Comparison of Self-Reported Speed of Eating with an Objective Measure of Eating Rate

Factors associated with eating rate: a systematic review and narrative synthesis informed by socio-ecological model

Accumulating evidence shows associations between rapid eating and overweight. Modifying eating rate might be a potential weight management strategy without imposing additional dietary restrictions. A comprehensive understanding of factors associated with eating speed will help with designing effective interventions. The aim of this review was to synthesise the current state of knowledge on the factors associated with eating rate. The socio-ecological model (SEM) was utilised to scaffold the identified factors. A comprehensive literature search of eleven databases was conducted to identify factors associated with eating rate. The 104 studies that met the inclusion criteria were heterogeneous in design and methods of eating rate measurement. We identified thirty-nine factors that were independently linked to eating speed and mapped them onto the individual, social and environmental levels of the SEM. The majority of the reported factors pertained to the individual characteristics (n = 20) including demographics, cognitive/psychological factors and habitual food oral processing behaviours. Social factors (n = 11) included eating companions, social and cultural norms, and family structure. Environmental factors (n = 8) included food texture and presentation, methods of consumption or background sounds. Measures of body weight, food form and characteristics, food oral processing behaviours and gender, age and ethnicity were the most researched and consistent factors associated with eating rate. A number of other novel and underresearched factors emerged, but these require replication and further research. We highlight directions for further research in this space and potential evidence-based candidates for interventions targeting eating rate.

Association between eating rate and childhood overweight/obesity: a systematic review and meta-analysis

Many studies have reported the relationship between eating rate and childhood overweight/obesity, while results remain inconclusive. The present study was done to estimate the association between eating rate and childhood overweight/obesity through a systematic review of prevalence studies. Relevant studies were searched by two independent researchers in databases including PubMed, Embase, Cochrane Library, and Web of Science, and data were collected from relevant studies published through June 2023 using predefined inclusion/exclusion criteria. A summary estimate was calculated using a random-effect model, and subgroup analysis was performed to explore sources of heterogeneity. Data from 16 published studies were eligible for inclusion. Fast eating was associated with a higher risk of overweight/obesity compared with a medium eating rate (OR = 1.80; 95% CI: 1.49, 2.18), and slow eating showed a declined overweight/obesity risk among children and adolescents (OR = 0.65; 95% CI: 0.52, 0.81). Subgroup analysis performed according to age showed that in all age groups, eating fast was positively correlated with overweight/obesity, while eating slowly was negatively associated with overweight/obesity. According to our study, eating rate was closely related to childhood overweight/obesity, and eating fast was associated with an increased likelihood of being overweight/obesity. In the future, it will be necessary to understand the factors that influence fast eating and develop methods to slow down the eating rate in children and adolescents.

Eating Speed Measurement Using Wrist-Worn IMU Sensors Towards Free-Living Environments

Eating speed is an important indicator that has been widely investigated in nutritional studies. The relationship between eating speed and several intake-related problems such as obesity, diabetes, and oral health has received increased attention from researchers. However, existing studies mainly use self-reported questionnaires to obtain participants' eating speed, where they choose options from slow, medium, and fast. Such a non-quantitative method is highly subjective and coarse at the individual level. This study integrates two classical tasks in automated food intake monitoring domain: bite detection and eating episode detection, to advance eating speed measurement in near-free-living environments automatically and objectively. Specifically, a temporal convolutional network combined with a multi-head attention module (TCN-MHA) is developed to detect bites (including eating and drinking gestures) from IMU data. The predicted bite sequences are then clustered into eating episodes. Eating speed is calculated by using the time taken to finish the eating episode to divide the number of bites. To validate the proposed approach on eating speed measurement, a 7-fold cross validation is applied to the self-collected fine-annotated full-day-I (FD-I) dataset, and a holdout experiment is conducted on the full-day-II (FD-II) dataset. The two datasets are collected from 61 participants with a total duration of 513 h, which are publicly available. Experimental results show that the proposed approach achieves a mean absolute percentage error (MAPE) of 0.110 and 0.146 in the FD-I and FD-II datasets, respectively, showcasing the feasibility of automated eating speed measurement in near-free-living environments.

