Energy intake and appetite are related to antral area in healthy young and older subjects. Helping understand nutritional gaps in the elderly (HUNGER): a prospective study of patient factors associated with inadequate nutritional intake in older medical inpatients. Effects of age on concentrations of plasma cholecystokinin, glucagon-like peptide 1, and peptide YY and their relation to appetite and pyloric motility. Serum brain-derived neurotrophic factor is associated with reduced appetite in healthy older adults Effect of exogenous cholecystokinin (CCK)-8 on food intake and plasma CCK, leptin, and insulin concentrations in older and young adults: evidence for increased CCK activity as a cause of the anorexia of aging. Appetite and endocrine regulators of energy balance after 2 days of energy restriction: insulin, leptin, ghrelin, and DHEA-S. Food form and portion size affect postprandial appetite sensations and hormonal responses in healthy, nonobese, older adults. Relation between food intake and visual analogue scale ratings of appetite and other sensations in healthy older and young subjects Reproducibility of energy intake, gastric emptying, blood glucose, plasma insulin and cholecystokinin responses in healthy young males. Dietary factors in relation to weight change among men and women from two southeastern New England communities Effects of oral and gastric stimulation on appetite and energy intake. Effects of exercise on energy-regulating hormones and appetite in men and women. Compensatory mechanisms activated with intermittent energy restriction: A randomized control trial. Oral processing effort, appetite and acute energy intake in lean and obese adults Low Energy Reporting Related to Lifestyle, Clinical, and Psychosocial Factors in a Randomly Selected Population Sample of Greek Adults: The ATTICA Study Effect on body weight, quality of life and appetite following individualized, nutritional counselling to home-living elderly after rehabilitation – An open randomized trial Relation between appetite ratings before and after a standard meal and estimates of daily energy intake in obese and reduced obese individuals
BACKGROUND Gastric distension reduces food intake , and antral , rather than proximal , gastric distension may be the dominant mechanism in the induction of appetite-related sensations . Healthy aging is associated with reduced appetite . OBJECTIVE We examined the effects of different energy preloads on appetite , plasma cholecystokinin , antral area , and subsequent energy intake in healthy older and young subjects . DESIGN On 3 separate days , 12 young and 12 older subjects consumed 400 mL of a drink containing either 0 kcal ( water ) , 250 kcal , or 750 kcal 70 min before a buffet-style meal . RESULTS Hunger was less in the older than in the young subjects ( P < 0.001 ) . Both nutrient preloads reduced hunger and increased fullness more than did water ( P < 0.02 ) , and older subjects were more full than were the young ( P < 0.05 ) . Antral area was greater after the nutrient preloads than after water ( P = 0.001 ) and greater in the older than in the young subjects ( P = 0.005 ) . In both groups , food intake was suppressed in an energy-dependent manner ( P = 0.008 ) . Plasma cholecystokinin was greater in the older than in the young subjects ( P = 0.003 ) . Immediately before the meal , hunger ( r = -0.59 ) and energy intake ( r = -0.90 ) were inversely related and fullness ( r = 0.66 ) was directly related to antral area ( all : P < 0.001 ) . Antral area , but not plasma cholecystokinin , was a predictor of subsequent energy intake . CONCLUSION In healthy young and older subjects , the suppression of subsequent energy intake by a liquid preload is nutrient dependent and comparable , and both satiation and satiety are related to antral area and ( presumably ) antral distension BACKGROUND & AIMS Malnutrition and poor intake during hospitalisation are common in older medical patients . Better underst and ing of patient-specific factors associated with poor intake may inform nutritional interventions . The aim of this study was to measure the proportion of older medical patients with inadequate nutritional intake , and identify patient-related factors associated with this outcome . METHODS Prospect i ve cohort study enrolling consecutive consenting medical in patients aged 65 years or older . Primary outcome was  energy intake less than resting energy expenditure  estimated using weight-based equations .  