in adolescents than adults.
Li et al^Citation22	16 lean and 14 young men with obesity	Ad libitum pork pie eaten with as much chewing or as little chewing as possible (40 vs 15 chews/10 gm bite)	Fast chewers had less energy intake, higher pp GLP-1 and CCK and lower pp ghrelin in the lean and subjects with obesity.
Zhu et al^Citation23	21 healthy males	Fixed amount of pizza chewed 15 times (slow) or 40 times (fast)	Lower ratings for hunger and higher pp glucose, insulin, GIP and CKK after fast chewing
Cassady et al^Citation24	13 healthy adults	55 g of almonds chewed 10, 25 or 40 times	Higher suppression of hunger after 40 than 10 chews and higher pp GLP-1 after 40 than 25 chews
Hawton et al^Citation25	21 normal-weight adults	600 kcal meal eaten over 24 minutes (normal) or 6 minutes (fast)	Greater 2-hour fullness and less energy from snacks with normal eating with greater pp ghrelin suppression, and greater pp PYY from baseline
Alsalim et al^Citation26	24 healthy adults	524 Kcals solid breakfast eaten over 5 minutes (fast) or 12 minutes (slow)	No difference in pp glucose, insulin, GLP-1 and GIP
Shah et al^Citation27	25 men and women	Breakfast eaten over 10 min (fast) or 30 minutes (slow)	No difference in hunger, fullness and pp ghrelin, GLP-1 and PYY

Abbreviation: pp, postprandial.

Table 2 Cross-Sectional and Longitudinal Pediatric Studies Relating Speed of Eating to Obesity or Overweight

Study	Type of Study	Subjects	Procedure	Results
Liu et al^Citation30	Cross-sectional	1123 pre-school Chinese children	3-point scale for speed of eating	Fast eating increased adjusted odds ratio for overweight of 1.92 (1.31–2.80) and for obesity 1.37 (1.0–1.88)
Lin et al^Citation31	Cross-sectional	1138 preschool Chinese children	Observation of lunch duration	Each 5-minute increase in meal duration decreased likelihood for obesity by 0.861. Adjusted odd ratio 0.970 for overweight for meal duration
Zhang et al^Citation32	Cross-sectional	767 7–12-year-old students	2-point scale for speed of eating	Odds ratio for obesity of 3.18 (2.28–4.44)
Zeng et al^Citation33	Cross-sectional	50,037 7–17-year-old Chinese children	3-point scale for speed of eating	Fast eating odds ratio for obesity of 1.51–1.61 compared to medium speed of eating
Ochiai et al^Citation34	Cross-sectional	3256 12–13-year-old male and female Japanese adolescents	3-point scale for speed of eating and 2-point scale for eating until full (yes or no)	Increased adjusted odds ratio for overweight in boys with fast eating compared to medium, and in those eating until full compared to not eating until full 2.78 (1.76–4.38). Fast eating in girls led to a significant increase in odds ratio but only in those eating until full
Ochiai et al^Citation35	Longitudinal	427 Japanese schoolgirls aged 9–10 years who were non-overweight and obese	2-point scale for speed of eating and followed for 3 years	Differences in BMI, % body fat, waist circumference and waist to height ratio increased only in those who ate quickly
Yamagishi et al^Citation36	Longitudinal	1490 boys and girls aged 3 years who returned questionnaires at 6 and 12 years	4-point scale for speed of eating at 6 and 12 years	Children with increased speed of eating had higher BMI than those who never increased speed of eating: 20 vs 17.9 for boys and 20 vs 18.4 kg/m^2 for girls
Ochiai et al^Citation37	Longitudinal	934 non-overweight Japanese children age 9–10 years	3-year follow-up using a 3-point scale for speed of eating	Eating quickly associated with relative risk for becoming overweight 3.65 (1.52–8.76)

Note: The brackets contain the 95% confidence intervals.

Figure 1 Hypothesized scheme for the associations between highly processed foods, oral processing, energy density, persistent hunger and obesity.

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