Association between Self-Perception of Chewing, Chewing Behavior, and the Presence of Gastrointestinal Symptoms in Candidates for Bariatric Surgery

Given the changes in the digestive tract post-bariatric surgery, adapting to a new pattern of eating behavior becomes crucial, with special attention to the specifics of chewing mechanics. This study aimed to investigate the association between self-perception of chewing, chewing behavior, and the presence of gastrointestinal symptoms in preoperative patients undergoing bariatric surgery. Sixty adult candidates for bariatric surgery at a public hospital in Belém (Brazil) were analyzed. Participants predominantly exhibited unilateral chewing patterns (91.6%), a fast chewing rhythm (73.3%), a large food bolus (80%), liquid intake during meals (36.7%), and 41.7% reported that chewing could cause some issue. Significant associations were found between the perception of causing problems and chewing scarcity (p = 0.006), diarrhea (p = 0.004), absence of slow chewing (p = 0.048), and frequent cutting of food with front teeth (p = 0.034). These findings reveal a relationship between the perception of chewing problems and chewing scarcity, presence of diarrhea, and fast chewing.

Bolus rheology of texture adjusted food-Effect of age

Swallowing disorders, or dysphagia, affect a large part of the population due to factors such as degenerative diseases, medication side effects or simply age-related impairment of physiological oropharyngeal function. The management of dysphagia is mainly handles through texture-modified foods of progressively softer, smoother, moister textures, depending on the severity of the disorder. Rheological and physiological-related properties of boluses were determined for a group of five older persons (average age, 74) for a set of texture-modified foods: bread, cheese and tomato and the combination into a sandwich. The softest class was gel food, after which came a smooth timbale; both were compared to boluses of regular food. The subjects chewed until ready to swallow, at which point the bolus was expectorated and measured regarding saliva content, linear viscoelasticity and shear viscosity. The results were compared to those of a previously studied younger group (average age, 38). The general physiological status of the subjects was determined by hand and tongue strength, diadochokinesis and one-legged standing and showed that all subjects were as healthy and fit as the younger group. Age-related properties such as one-legged standing with closed eyes and salivary flow plus bolus saliva content were lower for the older group, but the average chews-until-swallow was surprisingly also lower. Consequently, bolus modulus and viscosity were higher than for the younger group. Overall, the intended texture modification was reflected in bolus rheological and physiological-related properties. Bolus modulus, viscosity, saliva content and chews-until-swallowed all decreased from regular food to timbale food to gel food.

Relationships of rapid eating with visceral and subcutaneous fat mass and plasma adiponectin concentration

Rapid eating has been demonstrated to be associated with obesity and overweight. However, few studies have characterized the separate relationships of eating speed with visceral and subcutaneous fat mass or circulating adiponectin concentration. We hypothesized that rapid eating is associated with the larger visceral fat tissue (VFT) area and lower adiponectin concentration, but not with the subcutaneous fat tissue (SFT) area in men and women. We performed a cross-sectional study of 712 adults aged 20-86 years (528 men and 184 women; mean ± SD age 59.36 ± 13.61 years). The participants completed a self-reported questionnaire, and underwent anthropometric and laboratory measurements and computed tomographic imaging of the abdomen as a part of annual medical check-ups. Multivariate linear regression analyses revealed that rapid eating was associated with larger visceral (B = 24.74; 95% CI 8.87-40.61, p = 0.002) and subcutaneous fat areas (B = 31.31; 95% CI 12.23-50.38, p = 0.001), lower adiponectin concentration (B =  - 2.92; 95% CI - 4.39- - 1.46, p < 0.001), higher body mass index (BMI) (B = 2.13; 95% CI 1.02-3.25, p < 0.001), and larger waist circumference (B = 5.23; 95% CI 2.16-8.30, p < 0.001) in men, which is partially consistent with the hypothesis. In contrast, rapid eating was found to be associated only with BMI, and not with abdominal adipose area or adiponectin concentration in women, which is a result that is not consistent with the hypothesis. These results suggest that there is no difference in the association of rapid eating with VFT and SFT areas.