Energy intake was calculated for a single day using direct observation of plate waste . Explanatory variables included age , gender , number of co-morbidities , number of medications , diagnosis , usual residence , nutritional status , functional and cognitive impairment , depressive symptoms , poor appetite , poor dentition , and dysphagia . RESULTS Of 134 participants ( mean age 80 years , 51 % female ) , only 41 % met estimated resting energy requirements . Mean energy intake was 1220 kcal/day ( SD 440 ) , or 18.1 kcal/kg/day . Factors associated with inadequate energy intake in multivariate analysis were poor appetite , higher BMI , diagnosis of infection or cancer , delirium and need for assistance with feeding . CONCLUSIONS Inadequate nutritional intake is common , and patient factors contributing to poor intake should be considered in design ing nutritional interventions BACKGROUND Aging is associated with a decrease in appetite and a slowing of gastric emptying . The gastrointestinal hormones cholecystokinin ( CCK ) , glucagon-like peptide 1 ( GLP-1 ) , and peptide YY ( PYY ) may mediate these changes . OBJECTIVE We investigated whether aging influenced the secretion of CCK , GLP-1 , and PYY and their effects on appetite and pyloric motility . DESIGN Eight healthy older ( 65 - 80 y ) and 7 younger ( 20 - 34 y ) men received isoenergetic ( 12.1 kJ/min ) intraduodenal infusions of lipid and glucose for 120 min on separate days . Plasma CCK , GLP-1 , and PYY concentrations were measured . RESULTS Plasma CCK concentrations were higher in older than in younger subjects ( P = 0.004 ) as a result of higher baseline values ( 4.7+/-0.2 compared with 3.2+/-0.2 pmol/L ; P < 0.0001 ) and a greater rise during lipid infusion ( increase from baseline : 7.1+/-0.5 compared with 5.3+/-0.6 pmol/L ; P = 0.048 ) . Plasma GLP-1 and PYY concentrations were not significantly different between groups . The decrease in hunger during intraduodenal lipid infusion was inversely related to the increase in CCK , GLP-1 , and PYY in younger but not older subjects . During intraduodenal lipid infusion , the increase in isolated pyloric pressure wave ( IPPW ) frequency was positively related to GLP-1 and PYY and the increase in IPPW amplitude was positively related to CCK in older but not younger subjects , whereas the increase in IPPW amplitude and pyloric tone was negatively related to GLP-1 and PYY in younger subjects . CONCLUSIONS Human aging is associated with increased CCK concentrations , which may contribute to the slowing of gastric emptying , mediated by increased pyloric motility . The role of increased plasma CCK concentrations in mediating the age-related decrease in appetite remains to be established Objective : Loss of appetite and body mass are common in older adults and are associated with negative consequences . Research indicates that these processes likely involve increases in serum brain-derived neurotrophic factor ( BDNF ) . Animal and human models demonstrate that BDNF may serve a regulatory function in food intake , but no study has addressed the possibility that BDNF may be involved in appetite reduction and loss of body mass in older adults . Design and Participants : 34 older adults without significant neurological or psychiatric history underwent fasting blood draw and measurement of body composition .  Appetite and eating behavior were assessed by question naire and related to serum BDNF levels . Results : Partial correlations showed serum BDNF levels were inversely related to appetite ( r = −.38 , p = .02 ) . No significant correlations emerged between serum BDNF and age , diet , or body composition . Conclusions : The current study extends past work and shows that BDNF is associated with appetite in healthy older adults . Further work is needed to clarify mechanisms for these findings , particularly prospect i ve studies Healthy aging is associated with reductions in appetite and food intake -- the so-called anorexia of aging , which may predispose to protein-energy malnutrition . One possible cause of the anorexia of aging is an increased satiating effect of cholecystokinin ( CCK ) . To investigate the impact of aging on the satiating effects of CCK , 12 young and 12 older healthy subjects received 25-min iv infusions of saline ( control ) and CCK-8 , 1 ng/kg per min or 3 ng/k per min , on 3 separate days before a test meal . Older subjects ate less than young subjects , and food intake was suppressed 21.6 % by CCK-8 , compared with the control day ( P < 0.05 ) . The suppression of energy intake by CCK-8 in older subjects was twice that in young subjects ( 32 + /- 6 % vs. 16 + /- 6 % SEM , P < 0.05 ) and was related to plasma CCK-8 concentrations , which were higher at baseline ( P < 0.05 ) and increased more during CCK-8 infusions in older than young subjects ( P < 0.01 ) . The extent of suppression of food intake per