1. Adam DrewnowskiLos Humanos y el Dulzor:¿Porquénosgustanlascosasdulces?

3. Los Humanos y el Dulzor: ¿Porquénosgustanlascosasdulces? Adam Drewnowski, PhD Director, Center for Public Health Nutrition Director, UW Center for Obesity Research School of Public Health and Community Medicine University of Washington Seattle, WA Serie Cientifica Latinoamericana Simposio de Edulcorantes no Caloricos, Bogota, Colombia, Agosto 24 y 25, 2011

4. We choose foods by taste Energy density Pleasure Taste Cost Taste Consumer Food Behavior Access/ time Health Variety

5. Good-tasting foods were once viewed as the most nutritious Whatever is the most delicious is also the most nutritious Magninus of Milan 17th C If the human body is healthy, then the foods that taste the best are also the most nutritious Aldebrandin of Siena 1606 Jean-Pierre Flandrin Histoire de l’Alimentation, Paris, 1996

7. Mixed with water, sugar produces sugar water, a refreshing, healthy, pleasant drink.Jean Anthelme Brillat-Savarin 1825 Jean Anthelme Brillat-Savarin 1825

8. Sugar is nutritious: US 1948 The energy of sunshine is crystallized in Dextrose sugar

9. Taste is the main influence on food behavior

11. Humans have 3-4 different taste receptors for sweet

12. Sugars and intense sweeteners are structurally related

13. Humans have 40-80 different taste receptors for bitter

14. Compounds that elicit bitter taste are completely unrelated

16. 3-day old infants like sweet and reject bitter tastes Liking for sweet Rejection of bitter Mennella and Beauchamp, Nutr Rev 1998

17. Children like familiar sweet foods chocolate Wardle et al., Appetite 2001;37:217-223 tofu avocado melon leeks

18. Children liked energy-dense fruit best Wardle al, Appetite 2003 Banana Potatoes Grapes Apple

19. What do adults “crave”?Foods that are energy-dense, with fat, sugar, and/or salt Sweet beverages are liked but are not “craved” like chocolate. Their energy density is too low

20. Energy density (MJ/kg) and water content oil = 9 kcal/g oil butter candy sugar soft drinks water = 0 kcal/g

21. Energy density (MJ/kg) and water content oil = 9 kcal/g oil butter candy carbohydrate = 4 kcal/g cheese sugar meat ice cream milk soft drinks water = 0 kcal/g

22. Energy density (MJ/kg) and water content oil oil butter candy carbohydrate = 4 kcal/g cheese sugar meat grains ice cream milk soft drinks water = 0 kcal/g

23. Energy density (MJ/kg) and water content oil oil butter candy cheese sugar meat grains ice cream milk soft drinks water = 0 kcal/g

24. What is the impact of sweet foods and beverages on the diet?Where do sugar calories come from?

25. Soda, sports & energy drinks 5.5%

26. Added sugars consumption (tsp/d) declines with age – obesity and diabetes go up Added sugars intake by age Obesity and diabetes by age NHANES 2003-4 24h NHIS 2005 screener Thompson et al. Added sugars intake, SES and race/ethnicity JADA 2009;109:1376 Mokdad et al. Prevalence of obesity, diabetes, and obesity related health risk factors JAMA 2003:289:76-79

27. Added sugars, obesity and diabetes by race/ethnicity and education Data are estimated least square mean intakes of added sugars in tsp/d (1 tsp = 4g) Added sugars intake by age Obesity and diabetes by age Thompson et al. Added sugars intake, SES and race/ethnicity JADA 2009;109:1376

28. What about sweetness, satiety, and appetite control? Is it true that liquid calories have no satiating power? What do we know about the effects of low calorie sweeteners on satiety? Can low calorie beverages help in the management of body weight?

29. Solids versus liquids: still not settled Liquified foods (soups) are more satiating than solids, as measured by food intake reduction. Kissileff AJCN 1985 Solid carbohydrates (jelly beans) elicited precise 100% dietary compensation; liquids (soda) elicited none. DiMeglio & Mattes IJO 2000 Solid watermelon led to more compensation at lunch compared to watermelon juice (24% vs 6%). Beverages elicited a weaker compensatory response than did solid foods. No effect on hunger or satiety ratings was observed. Mourao, Bressan, Campbell & Mattes IJO 2007 Solid apples, semisolid apple sauce, and liquid apple juice (300 kcal) did lead to different hunger/satiety ratings. No effect on energy intakes was observed. Mattes & Campbell JADA 2009

30. Hunger and energy intakes at lunch after solid vs. liquid preloads (125 or 225 kcal) Protein = milk versus cheese Carbohydrate = watermelon versus watermelon juice Fat = coconut meat versus coconut milk Mourao, Campbell and Mattes Int J Obesity 2007; 31: 1688.