Development of a Video-Based Tool for the Self-Assessment of Eating Rates in Young Adult Females

Eating speed assessments are often based on self-reports, and establishing objective "ratings" is required to improve accuracy. However, no relevant simple assessment tool incorporating "ratings" is currently available. This study aimed to develop a group-adaptable eating rate assessment tool for young females using smartphones. Fifty female college students were directly observed while eating, and a self-assessment tool for the eating rate was created using video. Using the directly observed eating rate of a test food A as the gold standard (GS), we compared the eating rate self-assessment findings between those obtained using a conventional questionnaire and those obtained using an assessment tool. The validity and reproducibility of the assessment tool were verified. In terms of validity, the correlation coefficient for the GS questionnaire (r=0.442, p<0.001) was similar to that for the self-assessment tool (r=0.491, p<0.001). The reproducibility of repeated measurements of the self-assessment tool was inferior to that of the questionnaire (weighted kappa coefficients; 0.393 vs. 0.804). This may be explained in part by participants selecting the same items with specific words such as "fast" or "slow" on two occasions. As for the validity of test food A, additional measurements for test food C on a subset of subjects (n=16) showed a strong positive correlation (r=0.845, p<0.001) between A and C. The present study suggests that a video-based self-assessment tool we developed for young adult females is straightforward, and allows the subjects to observe specific and visual ratings in a manner that is less burdensome and time-effective than conventional questionnaire methods.

Development and validation of a new methodological platform to measure behavioral, cognitive, and physiological responses to food interventions in real time

To fully understand the causes and mechanisms involved in overeating and obesity, measures of both cognitive and physiological determinants of eating behavior need to be integrated. Effectively synchronizing behavioral measures such as meal micro-structure (e.g., eating speed), cognitive processing of sensory stimuli, and metabolic parameters, can be complex. However, this step is central to understanding the impact of food interventions on body weight. In this paper, we provide an overview of the existing gaps in eating behavior research and describe the development and validation of a new methodological platform to address some of these issues. As part of a controlled trial, 76 men and women self-served and consumed food from a buffet, using a portion-control plate with visual stimuli for appropriate amounts of main food groups, or a conventional plate, on two different days, in a random order. In both sessions participants completed behavioral and cognitive tests using a novel methodological platform that measured gaze movement (as a proxy for visual attention), eating rate and bite size, memory for portion sizes, subjective appetite and portion-size perceptions. In a sub-sample of women, hormonal secretion in response to the meal was also measured. The novel platform showed a significant improvement in meal micro-structure measures from published data (13 vs. 33% failure rate) and high comparability between an automated gaze mapping protocol vs. manual coding for eye-tracking studies involving an eating test (ICC between methods 0.85; 90% CI 0.74, 0.92). This trial was registered at Clinical Trials.gov with Identifier NCT03610776.

Body mass index and variability in meal duration and association with rate of eating

Background

A fast rate of eating is associated with a higher risk for obesity but existing studies are limited by reliance on self-report and the consistency of eating rate has not been examined across all meals in a day. The goal of the current analysis was to examine associations between meal duration, rate of eating, and body mass index (BMI) and to assess the variance of meal duration and eating rate across different meals during the day.

Methods

Using an observational cross-sectional study design, non-smoking participants aged 18–45 years (N = 29) consumed all meals (breakfast, lunch, and dinner) on a single day in a pseudo free-living environment. Participants were allowed to choose any food and beverages from a University food court and consume their desired amount with no time restrictions. Weighed food records and a log of meal start and end times, to calculate duration, were obtained by a trained research assistant. Spearman's correlations and multiple linear regressions examined associations between BMI and meal duration and rate of eating.

Results

Participants were 65% male and 48% white. A shorter meal duration was associated with a higher BMI at breakfast but not lunch or dinner, after adjusting for age and sex (p = 0.03). Faster rate of eating was associated with higher BMI across all meals (p = 0.04) and higher energy intake for all meals (p < 0.001). Intra-individual rates of eating were not significantly different across breakfast, lunch, and dinner (p = 0.96).

Conclusion

Shorter beakfast and a faster rate of eating across all meals were associated with higher BMI in a pseudo free-living environment. An individual's rate of eating is constant over all meals in a day. These data support weight reduction interventions focusing on the rate of eating at all meals throughout the day and provide evidence for specifically directing attention to breakfast eating behaviors.

Prevalence of tachyphagia at lunch and associated factors in a population of workers

PURPOSE

Obesity is a public health problem worldwide. The eating habits of French workers need to be clarified. In particular, tachyphagia (meal lasting < 15 min) promotes weight gain. The present study aimed to investigate the presence of tachyphagia at lunchtime, the factors associated with tachyphagia, and the relationship between tachyphagia and obesity among workers.