given rise in plasma CCK-8 concentrations did not differ between the two age groups ( P = 0.35 ) . Endogenous CCK concentrations were higher at baseline in older subjects ( P < 0.001 ) and decreased during the CCK-8 but not control infusions ( P < 0.01 ) , suggesting that CCK suppresses its own release . Plasma leptin concentrations were not affected by CCK infusion , whereas postpr and ial insulin concentrations were lowered and the peak postpr and ial glucose concentration was delayed but not affected by CCK-8 infusion . Because older people retain their sensitivity to the satiating effects of exogenous CCK and plasma endogenous CCK concentrations are higher in older people , increased CCK activity may contribute to the anorexia of aging Using a double-blind , placebo-controlled crossover design , the effects of 48 h near complete energy restriction on endocrine regulators of appetite and satiety were assessed . Twelve men and one woman participated in this controlled , 2-day diet intervention study . One experimental trial was completed in a calorie deprived state ( CAL-DEP ; < 10 % of estimated energy requirements ) and others in a fed condition ( carbohydrate only and carbohydrate and fat ; data were pooled and compared to CAL-DEP ) . Test meals containing prescribed energy intake and indistinguishable in sensory characteristics were provided during each trial . Glucose , insulin , leptin , ghrelin , cortisol , dehydroepi and rosterone-sulfate ( DHEA-S ) , and satiety were repeatedly assessed . Mean glucose , insulin , and leptin concentrations were lower ( P < 0.0001 ) for CAL-DEP compared to the fully fed ( FED ) state . Ghrelin and DHEA-S were higher ( P < 0.0001 ) for CAL-DEP relative to FED . Cortisol levels declined each day regardless of diet ( P < 0.0001 ) but were 32 % higher ( P < 0.01 ) at the conclusion of the session for CAL-DEP compared to FED . Satiety was 25 % lower ( P < 0.0001 ) for CAL-DEP relative to FED and decreased ( P < 0.0001 ) over time regardless of diet . In the FED state , insulin ( r = 0.55 ) , glucose ( r = 0.76 ) , cortisol ( r = -0.59 ) , and DHEA-S ( r = -0.62 ) were associated ( P < 0.05 ) with satiety , but not during CAL-DEP . These findings show that 2 days of severe energy restriction alter several endocrine regulators of appetite independent of perception of increased hunger suggesting a physiological mechanism to explain overeating following acute periods of severe energy restriction Data are limited concerning the dietary factors that influence appetite control in older adults . This study examined the effects of food form and portion size on appetite in 43 older adults ( age : 72 + /- 1 years ; BMI : 25.6 + /- 0.3 kg/m(2 ) ) . Subjects were assigned to groups based on portion size of the test meal ( 12.5 % ( n = 18 ) vs. 25 % ( n = 25 ) of estimated energy need ) . Subjects r and omly consumed , on two separate days , the respective solid or beverage test meal .  Appetite sensations and hormonal responses were measured over 4 h. Main effects of food form ( P < 0.05 ) and /or portion size ( P < 0.05 ) were observed for each appetite sensation . Postpr and ial hunger and desire to eat were greater following beverage vs. solid meal ( between 12.5 % vs. 25 % ) , whereas fullness was lower after beverage vs. solid meal ( P < 0.05 ) . Main effects of food form and /or portion size were observed for glucose , insulin , and ghrelin . Postpr and ial glucose and insulin concentrations were lower after beverage vs. solid meal ( between 12.5 % vs. 25 % ; all comparisons , P < 0.05 ) whereas beverage meal led to greater 4-h ghrelin vs. solid meal ( P = 0.09 ) . No main effects were observed for glucagon-like peptide-1 ( GLP-1 ) or cholecystokinin ( CCK ) . When adjusting for age , food form remained significant for postpr and ial hunger and fullness ; portion size remained significant for postpr and ial glucose . Greater hunger and reduced satiety with accompanying glucose , insulin , and ghrelin following the beverage vs. solid meals , and to some extent , in smaller vs. larger portions suggest that appetite control is influenced by food form and portion size in older adults . These findings may enhance the development of appropriate dietary strategies that help to regulate energy balance Objective : Visual analogue scales are widely used in appetite research , yet the validity of these scales to evaluate appetite and mood has not been assessed in older subjects . The aim of this study was to determine the relations between food intake and visual analogue scale ( VAS ) ratings of appetite and nonappetite sensations in healthy older and young subjects . Design : Retrospective combined analysis