31. The preload study design that we use satiation satiety Appetitive ratings Hunger, fullness, desire to eat, thirst Next meal Liquid This meal Food records Solid Variable interval: 15 min – 6h time Expectation: Subjects ingesting a preload will eat less at this/next meal

32. Lunch meal: 1734 kcal Additional servings of the same foods available from a side buffet

33. Is if food form (liquid versus solid)or is it time? Almiron-Roig, Flores, Drewnowski, Physiol & Behav 2004;82:671

34. Study design: 2 time delays Keep energy constant (300 kcal)– vary texture and time lag 2h 1.5h Lunch Breakfast 2h 1.5h Lunch Breakfast 20 min 3.5 h Lunch Breakfast 20 min 3.5 h Breakfast Lunch Almiron-Roig, Flores, Drewnowski, Physiol&Behav 2004;82:671

35. Hunger, satiety, thirst after soda or cookies Breakfast Lunch Almiron-Roig, Flores, Drewnowski, Physiol & Behav 2004;82:671

36. Can cola spoil your appetite? Yes * Prediction: Degree of compensation may depend on time to the next meal. Short interval = more compensation. Long interval = little or no compensation.

37. What about sweetness, satiety, and appetite control? Is it true that liquid calories have no satiating power? What do we know about the effects of low calorie sweeteners on satiety? Can low calorie beverages help in the management of body weight?

38. Compare diet and regular beverages satiety Appetitive ratings Hunger, fullness, desire to eat, thirst Next meal LCS Calories time Interval 60-90 min Expectation: calorie effects and volume effects have different time course

39. Beverage volume affects satiety N = 37 volunteers (19 men; 18 women), age 23y Body mass index: 23.4 (men), 21.9 (women) Hunger, thirst, fullness, and desire to eat measured every 30 min (9-point scale) Lunch foods pre-weighed by experimenters. Plate and water waste measured.

40. Hunger and satiety after 6 beverages LUNCH PRELOAD Hunger Fullness Perrigue et al. Presentation at Experimental Biology 2006 in San Francisco April 2006

41. Hunger and satiety after LCS and milk LUNCH PRELOAD Hunger Fullness Perrigue et al. AJCN 2007

42. Diet soft drink did not affect food consumption at lunch Same as for no beverage Perrigue et al. AJCN 2007

43. Lunch consumption after 6 beverages Some compensation (not much) Perrigue et al. AJCN 2007

44. What the science tells us Liquids are as satiating as solids Soft drinks vs. cookies Liquid sugars have satiating power Soft drinks vs. juices or milk Low calorie sweeteners do not promote hunger Aspartame vs. milk

45. What about sweetness, satiety, and appetite control? Is it true that liquid calories have no satiating power? What do we know about the effects of low calorie sweeteners on satiety? Can low calorie beverages help in the management of body weight?

46. Final question:Who are LCS consumers and what is their diet quality?

47. Who are LCS consumers? Data from 2001-2 NHANES Rehm and Drewnowski [1] Excluded from analysis due to small numbers and unstable estimates [2] Age-adjusted to US standard population (2000)

48. Was there a reduction in added sugar and carbs? [1] Mean is adjusted for age group, gender and energy. Values represent those for individuals who consume 2,000 calories. Data from 2001-2 NHANES Rehm and Drewnowski

49. What are their diets like? Data from 2001-2 NHANES Rehm and Drewnowski [1] Mean is adjusted for age group, gender and energy. Values represent those for individuals who consume 2,000 calories. [2] Higher score represents better diet quality. Component scores are HEI 1 – 12 are score as either 5, 10 or 20 points. Higher scores always indicate better quality (e.g., higher vegetables or lower sodium).

50. Did diet soda consumers have better diets? Yes

51. Recent issues about LCS: The press has raised questions about LCS: They over-stimulate sweet taste receptors. They make you hungry. They trick the body into overeating. They create sweet taste addictions. They may fuel the obesity epidemic. What does science tell us?

52. What the science tells us Low calorie sweeteners (LCS) provide sweet taste without calories. LCS have no impact on satiety beyond a transient volume effect. The addition of LCS to a plain beverage does not lead to overeating. LCS may lead to lower energy intakes at the end of the day In replacing SSB, LCS have contributed to weight loss.

54. How people choose foods Taste Energy density Money Cost Time Food Selection Eating behavior Access Nutrient density Health Nutrition knowledge Weight concerns