Relationship between Eating Quickly and Overweight : A Cohort Study of Schoolchildren in Japan

Health-Related Lifestyles in Relation to Body Mass Index Among Young and Middle-Aged Women in Japan

BACKGROUND

Being underweight, overweight, or obese can lead to adverse health effects. Hence, it is important to understand the specific factors that change the burden of underweight and overweight to target appropriate disease control strategies. This study was designed to examine the prevalence and factors associated with underweight and overweight among young and middle-aged women in Japan.

MATERIALS AND METHODS

A cross-sectional study was conducted among women aged 20-59 years who participated in health checkups at a regional health care center in 2018 and 2019 (N = 1722). The assessments included anthropometric, blood pressure measurements, and a standardized self-administered questionnaire. Multivariable logistic regression analysis assessed lifestyle factors associated with body mass index for underweight <18.5 kg/m²) and overweight/obesity (25.0 kg/m² and above).

RESULTS

The prevalence of underweight and overweight/obesity were 12.3%, and 22.5%, respectively. No lifestyle factors were found to be significantly associated with being underweight. Having dinner within 2 hours before bed was positively associated with being overweight/obese [adjusted odds ratio (AOR): 1.448, 95% confidence interval (CI): 1.014-2.068]. Women who gained 10 kg since their 20s were more likely to fall into overweight/obesity category (AOR: 9.674, 95% CI: 1.014-2.068). Women who were using a lipid-lowering medication (AOR: 3.150, CI: 1.892-5.246) were associated with three times higher risk of being overweight/obese. Hypertension and dyslipidemia were significantly associated with overweight/obesity (AOR: 3.094, 95% CI: 2.201-4.351 and AOR: 2.498, 95% CI: 1.831-3.409, respectively).

CONCLUSION

One in five middle-aged women was overweight or obese, whereas one in eight was underweight. In relation to the prevention of overweight/obesity, specific health promotion messages regarding eating timing should be developed.

Self-reported eating speed is associated with overweight among Chinese schoolchildren: a cross-sectional survey

PURPOSE

This study aimed to examine the association between eating speed and overweight in Chinese schoolchildren.

METHODS

In all, 664 schoolchildren (10-12 years) from three primary schools participated in this study in China. Their height and body weight were measured. Information about eating speed and other lifestyle behaviors were collected using a self-administered questionnaire. Multivariable logistic regression model was used to estimate the odds ratio (OR) and 95% confidence interval (95% CI) for overweight.

RESULTS

Data from 629 students were analyzed. 26.2% of participants reported they were eating fast. The prevalence of overweight (including obesity) was 22.9%, and the mean of sleep duration was 9.69 (SD = 0.63) hours (Table 1). In the multiple linear regression analysis, slower eating speed was independently associated with lower BMI (B = - 0.70, 95% CI - 1.26 to - 0.14) and TG (B = - 0.16, 95% CI - 0.28 to - 0.04). In addition, participants who ate fast were more likely to be overweight (OR 1.81, 95% CI 1.19-2.75) after adjusting for potential confounding factors.

CONCLUSIONS

This study indicates that eating fast is associated with overweight among Chinese school children.

LEVEL OF EVIDENCE

Cross-section descriptive study, Level V.

Eating Slowly Is Associated with Undernutrition among Community-Dwelling Adult Men and Older Adult Women

The double burden of malnutrition refers to the co-occurrence of overweight and obesity and undernutrition. Eating quickly has been linked to overweight and obesity. However, no study has examined the association between eating speed and undernutrition. This retrospective, cross-sectional study analyzed data from 3529 community-dwelling residents. Eating speed was divided into three categories: fast, medium, and slow. Undernutrition was defined as body mass index (BMI) of <18.5 kg/m² in adults aged < 70 years (adults) and as <20 kg/m² in adults aged ≥ 70 years (older adults), in accordance with the Global Leadership Initiative on Malnutrition criteria for Asians. Multivariable logistic regression analysis was used to examine the association between eating speed and undernutrition. Among adult men, compared with eating quickly, eating slowly was associated with elevated prevalence of undernutrition (odds ratio (OR) 9.68, 95% confidence interval (CI) 2.32–40.51, p = 0.001). Among older adult women, the prevalence of undernutrition in the slow-eating group was higher than that in the fast-eating group (OR 3.82, 95% Cl 1.51–9.69, p = 0.005). Eating slowly is independently associated with the prevalence of undernutrition among community-dwelling adult men and older adult women in Japan.