of four single-blind , r and omised , controlled appetite studies . Setting : All studies were conducted in the University of Adelaide , Department of Medicine , Adelaide , Australia . Subjects : A total of 45 healthy young men ( n=24 ) and women ( n=21 ) aged 18–35 y and 45 healthy older men ( n=24 ) and women ( n=21 ) aged 65–85 y were recruited by advertisement . Interventions : Oral , intraduodenal or intravenous administration of treatments which suppressed food intake were compared to control . Up to 90 min after treatment , a test meal was offered and subjects ate freely for between 30 and 60 min . Perceptions were assessed by 100-mm visual analogue scales administered at regular intervals . Results : Food intake at the test meal was positively related to perceptions of hunger , drowsiness , and calmness at both baseline and premeal ( r>0.16 , P<0.05 ) , and inversely related to premeal ratings of fullness ( r > 0.2 , P<0.05 ) in both older and young subjects . Food intake was related to VAS ratings at least as strongly , if not more so , in older as in young subjects . Conclusions : These observations ( i ) confirm that food intake is related to perceptions of hunger and fullness as assessed by VAS in healthy older and young subjects , and ( ii ) suggest that sensations , not obviously associated with appetite , including ‘ drowsiness ’ and ‘ calmness ’ , are also associated with food intake Gastric emptying , as well as intragastric meal distribution , and gastrointestinal hormones , including cholecystokinin ( CCK ) , play an important role in appetite regulation . The evaluation of gastrointestinal factors regulating food intake is commonly performed in healthy , lean , young male participants . It has , however , been suggested that there is a marked interindividual variability in the effects of nutrient ' preloads ' on energy intake in this group . Whether there is significant intraindividual variation in acute energy intake after a nutrient preload , and , if so , how this relates to day-to-day differences in gastric emptying and gastrointestinal hormone release , is unclear . The purpose of the present paper is to evaluate the hypothesis that energy intake after a nutrient preload would be reproducible and associated with reproducible patterns of gastric emptying , intragastric distribution and gastrointestinal hormone release .  Fifteen healthy men ( age 25 ( sem 5 ) years ) consumed a glucose preload ( 50 g glucose in 300 ml water ; 815 kJ ) on three occasions . Gastric emptying and intragastric meal distribution ( using  three-dimensional ultrasound )  , blood glucose , plasma insulin and CCK concentrations and appetite perceptions were evaluated over 90 min , and energy intake from a cold buffet-style meal was then quantified . Energy intake was highly reproducible within individuals between visits ( intraclass correlation coefficient , ri = 0.9 ) . Gastric emptying , intragastric meal distribution , blood glucose , plasma insulin and CCK concentrations and appetite perceptions did not differ between visits ( ri>0.7 for all ) . In healthy males , energy intake is highly reproducible , at least in the short term , and is associated with reproducible patterns of gastric emptying , glycaemia , insulinaemia and CCK release OBJECTIVE : Dietary factors , independent of total energy , may be important in promoting obesity . We examined prospect ively the relationship between baseline diet composition and weight gain among adult men and women from southeastern New Engl and . DESIGN : The prospect i ve association of nutrient consumption and weight change was examined in a r and omly selected cohort examined four years apart . SUBJECTS : Adults aged 18 through 64 years from two communities in Southeastern New Engl and were r and omly selected for the study after being interviewed in their homes . The present investigation is based on a subgroup of 465 individuals who completed a food-frequency question naire in 1986 or 1987 and were reinterviewed four years later . STATISTICAL ANALYSES : Multiple regression analyses were used to determine the association of weight change with different nutrients and food groups after adjusting for age , smoking status , baseline body mass index , physical activity level , and total energy . RESULTS : Total energy was positively associated with weight gain and age was inversely associated with weight gain . None of the nutrients or food groups were significantly related to weight gain . CONCLUSIONS : These findings indicate that weight gain increased with increasing baseline total energy intake , particularly in the young . Future research is required to determine ways of decreasing energy intake in younger individuals Appetite is regulated by many factors , including oro-sensory and gastric signals . There are many studies on contributions of and possible interaction between sensory and gastric stimulation , but there are few studies in humans using simultaneous oral and gastric stimulation . We investigated the effect of simultaneous , but independently manipulated , oral and gastric stimulation on appetite ratings and energy intake . We hypothesized that compared with no stimulation , oral and gastric stimulation would equally and additively decrease appetite ratings and energy intake .  