METHODS

This cross-sectional study was conducted between January and May 2016 in five departments of occupational medicine. An anonymous self-administered questionnaire was used to gather general declarative data, such as weight and height (to calculate body mass index [BMI]) and information about lunchtime habits, including the time spent eating.

RESULTS

A total of 415 workers with a mean age of 41.1 ± 12.6 years were included. The mean BMI was 23.8 ± 4.6 kg/m², and the prevalence of obesity was 15.9%. Tachyphagia occurred in 20.3% of the cases and was more frequent in younger workers. Multivariate analysis revealed that skipping meals, eating standing up, and eating fast food were positively associated with tachyphagia (p = 0.015, p = 0.028, and p = 0.027, respectively). Older age and eating with colleagues/friends were negatively associated with tachyphagia (p = 0.003 and p < 0.0001, respectively). No significant association was observed between tachyphagia and obesity.

CONCLUSION

Our study provides important information about the lunchtime habits of workers. Maintaining commensality is crucial, particularly in young workers. Companies should play a role in organising their employees' lunch breaks. Level III Evidence obtained from well-designed cohort or case-control analytic studies.

Impact of Masticatory Behaviors Measured With Wearable Device on Metabolic Syndrome: Cross-sectional Study

Background

It has been widely recognized that mastication behaviors are related to the health of the whole body and to lifestyle-related diseases. However, many studies were based on subjective questionnaires or were limited to small-scale research in the laboratory due to the lack of a device for measuring mastication behaviors during the daily meal objectively. Recently, a small wearable masticatory counter device, called bitescan (Sharp Co), for measuring masticatory behavior was developed. This wearable device is designed to assess objective masticatory behavior by being worn on the ear in daily life.

Objective

This study aimed to investigate the relation between mastication behaviors in the laboratory and in daily meals and to clarify the difference in mastication behaviors between those with metabolic syndrome (MetS) and those without (non-MetS) measured using a wearable device.

Methods

A total of 99 healthy volunteers (50 men and 49 women, mean age 36.4 [SD 11.7] years) participated in this study. The mastication behaviors (ie, number of chews and bites, number of chews per bite, and chewing rate) were measured using a wearable ear-hung device. Mastication behaviors while eating a rice ball (100 g) in the laboratory and during usual meals for an entire day were monitored, and the daily energy intake was calculated. Participants’ abdominal circumference, fasting glucose concentration, blood pressure, and serum lipids were also measured. Mastication behaviors in the laboratory and during meals for 1 entire day were compared. The participants were divided into 2 groups using the Japanese criteria for MetS (positive/negative for MetS or each MetS component), and mastication behaviors were compared.

Results

Mastication behaviors in the laboratory and during daily meals were significantly correlated (number of chews r=0.36; P<.001; number of bites r=0.49; P<.001; number of chews per bite r=0.33; P=.001; and chewing rate r=0.51; P<.001). Although a positive correlation was observed between the number of chews during the 1-day meals and energy intake (r=0.26, P=.009), the number of chews per calorie ingested was negatively correlated with energy intake (r=–0.32, P=.002). Of the 99 participants, 8 fit the criteria for MetS and 14 for pre-MetS. The number of chews and bites for a rice ball in the pre-MetS(+) group was significantly lower than the pre-MetS(–) group (P=.02 and P=.04, respectively). Additionally, scores for the positive abdominal circumference and hypertension subgroups were also less than the counterpart groups (P=.004 and P=.01 for chews, P=.006 and P=.02 for bites, respectively). The number of chews and bites for an entire day in the hypertension subgroup were significantly lower than in the other groups (P=.02 and P=.006). Furthermore, the positive abdominal circumference and hypertension subgroups showed lower numbers of chews per calorie ingested for 1-day meals (P=.03 and P=.02, respectively).

Conclusions

These results suggest a relationship between masticatory behaviors in the laboratory and those during daily meals and that masticatory behaviors are associated with MetS and MetS components.

Trial Registration

University Hospital Medical Information Network Clinical Trials Registry R000034453; https://tinyurl.com/mwzrhrua

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.