Self-Reported Eating Speed Is Associated with Indicators of Obesity in Adults: A Systematic Review and Meta-Analysis

Eating speed (ES) as a dietary behaviour has become a widely discussed factor for weight management and obesity. This study analysed the relationship between ES and anthropometric indicators of obesity, including BMI and waist circumference (WC) in adults. A search conducted of PubMed, Web of Science, Science Direct and Scopus found six longitudinal studies and fifteen cross-sectional studies published for further analysis. A quality assessment was performed with the MINORS checklist. Eight studies were included in the meta-analysis and almost all reviewed studies showed that ES was associated with BMI, and non-fast eaters had significantly lower BMI than fast eaters. Therefore, it was assumed that slowing down the ES may be an effective strategy for weight management and lowering obesity risk. There was also an association between WC and ES. Assessment of eating speed can be included in nutrition surveys to analyse obesity risk. More broadly, research is also needed to establish a validated and standardised methodology to determine eating speed. Further research needs to examine the links between eating speed, obesity, ethnicity, sex, food culture and chronic diseases.

A Questionnaire-Based Assessment of Hunger, Speed of Eating and Food Intake in Children with Obesity

PURPOSE

The aim of this study was to investigate the hypothesis that obesity in Israeli children is associated with chronically increased hunger and to examine for persistent abnormalities of satiation and between-meal satiety in these children.

SUBJECTS/METHODS

The parents of 200 children with obesity and 100 normal-weight children completed a questionnaire together with their child that rated hunger, food intake at main meal, and speed of eating. Time to hunger from the main meal was also recorded. Children with hunger ratings above 4 on a 7-point scale were considered to have persistent hunger. Food intake ratings at the main meal were used as an approximate indicator of satiation and time from main meal to feeling hunger as an approximate indicator of between-meal satiety.

RESULTS

There were marked differences between children with obesity and controls for hunger, food intake at main meal and speed of eating ratings (all p<0.001). The difference to time to hunger reached significance after adjusting for age and sex (p=0.048). 41% of the children with obesity had the highest rating for persistent hunger versus 5% of controls (p<0.001).

CONCLUSION

Persistent hunger, abnormal food intake at the main meal and rapid eating are common in children with obesity and are often of marked degree. These findings could have implications for understanding how pediatric obesity perpetuates itself and even worsens and its resistance to successful treatment over the long term.

Oral Processing, Satiation and Obesity: Overview and Hypotheses

Increasing the speed of eating or decreasing the amount of chewing of a test meal significantly decreases its satiation, increases concomitant caloric intake, and influences entero-endocrine secretion. Speed of eating is a strong risk factor for obesity and longitudinal studies suggest an etiological relationship. Individuals with obesity have an increase in bite size, less chewing per bite, decreased satiation, and greater food intake. Oral processing in terms of bite size and amount of chewing per gram of food is influenced by food texture and textural complexity. Soft foods increase bite size and decrease chewing per gram of food and meal duration compared to hard foods. An ultra-processed diet can lead to greater weight gain than a non-processed diet and a significant increase in eating rate. Many children with obesity are noted by their parents to have persistent hunger on a questionnaire and this is often extreme. Results of attempts to change eating behavior have been mixed in terms of producing long-term changes in eating behavior and body weight. It is hypothesized that there may be a unidirectional relationship between changes in oral processing, satiation and weight gain. However, the presence of persistent hunger can produce a vicious cycle that may exacerbate obesity and make treatment difficult. The increased energy density of foods as found particularly in ultra-processed foods also influences energy intake and obesity.

Clinical Practice Guideline for the Diagnosis and Treatment of Pediatric Obesity: Recommendations from the Committee on Pediatric Obesity of the Korean Society of Pediatric Gastroenterology Hepatology and Nutrition

The Committee on Pediatric Obesity of the Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition newly developed the first Korean Guideline on the Diagnosis and Treatment of Obesity in Children and Adolescents to deliver an evidence-based systematic approach to childhood obesity in South Korea. The following areas were systematically reviewed, especially on the basis of all available references published in South Korea and worldwide, and new guidelines were established in each area with the strength of recommendations based on the levels of evidence: 1) definition and diagnosis of overweight and obesity in children and adolescents; 2) principles of treatment of pediatric obesity; 3) behavioral interventions for children and adolescents with obesity, including diet, exercise, lifestyle, and mental health; 4) pharmacotherapy; and 5) bariatric surgery.

Clinical practice guideline for the diagnosis and treatment of pediatric obesity: recommendations from the Committee on Pediatric Obesity of the Korean Society of Pediatric Gastroenterology Hepatology and Nutrition

The Committee on Pediatric Obesity of the Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition newly developed the first Korean Guideline on the Diagnosis and Treatment of Obesity in Children and Adolescents to deliver an evidence-based systematic approach to childhood obesity in South Korea. The following areas were systematically reviewed, especially on the basis of all available references published in South Korea and worldwide, and new guidelines were established in each area with the strength of recommendations based on the levels of evidence: (1) definition and diagnosis of overweight and obesity in children and adolescents; (2) principles of treatment of pediatric obesity; (3) behavioral interventions for children and adolescents with obesity, including diet, exercise, lifestyle, and mental health; (4) pharmacotherapy; and (5) bariatric surgery.