Healthy men ( n = 26 , 21 ± 2 years , BMI 22 ± 3 kg/m(2 ) ) participated in a r and omized crossover trial with four experimental conditions and a control condition . Experimental conditions consisted of oral stimulation , with either 1 or 8 min modified sham feeding ( MSF ) , and gastric stimulation , with either 100 or 800 ml intragastrically infused liquid ( isocaloric , 99 kcal , 100 ml/min ) . The control condition consisted of no oral or gastric stimulation . Outcome measures were energy intake 30 min after the treatment and appetite ratings . Compared with the control condition , energy intake decreased significantly after the 8 min/100 ml ( 19 % lower , P = 0.001 ) and 8 min/800 ml conditions ( 15 % lower , P = 0.02 ) , but not after the 1 min/100 ml ( 14 % lower , P = 0.06 ) and 1 min/800 ml conditions ( 10 % lower , P = 0.39 ) . There was no interaction of oral and gastric stimulation on energy intake . Hunger and fullness differed across all conditions ( P ≤ 0.01 ) . In conclusion , duration of oral exposure was at least as important in decreasing energy intake as gastric filling volume . Oral and gastric stimulation did not additively decrease energy intake . Longer oro-sensory stimulation , therefore , may be an important contributor to a lower energy intake When previously sedentary men and women follow exercise training programs with ad libitum feeding , men lose body fat , but women do not . The purpose of this study was to evaluate whether this observation could be related to sex differences in the way energy-regulating hormones and appetite perception respond to exercise . Eighteen ( 9 men , 9 women ) overweight/obese individuals completed four bouts of exercise with energy added to the baseline diet to maintain energy balance ( BAL ) , and four bouts without energy added to induce energy deficit ( DEF ) . Concentrations of acylated ghrelin , insulin , and leptin , as well as appetite ratings were measured in response to a meal after a no-exercise baseline and both exercise conditions . In men , acylated ghrelin area under the curve ( AUC ) was not different between conditions . In women , acylated ghrelin AUC was higher after DEF ( + 32 % ) and BAL ( + 25 % ) , and the change from baseline was higher than men ( P < 0.05 ) . In men , insulin AUC was reduced ( -17 % ) after DEF ( P < 0.05 ) , but not BAL . In women , insulin AUC was lower ( P < 0.05 ) after DEF ( -28 % ) and BAL ( -15 % ) . Leptin concentrations were not different across conditions in either sex . In men , but not in women , appetite was inhibited after BAL relative to DEF . The results indicate that , in women , exercise altered energy-regulating hormones in a direction expected to stimulate energy intake , regardless of energy status . In men , the response to exercise was abolished when energy balance was maintained . The data are consistent with the paradigm that mechanisms to maintain body fat are more effective in women BACKGROUND & AIMS Strong compensatory responses , with reduced resting metabolic rate ( RMR ) , increased exercise efficiency ( ExEff ) and appetite , are activated when weight loss ( WL ) is achieved with continuous energy restriction ( CER ) , which try to restore energy balance . Intermittent energy restriction ( IER ) , where short spells of energy restriction are interspaced by periods of habitual energy intake , may offer some protection in minimizing those responses . We aim ed to compare the effect of IER versus CER on body composition and the compensatory responses induced by WL . METHODS 35 adults ( age : 39 ± 9 y ) with obesity ( BMI : 36 ± 4 kg/m2 ) were r and omized to lose a similar weight with an IER ( N = 18 ) or a CER ( N = 17 ) diet over a 12 week period . Macronutrient composition and overall energy restriction ( 33 % reduction ) were similar between groups . Body weight/composition , RMR , fasting respiratory quotient ( RQ ) , ExEff ( 10 , 25 , and 50 W ) , subjective appetite ratings ( hunger , fullness , desire to eat , and prospect i ve food consumption ( PFC ) ) , and appetite-regulating