Eating Speed and Incidence of Diabetes in a Japanese General Population: ISSA-CKD

Background: We investigated whether eating speed was associated with the incidence of diabetes in a Japanese general population. Methods: A total of 4853 Japanese individuals without diabetes at baseline were analyzed. Self-reported eating speed was categorized as slow, medium, and fast on the basis of questionnaire responses. The study outcome was the incidence of diabetes. Results: After an average follow-up period of 5.1 years, 234 individuals developed diabetes. The incidence of diabetes per 1000 person-years was 4.9 in the slow eating speed group, 8.8 in the medium eating speed group, and 12.5 in the fast eating speed group, respectively (*** p < 0.001 for trend). The HRs were 1.69 (95%CI 0.94–3.06) for the medium eating speed and 2.08 (95%CI 1.13–3.84) for the fast eating speed, compared to the slow eating speed (* p = 0.014 for trend) after adjustment for age, gender, smoking status, drinking, exercise, obesity, hypertension, and dyslipidemia. Conclusion: Faster eating speed increased a risk for the incidence of diabetes in a general Japanese population.

Fast Eating Is Associated with Increased BMI among High-School Students

Fast self-reported eating rate (SRER) has been associated with increased adiposity in children and adults. No studies have been conducted among high-school students, and SRER has not been validated vs. objective eating rate (OBER) in such populations. The objectives were to investigate (among high-school student populations) the association between OBER and BMI z-scores (BMIz), the validity of SRER vs. OBER, and potential differences in BMIz between SRER categories. Three studies were conducted. Study 1 included 116 Swedish students (mean ± SD age: 16.5 ± 0.8, 59% females) who were eating school lunch. Food intake and meal duration were objectively recorded, and OBER was calculated. Additionally, students provided SRER. Study 2 included students (n = 50, mean ± SD age: 16.7 ± 0.6, 58% females) from Study 1 who ate another objectively recorded school lunch. Study 3 included 1832 high-school students (mean ± SD age: 15.8 ± 0.9, 51% females) from Sweden (n = 748) and Greece (n = 1084) who provided SRER. In Study 1, students with BMIz ≥ 0 had faster OBER vs. students with BMIz < 0 (mean difference: +7.7 g/min or +27%, p = 0.012), while students with fast SRER had higher OBER vs. students with slow SRER (mean difference: +13.7 g/min or +56%, p = 0.001). However, there was “minimal” agreement between SRER and OBER categories (κ = 0.31, p < 0.001). In Study 2, OBER during lunch 1 had a “large” correlation with OBER during lunch 2 (r = 0.75, p < 0.001). In Study 3, fast SRER students had higher BMIz vs. slow SRER students (mean difference: 0.37, p < 0.001). Similar observations were found among both Swedish and Greek students. For the first time in high-school students, we confirm the association between fast eating and increased adiposity. Our validation analysis suggests that SRER could be used as a proxy for OBER in studies with large sample sizes on a group level. With smaller samples, OBER should be used instead. To assess eating rate on an individual level, OBER can be used while SRER should be avoided.

Reliability of a novel wearable device to measure chewing frequency

Purpose In recent years, the chewing frequency, i.e., the number of chewing cycles, has decreased owing to changes in dietary habits. Although these changes may be related to complete body health, there is no evidence-based tool to measure the dietary habits. We developed a small ear-hung wearable device for monitoring mastication behavior. The device, worn on the ear pinna, allows the counting of the number of chewing cycles, and data are collected on a smartphone via Bluetooth. In this study, the reliability of the novel device was verified.Methods A total of 22 healthy volunteers participated in the study. During measurement, the subjects wore the novel wearable device on their right ear pinna and were asked to chew gum, gummy jellies, and rice balls. The number of chewing cycles was counted by the device. A mandibular kinesiograph (MKG) was also recorded, and the chewing activity was recorded as a video. The accuracy, precision, and recall of the ear-hung device were calculated by comparing the data obtained from the MKG and the video recording. Additionally, the factors affecting reliability were examined.Results The accuracy, precision, and recall of the novel device were 101.6 ± 13.6%, 85.3 ± 11.0%, and 84.5 ± 9.5%, respectively. Although the accuracy was not affected by any factor, precision and recall of the novel device for women were significantly worse than that for men, and were greatest when the subjects were chewing gum.Conclusions Our findings suggest that the newly developed ear-hung wearable device for counting the number of chewing cycles was sufficiently reliable.