hormones ( active ghrelin ( AG ) , cholecystokinin ( CCK ) , total peptide YY ( PYY ) , active glucagon-like peptide-1 ( GLP-1 ) , and insulin ) were measured before and after WL . RESULTS Changes in body weight ( ≈12.5 % WL ) and composition were similar in both groups . Fasting RQ and ExEff at 10 W increased in both groups . Losing weight , either by IER or CER dieting , did not induce significant changes in subjective appetite ratings . RMR decreased and ExEff at 25 and 50 W increased ( P < 0.001 for all ) in IER group only . Basal and postpr and ial AG increased ( P < 0.05 ) in IER group , whereas basal active GLP-1 decreased ( P = 0.033 ) in CER group only . Postpr and ial CCK decreased in both groups ( P = 0.0012 and P = 0.009 for IER and CER groups , respectively ) . No between group differences were apparent for any of the outcomes . CONCLUSIONS The technique used to achieve energy restriction , whether it is continuous or intermittent , does not appear to modulate the compensatory mechanisms activated by weight loss . CLINICAL TRIAL REGISTRATION NUMBER NCT02169778 ( the study was registered in clinical trial.gov ) Chewing reportedly contributes to satiation and satiety signals . Attempts to document and quantify this have led to small and inconsistent effects . The present trial manipulated oral processing effort though required chewing of gums of different hardness and measured appetitive sensations , energy intake , gastric emptying , GI transit time , and concentrations of glucose , insulin , GLP-1 , ghrelin and pancreatic polypeptide . Sixty adults classified by sex and BMI ( 15 each of lean females , obese females , lean males and obese males ) were tested in a r and omized , controlled , cross-over trial with three arms . They chewed nothing , soft gum or hard gum for 15 min while sipping grape juice ( 10 % of individual energy needs ) containing acetaminophen and lactulose on one day each separated by 7 days . Electromyographic recordings and self-reports were obtained during and after chewing to quantify oral processing effort . Blood was sample d through an indwelling catheter and appetite ratings were obtained at baseline and at 0 , 15 , 30 , 45 , 60 , 90 , 120 , 180 and 240 min after chewing initiation . Breath sample s were collected at 10 min intervals for the first 2h and at 30 min intervals for the next 2h . No effects of chewing were observed for appetitive sensations or gut peptide concentrations . Energy intake tended to decline in lean and increase in obese participants so that daily energy intake differed significantly between the two groups when chewing either gum , while no difference was observed on the non-chewing day . Serum glucose and insulin were significantly lower at selected time points 90 - 240 min after chewing compared to baseline and the non-chewing day . These data indicate chewing effort does not affect appetitive sensations or gut peptide secretion , but may exert a small differential effect on acute energy intake in lean and obese individuals and lead to greater post-pr and ial declines of serum glucose and insulin . The efficacy of gum chewing as a substitute for eating for weight management remains uncertain Objective : Aim of the present study was to identify potential dietary , lifestyle , psychosocial and clinical correlates of underreporting in a population -based sample . Methods : Following a r and om multistage sampling , 1514 men ( 46±13 years old ) and 1528 women ( 45±13 years old ) from the Attica area , in Greece , participated in this study . All participants underwent a st and ard assessment procedure that included clinical , psychosocial and lifestyle parameters . Food consumption was assessed through a vali date d semi-quantitative food frequency question naire . The ratio of energy intake to estimated basal metabolic rate ( EI/BMR ) and the Goldberg cut-off points were used for the classification of subjects as low energy reporters ( LERs ) and non-LERs . Results : LERs represented 12.2 % of the sample . This percentage was higher in obese subjects compared to overweight or normal weight ( 20.6 % vs. 9.9 % vs. 10.6 % , p = 0.05 ) , as well as in women compared to men ( 14.6 % vs. 9.9 % , p<0.001 ) . Data analysis was stratified by gender , since a significant interaction was observed between gender and LER group on several dietary parameters . Female LERs had higher Med Diet Score compared to non-LERs ( 30.6 ± 8.2 , 95%CI 30.2–31.04 vs. 26.9 ± 6.3 , 95%CI 26.05–27.7 , p<0.001 ) . Multiple regression analysis revealed that lower EI/BMR values were associated with younger age ( p<0.001 ) , higher BMI ( p<0.001 ) , presence of diabetes mellitus ( p=0.012 ) and lower depression score ( p=0.056 ) in women , whereas with younger age ( p<0.001 ) , higher BMI ( p<0.001 ) , higher education level ( p=0.046 ) and higher anxiety score ( p=0.08 ) in men . Conclusion : Several psychosocial and clinical characteristics operate in low energy reporting in both genders . Nutrition-related professionals should be aware of these gender-specific trends in dietary assessment procedures Objectives We examined if individually-adapted nutritional counselling could prevent > 5 % weight loss among elderly patients 3 months after discharge from a rehabilitation institution . In addition we assessed quality of life ( QoL ) and appetite . Design An open , r and omized trial . Setting Godthaab Health and Rehabilitation Institution in Bærum , Norway . Participants Patients identified as being undernourished or at risk of disease-related malnutrition using the Nutritional Risk Screening tool NRS-2002 . InterventionS hortly before discharge , patients in the intervention group received an individually-tailored nutrition plan . During the subsequent 3 months these patients were contacted 3 times via telephone calls and they received one visit at their homes , for nutrition counselling . Focus on this counselling was on optimizing meal environment , improving appetite , increasing food intake , advice on food preparation , and motivation and support . Measurements In addition to weight , QoL and appetite were assessed using the EQ-5D question naire and a modified version of the Disease-Related Appetite Question naire , respectively . Results Among 115 considered eligible for the study , 100 were enrolled ( 72 women and 28 men ) , with a mean age of 75 years and a mean body mass index of 20 kg/m2 . Two in the intervention group ( n = 52 ) and 5 in the control group ( n = 48 ) lost > 5 % of their body weight , giving an odds ratio of 0.34 ( 95 % CI : 0.064–1.86 ; p = 0.22 ) . We did not detect any significant differences in the QoL- or appetite scores between the two study groups after three months . Conclusion An individually-adapted nutritional counselling did not improve body mass among elderly patients 3 months after discharge from a rehabilitation institution . Neither quality of life nor appetite measures were improved . Possibly , nutritional counselling should be accompanied with nutritional supplementation to be effective in this vulnerable group of elderly . The trial is registered in Clinical Trials ( ID : NCT01632072 ) The aim of the present study was to relate appetite ratings before and after a st and ard breakfast to estimates of daily energy intake , before and after weight loss obese men and women . Nineteen obese subjects ( 9 men and 10 women ) took part in a 15-week drug-based weight-loss program coupled to energy intake restriction .  Body weight and body composition were significantly decreased in men and women . Both before and after the weight loss program , desire to eat , hunger , fullness and prospect i ve food consumption ( PFC ) were measured after an overnight fast and at 10-min intervals in the hour following the ingestion of a st and ardized breakfast .  Energy intakes were also measured and reported before and after weight loss . Fasting desire to eat and postpr and ial area under the curve ( AUC ) for hunger were significantly increased ( p<0.05 ) after the intervention . No association was observed between measured or reported energy intakes and appetite ratings before weight loss in either men or women . Reported energy intake was not associated with appetite sensations after weight loss either . In contrast , measured energy intake was significantly associated with postpr and ial AUC for fullness ( r=-0.90 , p<0.01 ) and PFC ( r=0.80 , p<0.01 ) in men at the end of the program . In stepwise multiple regression analysis , only postpr and ial AUC for PFC contributed independently to the variance of measured energy intake after weight loss ( r(2)=0.60 , p=0.01 ) . This study did not show consistent associations between averaged appetite ratings after a meal and daily energy intake , either before or after weight loss
Higher circulating concentrations of insulin , leptin , cholecystokinin and peptide-YY accord with reduced appetite and energy intakes in healthy older adults .
Interventions to reduce circulating levels of these hormones may be beneficial for combatting the anorexia of ageing
Ageing is associated with reduced appetite and energy intakes .
However , the mechanisms underlying this phenomenon are not fully understood .
This systematic review and meta- analysis quantified differences in circulating concentrations of appetite-related hormones between healthy older and younger adults .